PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION, Exams of Nursing

Download PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION and more Exams Nursing in PDF only on Docsity! PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION 1. Applying the Nursing process to drug therapy ● Assessment: Gather information such as pt history, assessment of the specific drug, pt lab tests and observations to determine how the pt and medication are compatible ● Analysis: 3 things- Judge the appropriateness of the prescribed regimen, Identify potential health problems medication could cause, Determine the pt’s capacity for self-care ● Planning: define goals, set priorities, identify nursing interventions needed, establish what you will for in evaluation ● Implementation: administer drug, educate pt (on dosage size, dosage schedule, route, expected outcome, method storage,etc.), minimize bad effects ● Evaluation: check for therapeutic response, drug reaction, interaction, satisfaction, adherence 2. Drug properties and the ideal ● Effectiveness: elicits a response ● Safety: cannot produce harmful effects, although adverse effect cannot be fully avoided ● Selectivity: a drug that gives only the response for which it is given for (no drug is wholly selective) ● Reversible reaction PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION ● Predictability ● Ease of Administration ● Freedom of drug interactions ● Low cost ● Chemical stability ● Simple generic name 3. Medication Administration Safely ● Right medication ● Right dosage ● Right patient ● Right route ● Right time ● The Food, Drug and Cosmetic Act of 1938: congress required that all drugs undergo testing for safety PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION - Drug responses that do not involve receptors: simple physical or chemical interactions with other small molecules (antacids, antiseptics, saline laxatives, chelating agents) - Interpatient variability in drug responses: the dose required to produce a therapeutic response can vary substantially among pt’s (initial dose of drug is an approximation, subsequent is “fine tuned”) - The therapeutic index: measure of drug’s safety LD50/ED50 (the higher the therapeutic index, the safer the drug) (ch.5) PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION 5. Recognizing medical errors - Medical Error: Any preventable event that may cause or lead to inappropriate med use or pt harm, while the med is in the control of the healthcare professional, pt, or consumer - Wrong time - Wrong pt PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION - Wrong route - Wrong dose (overdose) - Omitted dose - Wrong dose form - Wrong diluent - Wrong strength - Wrong infusion rate - Wrong technique - Communication, confirming pt name, checking appropriate packaging, checking behind healthcare team and computers - The nurse is the last person of sequence and thus the first line of defense 6. Variation in drug response -because of individual variation, we must tailor drug therapy to each patient. In this chapter, we discuss the major factors that can cause one patient to respond to drugs differently than another. With this information, you will be better prepared to reduce individual variation in drug responses, thereby maximizing the benefits of treatment and reducing the potential for harm. - Key factors that cause one patient to react differently to a medication than another patient. ● Body weight and composition PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION ➢ Metabolic tolerance: tolerance resulting from accelerated drug metabolism. This form of tolerance is brought about by the ability of certain drugs (eg, barbiturates) to induce synthesis of hepatic drug-metabolizing enzymes, thereby causing rates of drug metabolism to increase. ➢ Tachyphylaxis: a reduction in drug responsiveness brought on by repeated dosing over a short time ● Gender ➢ Alcohol is metabolized more slowly by women than by men. ➢ Certain opioid analgesics are much more effective in women than in men. ➢ Quinidine causes greater QT interval prolongation in women than in men. ● Race ➢ Genetic variations ➢ Psychosocial factors PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION ● Failure to take medicine as prescribed ➢ Issues include manual dexterity, visual acuity, intellectual capacity, psychologic state, attitude toward drugs, and ability to pay for medication. ● Drug interactions ➢ One drug alters the effects of another. ● Diet ➢ Starvation reduces protein binding of drugs, which increases levels of free drugs. 7. Over the Counter Drugs (OTC) ● Americans spend about $20 billion annually on OTC drugs. ● OTC drugs account for 60% of all doses administered. ● 40% of Americans take at least one OTC drug every 2 days. ● Four times as many illnesses are treated by a consumer using an OTC drug as by a consumer visiting a physician. ● With most illnesses (60%–95%), initial therapy consists of self-care, including self-medication with an OTC drug. ● The average home medicine cabinet contains 24 OTC preparations. PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION 8. Acetaminophen ● there is a range of plasma drug levels, falling between the MEC and the toxic concentration, that is termed the therapeutic range. When plasma levels are within the therapeutic range, there is enough drug present to produce therapeutic responses but not so much that toxicity results. The objective of drug dosing is to maintain plasma drug levels within the therapeutic range. ● The width of the therapeutic range is a major determinant of the ease with which a drug can be used safely. Drugs that have a narrow therapeutic range are difficult to administer safely. Conversely, drugs that have a wide therapeutic range can be administered safely with relative ease. Acetaminophen, for example, has a relatively wide therapeutic range: The toxic concentration is about 30 times greater than the MEC. Because of this wide therapeutic range, the dosage does not need to be highly precise; a broad range of doses can be employed to produce plasma levels that will be above the MEC and below the toxic concentration. In contrast, lithium (used for bipolar disorder) has a very narrow therapeutic range: The toxic concentration is only 3 times greater than the MEC 9. Aspirin (salicylate) ● A side effect is formally defined as a nearly unavoidable secondary drug effect produced at therapeutic doses. Common examples include drowsiness caused by traditional antihistamines and gastric irritation caused by aspirin ● Other drugs noted for causing allergic reactions include the nonsteroidal antiinflammatory drugs (eg, aspirin) ● Aspirin and related drugs, when taken chronically in high therapeutic doses, can cause life-threatening gastric PHARMACOLOGY FINAL EXAM TEST1 STUDY GUIDE BEST GUIDE SOLUTION