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NSG 124 Pharmacology EXAM I Test Plan
Unit 1 Module 1 and 2
Assessing Pain and pain management: a. defining goals b. identifying interventions c. evaluating success
Location NSG124.01.01.01
Student Notes DEFINING GOALS- THE GOAL OF DRUG THERAPY IS TO PRODUCE MAXIMUM BENEFIT WITH MINIMAL HARM. *MAXIMIZE THERAPEUTIC RESPONSES WHILE PREVENTING OR MINIMIZING ADVERSE REACTIONS* IDENTIFYING INTERVENTIONS- THE NURSE MUST CONSIDER DOSAGE AND ROUTE OF ADMINISTRATION AS WELL AS TIMING (WITH RESPECT TO MEALS AND OTHER DRUGS). FOUR MAJOR GROUPS: -DRUG ADMINISTRATION. -INTERVENTIONS TO ENHANCE THERAPEUTIC EFFECTS. -INTERVENTIONS TO MINIMIZE ADVERSE EFFECTS AND INTERACTIONS. -PATIENT EDUCATION. EVALUATING SUCCESS- SUMMARY OF MONITORING, EVALUATING THERAPEUTIC EFFECTS, MINIMIZING ADVERSE EFFECTS AND INTERACTIONS, AND MANAGING TOXICITY. THE PATIENT MUST BE EVALUATED FOR: -THERAPEUTIC RESPONSES. -ADVERSE DRUG REACTIONS AND INTERACTIONS. -ADHERENCE TO PRESCRIBED REGIMEN. -SATISFACTION WITH TREATMENT.
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Drug Names a. Generic b. Proprietary
Over the Counter Meds a. Assessment b. Education, Medication food interactions
NSG124.01.01.02
NSG124.01.01.03 x2
NONPROPRIETARY (GENERIC)- LESS COMPLEX THAN THE CHEMICAL NAME; FINAL SYLLABULS INDICATE PHARM CLASS. *HAS ONLY ONE* PROPRIETARY (BRAND)- NAMES UNDER WHICH A DRUG IS MARKETED; CREATED BY DRUG COMPANIES. *SINGLE DRUG MAY HAVE SEVERAL* OTC MEDS: ASSESSMENT- WHEN USED PROPERLY, THEY PROVIDE RELIEF FOR MANY ALIMENTS WHILE SAVING CONUSMERS THE EXPENSE AND INCONVINENCE OF VISITING PERSCRIBER. EDUCATION- NEWSLETTERS, REFERENCE BOOKS, AND THE INTERNET. MEDICATION FOOD INTERACTIONS- MAY RESULT IN TOXICITY OR THERAPEUTIC FAILURE. IMPACT OF FOOD ON DRUG ABSORPTION: -DECREASED ABSORPTION. -INCREASED ABSORPTION. -IMPACT ON DRUG METABOLISM. -IMPACT ON DRUG TOXICITY. -TIMING. NOTE ACTUAL FOOD INTERACTIONS
Major Pharmacokinetics Processes: a. Medication absorption b. Medication distribution c. Medication metabolism d. Medication excretion Assessment and Evaluation
NSG 124.01.01.04 x2
MEDICATIOIN ABSORPTION- THE MOVEMENT OF A DRUG FROM SITE OF ADMINISTRATION TO BLOOD; THE RATE DETERMINES HOW SOON THE EFFECTS WILL BEGIN. *AMOUNT OF ABSORPTION DETERMINES HOW INTENSE THE EFFECTS WILL BE* MEDICATION DISTRIBUTION- DRUG MOVEMENT FROM THE
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BLOOD TO INTERSTITIAL SPACE OF TISSUES AND INTO CELLS. MEDICATION METABOLISM- BIOTRANSFORMATION: DEFINED AS CHEMICAL ALTERATION OF DRUG STRUCTURE. THERAPEUTIC CONSEQUENCES: -ACCELERATED RENAL EXCRETION. -DRUG INACTIVATION. -INCREASES THERAPEUTIC ACTION. -ACTIVATION OF “PRO-DRUGS.” -INCREASED AND DECREASED TOXICITY.
Drug levels and half life a. Half-life b. First-pass effect c. Renal Medication excretion d. Therapeutic Index
NSG124.01.01.05 x2
MEDICATION EXCRETION- PROCESS OF DRUG REMOVAL FROM THE BODY. HALF-LIFE- THE TIME REQUIRED FOR THE AMOUNT OF DRUG IN THE BODY TO DECREASE BY 50%; CAN BE MINUTES OR EXCEED A WEEK. SHORT- LEAVE QUICKLY. LONG- LEAVE SLOWLY. FIRST-PASS EFFECT- RAPID HEPATIC INACTIVATION OF SOME ORAL DRUGS; *OCCURS DURING METABOLISM* RENAL MEDICATION EXCRETION-THE MAJORITY OF THE DRUGS ARE METABOLISED THROUGH THE KIDNEY. THERAPEUTIC INDEX- A MEASURE OF A DRUGS SAFETY AND DETERMINED USING LABORATORY ANIMALS. LARGE INDEX- INDICATES A DRUG IS RELATIVELY SAFE. SMALL INDEX- INDICATES A DRUG IS RELATIVELY UNSAFE.
