Principle of Pharmacology

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Questions and Answers

Which of the following is a common medical error?

Inappropriate prescribing of the drug (correct)

Proper technique when administering drug

Correct preparation of a drug

Administering medication on schedule

It is acceptable to leave prepared drugs unattended in order to complete other tasks.

False

What should a nurse do if a medication error occurs?

Check the patient for adverse effects, notify the nurse manager and physician, and document the error in the EMR.

A __________ system helps to prevent medication errors by utilizing barcodes.

Bar-code Medication Signup and view all the answers

Match the following medical errors with their descriptions:

Inappropriate prescribing = Wrong medication prescribed Omitted doses = Missed administering scheduled medication Administering wrong route = Providing medication via incorrect method Incorrect drug preparation = Preparing medication mistakenly Signup and view all the answers

What is the initial step in the drug regimen process for preventing errors?

Avoiding interruptions and distractions Signup and view all the answers

Patients should be educated on the name, dose, action, and frequency of their medication before administration.

True Signup and view all the answers

Name one reason why a drug might be administered incorrectly.

Administering medication to the wrong patient. Signup and view all the answers

What does the National Drug Code (NDC) number identify?

A specific drug Signup and view all the answers

Generic names of drugs are owned by pharmaceutical companies.

False Signup and view all the answers

What is the main difference between a generic drug and its trade name?

A generic drug is identified by its active ingredient, while a trade name is the brand name selected by a pharmaceutical company. Signup and view all the answers

The __________ indicates when a drug reaches its highest blood concentration.

peak action Signup and view all the answers

Match the following medication identifiers with their descriptions:

Onset of Action = Time to reach minimum effective concentration Dose = Amount available in the product Expiration Date = Date after which the drug should not be used Lot Number = Specific drug batch used for recalls Signup and view all the answers

Which of the following factors can affect drug action?

All of the above Signup and view all the answers

Documentation of medication administration is optional.

False Signup and view all the answers

What is meant by 'slow or continuous release' in medication?

It refers to medications designed to release the drug over an extended period to maintain consistent therapeutic levels. Signup and view all the answers

The __________ indicates whether a drug is prescription only.

Prescription Status Signup and view all the answers

Which medication form refers to a preparation designed for oral use in a dissolving format?

Troche Signup and view all the answers

What is the primary function of pharmacokinetics?

The effect that the body has on a drug Signup and view all the answers

An adverse effect of a drug is always predictable.

False Signup and view all the answers

What is the main organ responsible for drug metabolism?

Liver Signup and view all the answers

The ________ is usually the main route for drug excretion.

kidney Signup and view all the answers

Which of the following is NOT one of the 9 Rights of Medication Administration?

Right Storage Signup and view all the answers

Match the following types of medication orders with their descriptions:

Standing Order = Carried out until canceled PRN = As needed based on patient request Stat Order = Immediate one-time order Signup and view all the answers

Med checks involve comparing the medication to the MAR before administration.

True Signup and view all the answers

Name one factor that affects the absorption of a drug.

Route of Administration Signup and view all the answers

A ________ effect is a non-therapeutic reaction to a drug that may be either desirable or undesirable.

side Signup and view all the answers

Which of the following is a factor affecting drug distribution in the body?

Lipid solubility Signup and view all the answers

Which of the following is a step in the prevention of medication errors?

Avoiding interruptions and distractions Signup and view all the answers

It is essential to recount controlled substances during each off-going shift.

True Signup and view all the answers

What should a nurse do immediately after realizing a medication administration error?

Check the patient for adverse effects and inform the nurse manager and physician. Signup and view all the answers

A __________ is required when wasting a narcotic, and it involves another nurse as a witness.

count Signup and view all the answers

Match the following types of medication errors with their descriptions:

Inappropriate prescribing = Prescribing a drug unsuitable for the patient Wrong patient administration = Giving medication to the incorrect individual Expired drug = Administering medication past its expiration date Incorrect preparation = Failing to prepare medication as per guidelines Signup and view all the answers

What action should a nurse NOT take to prevent medication errors?

Leave prepared drugs unattended Signup and view all the answers

Documentation of medication administration is mandatory for all errors.

True Signup and view all the answers

Describe what the term 'BARCODE medication system' refers to in medication administration.

