Principles of Medicines Management

Why does IV Medication have a 100% bioavailability?
Initially, it does not have to go past the liver for a first pass effect
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Who is allowed to order controlled drugs from the pharmacy?
A registered nurse, who's signature is on a list with pharmacy
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What is ethics about?
Right and wrong and the morality of human acts
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Why do you need to use the BNF when giving medication?
To know the indication, does, side effects, contra-indications and interactions
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What are critical drugs and can you give an example of these?
Medication that cannot be omitted due to potential consequences. For instance; insulin, stat dose of a medication or epilepsy meds
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What is therapeutic failure and toxicity?
Both to do with the dosage of the drug. Therapeutic failure is too low a dose, therefore it isn't working and toxicity is too high a dose, therefore, the adverse effects are causing harm to the body
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What is the half life of a drug?
The time it takes for the amount of the drug in the body, to decrease to half of the peak level it previously achieved
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What is the yellow form in the BNF about?
To report any unexpected side effects to drugs - this can be further reviewed
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Name 4 common reactions to taking medications
Nausea/vomiting, constipation, blurred vision and cardiac problems
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What does the nurse need to consider when seeking consent from a patient?
Any consent needs to be informed, a patient requires capacity, they should receive sufficient information and be voluntary
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List 3 prescription only (POM) medicines
Medicinal products containing listed substances, medicinal products containing a drug controlled under the misuse of drugs act (1971) and medicinal products for parental use
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What do you understand by the term absorption?
Absorption is what happens to a drug from the time that it is introduced in to the body, until it reaches the circulating fluids and tissues
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What do you understand by the term adverse drug reaction?
An unwanted or unintended effect of a medicine that occurs during proper use at normal doses and has a an adverse effect on a patient
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Name 3 situations in which administering a medicine via injection is recommended?
Rapid reaction required, drug not available in oral form and the patient is unable to take the drug orally
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Why would some people none-intentionally not take medication that is prescribed for them?
Not able to take the prescription to the chemist, unable to open the container and the patient does not understand the instruction/can't read them
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Name 3 aims of encouraging patients to self administer medicines (SAM)?
Promote+maintain patients independence, improve patients+their carers knowledge of the medication and involve patients in their own health
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Name the 3 types of consent
Verbal, written and implied
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Name 4 factors which can effect the absorption of a drug
Gastric emptying time, surface area of the intestine, tablet disintegration and the stability in the GI tract
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What do you understand by the term medicines management?
The clinical, cost-effective and safe use of medicines, to ensure patients get the maximum benefit from the medicines they need, while at the same time, minimising the potential harm
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What do you understand by the term pharmacodynamics?
How the drug affects the body
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What is anaphylaxis? And name some triggers that may cause an anaphylaxis reaction
A severe life threatening, generalised or systemic hypersensitivity reaction, through an exposure to an allergen, which causes circulation and airway problems. It can be triggered by antibiotics, anit-inflammatories, latex or a wasp/bee sting
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What is your understanding by the term steady state?
Steady state is the rate of absorption being equal to the rate of elimination and is achieved after multiple and regular dosing
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Name 4 reasons why some people would intentionally not take their medication that is prescribed for them?
Cost of the drug, the side effects, don't believe the medication will help and confusion about what the prescriber has told them
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What are the 4 ethical principles underpinning medial ethics?
Autonomy, beneficence, non-maleficence and justice
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Name the 3 physiochemical properties of drugs
Fat solubility, water solubility and molecular size
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What is pharmacovigilance?
The process involving detection, assessment, understanding and prevention of adverse effects. Ensures medicines are used in full knowledge of the risks.
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Name 3 ways in which a nurse can keep up to date with medicines
Clinical software, British National Formulary (BNF) and training+development
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List 4 sites an intra-muscular injection can be administered
Arm (deltoid muscle), hip, buttocks and thigh
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Identify 4 symptoms, that someone having an anaphylaxis reaction may be displaying
Closed/horse throat, cyanosis, angina and a rash/swelling
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What is a loading dose?
An initial higher dose of a drug, that may be given at the beginning of a course of treatment before it is dropped to a therapeutic level/range
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Name 2 differences between an adverse effect and a side effect
An adverse effect can hinder the treatment and lead to more complications, however a side effect doesn't hinder the main effect of a drug. An adverse effect is more severe and life threatening, however a side effect is mild and resolving.
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Name the 5 classifications of adverse effects
Augmented (exaggeration), Bizarre (not understood), Chronic (persistent reactions), Delayed (apparent after use) and Ending of use (withdrawal reactions)
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What is a drug interaction?
Occurs when one drug interacts with another drug, herbal medicine, food or drink and causes unanticipated effects
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What are the 3 types of adverse events?
Local (pain and swelling), systemic (fever and headache) and allergic reactions (anaphylaxis)
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What is adrenaline?
A hormone or medication
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What are the 3 legal categories or medics - British National Formulary?
