NU 311 Skills Exam 3- Medication |\ |\ |\ |\ |\ |\
Administration latest update |\ |\
Generic name |\
the official name that is listed in official publications such as the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
United States Pharmacopeia (USP) |\ |\ |\
Trade name |\
the name used to market the medication; it has the symbol TM at
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the upper right of the name indicating a manufacturer trademark
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of the drug
|\ |\ |\
it suggests the action of the drug
|\ |\ |\ |\ |\ |\
What does it mean when a drug is in therapeutic range
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is a range of plasma drug levels between the minimum
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
effective concentration and the toxic concentration. When |\ |\ |\ |\ |\ |\ |\
plasma levels are within the therapeutic range, there is enough
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
drug present to produce therapeutic responses but not so much
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that toxicity results. When administering a drug, the objective is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to maintain plasma drug levels within the therapeutic range. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
width of therapeutic range determines whether or not a drug is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
easily administered safely. |\ |\ |\
Drugs with a narrow therapeutic range are difficult to administer
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
safely. |\
Drugs with a wide therapeutic range can be safely administered
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
much easier. |\
- it is the intended or desired physiological response of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication
,guidelines for administering controlled substances |\ |\ |\ |\
•Store all narcotics in a locked, secure cabinet. Automated
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication dispensing system (AMDS) or a locked room. |\ |\ |\ |\ |\ |\ |\ |\
(Computerized, locked cabinets are preferred.) |\ |\ |\ |\
•Count narcotics frequently, during the opening of narcotic
|\ |\ |\ |\ |\ |\ |\ |\
drawers and/or at shift change. |\ |\ |\ |\
•Report discrepancies in narcotic counts immediately.
|\ |\ |\ |\ |\
•Use a special inventory record each time a narcotic is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dispensed. Records are often kept electronically and provide an
|\ |\ |\ |\ |\ |\ |\ |\ |\
accurate ongoing count of narcotics used, wasted and remaining.
|\ |\ |\ |\ |\ |\ |\ |\
•Use the record to document the patient's name, date, time of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication administration, name of medication, dose, and |\ |\ |\ |\ |\ |\ |\
signature of nurse dispensing the medication. |\ |\ |\ |\ |\
•If you give only part of a premeasured dose of a controlled
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
substance, a second nurse witnesses disposal of the unused |\ |\ |\ |\ |\ |\ |\ |\ |\
portion. Both nurses sign their names on the required form.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Computerized systems record the nurses' names electronically. |\ |\ |\ |\ |\ |\ |\
Do not place wasted portions in the sharps containers. Instead,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dispose of medications properly following institutional policy.
|\ |\ |\ |\ |\ |\
Absorption
the passage of medication molecules into the blood from the site
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of administration.
|\
Factors that affect the rate of absorption
|\ |\ |\ |\ |\ |\
the administration route, ability of a medication to dissolve, blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
flow to the administration site, body surface area, and lipid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
solubility of a medication |\ |\ |\
Distribution
after the medication is absorbed, the medication goes to the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tissues and organs and then to the site of drug action.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,Distribution is affected by |\ |\ |\
circulation, cell membrane permeability, and protein binding
|\ |\ |\ |\ |\ |\
Metabolism
after the medication reaches its site of action, it is metabolized
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
into a less active or inactive form.
|\ |\ |\ |\ |\ |\ |\
This metabolism or biotransfusion takes place under the
|\ |\ |\ |\ |\ |\ |\ |\
influence of enzymes that detoxify, degrade, and remove
|\ |\ |\ |\ |\ |\ |\ |\
biologically active chemicals. |\ |\ |\
Most metabolism takes place in the liver, but the lungs, kidneys,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blood, and intestines also take part in breaking down the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication.
