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Pharmacology and Nursing (Unit 6) (Controlled Substances (Schedule I…
Pharmacology and Nursing
(Unit 6)
History
Food, Drug, and Cosmetic Act (1938)
Label foods and meds effetely and test for harmful effects
Durkham-Humphrey Amendment (1952)
Classify prescription vs. over the counter
Kefauver-Harris Amendment (1962)
Prove safety and effectiveness and had to have proof that it produced a desired effect
Comprehensive Drug Abuse Prevention and Control Act (1970)
Categorized controlled substances, limited filling times, and developed programs for addicted people
Pharmacodynamics:
What the drug does to the body
Agonist: Produces a desired effect (Morphine)
Antagonist: Blocks a response (Narcan)
Pharmacokinetics:
What the body does to the drug
Absorption
First pass effect: Presystemic circulation
Distribution
Transport drug from site of absorption to site of action
Fat solube
Increase fat tissue, accumulation of drug; Half life is a lot longer
Protein bound
Albumin: 4 binding sites
Malnutrition pts. have decreased albumin, decreased binding sites, thus increased active drugs not bound
Water soluble
Dehydrate pts, lots of active drug not bound to water
FVE pts have lots of bound (not active) drug
Metabolism
Breakdown of drug
Makes more water soluble
Excretion
Process where metabolites and drugs are eliminated from the body
Kidney
Controlled Substances
Schedule I
Highest abuse potential
Elicit drugs: LSD, Heroine, Marajuana
Schedule II
Dilauded, Morphine, Cocaine direivatives
Schedule III
Vicoden, Hydrocodone, Tylenol with Codine
Schedule IV
Xanax, Valium, Ativan, tramadol
Schedule V
Lyrica (nerve pain), Lemodil (anti-diarrhea), Some cough meds.
Parenteral Medications
Intradermal
25-27 gauge needle
1/4-5/8 inch needle
Forearms, back
TB test, allergy testing
Create a wheal
Bevel UP!
Subcutaneous
25 gauge
3/8-5/8 inch needle
45-90 degree
Abd, back of arm, top of legs
Insulin, subcut Heparin, Lovenox, Lidocaine
Intramuscular
21-23 gauge needle
1-1.5 inch needle
90 degree needle insertion
Deltoid, vastus lateralis (side of leg), rectus femoris (top of thigh), ventral gluteal (forward), dorsal gluteal (Back-Butt)
Birth control, tetinus, vaccines, boosters, antibiotic, steroids, flu, pneumo vaccine
Z-track method to protect subcutaneous tissue