NUR 2474 Exam 1 2023 Blueprint

NUR 2474 Exam 1 2023 Blueprint Half-life- time required for the concentration or amount of drug in the body to be reduced by one-half handwritten orders- A prescription for medications/ referrals Application of Pharmacology in Patient care= (1) pre-administration assessment, (2) dosage and administration, (3) evaluating and promoting therapeutic effects, (4) minimizing adverse effects, (5) minimizing adverse interactions, (6) making PRN decisions Receptor binding Binding of a ligand to a receptor changes its shape or activity, allowing it to transmit a signal or directly produce a change inside of the cell. Stages of signal transduction: ligand-receptor binding, signal relay, response. Pharmacokinetics -Absorption-distribution-metabolism-Excretion-- how a body processes a drug Pharmacodynamics- what a drug does to the body) Adverse effect/side effect and expected and unexpected. Teratogenic effect- are drugs, chemicals, or even infections that can cause abnormal fetal development Paradoxical effect-not the intended effect (lavender to calm but it makes em crazy) Cholinergic vs Anticholinergic side effects • Anticholinergic o Can’t see, can’t pee, can’t spit, can’t shit • Cholinergic o S-alivation o L-acrimation (tears) o U-rination o D-efication Dosage Calculations Medication Rights • Right dose, person, time, med, route Nursing Process: Assessment, diagnosis, planning, implementation, and evaluation. (ADPIE) Terminology: EPS, Tardive dyskinesia, Akathisia, dystonia, parkinsonism • Extrapyramidal symptoms. Weird mouth movements. Fidgeting. Involuntary muscle contraction. • Parkinsonism is any condition that causes a combination of the movement abnormalities seen in Parkinson's disease — such as tremor, slow movement, impaired speech, or muscle toughness — especially resulting from the loss of dopamine-containing nerve cells. AKA EPS Carvidopa/levodopa (Sinemet)- *Parkinson Med* - Know action (what does it do), Nurse recommendation for patients who develop SE/AE of medication, Anticipated SE/AE of this medication, Pt education • BASICALLY- levodopa turns into dopamine, increasing dopamine in the brain and balancing dopamine and acetylcholine. Carbidopa helps the body absorb levodopa which makes it more available to the CNS. C/L=Dopamine agonist AE/Recommendations • N/V-can be reduced by administering with meals • Dyskinesias-can be managed in 3 ways- lower med dose, give amantadine, or surgery/electrical stimulation • Hypotension-can be reduced by increasing salt and water intake • Psychosis-can be reduced by lowering dose, anti-psych meds (have their own SE) • Expected SE: Anticholinergic effects, GI upset, fall risk, hallucinations Neuroleptic Malignant Syndrome -What is this? How does this occur? Interventions? • NMS happened when someone takes 2 types of neuroleptic drugs at one time. Hold med if toxicity is suspected. • F-E-V-E-R Alzheimer’s Medications (Donepezil; Galantamine; Memantine)- Cholinesterase Inhibitors -What is their action? • Block the action of acetylcholinesterase - This increases the concentration of acetylcholine in the brain which may improve memory and cognitive function. How do they help? • Delay progression of disease- does not cure Nurse recommendation for patients who develop SE/AE of medication • Monitor CNS, give in the PM • Cardiovascular effects-bradycardia, which can lead to falls and fainting- drug withdrawal may be indicated Anticipated SE/AE of this medication • Loss of appetite, PEPTO, More frequent bowel movements, Bruising, Muscle cramps, Headaches, Fatigue Pt education • Give at bedtime, can be sedating, can cause bad dreams Contraindications • Contraindicated if the pt has had a previous allergy to cholinesterase inhibitors, liver/heart disease or bradycardia. Drugs for MS Interferon Beta 1a -Know action (what does it do), Nurse recommendation for patients who develop SE/AE of medication, Anticipated SE/AE of this medication, Pt education • Inhibits inflammatory WBC from getting to the brain and suppresses T- helper cell activity. (antiviral) • SE: flu like sx-can be avoided by starting med at a lower dose or giving NSAIDs. Hepatotoxicity-reduction in dosage is indicated. injection site reactions-rotate sites, ice before and warm after injection. Baclofen (Muscle relaxant, Anti spastic) - Know action (what does it do), Nurse recommendation for patients who develop SE/AE of medication, Anticipated SE/AE of this medication, Pt education • Acts w/in the spinal cord to suppress hyperactive reflexes. • SE: drowsiness, dizziness, weakness, fatigue (CNS depression)-can be minimized with smaller med doses.