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anaphylaxis An extreme allergic reaction that can lead to respiratory distress, circula-

an-a fi-LAK-sis tory collapse, and death antagonist A substance that interferes with or opposes the action of a drug an-TAG-o-nist

contraindication kon-tra-in-di-KA-shun

A factor that makes the use of a drug undesirable or dangerous

efficacy EF-i-ka-se

The power to produce a specific result; effectiveness

generic name

The nonproprietary name of a drug, that is, a name that is not privately owned or trademarked; usually a simplified version of the chemical name; not capitalized

potentiation po-ten-she-A-shun

Increased potency created by two drugs acting together

prescription (Rx) pre-SKRIP-shun

Written and signed order for a drug with directions for its administration

side effect

An undesirable effect of treatment with a drug or other form of therapy

substance dependence

A condition that may result from chronic use of a drug, in which a person has a chronic or compulsive need for a drug regardless of its adverse effects; dependence may be psychological or physical

synergy_ SIN-er-je

Combined action of two or more drugs working together to produce an effect greater than any of the drugs could produce when acting alone; also called synergism (SIN-er-jizm)

tolerance

A condition in which chronic use of a drug results in loss of effectiveness and the dose must be increased to produce the original response

trade name

The brand name of a drug, a registered trademark of the manufacturer; written with a capital letter

withdrawal

A condition that results from cessation or reduction of a drug that has been used regularly

TABLE 8-1 Word Parts Pertaining to Drugs

WORD PART MEANING EXAMPLE DEFINITION OF EXAMPLE

TABLE 8-1 Word Parts Pertaining to Drugs

WORD PART MEANING EXAMPLE DEFINITION OF EXAMPLE

SUFFIXES

-lytic

dissolving, reducing, loosening

anxiolytic ang-zi-O-LIT-ik

agent that reduces anxiety

-mimetic

mimicking,

sympathomimetic

mimicking the effects of the sympathetic

simulating

sim-pa-tho-mi-MET-ik

nervous system

-tropic

acting on

inotropic in-O-TROP-ik

acting on the force of muscle contraction (in/o means "fiber")

PREFIXES

anti-

against

antidote AN-ti-dOt

substance that counteracts a poison

TABLE 8-1 Word Parts Pertaining to Drugs, continued

WORD PART

MEANING

EXAMPLE

DEFINITION OF EXAMPLE

contra-

against

contraceptive kon-tra-SEP-tiv

preventing conception

counter-

opposite, against

countercurrent kown-ter-KUR-ent

flowing in an opposite direction

ROOTS

alg/o, algi/o, algesi/o

pain

algesic al-JE-sik

painful

chem/o

chemical

chemotherapy ke-mo-THER-a-pe

treatment with drugs

hypn/o

sleep

hypnosis hip-NO-sis

an altered state with increased responsiveness to suggestion

narc/o

stupor

narcotic nar-KOT-ik

drug that induces stupor

pharmac/o

drug

pharmacy FAR-ma-se

the science of preparing and dispensing drugs, or the place where these activities occur

pyr/o, pyret/o

fever

antipyretic an-ti-pi-RET-ik

counteracting fever

tox/o, toxic/o

poison, toxin

toxic TOK-sik

poisonous

vas/o

vessel

vaso motor vas-o-MO-tor

pertaining to change in vessel diameter

# Exercise 8-1

Identify and define the suffix in each of the following words:

Suffix Meaning of Suffix

2. parasympathomimetic

(par-a-sim-pa-tho-mi-MET-ik) __________________________________

Using the prefixes listed in Table 8-1, write the opposite of each of the following words:

5. indicated _

6. inflammatory _

9. conception _

Identify and define the root in each of the following words:

Root Meaning of Root

Define each of the following words:

15. vasoconstriction _

16. pharmacology _

17. gonadotropic _

18. antitoxin _

ABBREVIATIONS

Drugs and Drug Formulations

APAP Acetaminophen

ASA Acetylsalicylic acid (aspirin)

cap Capsule elix Elixir

FDA Food and Drug Administration

INH Isoniazid (antitubercular drug)

MED(s) Medicine(s), medication(s)

NCCAM National Center for Complementary and Alternative Medicine NSAID(s) Nonsteroidal anti-inflammatory drug(s)

ODS Office of Dietary Supplements

OTC Over-the-counter

PDR Physicians' Desk Reference

Rx Prescription supp Suppository susp Suspension tab Tablet tinct Tincture

USP United States Pharmacopeia ung Ointment

Dosages and Directions a Before (Latin, ante)

ac

Before meals (Latin, ante cibum)

ad lib

As desired (Latin, ad libitum)

aq

Water (Latin, aqua)

