Pharmo co lo gy

and the nursing pro cess

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nursing-pro cess-70 31359
1. Ri ght D rug (RN i s responsi bl e f or checki ng al l medi cati ons)
2. Ri ght D ose (Al ways check the dose, & i ts approperi ate f or the pati ent wi th
age/si z e)
"Si x Ri ghts" of medi cati on admi ni strati on 3.) Ri ght T i me ( 1/2 hr bef ore or af ter actual ti me speci f i ed i n order
4.) Ri ght Route: ( Cl ari f y route, do not assume)
5.) Ri ght Pati ent: (i denti f y pt: wri st band, Bi rth)
6.) Ri ght D ocumentati on: (data, ref usal s ect)

A drug wi l l have atl east three di f f erent names. T he chemi cal name descri bes
the drug's chemi cal composti on and mol ecul ar structure.
what?

(1+1=2 ) f or thei r addi ti ve ef f ects so that smal l er doses of each are gi ven.
Addi ti ve E f f ects E x: anal gesi c (anti hi stami ne and opi oi d combi nati on) f or treatment of col d
symptoms or acetami nophen and opi oi d combi nati on f or treatment of pai n

i s a broad term f or any undesi rabl e occurence i nvol vi ng medi cati on. Adverse drug
ef f ects vary f rom no harm to mi l d or l i f e-threateni ng.
Adverse D rug E vent (AD E )
E x: two most common adverse drug events are medi cati on errors and adverse drug
reacti on

M onoami ne oxi dase i nhi bi tor (depressi on or Parki nson D i sease) resul ts i n a
Aged cheese, wi ne have what common drug i nteracti on?
H ypertensi ve cri si s (i rreversabl e organ damage)

Agoni st D rug bi nds to a receptor; there i s no response

Antagoni st D rug bi nds to a receptor; there i s no response

(1+1= l ess than 2) Occurs when a combi nati on of two drugs resul t i n drug ef f ects
that are l ess than the sum of the ef f ects f or each drug gi ven seperatel y
Antagoni sti c E f f ects E x: Anti bi oti c Ci prof l oxaci n gi ven wi th anti aci d, vi tami n, i ron or dai ry products
wi l l reduce absorbti on of Ci prof l oxi n and l ead to decrease ef f ecti veness of
anti bi oti c
 Pharmo co lo gy and the nursing pro cess
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Obj ecti ve D ata: may be obtai ned f rom the nursi ng physi cal assessment; nursi ng
hi story; past or present medi cal hi story; resul t of l aboratory test, di agnosti c
Assessment studi es, or procedures, vi tal si gns, wei ght hei ght.
Subj ecti ve D ata: i nf ormati on shared through spoken word by any rel i abl e source:
pati ent, spouse, f ami l y, caregi ver ect...

i s the term used to express the extent od drug absorbti on.

Bi oavai l abi l i ty E x: a drug that absorbsed f rom the i ntesti ne must f i rst pass through the l i ver
bef ore i t reaches the systemi c ci rcul ati on.

Research desi gned i n whi ch the subj ects are purposel y unaware of whether the
Bl i nded I nvesti gati onal drug study
substance they are admi ni stered i s the drug under study or pl acebo.

restri cts the passage of vari ous chemi cal s and mi croscopi c enti ti es between the
Bl ood Brai n Barri er System bl ood stream and CN S. But wi l l al l ow passage of oxygen
E x: bacteri a, vi rus

T he oral mucosa between the cheeks and the gums, absorbed rapi dl y i nto the
Buccal Route bl oodstream and del i vered to the si te of acti on.
E x: N i trogl yceri n to di al ate the (coronary arteri es)

CR stands f or Control l ed rel ease

-Ski n i s thi nner and more permeabl e

-Stomach l acks aci d to ki l l bacteri a
Characteri sti cs of pedi atri c pati ents that have a si gni f i cant ef f ect of dosage -Lungs have weaker mucous barri er
i ncl ude the f ol l owi ng: -Body temperature i s l ess wel l regul ated
-D ehydrati on occurs easi l y
-Li ver and ki dneys are i mmature/ drug metabol i sm and excreti on are i mpai red