A system that uses barcodes to verify patient, medication, and dosage. Signup and view all the answers

Which of the following identifiers is used specifically to identify a drug's specific batch for recall information?

Lot Number Signup and view all the answers

The trade name of a drug is universally accepted and owned by a single pharmaceutical company.

False Signup and view all the answers

What does NDC stand for in medication identifiers?

National Drug Code Signup and view all the answers

The __________ indicates the duration of time that a drug maintains its effect.

duration Signup and view all the answers

Match the following medication identifiers to their definitions.

Drug Dose = Dose available in the product Warnings = Specific drug warnings Administration = Indicates route and dosage Drug Manufacturer = Pharmaceutical house that produces the drug Signup and view all the answers

Which factor is NOT typically considered when assessing drug action?

Caffeine Consumption Signup and view all the answers

Pharmacological effects of medication are not influenced by the patient's environment.

False Signup and view all the answers

Name one medication form that allows for slow or continuous release.

Extended Release (ER) tablet Signup and view all the answers

The __________ occurs when a drug reaches its highest concentration in the blood.

peak action Signup and view all the answers

What factors can affect the onset of action for a medication?

All of the above Signup and view all the answers

Which term describes a pharmacological event that is unpredictable and considered dangerous?

Adverse Effect Signup and view all the answers

Drug interactions can only occur when the patient takes an incorrect dose of medication.

False Signup and view all the answers

Name one factor that affects the absorption of a drug.

Route of administration Signup and view all the answers

The primary organ responsible for drug metabolism is the __________.

liver Signup and view all the answers

Match the following types of medication orders with their descriptions:

Standing Order = Carried out until canceled by another order PRN = Received as needed by a patient Stat Order = Immediate order to be carried out at once Routine Order = Same as standing order but with specific instructions Signup and view all the answers

What is a common risk associated with impaired renal function?

Toxicity in the body Signup and view all the answers

The 9 Rights of Medication Administration include checking the right patient, right dose, and right documentation.

True Signup and view all the answers

What is one of the three med checks a nurse must perform?

When the nurse reaches for the unit dose package Signup and view all the answers

A __________ is a medication order that is carried out immediately only one time.

Stat order Signup and view all the answers

Which factor does NOT affect drug distribution in the body?

Time of day Signup and view all the answers

Study Notes

Medication Management

Medications on hand must be counted and accounted for daily.
Off-going shifts should complete a controlled substance count.
A witness is required when counting and wasting narcotics.

Common Medication Errors & Prevention

Common medication errors include:
- Inappropriate prescribing
- Extra, omitted, or wrong doses
- Administering to the wrong patient
- Wrong route or rate
- Failure to administer within the prescribed time frame
- Incorrect drug preparation
- Improper administration technique
- Expired or deteriorated medication
If a medication error occurs:
- Check the patient for adverse effects
- Advise the nurse manager and physician
- Document the error in the EMR and quality assurance documentation (incident report)
Prevention strategies include:
- Drug Regimen Process: Avoidance of interruption and distractions
- Series of Checks: By nurse and patient.
- Reporting Medication Errors
Never leave prepared medications unattended.

Bar-code Medication System

Patients have unique identifiers (ID, Stickers)
Nurses have unique barcodes
Drugs have unique barcodes that identify:
- Drug form
- Dosage
- National Drug Code (NDC)
Administering Medication:
- Scan the patient ID first, then the drug
  - If correct, the system will allow medication administration
  - If incorrect, the system will prevent administration.

Patient Teaching

Explain the medication and its effects in understandable language before administration.
Common teaching topics include:
- Drug name
- Drug dose
- Drug action
- Frequency of administration
- Storage and preparation (discharge)
Encourage patients to restate the information to ensure understanding.

Patient Assessment

Ongoing or after medication administration
Vital signs and head-to-toe assessment.
Some medications have special instructions/limitations
Nursing Diagnoses are developed based on assessment data.
Patient-centered outcomes are evaluated after implementing a plan of care.

