567 pharm quiz 1
Terms
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Pharmaceutics
Pharmacokinetics
Pharmacodynamics
Pharmacotherapeutics - 4 components of pharmacology
- in clinical pharmacology, this term combines everything - drugs or chemicals used for treatment, prevention and diagnosis of disease
- Pharmacotherapeutics
- Interactions between drugs and chemical components of living tissues or systems (the basic science of the drug – how and why). It determines the nature and intensity of the response.
- Pharmacodynamics
- study of movement of drugs in body - absorption, distribution, metabolism, excretion
- Pharmacokinetics
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1.sources
2.constituents
3.dosage forms
4.routes of administration
5.stability
6.storage (follow directions of how to handle) - Pharmaceutics
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ANY CHEMICAL that is put into the human body with the intent to affect function.
food extracts, herbs, supplements, Rx, illegal (natural is not safe)
FDA definition: a chemical INTENDED to diagnose, cure, mitigate, treat, or prevent disea - Drug
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It reviews the implementation of the Food, Drug and Cosmetic Act of 1938 – to regulate drug safety, all new drugs must undergo testing for toxicity. It oversees and approves/denies new drugs for marketing, including both Rxs and OTCs
(BEFORE - Federal Drug Administration (FDA)
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1.Marketing
2.Not required to report OTC adverse reactions
3.Can substitute a GRASE* ingredient without changing name of OTC drug
4.Can substitute a GRASE ingredient without warning (label) to public
*(GRASE generally regarded as saf - What is not regulated by the FDA of Over the Counter Drugs (OTCs)
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The FDA does not authorize or monitor premarket testing of these.
No quality control.
As long as the manufacturer does not use the terms "cure" or "treat" a specific disease, they can legally get away with selling a lot of u - FDA does not regulate supplements - a supplement is not a drug
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1.Chemical classification - like structure
2.Pharmacological classification - mechanism of action
3.Therapeutic classification - indications or uses
4.Prototypes - Individual drugs that represent a group (classification) of drugs. Other dr - Drug Classification
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This is therapeutically equivalent to original trade name.
Must prove BIOEQUIVALENCE without repeating all of the R&D (occasional differences in absorption - increase could lead to toxicity while decrease could lead to lessened therapeutic effec - Generic Drug
- The generic name is consistent (universal) for all. For older drugs, there may be many trade names. Not everyone prescribes the same trade name.
- Why is the generic name used in drug reference books?
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-Not everyone knows/uses the same trade
-Single chemical can have multiple trade names
-Different chemicals can have same trade name
-leads to miscommunication and medication errors - What are the disadvantages of using trade names?
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Unapproved use of an FDA approved drug.
Practitioner prescribes drug for a different Dx that has not undergone research for that use.
Not illegal (malpractice if outcome is bad). - Off label Drug (unlabeled)
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research only, no legal use
peyote, LSD, heroin -
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule I -
Therapeutic use, high abuse potential
no refills on Rx; rewrite only
amphetamine
morphine
cocaine
opium -
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule II -
lower abuse potential
5 refills before rewrite
refills must be made w/i 6 mos
stimulants
amobarbital
pentobarbital
paregoric
anabolic steroids -
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule III -
lower abuse potential with possible psychological dependence
phenobarbital
petazocine
diazepam -
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule IV -
low abuse potential
states vary
Terpin hydrate w/ codeine
triamine w/cod
Lomotil
Robitussin A-C -
UNITED STATES CONTROLLED DRUG SCHEDULE DEA
Schedule V -
TO ADMINISTER DRUGS
(per order of MD/DO, APN with *CTP)
*CTP=certificate to prescribe - What is the nursing legal responsibility regarding drugs?
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right drug
right dose
right client
right time
right route of administration
Documentation sometimes considered the "sixth right" - 5 Rights
- T/F: an RN Cannot DISPENSE DRUGS IN OHIO.
- T: an RN Cannot DISPENSE DRUGS IN OHIO.
- T/F: MD/DO, APN with CTP can prescribe drugs in Ohio.
- T: MD/DO, APN with CTP can prescribe drugs in Ohio.
- MD/DO, APN with CTP
- WHO CAN DISPENSE DRUGS or SAMPLES IN OH?
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When discussing the use of any chemical with a patient, the professional and ethical responsibility is the same no matter what the chemical.
What are the chemicals? -
Prescriptive
Over the counter FDA approved drug
Herbal or supplement not approved by FDA - A customized medication prepared by a pharmacist according to a doctor's specifications to meet an individual patient need. Pharmacists make medications from scratch using raw chemicals, powders and devices to meet the unique needs of prescribers and pat
- Compound Pharmacy
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Ask your pharmacist for recipe
Ask your pharmacist for reference on pharmacokinetics e.g. at MCO: Micromedic data base - How you find out about the drugs compounded
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drug used for Dx, Tx, or prevent disease or condition affecting <200,000 people USA.
Not considered good financial investment for R&D and marketing. - orphan drug
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1. preadministration assessment
2. dosage and administration
3. evaluating and promoting therapeutic effects
4. minimizing adverse effects
5. minimizing adverse interactions
6. making PRN decisions
7. managing toxicity - Seven aspects of drug therapy
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5 rights – drug, patient, dose, time, route (documentation), in addition,
1.certain drugs have more than one indication
2.Many drugs can be administered by more than one route and dosage
3.certain intravenous agents can cause severe loca - "dosage and administration" basic guidelines to help the nurse provide correct drug administration
- pro re nata – as needed. Need to know the reason for the drug
- PRN decision
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1.drug name and therapeutic category
2.dosage size
3.dosing schedule
4.route and technique of administration
5.expected therapeutic response and when
6.nondrug measures to enhance
7.duration of tx
8.method of drug stora - 10 items the nurse must provide during patient education
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a.collect baseline data needed to evaluate therapeutic responses
b.collect baseline data needed to evaluate adverse effects
c.ID high-risk pts
d.asses the pts. capacity for self-care
DRUG HISTORY: included Rx, OTCs, supplementals and -
Nursing Process For Drugs:
1. Preadministration Assessment -
a.judge the appropriateness of the prescribed regimen
b.id potential problems the drug may cause
c.determine the pts capacity for self-care -
Nursing Process For Drugs:
2.Analysis: 3 objectives -
⬢the drug has no actions that are known to benefit individuals with the pts medical diagnosis
⬢the pt failed to respond to the drug in the past
⬢the pt had a serious adverse rxn to the drug in the past
⬢pt has a condition or is usi - When to question a drug's appropriateness
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goal: to produce maximum benefit with minimum harm.
Allows you to anticipate adverse effects, rather than react after the fact.
a. define goals
b. set priorities
c. id interventions
-drug administration, interventions to enhance -
Nursing Process For Drugs:
3. Planning -
a.drug administration
b.pt education
c.interventions to promote therapeutic effects
d.interventions to minimize adverse effects -
Nursing Process For Drugs:
Implementation -
a.therapeutic responses
b.adverse drug rxns and interactions
c.compliance
d.satisfaction with Tx -
Nursing Process For Drugs:
5.Evaluation - To reinforce the relationship between pharmacologic knowledge and nursing practice.
- What is the reason nursing implications are integrated into each chapter?
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1.Preadministration Assessment
Therpaeutic Goals
Baseline Data
ID High-Risk Pts
2.Implementation: Administration-Routes, Administration
Implementation: Measures to Enhance Therapeutic Effects
3.Ongoing Evaluation and Inte - Modified Nursing Process Format
- deficient knowledge related to the drug regimen
- A good all-purpose nursing diagnoses when it comes to drugs.