Levof l oxaci n, tetracycl i ne,ci prof l oxaci n, moxi f l oxaci n (anti bi oti cs) are chemi cal
D ai ry products have what common drug i nteracti on?
bi ndi ng of the drug l eadi ng to decreased ef f ects of treatment f ai l ures
 Pharmo co lo gy and the nursing pro cess
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T he passi ve movement of a substance (drug) between di f f erent ti ssues f rom areas

D i f f usi on
of hi gher concentraton to areas of l ower concentrati on

D osage f orms that are admi ni stered vi a i nj ecti on are cal l ed? Parenteral F orms

Both i nvesti gators and the subj ects are purposel y unaware j of whether the
D oubl e-bl i nded i nvesti gati onal drug study
substance admi ni stered to a gi ven subj ect i s a drug or a pl acebo.

-Oral , buccal tabl ets,

-l i qui ds
-Suspensi on sol uti on

D rug Absorpti on (f astest-sl owest) -Powder

-Capsul es
-T abl ets
-Coated tabl ets
-E nteri c-coated tabl et

D rug i nduced T eratogenesi s D rugs that are capabl e of crossi ng the pl acenta can cause thi s.

occurs when the presence of one drug decreases or i ncreases the acti ons of another
D rug-D rug I nteracti on drug that i s admi ni stered concurrentl y
E x: gi ven at the same ti me

D rugs that can sti mul ate drug metabol i sm are cal l ed? E nz yme i nducers

D rugs that i nhi bi t drug-metabol i z i ng enz ymes are cal l ed? E nz yme i nhi bi tors
 Pharmo co lo gy and the nursing pro cess
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D rugs to be taken on an empty stomach
D rugs to be taken wi th f ood
E l derl y
E nteri c-coated tabl ets
E xposure to the f etus to drugs i s most detri mental duri ng whi ch tri mester?
F i rst-pass ef f ect
F ormul as i nvol vi ng age i ncl ude
Grapef rui t j ui ce have what common drug i nteracti on?
-Wi th atl east 6 oz of water
-Al endronate sodi um
-Ri sedronate sodi um
-carbamaz epi ne,i ron, i ron-contai ng products, hydral az i ne, l i thi um, propranol ol ,
spi ronol actone, nonsteroi dal anti i nf l ammatory drugs, and theophyl l i ne
Pertai ni ng to a person who i s 65 years of age or ol der
-H ave a coati ng that prevents f rom bei ng broken down i n the aci di c PH
envi ornment of the stomach and can not be absorbed unti l hi gher Al kal i ne PH of
i ntesti nes.
-And shoul d not be crused as thi s coul d accel erate rel ease of drug f rom the
dosage f orm and possi bl e toxi ci ty
F i rst T ri mester, drug transf ers to the f etus i s more l i kel y duri ng l ast tri mester
Reduces the bi oavai l abi l i ty of the drug to l ess than 100%.
-D rugs admi ni ster oral l y by mouth have a l ess bi oavai l abi l ty
-D rugs admi ni sters i ntravenous rout are 100% bi oavai l abi l i ty.
Age
Wei ght
Body surf ace area ( BSA)
are most accurate of these dosage f ormul as
-Ami odarone ( Anti dysrhythmi c)
-Buspi rone (Anti anxi ety)
-Cabamaz epi ne ( Anti Sei z ure)
-Cycl ospori ne or T acrol i mus (i mmunosupressant)
-F el odi pi ne, N i f edpi ne,ni modi pi ne (PI N E = Cal ci um channel bl ocker) treats
H i gh BP
-Si mvastai n, atorvastati n ( anti chol estrol drug)
 Pharmo co lo gy and the nursing pro cess
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H al f -Li f e of drug i s the ti me requi red f or one hal f 50% of a gi ven drug to be removed f rom the body.

