sNR293 Pharmacology for Nursing Running Review

sNR293 Pharmacology for Nursing Running Review o Introduction to Pharmacology: ▪ Labs: ● Sodium (Na+): 135-145 ● Potassium (K+): 3.5-5 ● Albumin: 3.5-5 ● Total Protein:6-8.3 ▪ The Nursing Process and Drug Therapy: ● Compliance: implementation / fulfillments of a prescriber’s / caregiver’s prescribed course of tx / therapeutic plan by a pt. ● Medication Error: any preventable adverse drug event involving inappropriate med. use by a pt. / health care professional; may / may not cause a pt. harm ● Noncompliance: an informed decision on the part of the pt. not to adhere to / follow a therapeutic plan / suggestion ● Nursing Process: an organization framework for the practice of nursing o assessment - nursing diagnoses - planning - implementation - evaluation ● Outcome: descriptions of specific pt. behaviors / responses that demonstrate meeting of / achievement of behaviors related to each nursing diagnoses ● Prescriber: any health care professional licensed by the appropriate regulatory board to prescribe meds. ● ADPIE: assessment - diagnosis - planning - implementation / intervention - evaluation ● SMART Goals: specific - measurable - achievable - results focused - time ● QSEN do’s and don’ts of charting: o Do’s chart --> ▪ correct chart ▪ chart only facts ▪ include time and route of med. and pt’s response ▪ chart pt teaching ▪ any precautions / preventative measures ▪ each phone call to physician w/ exact time, message, and response ▪ give precise descriptions ▪ pt care at the time provided ▪ pt’s refusal to allow a tx / take a med and report to the pt’s physician and charge nurse o Don’ts chart --> ▪ alter pt’s record ▪ give excuses (EX. med not given bc med not available) ▪ chart ahead of time ▪ don’t mention term incident report in charting ▪ don’t use: by mistake, by accident, accidentally, unintentional, miscalculated ▪ don’t chart casual conversations w/ peers, prescribers, other members of health care team ▪ don’t use abbreviations ▪ don’t use negative language ▪ Pharmacologic Principles: ● Additive Effects: drug interactions in which the effect of a combo of 2 or more drugs w/ similar actions is equivalent to the sum of the individual effects of the same drug given alone ● Adverse Effects: any undesirable occurrence related to administering / failing to administer a prescribed med. ● Agonist: drug that binds to and stimulate the activity of one / more receptors in the body ● Allergic Reaction: an immunologic hypersensitivity reaction resulting from the unusual sensitivity of a pt. to a particular med. ● Antagonist: a drug that binds to and inhibits the activity of 1 or more receptors in the body ● Antagonistic Effects: drug interactions in which the effect of a combo. of 2 or more drugs is less than the sum of the individual effects of the same drug given alone ● Bioavailability: a measure of the extent of drug absorption for a given drug and route ● Blood-Brain Barrier: the barrier system that restricts the passage of various chemicals and microscopic entities between the bloodstream and the CNS ● Drug Classification: a method of grouping drugs ● Duration of Action: the length of time the concentration of a drug in the blood / tissues is sufficient to elicit a response ● Enzymes: protein molecules that catalyze 1 or more of a variety of biochemical reactions ● First-Pass Effect: the initial metabolism in the liver of a drug absorbed from the GI tract before the drug reaches systemic circulation through the bloodstream ● Half-Life: the time required for half of an administered dose of drug to be eliminated by the body / the time it takes for the blood level of a drug to be reduced by 50% ● Medication Error: any preventable adverse drug event involving inappropriate med. used by a pt. / health care professional; may / may not cause the pt. harm ● Onset of Action: the time required for a drug to elicit a therapeutic response after dosing ● Peak Effect: the time required for a drug to reach its maximum therapeutic response in the body ● Peak Level: the maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring ● Receptor: a molecular structure w/in or on the outer surface of a cell; they bind specific substances ● Synergistic Effects: drug interactions in which the effect of a combo. of 2 or more drugs w/ similar actions is greater than the sum of the individual effects of the same drugs given alone ● Therapeutic Drug Monitoring: the process of measuring drug levels to identify a pt’s drug exposure and to allow adjustment of dosages w/ the goals of maximizing therapeutic effects and minimizing toxicity ● Therapeutic Effect: the desired / intended effect of a particular med. ● Therapeutic Index: the ratio between the toxic and therapeutic concentration of a drug ● Toxicity: the condition of producing adverse bodily effects due to poisonous qualities ● Trough Level: the lowest concentration of drug reached in the body after it falls from its peak level ● Drug Class and Structure vs. Therapeutic Use: o Drug Classification: drugs are grouped together based on their similar properties ▪ can be classified by their structure or therapeutic use ● protein binding and low albumin D/T malnutrition and/or burns ▪ Albumin is the most prevalent protein in plasma and the most important ▪ only drug molecules not bound to plasma proteins can freely distribute to extravascular tissue to reach site of action ▪ of a drug is bound to plasma proteins, the protein-bound complex is too large to pass through the walls of blood capillaries into tissues ● p450 enzyme: large class of enzymes that play a large role in drug metabolism and drug interactions ▪ control a variety of reactions that aid in the metabolism of medications ▪ target lipid-soluble drugs ● most drugs are metabolized by the liver and excreted by the kidneys ● figure 2-7 (receptors, blockers, enzymes): drugs act by forming a chemical bond w/ specific receptor sites (think a key and a lock). The better the “fit,” the better the response. Drugs w/ complete attachment and response are agonists whereas drugs that attach but do not elicit a response are called antagonists. ............................CONTINUED.......................