Pharmacology 1 > Medication Administration > Flashcards

Medication Administration Flashcards

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1
Q

Medication Rights

What are the 8 rights of medication administration?

The right…

(“Do dogs train relentlessly for praise during regular running outings?”)

A
  1. Drug
  2. Dose
  3. Time
  4. Route & Form
  5. Patient
  6. Documentation
  7. Reason
  8. Reponse Occurs
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2
Q

Medication Rights

What are the other rights of medication administration besides the 8?

A
  • The right for the patient to refuse the medication
  • The right for the medication to be presented in the right professional manner
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3
Q

Do’s and Don’ts of charting medication errors!

  • Chart just the ___(1)_____
  • Don’t chart about ___(2)______ or ____(3)___ on the unit
  • Don’t mention that an ___(4)______ was filled out
  • Don’t use words like ____(5)_____, ____(6)___, or ____(7)______
  • Comment on patient’s resopnse….maybe chart a new set of _____(8)_____
A
  1. FACTS!
  2. staffing problems
  3. conflicts
  4. incident report
  5. “accident”
  6. “mistake”
  7. “miscalutation”
  8. vital signs
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4
Q

Names of Medications

Generic Name

A

Long chemical names

-Every drug has ONE generic name

(memorize generic name for NCLEX)

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5
Q

Names of Medications

Trade Name

A

The catchy drug company name

-Each drug has SEVERAL trade names

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6
Q

Which is the generic name and which is the trade from the example?

Acetylsalicylic Acid

Aspirin

A

Generic name: acetysalicylic acid

Trade name: aspirin

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7
Q

Class Overview

In this class, we will be learning about drugs by _____(1)______ (big groups) of medications which usually have a similar use or action.

Then we will learn “____(2)____” or “____(3)___” for each drug classification.

A
  1. Drug classifications
  2. Prototype
  3. Typical drugs
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8
Q

Pharmacology Terminology

Pharmacodynamics

A

How the medication works & affects the body on the chemical level

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9
Q

Pharmacology Terminology

Pharmacotherapeutics

A

Understanding of drug actions for the treatment and prevention of disease

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10
Q

Pharmacology Terminology

Pharmacokinetics

A

The drug’s actions

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11
Q

Pharmacology Terminology

Absorption

A

Getting the medication inside the body into the blood

From outside, to the blood

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12
Q

Types of Absorption Routes

“PIE IT”

A
  1. Parenteral: Injections
  2. Enteral
  3. Intravenous
  4. Topical
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13
Q

Routes

P.O.

A

Enteral

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14
Q

Routes

Enteral (P.O.)

A

By mouth (oral)

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15
Q

Routes

Enteral (P.O.) medicinations are subjected to what effect?

A

First-pass effect

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16
Q

Routes

First-Pass Effect

A

When the medication passes through the liver before getting into the blood

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17
Q

Routes

What is the primary organ involved in the first pass effect?

A

Liver

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18
Q

Routes

What happens to the medication’s effectiveness when it goes through the first pass effect?

A

The liver starts to break down medications

Limits bioavailability

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19
Q

Routes

Pros of P.O. (enteral) Medications

A
  • Easy, cheap
  • Takes 30 minutes to work
  • Comes in a variety of different forms:
    • Pills, tablets, capsules, and liquids
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20
Q

Routes

Cons of P.O. (enteral) medications?

A
  • Not all drugs can be given P.O. route
  • Many things can interfere with oral route:
    • Acid or food in stomach
    • Small intestine disease
    • Poor blood flow to the stomach/intestine
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21
Q

Routes

What are the other variations of enteral (P.O.) medications?

“Soups and Regular Salads are Eat Completely”

A
  1. Sublingual
  2. Rectal Suppositories
  3. Enteric Coated
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22
Q

Routes

Enteric Coated Medications

A
  • Enteral (PO) route
  • Drugs that are destroyed by acid can sometimes be coated until they reach the alkaline pH of the intestine
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23
Q

Routes

Sublingual

A
  • Enteral (PO) route
  • Placed under the tongue
  • Absorbed into the venous system to bypass the liver
  • Avoids the “first-pass” effect
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24
Q

Routes

What can you NOT do to enteric coated medications?

