997849386

    Master this deck with 100 terms through effective study methods.

    Imported from Quizlet

    Created by @morgan123

    Standard dosage calculation

    Desired(Amount Ordered)/Have(Amount on hand) x volume (amount medication) = Give (amount given)

    IV formula with a pump

    Amt sol/time in HOURS = mL per hour

    IV formula without a pump

    amt sol x drop factor/ time in MINUTES = drops per minute

    Generic Names

    -identifies active ingredient -name is assigned by the manufacture -1 generic name for each drug -first letter is not capitalized

    Brand names

    -selected by the drug company that sells it and is protected by trademarks -may be many brand names and they are always capitalized

    What do you do before administering a suspension?

    the suspension meds must be shaken so the medication is mixed back together

    Bioavailability

    A measure of the extent of drug absorption for a given drug and route (from 0% to 100%). IV drugs are 100% while oral drugs are less than 100%

    Mechanism of action

    biochemical process by which a drug produces an effect in the body

    Therapeutic effect

    The desired or intended effect a medication is expected to have on the body.

    side effect

    any effect that is caused by a drug and that is different from the drug's intended effect

    adverse effect

    Unintended, undesirable, often unpredictable. May be severe

    contraindication

    a factor in the patient's condition that makes the use of a medication or specific treatment dangerous or ill advised

    Tolerance

    occurs when the body becomes accustomed to the effect of the drug

    Toxicity

    specific group of systems that carry risk for permanent damage or death

    idiosyncratic reaction

    Unusual response to a drug

    Pharmokinetic processes

    ADME 1. Absorption 2. Distribution 3. Metabolism 4. Excretion movement of the drug molecules in the body

    Absorption

    the process by which a drug is transferred from its site of entry into the body to the bloodstream for circulation

    Absorption - onset and intensity

    onset is determined by the rate of absorption and intensity is determined by the extent of absorption Ways the drugs can enter the body: enteral, parenteral, percutaneous

    Absorption - route of administration

    can affect the rate and extent of absorption

    Enteral routes of drug administration

    Through GI tract; oral, NG, PEG, J-tube, rectal

    Parenteral routes of administration

    outside the GI tract; injection, IV

    Percutaneous routes of administration

    through skin/mucous membranes of mouth, eyes, ears, lungs, vagina, rectum

    Loading dose

    a larger than normal dose, is usually given when a patient is in acute distress and the maximum therapeutic effect is desired as quickly as possible

    Distribution

    involves the transport of drug molecules within the body and is the drugs ability to move through the bloodstream

    What factors could affect distribution?

    if there is poor circulation the drug doesn't get transported as it should, blood brain barrier- made up of tightly packed capillary walls that supplies blood to the brain

    Metabolism

    method by which drugs are broken down by the body, metabolism occurs at different rates for different drugs.

    where is the primary site for metabolism?

    the liver is the primary site for metabolism.

    first pass effect

    a phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation; oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown

    What is a product of metabolism called?

    metabolite

    Excretion

    elimination of the drug from the body, kidneys, and bowels excrete most drugs.

    What is a concern of excretion when the kidneys aren`t working?

    toxicity can be a concern if the drug is backing up and not being excreted properly

    Rate of alcohol metabolism

    alcohol is metabolized in the liver at a constant rate, blood alcohol level decreases by 25 mg/dL per hour.

    What does alcohol affect in the pharmacokinetic process?

    alcohol affects absorption and metabolism of a drug by causing a delay or acceleration depending on the medication

    half life

    the time required for the serum level to decrease by 50% and is an important consideration in the prescriber's determination of dosage and frequency

    Anticholinergic effects

    anticholinergic blocks the neurotransmitter acetylcholine in the central nervous system, these agents inhibit parasympathetic nerve impulses by blocking acetylcholine at its receptor site

    Common anticholinergic side effects

    dry mouth, dry eyes, blurred vision, constipation, urinary retention, tachycardia

    therapeutic index

    the ratio between the toxic and therapeutic concentrations of a drug; when the lethal dose is relatively close to the therapeutic dose

    rationale for pediatric dosing

    mg/kg/day is divided, weight is used to find the safe therapeutic dose

    Famous drug-food interactions

    tetracycline/doxycycline- dairy products MAOIs - tyramine containing foods Calcium channel blockers - grapefruit juice Warfarin - Vitamin K containing foods

    Types of allergic reactions

    hypersensitivity/allergic reactions Anaphylaxis

    Hypersensitivity/Allergic Reactions

    immune system response that occurs when the body interrupts the drug as a foreign substance and forms antibodies against it, usually appears as a rash or hives. If it requires treatment and antihistamine is used.