_id

Twice a day (Latin, bis in die)

c

With (Latin, cum)

cc

Cubic centimeter

D/C, dc

Discontinue

ds

Double strength

gt(t)

Drop(s) (Latin, gutta)

hs

At bedtime (Latin, hora somni)

IM

Intramuscular(ly)

IU

International unit

IV

Intravenous(ly)

mcg

Micrograms

mg

Milligrams

LA

Long-acting

NS

Normal saline

p

After, post

pc

After meals (Latin, post cibum)

po

By mouth (Latin, per os)

pp

Postprandial (after a meal)

prn

As needed (Latin, pro re nata)

qam

Every morning (Latin, quaque ante

meridiem)

qd

Every day (Latin, quaque die)

qh

Every hour (Latin, quaque hora)

q ____ h

Every hours

ABBREVIATIONS

qid

Four times a day (Latin, quater in die)

SR

qod

Every other day (Latin, quaque [other] die)

ss

s

Without (Latin, sine)

tid

SA

Sustained action

U

SC, SQ,

Subcutaneous(ly)

Sustained release Half (Latin, semis)

Three times per day (Latin, ter in die)

Unit(s)

Times

DISPLAY 8-1 Common Drugs and Their Actions

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME

TRADE NAME

adrenergics ad-ren-ER-jiks

(sympathomimetics

[sim-pa-tho-mi-MET-iks])

mimic the action of the sympathetic nervous system, which responds to stress

epinephrine phenylephrine pseudoephedrine dopamine

Bronkaid Neo-Synephrine Sudafed Intropin

analgesics an-al-JE-siks

alleviate pain

narcotic nar-KO-tik

decrease pain sensation in central nervous system; chronic use may lead to physical dependence

meperidine morphine

Demerol Duramorph

nonnarcotic non-nar-KO-tik

act peripherally to inhibit prostaglandins (local hormones); they may also be anti-inflammatory and antipyretic (reduce fever)

aspirin (acetyl-

salicylic acid; ASA)

acetaminophen

ibuprofen celecoxib

Tylenol

Motrin, Advil Celebrex, Vioxx

anesthetics an-es-THET-iks

reduce or eliminate sensation

local lidocaine procaine general nitrous oxide midazolam

Xylocaine Novocain

Versed

anticoagulants an-ti-ko-AG-u-lants

prevent coagulation and formation of blood clots

heparin warfarin

Coumadin

anticonvulsants an-ti-kon-VUL-sants

suppress or reduce the number and/or intensity of seizures

phenobarbital phenytoin carbamazepine valproic acid

Dilantin Tegretol Depakene

antidiabetics an-ti-di-a-BET-iks

prevent or alleviate diabetes

insulin chlorpropamide glyburide metformin acarbose

Humulin (injected) Diabinese (oral) Micronase Glucophage Precose

DISPLAY 8-1 Common Drugs and Their Actions, continued

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME

TRADE NAME

antiemetics

relieve symptoms of nau

ondansetron

Zofran

an-te-e-MET-iks

sea and prevent vomiting

dimenhydrinate

Dramamine

(emesis)

prochlorperazine

Compazine

scopolamine

Transderm-Scop

promethezine

Phenergan

antihistamines

prevent responses medi

diphenhydramine

Benadryl

an-ti-HIS-ta-menz

ated by histamine: allergic

brompheniramine

Dimetane

and inflammatory

loratadine

Claritin

reactions

cetirizine

Zyrtec

antihypertensives

lower blood pressure by

clonidine

Catapres

an-ti-hi-per-TEN-sivs

reducing cardiac output,

prazosin

Minipress

dilating vessels, or pro

minoxidil

Loniten

moting excretion of water

losartan

Cozaar

by the kidneys; see also

captopril

Capoten

calcium channel blockers,

(ACE inhibitor; see

beta blockers, and diuret-

Chapter 9)

ics under cardiac drugs,

below

anti-inflammatory drugs

counteract inflammation

an-te-in-FLAM-a-to-re

and swelling

corticos-eroids

hormones from the cortex

dexamethasone

Decadron

kor-ti-ko-STER-oyds

of the adrenal gland; used

cortisone

Cortone

for allergy, respiratory,

prednisone

Deltasone

and blood diseases, injury,

hydrocortisone

Hydrocortone, Cortef

and malignancy; suppress

fluticasone

Flonase

the immune system

nonsteroidal

reduce inflammation

aspirin

anti-inflammatory

and pain by interfering

ibuprofen

Motrin, Advil

drugs (NSAIDs)

