Lauren Busse Pharmacology 1 Final Review
Schedule for Controlled Substances
Schedule 1
• High abuse potential
• Not legally approved
Schedule 2
• As above with accepted use
Schedule 3
• Lower abuse potential
Schedule IV
• Still lower abuse
Schedule V
• Contain only small amount of narcotic
• Minimal risk for abuse
* If wasting part of the narcotic, another nurse must witness the disposal of the medication. You dispose of a narcotic in the trashcan*
6 rights of Drug Administration
• Right client
• Right medication
• Right dose
• Right time
• Right route
• Right documentation
* Always assess for allergies before administering a medication*
* Always administer a medication and then document!!*
Pharmacokinetics: what the body does to the drug
4 major processes
• Absorption: how it gets in the body; the rate at which a drug leaves its site of administration and becomes bioavailable
• Distribution: how it gets around the body; process by which drug is carried from its site of absorption to its site of action
• Metabolism: how it’s broken down in the body (LIVER); process by which the body changes a drug from its original form to a form that is pharmacologically inactive and can be readily eliminated or excreted. A.K.A biotransformation
• First-pass effect: metabolism of a drug & its passage from liver into systemic circulation
• Drugs given parenterally bypass the first pass-effect
• Excretion: how you get rid of the drug (kidneys, lungs, sweat, breath); process where all drugs and/or their metabolites are eliminated from the body
Pharmacodynamics: what the drug does to the body
Half-life: time required to reduce by ½ the amount of drug concentration in the body; a measure of the rate at which the drug is eliminated
Antineoplastic Agents
Cell cycle non-specific- cytotoxic in any phase
• Alkylating agents
• Cytotoxic antibiotics
Cell cycle specific- cytotoxic in any phase
• Antimetabolites
• Natural products
• Hormonal agents
Chemotherapy: harmful to all rapidly growing cells
• Affects cancer cells plus normal human cells: hair follicles, GI cells, bone marrow cells
• Absorbed through skin or mucous membranes by: injection, ingestion, and inhalation
• Dose-limiting side effects due to high risk for toxicity
• Wear gown, gloves, & mask/eyewear
Extravasation: leaking of an antineoplastic drug into surrounding tissues during IV administration. Continuous monitoring of IV site is essential.
• If suspected, STOP IV SITE
• Aspirate remaining drug of blood from the tube
• DO NOT REMOVE IV LINE- may need to give antidote through existing IV tube. Some antidotes not given through IV catheter
• Cover are with sterile, occlusive dressing
• Apply warm or cold compresses
• Elevate the limb
• Follow extravasation instructions per facility protocol
Nursing Implications
• Assess baseline blood counts before giving any antineoplastic agents