    Anaphylaxis

    life threatening allergic reaction, results in respiratory distress, sudden severe bronchospasm and cardiovascular collapse, treated with emergency medications

    Types of immunizations

    attenuated, inactivated, toxoid, recombinant, booster, titer

    Attenuated vaccine

    live but weakened; ex: MMR

    Inactivated vaccine

    killed microbes, may require boosters; ex: Hep A

    Toxoid vaccine

    chemically modified so it's no longer toxic; ex: diphtheria, tetanus

    Recombinant vaccine

    partial organisms of bacterial proteins recombined (Hep B)

    Booster

    follow-up dose the provides sustained protection

    Titer

    a measurement of the amount of antibodies in the blood; this is the test to determine immunity

    Immunization

    form of active immunity (caused by a pathogen or vaccine) the body produces antibodies in response to pathogen or vaccine and its longer acting

    Immunoglobins

    passive immunity, preformed antibodies which are transferred from one person to another; shorter acting (Ex: mother via placenta) Can be obtained to give higher antibodies quicker and in instances of immunosuppression or high risk

    General side effects of chemotherapy

    Mucous membrane irritation/inflammation (oral stomatitis), Hair loss (alopecia), Nausea and vomiting/GI distress, bone marrow suppression (myelosuppression; pancytopenia occurs because normal cells are affected too), IV site pain-necrosis if extravasation, ova and sperm production abnormalities, teratogenicity

    vesicant reactions

    reaction to a chemical that causes blistering of the skin and mucous membranes, avoid extravasation, early symptoms include swelling, redness, and/or discomfort that is often described as burning or stinging sensation.

    Rationale for giving combinations of chemotherapy

    different drugs work during different phases of the cell cycle

    Alkylating agents

    -Good for treatment of slow growing cancers (lymphoma, leukemia) and reproductive cancers (breast, ovarian, testicular) -Renal and liver toxic

    Alkylating agents examples

    busulfan (Myleran), cisplatin (Platinol), cyclophosphamide (Cytoxan)

    Alkylating agent busulfan (Myleran) causes?

    pulmonary toxicity; monitor respiratory status carefully

    Alkylating agent cyclophosphamide (Cytoxan) causes?

    hemorrhagic cystitis; push fluids, rescue med: mesna (Mesnex) with cyclophosphamide to reduce the incidence by interacting with urotoxic metabolites

    Antimetabolites

    best for leukemias, some GI, and basal cell cancers, tough on kidneys and liver, category X-may cause spontaneous abortion, usually used in combination with other drugs due to resistance, works by inhibiting folic acid

    Antimetabolite examples

    cladribine (Leustatin), fluorouracil (Efudex), methotrexate (Rheumatrex); leucovorin (Wellcovorin)-used along methotrexate to protect normal cells from the adverse effects

    Antineoplastic (Antitumor) antibiotics

    useful in cancers with rapidly multiplying cells, toxic to many body systems

    Antineoplastic antibiotics examples

    bleomycin, doxorubicin (Adriamycin, Doxil) mitomycin (Mutamycin)

    Antineoplastic antibiotics effect on the heart

    doxorubicin (Adriamycin) causes cardiomyopathy- monitor the cardiovascular system carefully; rescue med- give dexrazoxane (Zinecard) 30 minutes before to interfere with cardiotoxic effects

    Mitotic Inhibitors

    Treats a variety of tumors and leukemias

    Mitotic inhibitor examples

    vincristine (Oncovin, Vincasar)

    Mitotic inhibitor side effects

    Most famous side effect is peripheral neuropathy; monitor neurovascular system carefully

    Rationale use of allopurinol for patients receiving chemotherapy treatments

    -the breakdown of large numbers of tumor cells by chemotherapy may lead to increased serum uric acid (hyperuricemia) -increase fluids -give allopurinol (Zyloprim); used for the prevention of gout attacks and to treat elevated uric acid levels in the blood and urine