Excretion
the process of medications exiting the body through the lungs,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
exocrine glands, bowel, kidneys, and liver.
|\ |\ |\ |\ |\ |\
A medication's chemical makeup determines the organ of
|\ |\ |\ |\ |\ |\ |\ |\
excretion. Nurses should know the method of excretion for their
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patients' medications, in order to properly provide care.
|\ |\ |\ |\ |\ |\ |\
Types of Medication Action
|\ |\ |\
therapeutic effect |\
side effect |\
adverse effect |\
toxic effect |\
idiosyncratic reaction |\
allergic reaction |\
Therapeutic effect |\
the intended or desired physiological response of a
|\ |\ |\ |\ |\ |\ |\ |\
medication. Some medications have many therapeutic effects |\ |\ |\ |\ |\ |\
side effects|\
, predictable and often unavoidable secondary effects |\ |\ |\ |\ |\ |\
produced at a usual therapeutic drug dose. They can be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
harmless or can cause injury, depending on the dose of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication. |\
Common side effect examples: anorexia, nausea, vomiting,
|\ |\ |\ |\ |\ |\ |\
dizziness, drowsiness, dry mouth, constipation, and diarrhea.
|\ |\ |\ |\ |\ |\
adverse effects |\
unintended, undesirable, and often unpredictable effects |\ |\ |\ |\ |\ |\
ranging from mild (rashes or photosensitivity to light) to
|\ |\ |\ |\ |\ |\ |\ |\ |\
potentially fatal (anaphylaxis). They are sometimes immediately
|\ |\ |\ |\ |\ |\ |\
apparent, and other times they may take weeks to months to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
develop.
toxic effects
|\
develop after prolonged intake of a medication, when a
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication accumulates in the blood because of impaired |\ |\ |\ |\ |\ |\ |\ |\
metabolism or excretion, or when too high a dose is |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
given. |\
Ex: Toxic levels of Morphine, an opioid, cause severe respiratory
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
depression and death. Antidotes are available to treat specific
|\ |\ |\ |\ |\ |\ |\ |\ |\
types of medication toxicity. For example, naloxone, an opioid
|\ |\ |\ |\ |\ |\ |\ |\ |\
antagonist, reverses the effects of opioid toxicity. |\ |\ |\ |\ |\ |\
Idiosyncratic Reactions |\
a response to a medication or therapy that is unique to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
an individual. It is a unpredictable effect in which a patient
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
overreacts or underreacts to a medication or has a reaction
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
different from normal. |\ |\
Allergic Reactions |\
adverse unpredictable responses to a medication.
|\ |\ |\ |\ |\ |\
Exposure to an initial dose of a medication causes a|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patient to become sensitized immunologically. The
|\ |\ |\ |\ |\ |\
Administration latest update |\ |\
Generic name |\
the official name that is listed in official publications such as the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
United States Pharmacopeia (USP) |\ |\ |\
Trade name |\
the name used to market the medication; it has the symbol TM at
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
the upper right of the name indicating a manufacturer trademark
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of the drug
|\ |\ |\
it suggests the action of the drug
|\ |\ |\ |\ |\ |\
What does it mean when a drug is in therapeutic range
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
is a range of plasma drug levels between the minimum
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
effective concentration and the toxic concentration. When |\ |\ |\ |\ |\ |\ |\
plasma levels are within the therapeutic range, there is enough
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
drug present to produce therapeutic responses but not so much
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
that toxicity results. When administering a drug, the objective is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
to maintain plasma drug levels within the therapeutic range. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
width of therapeutic range determines whether or not a drug is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
easily administered safely. |\ |\ |\
Drugs with a narrow therapeutic range are difficult to administer
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
safely. |\
Drugs with a wide therapeutic range can be safely administered
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
much easier. |\
- it is the intended or desired physiological response of a
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication
,guidelines for administering controlled substances |\ |\ |\ |\
•Store all narcotics in a locked, secure cabinet. Automated
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication dispensing system (AMDS) or a locked room. |\ |\ |\ |\ |\ |\ |\ |\
(Computerized, locked cabinets are preferred.) |\ |\ |\ |\
•Count narcotics frequently, during the opening of narcotic
|\ |\ |\ |\ |\ |\ |\ |\
drawers and/or at shift change. |\ |\ |\ |\
•Report discrepancies in narcotic counts immediately.
|\ |\ |\ |\ |\
•Use a special inventory record each time a narcotic is
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dispensed. Records are often kept electronically and provide an
|\ |\ |\ |\ |\ |\ |\ |\ |\
accurate ongoing count of narcotics used, wasted and remaining.
