NURSB-261 1st Edition Exam # 1 Study Guide Lectures: 1 - 6Lecture 1 (January 12)Introduction to Pharmacology/PathophysiologyI. Introduction1. Pathophysiology-The study of functional changes associate with or resulting from disease or injury2. Pharmacology-The study of drug therapyDrugs are indicated in REDPharmacotherapeutics Study of the therapeutic uses of drugsPharmacokinetics Movement of drugs within the bodyPharmacodynamics Effects of the drugs and the action the drug produces on the bodyContraindications A factor that prohibits the administration of a drugPrecautions A measure taken in advance to prevent somethingAdverse effects Harmful or unintended reactionDrug interactions Alteration of a drug through a reaction with another drug, food, or existing medical conditionsPrototype drug First form of a drug used to create alternative drugsDrug Response How the drug is absorbed, metabolized, used, and eliminatedP450 Group of isozymes responsible biotransformation of many drugsLoading dose Initial higher dose of a drugBlood brain barrier Blocks passage of certain substance trying to get the brainHealth status Holistic concept that measures wellnessDrug classifications Different ways to organize different types of drugsPharmacogenomics Study of how genes affect a person’s response to drugsPharmacogenetics Study of certain genetic factors on reactions to drugsGeneric Name Non commercial name; name by which nurses order drugsAgonist Initiate a responseAntagonist Block a responseTherapeutic index Ration comparing a safe dose to the unsafe doseMaintenance dose Amount of drug required to reach a steady stateTherapeutic range Dosage range expected to produce therapeutic effectsSteady state Occurs when the full dosage is present in the body (about 5-6 half lives)3. Pharmacotherapeutics-Answers, “Why is the patient taking the drug?”-The intended use of the drug4. Pharmacokinetics-Changes that occur to the drug as it moves through the body5. Pharmacodynamics-The effects of the drug on the body- Therapeutic effects- Adverse effects6. Important Patient Variables-Health status- The presence of disease, illness, or allergy; chronic condition causing system or organ dysfunction; diminished memory or mental capacity, etc.-Life span and gender- Age, physiologic development, reproductive stage, and gender -Lifestyle, diet, and habits- Amount of activity and exercise; sleep-wake patterns; occupation; financial resources or access to health insurance coverage to offset the cost of the drug, or both; eating preferences, etc. -Environment- Location in which the dug therapy will be administered, such as hospital, home, or long-term care facility; properties of the physical environment that may alter a drug’s action -Culture and inherited traits- Religious, social, and ethnic background that may affect the individual’s receptiveness to drug therapy II.Nursing Management of Drug Therapy1. Nursing Management-The process of planning and implementing actions that will maximize the therapeutic effects and minimize the adverse reactions of drugs2. The Nursing Process-Assessment - Identify core drug knowledge- Identify patient’s medicationo Polypharmacy?o Know the generic name- Patient interview and historyo Allergies?o Use open-ended questionso Go over core patient variables- Physical examinationo Evaluate each body system- Medical records-Diagnosis- Reflect a current, actual problem or the risk for developing a problem related to drug therapy- Highly individualized for the patient-Outcome Identification- Outcomes determine the desired resulto Must be specific, measurable, and in the time-frame- What do we want the patient to get out of the therapy?-Planning- How will you maximize therapeutic effects?o Promote absorption: take on empty stomach if instructed to do soo Take medication at appropriate timeo Monitor lab values- How will you minimize adverse effects?o Verify patient allergieso Monitor the patiento Identify drug contraindications-Interventions- Stop drug therapy if necessary-Evaluation- Measure the patient’s progress- Consider whether the drug achieved the desired effect- Identify the reason behind any treatment failureIII.Sources of Drugs1. Plants2. Animals3. Synthetic chemicals4. Genetically engineered chemicalsIV.Drug Nomenclature1. Chemical name-Precisely describes the drug’s atomic and molecular structure2. Generic name-Nonproprietary name-Identifies the drug’s active ingredient-Order drug by this name3. Trade name-Brand or proprietary nameV. Classes of Controlled Substances1. C-I: HIGH Abuse-Example: Heroin2. C-II: HIGH Abuse-Example: Morphine3. C-III: MODERATE Abuse-Example: Steroids4. C-IV: LOW Abuse-Example: Valium5. C-V: LIMITED Abuse-Example: Coughing syrupVI.Administering Medication1. Legally responsible-Responsible for all drugs nurses administer-Always assess patient before and after the administration of medications2. Effects of Medication-Local effects- Exert effects on site of administration-Systemic effects- Widespread reaction to druganaphylactic shockVII.Routes of Medication1. Medication Safety-Right patient-Right drug-Right time-Right dose-Right route2. Enteral Route-Gastrointestinal tract is used for the ingestion and absorption of drugs-Drug usually goes through first-pass metabolism and might require a higher dose -Oral forms Tablets- Sublingual and Buccal tablets- Troches- Capsules- Syrups- Elixirs- Emulsions and suspensions- NG or G tube for sedated or incubated patients-Patient Variables- Health Statuso Can the patient swallow the drug?- Life span and gendero Do not give elixirs to children-they contain alcoholo High sugar syrups can cause dental caries-Therapeutic Effects- Take at the right time- With or without food?-Adverse Effects- Drugs with enteric coatings should not be crushed, chewed, or brokeno Enteric coatings help slow down digestion- Before drug administration through NG or G tube, ensure proper tube placement3. Parenteral Route-IV, IM, or SQ- Intradermal: under the skin- Intra-articular: into the joint- Intra-articular: into the artery- Intrathecal: into the spinal cavity-Drug bypasses the GI system and usually escapes going through first-pass effect- Might need a lower dose-Faster onset because it avoids erratic absorption-Health Status- A parenteral route may be chose if the patient cannot tolerate oral drugs-Life span and gender- Infants have a smaller mass- Elderly people have decreased muscle mass and