I s most commonl y used to descri be parenteral drugs

-D rug i ncompati bi l i ty occurs when two parental drugs or sol uti ons are mi xed
I ncompati bi l i ty together and the resul ts i s a chemi cal deteri orati on of on eor both of the drugs or
the f ormati on of a physci al preci pi tate.
E x: drugs that produces a preci pi tate, haz i ness or col or change/ cl oudy

Leads to both f i rst pass and non f i rst pass ef f ects? Rectal , f i rst pass routes

Waraf i n (anti coagul ant): D ecreased anti coagul ati on ef f ect f rom waraf i n whi ch i s
Leaf y Green Vegetabl es have what common drug i nteracti ons?
a bl ood thi nner

i s a preventabl e event that may cause or l ead to i napproperi ate medi cati on use or
M edi cal E rror pati ent harm whi l e the medi cati on i s i n the control of a heal th care prof essi onal ,
pati ent or consumer.

1. Pati ent N ame

2. D ate of drug order was wri tten
3. N ame of D rugs
M edi cati on Order Check (si x el ements)
4. D rug dosage amount and f requency
5. Route of admi ni strati on
6. Prescri bers si gnature

M edi cati on absorpti on can be al tered, because stomach content are del i vered to
Gastri c D umpi ng
the i ntesti nes more rapi dl y than usual af ter such surgery i s cal l ed?

I s a wel l establ i shed, research support f ramework f or prof essi onal nursi ng practi ce.
N ursi ng Process E x: Assessment, N ursi ng D i agnosi s, Pl anni ng (goal s and outcomes), I mpl ementati on
(i ncl udi ng pati ent educati on), and E val uati on
 Pharmo co lo gy and the nursing pro cess
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a speci al category of drugs that have been i denti f i ed to hel p treat pati ents wi th
Orphan D rugs
rare di sease

I nj ecti on, i ntravenous i nj ecti on di rectl y i nto the ci rcul ati on, where i t i s
Parental Route di stri buted wi th the bl ood throughout the body.
-i ntramuscul ar and subcutaneous are absorbed more sl owl y than gi ven i ntravenousl y

-N ormal l y 17 years
-Research process take about 10 years
Patent l i f e f or newl y di scovered drug mol ecul es takes how l ong? -T he remai ni ng 7 years f or sal es prof i ts bef ore patent experi ati on. Af ter expi rati on
other drug compani es can l egal l y begi ne to manuf acuture generi c drugs wi th the
same acti ve i ngredi ent.

Peak Level H i ghest bl ood l evel of drug

Pedi ati c Pertai ni ng to a person who i s 12 years of age or younger

i s the study of how vari ous dosages f orms i nf l uence the way i n whi ch the drug
Pharmaceuti cs
af f ects the body

study of the economi c f astors i nf l uernci ng the cost of drug therapy. E x: cost
Pharmacoeconomi cs beni f i t anal ysi s of one anti bi oti c versus another when competi ng drugs are
consi dered f or i ncl usi on i n a hospi tal f ormul ary.

Pharmacoeconomi cs f ocuses on the economi c aspect of drug therapy

 Pharmo co lo gy and the nursing pro cess
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Pharmacognosy T he study of drugs that are obtai ned f rom a natural pl ant and ani mal source

T he source of al l earl y drugs was nature and the study of these natural drugs
Pharmacognosy
sources (pl ant and ani mal )

I s the process of what the body does to the drug. F rom the ti me i ts put i n the
body to the ti me i t metabol i z es and l ef t the body.
-Absorpti on
Pharmacoki neti cs
-D i stri buti on
-M etabol i sm
-E xcreti on

Pharmacotherapeuti c (T herapeuti cs) F ocuses on the cl i ni cal use of drugs to prevent or treat di sease