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Drug to Drug Interactions a. Adverse effects b. Therapeutic effects c. Enhance or decrease effects
NSG123.01.02.01
Toxicities and Assessment Skills a. Adverse Reactions b. Side Effect c. Toxicity d. Allergic Reaction e. Idiosyncratic Effect f. Paradoxical Effect g. Iatrogenic Disease h. Physical Dependence i. Carcinogenic Effect j. Teratogenic Effect Organ Specific a. Hepatotoxic b. QT Interval
NSG124.01.02.04
ADVERSE EFFECTS- UNEXPECTED OUTCOMES. THERAPEUTIC EFFECTS-EXPECTED OUTCOMES. ENHANCE OR DECREASE EFFECTS-INTERACTIONS THAT CAN REDUCE OR ENHANCE THE EFFECTS OF THE DRUG. ADVERSE REACTIONS- ANY NOXIOUS, UNINTENDED, AND UNDESIRED EFFECT THAT OCCURS AT NORMAL DRUG DOSES. *WE DON’T WANT* SIDE EFFECT- UNAVOIDABLE SECONDARY DRUG EFFECT PRODUCED AT THERAPEUTIC DOSES. TOXICITY- THE DEGREE OF DETRIMENTAL PHYSIOLOGICAL EFFECTS CAUSED BY EXCESSIVE DRUG DOSING. ALLERGIC REACTION- AN IMMUNE RESPONSE; THERE MUST BE A PRIOR SENSITIZATION OF THE IMMUNE SYSTEM. IDIOSYNCRATIC EFFECT- UNCOMMON DRUG RESPONSE RESULTING FROM A GENETIC PREDISPOSITION. *GENETIC MALFORMATION* PARADOXICAL EFFECT- THE OPPOSITE OF THE INTENDED DRUG RESPONSE. *WHAT YOU EXOECT TO SEE, EXPECTED RESPONSE* IATROGENIC DISEASE- A DISEASE THAT OCCURS AS THE RESULT OF MEDICAL CARE OR TREATMENT. (DISEASE PRODUCED BY DRUGS). PHYSICAL DEPENDENCE- A STATE IN WHICH THE BODY HAS ADAPTED TO DRUG EXPOSURE IN SUCH A WAY THAT ABSTINENCE SYNDROME WILL RESULT IF DRUG USE IS DISCONTINUED.
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CARCINOGENIC EFFECT- ABILITY OF CERTAIN MEDICATIONS AND ENVIORNMENTAL CHEMICALS TO CAUSE CANCERS. TETRATOGENIC EFFECT- A DRUG-INDUCED BIRTH DEFECT. *MEDICINES AND OTHER CHEMICALS CAPABLE OF CAUSING BIRTH DEFECTS ARE CALLED TERATOGENS* HEPATOTOXIC-DRUGS THAT UNDERGO METABOLISM BY THE LIVER AND ARE CONVERTED TO TOXIC PRODUCTS THAT CAN INJURE LIVER CELLS.
Med Errors Reporting and Reduction a. Types of Errors 1. Human 2. Communication 3. Name confusion
NSG124.01.02.05
QT INTERVAL-ABILITY OF SOME MEDICATIONS TO PROLONGTHE QT INTERVAL ON THE ELECTROCARDIOGRAM. *CREATING A RISK OF SERIOUS DYSRYTHMIAS* TYPES OF ERRORS: WRONG PATIENT, WRONG DRUG, WRONG ROUTE, WRONG TIME, WRONG DOSE, OMITTED DOSE, WRONG DOSAGE FORM, WRONG DILUENT, WRONG STRENGHT, WRONG INFUSION RATE, WRONG TECHNIQUE, DETERIORATED DRUG ERROR (EXPIRED), AND WRONG DURATION. HUMAN FACTORS: PERFORMANCE DEFICIT, KNOWLEDGE DEFICIT, MISCALCULATION OF DOSAGE, DRUG PREPERATION ERROR, COMPUTER ERROR, STOCKING ERROR, TRANSCRIPTION ERROR, STRESS, AND FATIGUE OR LACK OF SLEEP. COMMUNICATION: WRITTEN COMMUNICATION AND ORAL COMMUNICATION. NAME CONFUSION: BRAND NAME AND GENERIC NAME CONFUSION.