    Immune Stimulants

    Energize the immune system when it needs help fighting a specific pathogen; often in the form of interferons

    Interferons

    Antiviral proteins secreted by T cells; alpha (Alfa), beta, and gamma, can cause flu-like symptoms

    Interleukins

    proteins that stimulate the growth of B and T lymphocytes; aldesleukin (Proleukin) and oprelvekin (Neumega), can cause flu like symptoms

    colony stimulating factors

    multiplication and differentiation of leukocytes; filgrastim (Neupogen), pegfilgrastin (Neulasta): side effects include GI distress, weakness, and bone pain

    Immune Suppressants

    Also called immunosuppressants, work to block inflammatory reaction and decrease initial damage to cells, used to suppress rejection in organ transplant patients and treat auto immune diseases

    classes of immune suppressants

    Immune modulators T and B cell suppressors Interleukin receptor antagonists Monoclonal antibodies

    T and B cell suppressors are at risk of what?

    At risk for infection and are hepato-nephro toxic

    cyclosporine(Sandimmune)

    Immunosuppressant; works to prevent organ transplant rejection and treat RA and PsA

    mycophenolate (Cellcept)

    Immunosuppressant; works to prevent organ transplant rejection

    tacrolimus (Prograf)

    Immunosuppressant; works to prevent organ transplant rejection

    monoclonal antibodies MAB

    Bind to specific antigens on cells triggering an antigen-antibody type response

    How do monoclonal antibodies work?

    Flags cancer cells for destruction by immune system, prevent cancer cell blood vessel growth, destroy cells triggering wall, attack cancer cells directly; targets specific cells and by pass normal cells Treat a variety of conditions including cancer, renal transplant rejection, MS, crohns, asthma, RA, PsA

    What can be caused by monoclonal antibodies?

    Acute pulmonary edema, fluid retention, and flu like symptoms

    Examples of monoclonal antibodies

    adalimumab (Humira) infliximab (Remicade) nivolumab (Opdivo) pembrolizumab (Keytruda) rituximab (Rituxan) ustekinumab (Stelara) vedolizumab (Entyvio)

    hormone blockers

    Used for reproductive cancers; block estrogen getting to receptor site to slow growth/kill; estrogen is the food source for some reproductive tumors, including some forms of prostate and breast cancers

    What is a hormone blocker used for prostate cancer?

    leuprolide (Lupron)

    What is a hormone blocker used for breast cancer?

    tamoxifen (Soltamox)

    Side effect of hormone blockers

    They block estrogen so they may trigger menopausal symptoms, including hot flashes, vaginal/uterine bleeding in women, moodiness, hypercalcemia

    Corticosteroids

    Used medically as an anit-inflammatory agent

    Side effects of chronic corticosteroids

    Increased susceptibility to infection (priority to report), fluid retention, hyperglycemia, GI distress/bleeding, hirsutism (abnormal hair growth), mood swings, weight gain, easy bruising, and osteoporosis, longer the use higher the risk.

    Nursing tips for corticosteroids

    -give before 9 am to mimic natural corticosteroid surge -using them every other day can decrease side effects -give with food -don't stop at once taper off -monitor blood sugar -should be stopped months before surgery -may delay wound healing

    What is a normal AST value?

    11-48

    What is a normal ALT?

    8.5-66

    What is a normal BUN?

    5-20

    What is a normal CR?

    0.6-1.2

    What is a normal WBC?

    5000-10000

    What is a normal platelet count?

    150,000-300,000

    What is a normal RBC?

    3-5 million

    What is a normal hematocrit?

    34-50%

    What medication would you need to stimulate RBC production?

    epoetin (Epogen)

    What medications could you use to stimulate WBC production?

    filgrastim (Neupogen) or pegfilgrastim (Neulasta)

    busulfan (Myleran), cisplatin (Platinol), cyclophosphamide (Cytoxan) are what kinds of medications?

    Alkylating agents

    cladribine (Leustatin), fluorouracil (Efudex), methotrexate (Rheumatrex) are all what kinds of medications?

    Antimetabolites