Pharmcodynami cs T he study of what the drug does to the body

Cardi ovascul ar: D cardi ac output= D absorpti on

Gastri c GI : I pH = al t absorpti on, D peri stal i si s = del ay f astri c emptyi ng
Physi ol gi c Changes i n E l derl y Pati ents
H epati c: D enz yme = D metabol i sm
Renal : D Bl ood f l ow= D excreti on, D Gl omerul ar F i l trati on rate= D excreti on

Posi on Vs Anti dote

Gl ucagon
Beta bl ocker

Posi on Vs Anti dote

Oxygen hi gh concentrati on known as Bari atri c T herapy
Carbon M onoxi de ( By i nhal ati on)
 Pharmo co lo gy and the nursing pro cess
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Posi on Vs Anti dote

N al oxone
Opi ates, opi d drugs

Posi on Vs Anti dotes

E thonal (same as al ochol used f or dri nki ng gi ven i ntravenousl y)
E thyl ene gl ycol (automoti ve anti f reez e sol uti on) M ethanol

Posi on vs Ani tdotes

Sodi um bi carbonate
T ri cycl i ne anti depressant, qui ni de

Posi on vs Anti dotes

Acetyl cystei ne
Acetami nophen

Posi on vs Anti dotes

F l umaz eni l
Benz odi az epi nes

Posi on vs Anti dotes

I ntravenous cal ci um
Cal ci um channel bl ockers

Posi on vs Anti dotes

D i goxi n anti bodi es
D i goxi n or other cardi ac gl ycosi des

Posi on vs Anti dotes

D ef eroxami ne
I ron Sal ts
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Posi on vs Anti dotes

Atropi ne
Organophoshates ( i nsecti ci des)

Al bumi n bi ndi ng si tes are reduced because of decrease producti on of protei ns by

Protei n (al bumi n) does what i n E l derl y Pati ents?
the agi ng l i ver and reduced protei n i ntake

SA stands f or Sustai ned acti on

SR stands f or Sl ow Rel ease

Route absorbed i nto hi ghl y vascul ari z ed ti ssue under the tongue
Subl i ngual Route E x: ni trogl yceri n i s absorbed rapi dl y by hi gh bl ood suppl y under the tongue and
bypass the l i ver.

Repl acement therapy:

Suppl emental T herapy E x: admi ni steri ng i nsul i n to a di abeti c pati ent or Gi vi ng I ron to a pati ent wi th
I ron-def i ci ency anemi a

Occur when two drugs admi ni stered together i nteract i n such a way that thei r
combi ned ef f ects are greater than the sum of the ef f ect f or each drug gi ven al one
Synergi stri c E f f ects
(1+1= greater than 2)
E x: H ydrochl orothi az i de wi th l i si nopri l f or hypertensi on treatment

T eratogeni c E f f ect D rugs or other chemi cal s resul t i n structural def ects i n the f etus
 Pharmo co lo gy and the nursing pro cess
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T he study or sci ence of a drug i s known as? Pharmocol ogy

Of Peak & T rough val ues are measured to veri f y adequate drug exposure, maxi mi z e
T herapeuti c D rug M oni tori ng
therapeuti c ef f ects, and mi ni mi z e drug toxi ci ty.

T o ensure that the drug gi ven i s correct, you must check the speci f i c medi cati on
N eeds to be checked 3 ti mes
order agai nst the medi cati on l abel or prof i l e how many ti mes?

-T he qual i ty of bei ng poi sonous

T oxi c
E x: i nj uri ous to heal th or dangerous to l i f e

T he study of the adverse ef f ects of drugs and other chemi cal s on l i vi ng system
T oxi ci ty
-the condi ti on of produci ng adverse bodi l y ef f ects due to posi onous qual i ti es

T oxi col ogy I s the study of poi son, i ncl udi ng toxi c drug ef f ects, and appl i cabl e treatment

T rough Level Lowest bl ood l evel of drug

What i s the Beers Cri teri a? Preventi on of adverse drug events i n ol der adul ts
Pharmo co lo gy and the nursing pro cess
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XL stands f or E xtended l ength

XT stands f or E xtended ti me