1.) Discuss the prototype approach to drug classification. - “Prototype drug” is one drug, from a class of drugs that is well understood and serves as a model Predicts the actions and adverse effects of other drugs in that class. 2.) Distinguish between a drug’s chemical name, generic name, and trade name. - Chemical name: describes a drugs chemical structure. Generic name: official, nonproprietary, not owned by frug company, universally accepted, lowercase letters. Ex. ibuprofen Trade name: brand name, proprietary name, registered/trademarked, by drug company, always begins with capital letter. Ex. Advil 3.) Explain the meaning of a controlled substance. - A drug or chemical that has the potential for abuse whose manufacture, possession, or use is regulated by the government. Schedules 1-5 4.) Describe the roles and responsibilities of the nurse administering medication. - What drug is ordered - Name (generic/trade) & drug classification - Intended or proposed use - Effects on the body - Contradictions - Special considerations -Weight -Age -physiological state - Side effects - Why the medication was prescribed for the patient - How the medication is supplied by the pharmacy - How it should be administered+dosage range - Nursing process considerations related to the medication - Rights of medication administration: Right patient, Right medication, Right dose, Right route, Right time, Right documentation - 3 checks of drug administration: Checking the drug with the MAR, Checking when preparing the drug, Checking before administration 5.) Give specific examples of how the nurse can increase patient compliance in taking medication. - Cost, Insurance coverage, Schedule, Manage side effects (does not interfere with accustomed life style), Educate on the medication (ensure they wont get addicted) 6.) Identify the four components of pharmacokinetics. - Absorption, distribution, metabolism (biotransformation), excretion (elimination) 7.) Discuss factors affecting drug absorption. - Drug formulation & Dose (liquid vs solid) (liquid is faster) Dose (more dose faster absorption) Route of administration (IV best) Size of the drug molecule (smaller is faster) Surface area of absorption site (more surface=faster absorption) Digestive motility (can slow/speed up depending on drug & location) Blood flow (more blood more absorption) Lipid solubility (are faster than water soluable) (nonionized absorb faster than ionized) 8.) Discuss how drugs are distributed throughout the body. - Most: Heart, Liver, Kidneys, Brain Least: Skin, Bones, Adipose tissue 9.) Identify major processes by which drugs are excreted. - 10.) - Eliminated through kidneys Explain how enterohepatic circulation might affect drug activity. Also know as biliary excretion - Drugs are secreted via bile to enter the duodenum to eventually secrete through feces - A percentage of the drug may recirculate multiple times -these drugs are eventually processed by the liver & excreted by the kidneys -may continue several weeks after therapy - 11.) Increases elimination half life Differentiate between loading and maintenance dose. - Loading dose= higher amount of drug, often given only once or twice to "prime" the bloodstream with levels sufficient to quickly induce a therapeutic response - Maintenance doses: after loading dose before levels drop back toward zero, these doses are given to keep the plasma drug concentration in the therapeutic range. 12.) Discuss principles of pharmacodynamics and how they are applied to clinical practice. - Study of effects of drug on the body. 13.) - 14.) - Dose response relationship Patients sensitivity to a drug Compare and contrast the terms potency and and efficacy. Potency: amount of drug needed to elicit a specific physiologic response Efficacy (maximal): point at which increasing a drugs dose no longer increases the desired therapeutic response. Distinguish between agonist, partial agonist, and antagonist. Agonist: A drug that activates receptors and produces a desired response. Does the same or greater response with the endogenous chemical. Partial agonist: Elicit only moderate activity when binding to receptors. Prevent receptor activation by other drugs. Produces a weaker/less efficacious response with the endogenous chemical. Antagonist: Prevent receptor activation/ block response. Occupies the receptor & prevents the endogenous chemical from acting. 15.) - Explain the relationship between receptors and drug action. The drug will bind to a receptor to cause a change in body chemistry/physiology The better the drug fits the receptor, the more active the drug. Drugs binding to receptors can activate receptor and produce a response, or inactivate a receptor and block a response. Activity is determined by ability of drug to bind to specific receptor 16.) Explain how physical, cognitive, and psychomotor development influences pharmacotherapeutics. 17.) Match the five pregnancy categories with their definitions. 18.) Teach a breastfeeding mother about prescription and OTC drugs, as well as the use of herbal products. - If available postpone pharmacotherapy until baby has weaned If possible administer drug immediately after breast feeding Avoid alcohol, smoking, and illicit drugs Drugs with shorter half-lives are preferable -Avoid drugs with long half-lives Drugs with high protein should be selected because they are bit secreted as readily to milk OTC herbal products & dietary supplements should be avoided during lactation (unless provider prescribed due to safety not determined) 19.) Describe physiological and biochemical changes that occur in the older adult, and how these affect pharmacotherapy. - Absorption: is slower due to gastric motility & decreased blood flow (pH is low for absorption) Distribution: Increased body fat creates storage for lipid-soluble drugs & vitamins, Less water (less plasma) +dehydration, Less albumin (less protein binding, more drug-drug interactions), Less circulation (needs smaller dosages). - 20.) - Metabolism: Enzyme production is decreased & visceral blood flow is diminished Resulting in reduced hepatic drug metabolism. Excretion: Reduced renal blood flow & glomerular filtration rate; results in increased half life. Decreased drug excretion potential for drug toxicity Describe how nurse practice acts are designed to protect the public. Protect patients and our society, Define scope of nursing practices, Identify minimum level of nursing care that must be provided to patients. 21.) Explain the importance of documentation in the administration of medication. - Documentation provides specific nursing interventions that was implemented along with monitoring vital signs and assessing complications. 22.) Describe the strategies that the nurse may implement to prevent medication errors. - - - - 23.) Assessment: -Allergies -Current medications (& OTC) -Body functions Planning: -minimize factors that contribute to errors -avoid abbreviations -question orders -follow facility polices Implementation: -2 verification -correct procedures -calculations -3 checks -rights of meds Evaluation: Assess patient for expected outcomes and determine if adverse effects have occurred Explain how ethnicity can affect pharmacotherapuetic outcomes. - genetic differences - same factors as cultural differences (diet, alternative therapies, beliefs) 24.) Explain how community and environmental factors can affect health care outcomes. - Insurance coverage, Age, Socioeconomic status, Supplies (Food & Water), Language/Literacy, pop growth, complex technological advances, evolving globalization patterns, access to healthcare 25.) Identify how cultural values and beliefs can influence pharmacotherapeutic outcomes. - Dietary conditions: can/can't eat Alternative therapies: Ex. -Chinese herbalist -Hispanics use spices Beliefs about health diseases: -Shamans/healers instead of medical professionals 26.) Explain the role of complementary and alternative medicine in patient wellness. - Complementary & alternative medicine (CAM) is comprised of diverse therapies & healing systems Focus on treating each person as an individual Consider the health of the whole person Emphasize the integration of the mind and body Promote disease prevention, self-care, & self-healing Recognize the role of spirituality in health and healing 27.) Describe some adverse effects that may be caused by herbal preparations. - Increased bleeding risk/potential, Increased sedation, Toxicity, Etc.