|\ |\ |\ |\ |\ |\ |\ |\
•Use the record to document the patient's name, date, time of
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication administration, name of medication, dose, and |\ |\ |\ |\ |\ |\ |\
signature of nurse dispensing the medication. |\ |\ |\ |\ |\
•If you give only part of a premeasured dose of a controlled
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
substance, a second nurse witnesses disposal of the unused |\ |\ |\ |\ |\ |\ |\ |\ |\
portion. Both nurses sign their names on the required form.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
Computerized systems record the nurses' names electronically. |\ |\ |\ |\ |\ |\ |\
Do not place wasted portions in the sharps containers. Instead,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
dispose of medications properly following institutional policy.
|\ |\ |\ |\ |\ |\
Absorption
the passage of medication molecules into the blood from the site
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
of administration.
|\
Factors that affect the rate of absorption
|\ |\ |\ |\ |\ |\
the administration route, ability of a medication to dissolve, blood
|\ |\ |\ |\ |\ |\ |\ |\ |\
flow to the administration site, body surface area, and lipid
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
solubility of a medication |\ |\ |\
Distribution
after the medication is absorbed, the medication goes to the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
tissues and organs and then to the site of drug action.
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
,Distribution is affected by |\ |\ |\
circulation, cell membrane permeability, and protein binding
|\ |\ |\ |\ |\ |\
Metabolism
after the medication reaches its site of action, it is metabolized
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
into a less active or inactive form.
|\ |\ |\ |\ |\ |\ |\
This metabolism or biotransfusion takes place under the
|\ |\ |\ |\ |\ |\ |\ |\
influence of enzymes that detoxify, degrade, and remove
|\ |\ |\ |\ |\ |\ |\ |\
biologically active chemicals. |\ |\ |\
Most metabolism takes place in the liver, but the lungs, kidneys,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
blood, and intestines also take part in breaking down the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication.
Excretion
the process of medications exiting the body through the lungs,
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
exocrine glands, bowel, kidneys, and liver.
|\ |\ |\ |\ |\ |\
A medication's chemical makeup determines the organ of
|\ |\ |\ |\ |\ |\ |\ |\
excretion. Nurses should know the method of excretion for their
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patients' medications, in order to properly provide care.
|\ |\ |\ |\ |\ |\ |\
Types of Medication Action
|\ |\ |\
therapeutic effect |\
side effect |\
adverse effect |\
toxic effect |\
idiosyncratic reaction |\
allergic reaction |\
Therapeutic effect |\
the intended or desired physiological response of a
|\ |\ |\ |\ |\ |\ |\ |\
medication. Some medications have many therapeutic effects |\ |\ |\ |\ |\ |\
side effects|\
, predictable and often unavoidable secondary effects |\ |\ |\ |\ |\ |\
produced at a usual therapeutic drug dose. They can be
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
harmless or can cause injury, depending on the dose of the
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
medication. |\
Common side effect examples: anorexia, nausea, vomiting,
|\ |\ |\ |\ |\ |\ |\
dizziness, drowsiness, dry mouth, constipation, and diarrhea.
|\ |\ |\ |\ |\ |\
adverse effects |\
unintended, undesirable, and often unpredictable effects |\ |\ |\ |\ |\ |\
ranging from mild (rashes or photosensitivity to light) to
|\ |\ |\ |\ |\ |\ |\ |\ |\
potentially fatal (anaphylaxis). They are sometimes immediately
|\ |\ |\ |\ |\ |\ |\
apparent, and other times they may take weeks to months to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
develop.
toxic effects
|\
develop after prolonged intake of a medication, when a
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication accumulates in the blood because of impaired |\ |\ |\ |\ |\ |\ |\ |\
metabolism or excretion, or when too high a dose is |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
given. |\
Ex: Toxic levels of Morphine, an opioid, cause severe respiratory
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
depression and death. Antidotes are available to treat specific
|\ |\ |\ |\ |\ |\ |\ |\ |\
types of medication toxicity. For example, naloxone, an opioid
|\ |\ |\ |\ |\ |\ |\ |\ |\
antagonist, reverses the effects of opioid toxicity. |\ |\ |\ |\ |\ |\
Idiosyncratic Reactions |\
a response to a medication or therapy that is unique to
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
an individual. It is a unpredictable effect in which a patient
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
overreacts or underreacts to a medication or has a reaction
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
different from normal. |\ |\
Allergic Reactions |\
adverse unpredictable responses to a medication.
|\ |\ |\ |\ |\ |\
Exposure to an initial dose of a medication causes a|\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patient to become sensitized immunologically. The
|\ |\ |\ |\ |\ |\
