Pharmacology for Nurses. A Pathophysiologic Question And Answers

Pharmacology for Nurses. A Pathophysiologic Question And Answers prescription drugs Drugs legally available only with a physician's order. Over the counter drugs (OTC) can be purchased without a prescription Black Box Warnings One of the primary alerts for identifying extreme adverse drug reactions discovered during and after the review process; 1997 FDA created "Black Box Warnings" Contraindications factors that prevent the use of a drug or treatment why should healthcare professionals be concerned about patients taking herbal medicines? patients could be putting themselves at risk, potential herb-drug interactions U.S. Pharmacopoeia (USP) 1820; 1st comprehensive publication formulary used in the U.S.; drug purity, strength, and directions for synthesis. USP and National Formulary (NF) , two drug standards in the US by the American Pharmaceutical Association (APhA). 1. USP - all drug products. 2. National Formulary (NF) - pharmaceutical ingredients. U.S. Pharacopoeia -National Formulary (USP-NF) 1975 merged into a single publication Biologic Control Act 1902 standardized serum and blood-related products Pure Food and Drug Act 1906 - Established government control (FDA) for labeling medicines Shirley Amendment 1912 - Prohibited drugs labeled with false therapeutic claims Food, Drug, and Cosmetic Act (1938) and amendments 1938- Thorough testing of drug; Proof of safety and efficacy of drug Dietary Supplement Health and Education Act, 1994 1994-Controls misleading industry claims Four Stages of Approval for Therapeutic and Biologic Drugs 1. Preclinical investigation (1-3 years, average 18months) 2. Clinical investigation (2-10 years; average 5 years) 3. Review of new drug application (NDA) (2 months -7 years, average 24 months) 4. Postmarketing surveillance (adverse reaction reporting; surveys/sampling/testing; inspections) Addiction The overwhelming feeling that drives someone to use a drug repeated Dependence A physiological or psychological need for a substance Physical dependence An altered physical condition caused by the adaptation of the nervous system to repeated drug use. Psychological dependence Few signs of physical discomfort when drug is withdrawn, but intense compelling desire to continue drug use Controlled Substances Are restricted by the Controlled Substances Act of 1970. Have a high potential for addiction or dependence. Have restricted use. Are placed into one of five schedules: Schedule I drugs have the highest abuse potential, Schedule V the lowest Teratogenic Drug Classification Five categories of risk that a drug poses to a fetus in the case of a pregnant woman taking the drug. A, B, C, D, and X; Class A is the safest, while X poses the most danger to the fetus. Allergic Reactions a condition caused by an overreaction of the body's immune system Anaphylaxis Life threatening allergic reaction Five Rights of Drug Administration 1. Right patient 2. Right medication 3. Right dose 4. Right route of administration 5. Right time of delivery Right documentation Three Checks of Drug Administration 1. Checking drug with MAR (medical administration record) or medication information system when removing it from storage 2. Checking drug when preparing it 3. Checking drug before administering it to the patient Drug Compliance taking a medication in the mannerprescribed by the health care provider