Medicine/Med Identifiers

Generic vs. Trade
- Generic: Identifies the drug's active ingredient or chemical name (universally accepted).
- Trade: Selected by the pharmaceutical company that sells the drug (protected by trademark).
Form of the Drug: Determines the route of administration
Slow or Continuous Release:
- Some tablets are enteric coated (prevent stomach irritation)
12 Common Drug Identifiers
- National Drug Code (NDC)
- Generic Name
- Brand Name
- Drug Dose
- Warnings
- Administration
- Prescription Status
- Drug Manufacturer
- Quantity
- Storage Information
- Lot Number
- Expiration Date

Onset, Peak, & Duration

Onset of Action: Time it takes to reach the minimum effective concentration after drug administration.
Peak Action: When the drug reaches its highest blood concentration.
Duration: Length of time the drug has an effect.

Medication Documentation

Name of medication
Dosage
Route and time of administration
Nurse initials
Intentional or inadvertently omitted drugs
Refused drugs
Medication errors

Factors Affecting Drug Action

Developmental considerations
Weight
Biological sex
Cultural and genetic factors
Psychological factors
Pathology (Presence of disease)
Environment
Time of administration

Side Effect vs. Adverse Effect (Interactions)

Side Effects: Non-therapeutic drug reaction (can be desirable or undesirable).
Adverse Effects: Unpredictable pharmacological event (considered dangerous).
Drug Interactions: Patient sensitivity, allergic effect, incorrect dose.

Pharmacokinetics vs. Pharmacodynamics

Pharmacokinetics: The effect of the body on a drug.
- Absorption: Transportation of the drug from its site of entry.
  - Influencing Factors: Route of administration, Lipid solubility, pH, Blood flow, Location and condition of administration site, Drug dose.
- Distribution: Transportation of drug molecules throughout the body.
  - Depends on: Circulation, protein binding capacity, blood-brain barrier.
- Metabolism: Breakdown of an active drug into an inactivated or new form (primarily by the liver).
- Excretion: Removal of the drug from the body (primarily by the kidneys). Factors impacting excretion: Impaired renal function, age, disease.
Pharmacodynamics: How drugs act on specific target cells to alter cellular function.

Drug Orders

Standing Order (Routine Order): Carried out until canceled.
PRN (As Needed): Administered when requested by the patient or required by the physician based on specific criteria. (Pain, nausea, sleep medications).
Stat Order: Immediate, one-time order carried out at once.
Seven Parts of a Medication Order:
- Patient Name
- Date & Time of Order
- Drug Name
- Dosage
- Route of Administration
- Frequency
- Signature of Person Writing the Order

9 Rights of Administration

Right Medication
Right Patient
Right Dose
Right Route
Right Time
Right Reason
Right Assessment
Right Documentation
Right Response

Medication Checks

Three Medication Checks:
- When the nurse reaches for the unit dose package
- After retrieval from the drawer and compared with the MAR
- Before giving the unit dose medication to the patient

Controlled Substances

Record of narcotics administered should be kept.
Amount of controlled substances must be accounted for.

Controlled Substances

Controlled substances must be counted and documented.
Nurses must check the count of all controlled substances daily.
A witness, usually another nurse, is required when counting and wasting controlled substances.

Common Medical Errors & Prevention

Common medical errors include inappropriate prescribing, incorrect dosing, wrong patient or route of administration, missed medication, incorrect drug preparation, improper administration techniques, and expired or deteriorated medication.
Prevention strategies include the drug regimen process, avoiding interruptions and distractions, performing series of checks (nurse and patient), reporting medication errors, and never leaving prepared drugs unattended.

Bar-Code Medication System

Patients have unique identifiers (ID, stickers).
Nurses have unique barcodes that provide access to the medication system (Omnicell, MAR, COW).
Drugs have unique barcodes that identify the drug form, dosage, and NDC (National Drug Code).
Nurses scan the patient's ID first, then the drug. If the medication is correct, the system allows administration. If incorrect, the system alerts the nurse and prevents administration.

Patient Teaching

Before administration, the nurse must describe the medication and its effects in easy-to-understand language.
Patient teaching includes:
- Name of the drug
- Dose of the drug
- Action of the drug
- Frequency of administration
- How to store or prepare the drug for discharge
The patient should be able to restate the information to demonstrate understanding.

Patient Assessment

Ongoing assessment is required before and after medication administration.
Vital signs and a head-to-toe assessment should be performed.
Certain medications have specific instructions or limitations, for example, medications for blood pressure, heart rate, Lasix, or medications requiring lab testing.