with synthesis of

indomethacin

Indocin

non-ster-OYD-al

prostaglandins; also

naproxen

Naprosyn, Aleve

antipyretic

diclofenac

Voltaren

anti-infective agents

kill or prevent the growth

of infectious organisms

antibacterials

effective against bacteria

amoxicillin

Polymox

an-ti-bak-TE-re-als

penicillin V

Pen-Vee K

antibiotics

erythromycin

Erythrocin

an-ti-bi -OT-iks

vancomycin

Vancocin

linezolid

Zyvox

gentamycin

Garamycin

clarithromycin

Biaxin

cephalexin

Keflex

sulfisoxazole

Gantrisin

tetracycline

Achromycin

DISPLAY 8-1 Common Drugs and Their Actions, continued

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME

TRADE NAME

ciprofloxacin (acts

Cipro

on ulcer-causing

Helicobacter pylori)

isoniazid (INH)

Nydrazid

(tuberculosis)

antifungals

effective against fungi

amphotericin B

Fungizone

an-ti-FUNG-gals

miconazole

Monistat

nystatin

Nilstat

fluconazole

Diflucan

itraconazole

Sporanox

antiparasitics

effective against parasites:

iodoquinol

Yodoxin

an-ti-par-a-SIT-iks

protozoa, worms

(amebae)

quinacrine

Atabrine

antivirals

effective against viruses

acyclovir

Zovirax

an-ti-VI-rals

amantadine

Symmetrel

zanamivir (in-

Relenza

fluenza)

zidovudine (HIV)

Retrovir

indinavir (HIV pro

Crixivan

tease inhibitor)

antineoplastics

destroy cancer cells; they

cyclophosphamide

Cytoxan

an-ti-ne-o-PLAS-tiks

are toxic for all cells but

doxorubicin

Adriamycin

have greater effect on

methotrexate

Folex

cells that are actively

vincristine

Oncovin

growing and dividing;

tamoxifen (estro

Nolvadex

hormones and hormone

gen inhibitor)

inhibitors also are used to

slow tumor growth

cardiac drugs

KAR-de-ak

antiarrhythmics

correct or prevent abnor-

quinidine

Quinidex

an-te-a-RITH-miks

malities of heart rhythm

lidocaine

Xylocaine

digoxin

Lanoxin

beta-adrenergic

inhibit sympathetic ner

propranolol

Inderal

blockers (beta blockers)

vous system; reduce rate

metoprolol

Lopressor

ba-ta-ad-ren-ER-jik

and force of heart

atenolol

Tenormin

contractions

carvedilol

Coreg

calcium channel blockers

dilate coronary arteries,

diltiazem

Cardizem

KAL-se-um

slow heart rate, reduce

nifedipine

Procardia

contractions

verapamil

Calan

nitroglycerin

Nitrostat

isosorbide

Isordil

hypolipidemics

lower cholesterol in

cholestyramine

Questran

hi -po-lip-i-DE-miks

patients with high serum

lovastatin

Mevacor

DISPLAY 8-1 Common Drugs and Their Actions, continued

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME

TRADE NAME

levels that cannot be con

pravastatin

Pravachol

trolled with diet alone;

atorvastatin

Lipitor

hypocholesterolemics,

simvastatin

Zocor

statins

nitrates

dilate coronary arteries

nitroglycerin

Nitrostat

Nl-tratz

and reduce workload of heart by lowering blood pressure and reducing venous return; antianginal

isosorbide

Isordil

CNS stimulants

stimulate the central

methylphenidate

Ritalin

nervous system

amphetamine (chronic use may lead to drug dependence)

Adderall, Dexedrine

diuretics

promote excretion of

bumetanide

Bumex

di -u-RET-iks

water, sodium, and other

furosemide

Lasix

electrolytes by the kidneys;

mannitol

Osmitrol

used to reduce edema and

hydrochloroth-

blood pressure

iazide (HCTZ) triamterene + HCTZ

Hydrodiuril Dyazide

gastrointestinal drugs

gas-tro-in-TES-tin-al

antidiarrheais

treat or prevent diarrhea

diphenoxylate

Lomotil

an-ti-di-a-RE-als

by reducing intestinal

loperamide

Imodium

motility or absorbing irri-

attapulgite

Kaopectate

tants and soothing the

atropine

intestinal lining

histamine H2

decrease secretion of

cimetidine

Tagamet

antagonists

stomach acid by interfer

ranitidine

Zantac

HIS-ta-men

ing with the action of histamine at H2 receptors; used to treat ulcers and other gastrointestinal problems