Pharmacy Medicines (P), Generalised sales meds (GSL) and Prescription only meds (POM)
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What are 3 benefits of SAM to patients?
Patients gain a bette understanding of their medication, they will get their meds on time and improves communication and trust between the hospital team and the patient
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What are 3 benefits of SAM to the carer/relative?
Reduction in anxiety, more involvement in the patients treatment and enhancing their knowledge of their meds
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What are 3 benefits of SAM to hospital trusts?
Financial savings, potential to reduce the number of re-admissions and improves medicine compliance after discharge
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What is a drug and a medicine?
A drug is a substance other than food or water, which is administered to alter a physiological process. A. medicine is the overall package, which is designed to make administering a drug more effective.
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What are the 3 principles of drug treatment?
Maximise effectiveness, minimise side effects and optimise risk vs benefit ratio
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What is pharmacology?
The study of medicines and drugs, including their action, their use and the effects on the body
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What is pharmacokinetics?
The effect that the processes of the body, have on the drug, therefore, how the patient handles the drug
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What are the 4 types of membranes?
Cell membranes, walls of capillaries, blood/brain barrier and placental barrier
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Name 5 routes of administration
Oral, topical, sublingual, vaginal and rectal
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What is bioavailability?
The proportion of unchanged drug, that reaches the systemic circulation. And how much/the percentage of the dose that is absorbed
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What is a first pass effect?
Where the concentration of the drug is greatly reduced before it reaches the systemic circulation
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What is elimination and what can it be effected by?
Elimination is metabolism and excretion of a drug, which can be effected by pregnancy, PH of urine and liver disease
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How does the drug effect the body?
Targets molecules in cells, tissues cells, organ systems and the whole body
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What is potency?
The level of response to the drug and a measure of drug activity, which is the amount require to produce an effect
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What is efficacy?
The potential maximum therapeutic response that a drug can produce
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What are the 5 pharmacokinetic interactions?
Absorption, distribution, metabolism, excretion and transporter
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What are the 3 phrarmodynamic interactions?
Addictive, antagonistic and the drug
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What would you do if a drug was omitted?
Escalate to the nurse in charge/medical staff of that patient and monitor and record actions taken, to ensure the patient receives the meds
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What are the 3 stages to safe administration of medicines?
The patient, the medication and documentation
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What is an injection?
A sterile solution, emulsion or suspension by the use of a syringe or a needle
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How are drugs for injections presented?
Sterile doe preparations and multi-dose preparations
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Name 3 benefits of injections
Patient is unable to take the drug orally/not available orally, allows rapid absorption and it can produce blood levels
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What are the 3 things to consider with the injection site?
Needs to avoid major nerves and blood vessels, to be cautious of sciatic nerve damage and to ensure the injection is in to the muscle rather than the fat
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What are the 4 sites for a sub-cut injection?
Abdomen, arms, thighs and buttocks
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What are the 3 common veins for an IV injection?
Cephalic, Basilica and Metacarpal
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What are patient group directions (PGD)?
Written instructions for the administrations of medicines to groups of patients who may not be individually identified before presentation for treatment.
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What is metabolism?
A change by chemical reactions, which usually occurs in the liver
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What is excretion?
This is the final process where the drug passes through the kidneys to be excreted in the urine.
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Where do pharmacokinetic interactions take place?
GI tract, plasma, kidneys and liver
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What sources are used to make drugs?
Plant products, Genetic engineering, Fungi and inorganic compounds
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What are the 3 names applied to drugs?
Chemical, generic and trade
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What is concordance?
Coming to a joint decision together between the patient and prescriber
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What is adherence?
The patient adhering to the proper dosing schedule, whereby the patient is empowered to take matters into their own hands for their own health
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What is compliance?
Following or complying with the doctors recommendations for medication dosing
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What is drug distribution?
The physiological movement of drugs from the systemic circulation to the tissues
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What is excretion?
A process, whereby drugs are transferred from the external to internal environment
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What factors affect drug distribution?
Membrane permeability, tissue perfusion, protein binding and volume of distribution
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What is a selective drug?
It acts on one receptor, in a particular tissue, in a concentration that has little effect on the receptor in different organs
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What is a specific drug?
It acts at only one receptor, but can have multiple effects due to widespread location of receptors
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Other cards in this set

Card 2


Who is allowed to order controlled drugs from the pharmacy?


A registered nurse, who's signature is on a list with pharmacy

Card 3


What is ethics about?


Preview of the front of card 3

Card 4


Why do you need to use the BNF when giving medication?


Preview of the front of card 4

Card 5


What are critical drugs and can you give an example of these?


Preview of the front of card 5
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