Nursing Diagnosis & Patient-Centered Outcomes

Nursing diagnoses are created using assessment data.
Patient-centered outcomes are evaluated after implementing a plan of care.

Medicine/Med Identifiers

Generic Names:
- Identifies the drug's active ingredient or chemical name.
- Universally accepted and not owned by any drug company.
- Example: acetaminophen
Trade Names:
- Brand names selected by the pharmaceutical company selling the drug.
- Protected by trademark and can have multiple trade names.
- Example: Benadryl, Tylenol
Drug Form:
- Determines the route of administration.
- Examples: Tablet, injection, transdermal patch, cream.
Troche:
- A lozenge or cough drop.
Slow or Continuous Release:
- Some tablets are enteric-coated to prevent stomach irritation (Extended Release -> ER).
- Allows for slow and continuous release in the large intestine.

12 Common Drug Identifiers

NDC#: National Drug Code number used to identify specific drugs.
Generic Name
Brand Name
Drug Dose: Dose available in the product.
Warnings: Specific drug warnings.
Administration: Labels indicating route and dosage.
Prescription Status: Indicates whether the drug is prescription only.
Drug Manufacturer: Pharmaceutical house that produces the drug.
Quantity: Amount of the drug in the package.
Storage information
Lot number: Specific drug batch from which the drug was produced (important for recalls).
Expiration Date: Indicates the date after which the drug is no longer effective.

Onset, Peak, & Duration of Action

Onset of Action: Time it takes to reach the minimum effective concentration after drug administration.
Peak Action: Occurs when the drug reaches its highest blood concentration.
Duration: Length of time the drug maintains its effect.
Understanding these concepts helps with determining dosage and predicting effects.

Documentation

The following information must be documented for medications:
- Name of medication
- Dosage
- Route and time of administration
- Nurse initials
- Intentionally or inadvertently omitted medications
- Refused medications
- Medication errors

Factors Affecting Drug Action

Developmental Considerations: Age and developmental stage.
Weight: Body mass affects drug distribution.
Biological Sex: Hormonal differences can influence drug metabolism and effects.
Culture & Genetic Factors:
- Religious restrictions regarding medication use.
- Genetic predispositions can influence drug responses.
Psychological Factors: Patient expectations, compliance.
Pathology: Existing disease processes can affect drug absorption, metabolism, and excretion.
Environment: Sensory deprivation or overload, oxygen deprivation, nutrition.
Time of Administration: Food can delay or enhance absorption and affect irritation.

Side Effect vs. Adverse Effect (Interactions)

Side Effects: Non-therapeutic reaction to a drug, can be desirable or undesirable.
- Example: Percocet causing drowsiness.
Adverse Effects: Unexpected, dangerous, and unpredictable pharmacological event.
- Occur less frequently than side effects.
Drug Interactions:
- Patient sensitivity to the drug.
- Drug causing an unexpected response.
- Patient taking too much or too little of the drug.
- Hypersensitivity or allergic reaction.

Pharmacokinetics vs. Pharmacodynamics

Pharmacokinetics: How the body affects a drug.
- Absorption: The process of transferring a drug from its site of entry into the bloodstream.
  - Influencing Factors:
    - Route of administration
    - Lipid solubility
    - pH
    - Blood flow
    - Condition of the site of administration
    - Drug dose
- Distribution: Drug molecules are transported throughout the body after entering the bloodstream.
  - Factors:
    - Blood circulation
    - Protein-binding capacity
    - Selectively permeable blood-brain barrier
- Metabolism: The change of an active drug from its original form to an inactivated or new form.
  - Primary Source: Liver
  - Other Roles: Gastrointestinal tract, lungs, kidneys
- Excretion: Removing drug from the body.
  - Primary Route: Kidneys
  - Other Routes: Lungs for gaseous substances
  - Factors Affecting Excretion:
    - Impaired renal function
    - Aging
    - Diseases
Pharmacodynamics: How drugs act on specific target cells to create a change in cellular function.

Drug Orders

Standing Order (a.k.a. Routine Order):
- Carried out until canceled by another order.
- Includes specific instructions or limitations.
PRN Order (As Needed):
- Given when requested by the patient or required by the physician, meeting the specific order criteria.
- May include clinical parameters or timing between doses.
  - Example: Every 4 hours if the patient's pain level is between 5-7 (usually for pain, nausea, or sleep medications).
Stat Order: Immediate order, carried out at once. A one-time order.