laxatives

promote elimination from

LAK-sa-tivs

the large intestine; types include:

stimulants

bisacodyl

Dulcolax

hyperosmotics (retain

lactulose

Constilac, Chronulac

water)

stool softeners

docusate

Colace, Surfak

bulk-forming agents

psyllium

Metamucil

DISPLAY 8-1 Common Drugs and Their Actions, continued

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME

TRADE NAME

hypnotics

induce sleep or dull the

hip-NOT-iks

senses; see antianxiety

agents (below, under

psychotropics)

muscle relaxants

depress nervous system

baclofen

Lioresal

re-LAK-sants

stimulation of skeletal

carisoprodol

Soma

muscles; used to control

methocarbamol

Robaxin

muscle spasms and pain

psychotropics

affect the mind, altering

sT-ko-TROP-iks

mental activity, mental

state, or behavior

antianxiety agents

reduce or dispel anxiety;

lorazepam

Ativan

an-te-ang-ZT-e-te

tranquilizers; anxiolytic

chlordiazepoxide

Librium

agents

diazepam

Valium

hydroxyzine

Atarax

alprazolam

Xanax

buspirone

BuSpar

antidepressants

relieve depression by rais

amitriptyline

Elavil

an-ti-de-PRES-sants

ing brain levels of neuro-

imipramine

Tofranil

transmitters (chemicals

fluoxetine

Prozac

active in the nervous

paroxetine

Paxil

system)

sertraline

Zoloft

antipsychotics

act on nervous system to

chlorpromazine

Thorazine

an-ti-sl-KOT-iks)

relieve symptoms of

haloperidol

Haldol

psychoses

clozapine

Clozaril

risperidone

Risperdal

olanzapine

Zyprexa

respiratory drugs

antitussives

suppress coughing

dextromethorphan

Benylin DM

an-ti-TUS-sivs

bronchodilators

prevent or eliminate

albuterol

Proventil

brong-kO-di -LA-tors

spasm of the bronchi

epinephrine

Sus-Phrine

(breathing tubes) by relax-

metaproterenol

Alupent

ing bronchial smooth

salmeterol

Serevent

muscle; used to treat

theophylline

Theo-Dur

asthma and bronchitis

montelucast

Singulair

(prevents attacks)

expectorants

induce productive cough

guaifenesin

Robitussin

ek-SPEK-tO-rants

ing to eliminate respira

tory secretions

mucolytics

loosen mucus to promote

acetylcysteine

Mucomyst

mu-kO-LIT-iks

its elimination

DISPLAY 8-1 Common Drugs and Their Actions, continued

EXAMPLES

CATEGORY

ACTIONS; APPLICATIONS

GENERIC NAME TRADE NAME

sedatives/hypnotics

SED-a-tivs/hip-NOT-iks

induce relaxation and sleep; lower (sedative) doses promote relaxation leading to sleep; higher (hypnotic) doses induce sleep; antianxiety agents also used

phenobarbital

Zolpidem Ambien

tranquilizers tran-kwi-LI Z-ers

reduce mental tension and anxiety; see antianxiety agents (above, under psychotropics)

DISPLAY 8-2 Therapeutic Uses of Herbal Medicines

NAME

PART USED

THERAPEUTIC USES

aloe

leaf

treatment of burns and minor skin irritations

black cohosh

root

reduction of menopausal hot flashes

chamomile

flower

anti-inflammatory, gastrointestinal antispasmodic, sedative

echina_cea_ e-ki-NA-she-a

all

reduction in severity and duration of colds; may stimulate the immune system; used topically for wound healing

evening primrose oil

seed

source of essential fatty acids important for the health of the cardiovascular system; treatment of premenstrual syndrome (PMS), rheumatoid arthritis, skin disorders

flax

seed

source of fatty acids important in maintaining proper lipids (e.g., cholesterol) in the blood

ginkgo

leaf

improves blood circulation in and function of the brain; improves memory; used to treat dementia; antianxiety agent; protects the nervous system

ginseng

root

stress reduction; lowers blood cholesterol and blood sugar

green tea

leaf

antioxidant; acts against cancer of the gastrointestinal tract and skin; oral antimicrobial agent; reduces dental caries

kava

root

antianxiety agent; sedative

milk thistle

seeds

protects the liver against toxins; antioxidant

saw palmetto

berries

used to treat benign prostatic hyperplasia (BPH)

slippery elm

bark

as lozenge for throat irritation; for gastrointestinal irritation and upset; protects irritated skin

soy

bean

rich source of nutrients; protective estrogenic effects in menopausal symptoms, osteoporosis, cardiovascular disease, cancer prevention