A

CANNOT CRUSH THESE PILLS OR CAPSULES

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25
_Routes_ What can you **NOT** do to sublingual medications?
DO NOT CHEW or SWALLOW
26
_Routes_ What is the **most common sublingual** medication?
Nitroglycerin | (nitro-glyc-er-in)
27
_Routes_ Rectal Suppositories
* Not all are used for constipation (local effect) * **Often used when oral meds can't be given** * Ex. Children or vomitting patient * **Absorbed uncertainly** (stool interferes) * Avoids the "first-pass" effect (liver
28
_Routes_ What enteral (PO) medications bypass the liver ("first-pass" effect)?
* Sublingual * Rectal suppositories
29
_Routes_ Parental medications are also called?
Injections
30
_Routes_ Parental (injections) abbreviations: **SQ/SC** **IM**
SQ/ SC: subcutaneous IM: intramuscular
31
_Routes_ Parenteral: Injections (SQ/SC & IM)
* **Aborbed by diffusion** into capillaries * **_Blood flow is important_**
32
_Routes_ Parenteral: Injections SQ/SC
* Subcutaneous * Goes into the **fat** * Takes **20-30** minutes to begin
33
_Routes_ Parenteral: Injections IM
* Intramuscular * Goes into the **muscle** * **Faster** into the bloodstream * Takes **10-15** minutes to begin
34
_Routes_ What do **both** SQ/SC & IM parenteral/injections **avoid**?
Both avoid the "first-pass" effect by bypassing the liver
35
_Routes_ ## Footnote **Pros of parenteral: injections**
* Quick * Easy to learn to administer
36
_Routes_ ## Footnote **Cons of parenteral: injections**
* Can damage tissue * Cannot control precisely * Can be **affected by temperature of the body**
37
_Routes_ Intravenous (IV)
Into the veins
38
_Routes_ ## Footnote **Pros of intravenous (IV)**
* **Fastest method (immediate)** * **Complete absorption** * No barriers * Can be used for very irritating medications * Ex. potassium * 100% bio-available
39
_Routes_ Types of **topical medication** sites LENSE
* **L**​ungs * **E**yes * **N**ose * **S**kin * **E**ars
40
_Routes_ Type of **topical** medication used on **lungs**
Inhalers * Very quick response * Most for direst action on lungs
41
_Routes_ Types of **topical** medications for **skin**
* **Creams** * **Lotions** * Transdermal **patches** * Patches are **slow** * Patches are used for **systemic use**
42
_Routes_ Types of **topical** medications used on **eyes**
* Drops * Ointments
43
_Routes_ Type of **topical** medication used on **ears**
* Drops
44
_Routes_ Types of **topical** medications for the **nose**
* Drops * Sprays
45
_Routes_ **Pros of topical** medications
* Can have an excellent **local** affect * Bypasses the liver * No "first-pass" effect
46
_Routes_ **Cons of topical** medications
* Does **not** work **quickly** or **predictably** for a systematic effect
47
_Pediatric Variations in Pharmacokinetics_ **Absorption** * \_\_\_\_(1)\_\_\_\_\_\_ has less \_\_\_\_(2)\_\_\_ until \_\_\_\_(3)\_\_\_. * \_\_\_(4)\_\_ is \_\_\_(5)\_\_\_. * \_\_\_(6)\_\_\_\_ is faster d/t \_\_\_(7)\_\_\_\_. * \_\_\_(8)\_\_\_\_ is faster and irregular.
1. Stomach 2. acid 3. age 3 4. Peristalsis 5. irregular and slow 6. Topical absorption 7. thin skin 8. IM absorption
48
_Geriatric Variations in Pharmacokinetics_ **Absorption** * Less \_\_\_(1)\_\_\_. * Slowed \_\_\_(2)\_\_\_\_\_. * Less \_\_\_\_(3)\_\_\_\_. * \_\_\_\_(4)\_\_\_\_\_ = less \_\_\_\_(5)\_\_\_\_.
1. HCl acid in the stomach 2. GI emptying 3. blood flow to GI d/t **decrease** cardiac output 4. Villi flattening 5. absorptive area
49
_Pharmacokinetics_ ## Footnote **Distribution**
Getting the medication from the **blood into the cells** where it can be used * Begins to be eliminated by the liver or kidney
50
_Pharmacokinetics_ **Factors r/t Distribution** * \_\_\_(1)\_\_\_\_ is key. * More drug goes to areas where there is more \_\_\_(2)\_\_\_. * Such as \_\_\_\_\_\_(3)\_\_\_\_\_\_. * Less drug goes to areas like \_\_\_\_\_(4)\_\_\_\_.
1. blood flow 2. blood 3. organs- heart, liver, brain, kidneys, etc. 4. fat and bone
51
_Pharmacokinetics_ **Blood Brain Barrier** (BBB)
The BBB is a system of special capillaries with **limited entry.**
52
_Pharmacokinetics_ ## Footnote **Pros of the blood brain barrier (BBB)**