Seven Parts of a Medication Order

Patient Name
Date and time the order was written
Name of drug to be administered
Dosage of the drug
Route of administration
Frequency of administration
Signature of the person writing the order

Nine Rights of Medication Administration

Right Medication
Right Patient
Right Dose
Right Route
Right Time
Right Reason
Right Assessment
Right Documentation
Right Response

Med Checks

Three med checks:
- When reaching for the unit-dose package
- After retrieving the package from the drawer
- Before giving the medication to the patient

Controlled Substances

Records should be kept for each narcotic administered to the patient.
The amount of a controlled substance on hand must be accounted for.

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Questions and Answers

Which of the following is a common medical error?

It is acceptable to leave prepared drugs unattended in order to complete other tasks.

What should a nurse do if a medication error occurs?

A __________ system helps to prevent medication errors by utilizing barcodes.

Match the following medical errors with their descriptions:

What is the initial step in the drug regimen process for preventing errors?

Patients should be educated on the name, dose, action, and frequency of their medication before administration.

Name one reason why a drug might be administered incorrectly.

What does the National Drug Code (NDC) number identify?

Generic names of drugs are owned by pharmaceutical companies.

What is the main difference between a generic drug and its trade name?

The __________ indicates when a drug reaches its highest blood concentration.

Match the following medication identifiers with their descriptions:

Which of the following factors can affect drug action?

Documentation of medication administration is optional.

What is meant by 'slow or continuous release' in medication?

The __________ indicates whether a drug is prescription only.

Which medication form refers to a preparation designed for oral use in a dissolving format?

What is the primary function of pharmacokinetics?

An adverse effect of a drug is always predictable.

What is the main organ responsible for drug metabolism?

The ________ is usually the main route for drug excretion.

Which of the following is NOT one of the 9 Rights of Medication Administration?

Match the following types of medication orders with their descriptions:

Med checks involve comparing the medication to the MAR before administration.

Name one factor that affects the absorption of a drug.

A ________ effect is a non-therapeutic reaction to a drug that may be either desirable or undesirable.

Which of the following is a factor affecting drug distribution in the body?

Which of the following is a step in the prevention of medication errors?

It is essential to recount controlled substances during each off-going shift.

What should a nurse do immediately after realizing a medication administration error?

A __________ is required when wasting a narcotic, and it involves another nurse as a witness.

Match the following types of medication errors with their descriptions:

What action should a nurse NOT take to prevent medication errors?

Documentation of medication administration is mandatory for all errors.

Describe what the term 'BARCODE medication system' refers to in medication administration.

Which of the following identifiers is used specifically to identify a drug's specific batch for recall information?

The trade name of a drug is universally accepted and owned by a single pharmaceutical company.

What does NDC stand for in medication identifiers?

The __________ indicates the duration of time that a drug maintains its effect.

Match the following medication identifiers to their definitions.

Which factor is NOT typically considered when assessing drug action?

Pharmacological effects of medication are not influenced by the patient's environment.

Name one medication form that allows for slow or continuous release.

The __________ occurs when a drug reaches its highest concentration in the blood.

What factors can affect the onset of action for a medication?

Which term describes a pharmacological event that is unpredictable and considered dangerous?

Drug interactions can only occur when the patient takes an incorrect dose of medication.

Name one factor that affects the absorption of a drug.

The primary organ responsible for drug metabolism is the __________.

Match the following types of medication orders with their descriptions:

What is a common risk associated with impaired renal function?

The 9 Rights of Medication Administration include checking the right patient, right dose, and right documentation.

What is one of the three med checks a nurse must perform?

A __________ is a medication order that is carried out immediately only one time.

Which factor does NOT affect drug distribution in the body?

Study Notes

Medication Management

Common Medication Errors & Prevention

Bar-code Medication System

Patient Teaching

Patient Assessment

Medicine/Med Identifiers

Onset, Peak, & Duration

Medication Documentation

Factors Affecting Drug Action

Side Effect vs. Adverse Effect (Interactions)

Pharmacokinetics vs. Pharmacodynamics

Drug Orders

9 Rights of Administration

Medication Checks

Controlled Substances

Controlled Substances

Common Medical Errors & Prevention

Bar-Code Medication System

Patient Teaching