Pharmacology Exam 1 Review: Dosage Calculation and Therapeutic Index
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Questions and Answers

What is the primary concern when prescribing controlled substances?

  • Their ability to induce teratogenesis
  • Their addictive nature and potential for misuse (correct)
  • Their low risk of nephrotoxicity
  • Their potential to cause allergic reactions
  • What is the purpose of enteric coating on oral medications?

  • To delay the breakdown of the medication over time
  • To make the medication easier to swallow
  • To protect the stomach lining during absorption (correct)
  • To increase the bioavailability of the medication
  • What is the term for the loss of medication during its passage through the GI tract?

  • Toxicity
  • First-pass effect (correct)
  • Bioavailability
  • Absorption pattern
  • What type of medication administration is characterized by slow, gradual absorption?

    <p>Intradermal</p> Signup and view all the answers

    What is the term for severe liver damage or toxicity caused by a medication?

    <p>Hepatotoxicity</p> Signup and view all the answers

    What is the primary advantage of sublingual administration?

    <p>It bypasses the GI tract</p> Signup and view all the answers

    What is the term for the most severe form of allergic reaction?

    <p>Anaphylaxis</p> Signup and view all the answers

    What is the primary concern when prescribing medications to pregnant patients?

    <p>The risk of teratogenesis</p> Signup and view all the answers

    What type of medication is classified as having no medical use and being highly addictive?

    <p>Heroin</p> Signup and view all the answers

    What is the term for the study of the movement of medications within the body?

    <p>Pharmacokinetics</p> Signup and view all the answers

    Study Notes

    Dosage Calculation

    • 1 kg = 2.2 lbs
    • 1000 mcg = 1 mg
    • 1000 mg = 1 g
    • 30 mL = 1 oz
    • Infusion pump measures in mL/hr
    • Gravity transfusion drop measures in gtt/min
    • Tubing drip factors vary by package, e.g. Microdrip tubing = 60 drops/min

    Therapeutic Index

    • Peak: maximum serum concentration of medication
    • Trough: minimum serum concentration of medication, right before next dose
    • High therapeutic index: larger window for therapeutic effect, often OTC drugs
    • Low therapeutic index: smaller window for therapeutic effect, requires close monitoring, often prescription drugs

    Error Reduction

    • Only providers (physicians, NPs, PAs) can write or change prescription orders
    • Nurses have regulated responsibilities (BON) and code of ethics (ANA)
    • Use generic names and the "rights": medication, patient, dose, time, administration, and documentation
    • Never administer a medication prepared by someone else
    • Complete medication reconciliation on admission, transfer, and discharge
    • If a medication error occurs, assess the patient and report the error

    Patient Education

    • 3 domains of learning: cognitive, affective, and psychomotor
    • Determine patient's preferred learning style
    • Set SMART goals (specific, measurable, attainable, realistic, timely)
    • Bioavailability: amount of medication circulating in the bloodstream
    • Distribution: distribution of medication to the site of action
    • Metabolism (biotransformation): how the body breaks down the drug, primarily in the liver
    • Excretion: elimination of products, primarily by the kidneys

    Safe Medication Administration

    • Only providers can write or change prescription orders
    • The 6 rights: client, medication, dose, time, route, and documentation
    • Use two client identifiers (e.g. name, DOB, MRN)
    • Verify medication 3 times using MAR
    • Consider nomenclature: chemical, generic, and trade names
    • Consider uncontrolled substances (require monitoring) and controlled substances (habit-forming, addictive)

    Routes of Administration

    • Oral: sublingual, buccal, and enteric coating options
    • Intradermal and topical: slow, gradual absorption with local effects
    • Subcutaneous and IM (intramuscular): varying absorption patterns
    • Intravenous: no barriers to absorption, immediate effects

    Adverse Effects

    • Hepatotoxicity: severe liver damage/toxicity
    • Nephrotoxicity: severe kidney damage/toxicity
    • Toxicity: taking too much medication or taking for too long
    • Allergic reactions: immune system reacts with rash, hives, itching
    • Anaphylaxis: severe, life-threatening allergic reaction

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    Description

    Review of dosage calculation and therapeutic index concepts, including conversions, infusion pumps, and serum concentrations, for Pharmacology Exam 1.

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