Nursing Process & Drug Therapy
Pharmacology Final Exam Review
In a prescription what must you have: o nameofthemed
o route- (no route call the Dr. and verify it) o date/time
o dose
o time/frequency of med
o Dr.s
...
Nursing Process & Drug Therapy
Pharmacology Final Exam Review
In a prescription what must you have: o nameofthemed
o route- (no route call the Dr. and verify it) o date/time
o dose
o time/frequency of med
o Dr.signature
If you don’t understand the prescription:
o hold med & call the Dr.
Types of meds that cannot be crushed: o Enteric coated (EC)
o Long acting (extended release) o Sustainedaction(SA)
o SustainedRelease(SR)
If crushed it loses the effect, it will also dissolve sooner than it is supposed to increasing toxicity. DO NOT CRUSH!!
Do a pre assessment:
o Whatmedicationsisthepatienttaking
o Baselineofmedication
o Allergies
o OTCmedscurrentlytaking
o If taking Digoxin- check the Apical HR (60-100); if HR less than 60 CANNOT give
Digoxin; also check Digoxin level & K+ (if K+ level is high, it decreases the effect of
Digoxin; if the potassium level is low, increases the effect of Digoxin)
o ForBetaBlockers-checkifpulseislessthan60(Iflessthan60donotgivebeta
blocker), after the med is given you always Assess
o Diuretics- always give in the A.M (check K+ level, electrolyte levels, vital signs *mostly
BP, weight the pt, intake/output of pt)
Purpose of 9 rights of drug administration:
o to avoid medication error of OD (Safety of drug administration)
o rightmed,righttime,rightpatient,rightdose,righttorefuse,rightroute,right
documentation, right reason, & right response to med
o use2identifierstocheckpt
o read medication level 3 times!
o newborn-checkthemother’sidentifier/olderchildren-checktheparent’sidentifiers
o elderly-2identifiers;ifconfused(donotaskptforthename)
o give med 30 min before or 30 min after the due time (right time)
o TID:3times/day;BID:2times/day;QID:4times/day;DONOTuseQD(writetheword
Daily)
Pharmacokinetics:
o What the body does to the drug
o Four Principles of Pharmacokinetics:
Absorption (Route) depends on the site:
Parenteral goes 1st because- it bypasses 1st pass effect, so it has a
bioavailability of 100%, IV has more effect than oral
Oral: has the 1st pass effect, the bioavailability is 80%
Sublingual: under the tongue because of increase in vascularity
bypasses the 1st pass effect 100% bioavailability
Buccal: between the cheeks & the upper/lower molar & rotate, with
vascularity you also will bypass the 1st pass effect 100% bioavailability
Distribution- also depends on the site (high/more vascularity = more
distribution of the med)
Plasma protein affects distribution of meds (Albumin)
Albumin meds are highly protein bound so it attaches to the receptor
& once attached they remain in the bloodstream & the rest of meds
are free to go
2 meds together compete & can cause toxicity
Metabolism AKA (Biotransformation)- the main organ is the Liver
Is the process by which the body inactivates drugs
If you have liver problems- higher chances of toxicity because
medication cannot be broken down
Elderly & Newborns are at higher risk due to immature liver
Excretion- the main organ is the Kidney
If patient has renal failure cannot excrete the drugs so higher chances
of toxicity to occur; also newborns have immature kidneys so they as well are at higher risk of toxicity
o Half-LifeofaDrug:
Is the time required for 1 half of the medication to be removed from the body
EX: 800mg, half-life is every 8 hrs. Within 24 hrs. how much of the drug will be left/remain? 1st half life is 400; 2nd is 200; 3rd is 100 so the half-life is 100
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