BBB keeps **harmful substances out**
53
_Pharmacokinetics_ ## Footnote **Cons of blood brain barrier (BBB)**
The BBB keeps **helpful substances out** * Drugs must be **fat soluble** or have their own **transport system** to get past the BBB
54
_Pharmacokinetics_ **Fat soluble** drugs are.....
...better distributed b/c they **don't bind to proteins**.
55
_Pharmacokinetics_ **Water soluble** drugs are ...
...less well distributed- **proteins whisk them away** out of the body.
56
_Pediatric Variations in Pharmacokinetics_ **Distribution** * Greater \_\_\_\_(1)\_\_\_\_\_\_. * Less \_\_\_\_\_(2)\_\_\_\_\_. * Decreased \_\_\_\_(3)\_\_\_\_\_ d/t \_\_\_\_\_(4)\_\_\_\_\_ to make proteins. * Immature \_\_\_\_\_(5)\_\_\_\_\_ (drugs easily cross it).
1. total body water 2. fat content 3. protein binding 4. immature liver 5. blood brain barrier (BBB)
57
_Geriatric Variations in Pharmacokinetics_ **Distribution** * \_\_\_\_(1)\_\_\_\_\_ and less \_\_\_\_(2)\_\_\_\_\_ * Affects water soluble and fat soluble drugs. * Less \_\_\_\_(3)\_\_\_\_ produced by the \_\_\_\_(4)\_\_\_\_.
1. more fat 2. water 3. proteins 4. liver
58
_Pharmacokinetics_ ## Footnote **Metabolism**
**Transformation of the drug** into something that can be excreted or made (AKA bio-transformation) inactive.
59
_Pharmacokinetics_ What is the **main organ** of metabolism?
Liver
60
_Pharmacokinetics_ Metabolism is affected by (3):
1. **Age:** the very young have an immature live & the very old have a worn out liver. 2. **Malnutrition:** the liver doesn't have all the enzymes needed to metabolize medication. 3. **Route:** medication's contact with the liver
61
Pediatric Variations in Pharmokinetics Metabolism 1. Immature \_\_\_\_(1)\_\_\_\_ doesn't make many of the enzymes needed to \_\_\_\_(2)\_\_\_\_ drugs. 2. Older children may actually need \_\_\_\_\_(3)\_\_\_\_ because of their liver is working so well (age 8+).
1. liver 2. detoxify 3. a higher dose
62
Geriatric Variations Metabolism 1. Decreased \_\_\_\_\_\_\_\_\_\_(1)\_\_\_\_\_\_\_\_\_. 2. Decreased \_\_\_\_\_\_\_\_\_\_(2)\_\_\_\_\_\_\_\_\_.
1. enzyme production by liver 2. liver blood flow.
63
T/F Pediatric and geriatric patients have less stomach acid in the stomach which can impact the distribution of medications.
F Less stomach acid in the stomach affects absorption NOT distribution
64
Pharmacokinetics Excretion
Removal of the drug from the body
65
Pharmacokinetics Which is the main organ of excretion?
Kidneys
66
Pharmacokinetics Most drugs are excreted in the \_\_\_\_\_\_.
Urine
67
Pharmacokinetics Other routes that drugs are excreted from SIBBS
1. **S**aliva 2. **I**n expired air 3. **B**owels 4. **B**reast milk 5. **S**weat
68
Pediatric Variations in Pharmacokinetics Elimination 1. \_\_\_\_\_(1)\_\_\_\_\_\_ are immature so \_\_\_\_\_\_(2)\_\_\_\_\_\_\_\_. 2. Less blood flow to the \_\_\_\_\_\_(3)\_\_\_\_\_\_.
1. kidneys 2. filteration is slower 3. kidneys
69
Geriatric Considerations S/E: If there is a \_\_\_\_\_\_\_(1)\_\_\_\_\_\_ in \_\_\_\_\_\_(2)\_\_\_\_\_\_ or \_\_\_\_\_(3)\_\_\_\_\_\_, consider the patient's medications.
1. change 2. behavior 3. consciousness
70
Pharmacokinetics Geriatric Variations Elimination 1. Decreased \_\_\_\_\_\_(1)\_\_\_\_\_\_\_\_\_ 2. Less \_\_\_\_\_\_\_(2)\_\_\_\_\_\_\_\_.
1. number of functioning nephrons 2. blood flow to kidneys
71
Geriatric Considerations Physiologic changes with advanced age: 1. Cardiac: 2. GI: 3. Hepatic: 4. Renal:
1. Cardiac: decreased cardiac output (CO) = decreased blood flow 2. GI: less acid in stomach & less peristalsis 3. Hepatic: decrease in liver enzyme production 4. Renal: decrease of blood flow to the kidneys
72
Geriatric Considerations Polypharmacy
Multiple drugs take at once for a variety of problems
73
Geriatric Considerations Polypharmacy 1. Types of drugs used 2. More drugs causes what? 3. Polypharmacy is likely do to
1. Both prescription and OTC 2. More drugs = more interactions 3. Multiple MDs prescribing
74
Geriatric Considerations What is the goal of eliminating polypharmacy?
This goal is to eliminate unneeded drugs, so less drug interactions occur
Pharmacology 1
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