St. John's wort

flower

treatment of anxiety and depression; antibacterial and antiviral properties (note: this product can interact with a variety of drugs)

tea tree oil

leaf

nonirritating antimicrobial; used to heal cuts, skin infections, burns

valerian

root

sedative; sleep aid

DISPLAY 8-3 Routes of Drug Administration

ROUTE

DESCRIPTION

absorption

drug taken into the circulation through the digestive tract or by transfer across another

membrane

inhalation

administration though the respiratory system, as by breathing in an aerosol or nebulizer

in-ha-LA-shun

spray

instillation

liquid is dropped or poured slowly into a body cavity or on the surface of the body, such

in-stil-LA-shun

as into the ear or onto the conjunctiva of the eye (Fig. 8-1)

oral

given by mouth; per os (po)

OR-al

rectal

administered by rectal suppository or enema

REK-tal

sublingual (SL)

administered under the tongue

sub-LING-gwal

topical

applied to the surface of the skin

TOP-i-kal

transdermal

absorbed through the skin, as from a patch placed on the surface of the skin

trans-DER-mal

injection (Fig. 8-2)

administered by a needle and syringe (Fig. 8-3); described as parenteral (pa-REN-ter-al)

routes of administration

epidural

injected into the space between the meninges (membranes around the spinal cord) and

ep-i-DUR-al

the spine

intradermal (ID)

injected into the skin

in-tra-DER-mal

intramuscular (IM)

injected into a muscle

in-tra-MUS-kU-lar

intraven ous

injected into a vein

in-tra-VE-nus

spinal (int rathecal)

injected through the meninges into the spinal fluid

in-tra-THE-kal

subcu taneou s (SC)

injected beneath the skin; hypodermic

sub-ku-TA-ne-us

Conjunctival Sac

FIGURE 8-1. Instillation of eye drops into the lower conjunctival sac. (Reprinted with permission from Taylor C, Lillis C, LeMone P. Fundamentals of Nursing: The Art and Science of Nursing Care. 4th Ed. Philadelphia: Lippincott Williams & Wilkins, 2001.)

FIGURE 8-2. Comparison of the angles of insertion for intramuscular, subcutaneous, and intradermal injections.

Cap Chur Type Tranquilizer Syringes
Skin Subcutaneous tissue Muscle

□ Intramuscular injection

□ Subcutaneous injection

□ Intradermal injection

FIGURE 8-3. Parts of a needle and syringe.

FIGURE 8-3. Parts of a needle and syringe.

Nilstat Syringe

DISPLAY 8-4 Drug Preparations

FORM

aerosol AR-o-sol

solution dispersed as a mist to be inhaled

aqueous solution A-kwe-us

substance dissolved in water

elixir (elix) e-LIK-sar

a clear, pleasantly flavored and sweetened hydroalcoholic liquid intended for oral use

emulsion e-MUL-shun

a mixture in which one liquid is dispersed but not dissolved in another liquid

lotion LO-shun

solution prepared for topical use

suspension (susp sus-PEN-shun

) fine particles dispersed in a liquid; must be shaken before use

tincture (tinct) TINK-chur

substance dissolved in an alcoholic solution

SEMISOLID

cream krem

a semisolid emulsion used topically

ointment (ung) OYNT-ment

drug in a base that keeps it in contact with the skin

SOLID

capsule (cap) KAP-sui

material in a gelatin container that dissolves easily in the stomach

lozenge LOZ-enj

a pleasant-tasting medicated tablet or disk to be dissolved in the mouth, such as a cough drop

suppository (supp) substance mixed and molded with a base that melts easily when inserted into a body su-POZ-i-tor-e opening

tablet (tab) TAB-let

a solid dosage form containing a drug in a pure state or mixed with a nonactive ingredient and prepared by compression or molding; also called a pill

DISPLAY 8-5 Terms Pertaining to Injectable Drugs

TERM

MEANING

ampule AM-pui

a small sealed glass or plastic container used for sterile intravenous solutions (Fig. 8-4)

bolus BO-lus

a concentrated amount of a diagnostic or therapeutic substance given rapidly intravenously

catheter KATH-e-ter

a thin tube that can be passed into a body cavity, organ, or vessel (Fig. 8-5)

syringe sir-INJ

an instrument for injecting fluid (see Fig. 8-4)

vial VJ-al

a small glass or plastic container (see Fig. 8-4)

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    What is conjunctival sac eye?
    7 years ago

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