chapter 7 cultural and pharmocogenetic considerations

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Pharmacology
Chapter 7
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Ethnopharmacology

the study of drug responses that may be unique to an individual due to social, cultural, and biologic phenomena. Ethnopharmacology integrates pharmacokinetics (the process of drug movement in the body to achieve drug action and ultimately elimination), pharmacodynamics (drug concentrations and their effects on the body)

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pharmacogenetics

the effect of a drug that varies from the predicted response due to genetic factors)

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Who began the concept of transcultural Nursing?

The concept of transcultural nursing was formalized by Madeleine Leininger, a nurse anthropologist who founded the Transcultural Nursing Society in 1974. A challenge for nurses worldwide is the degree of cultural diversity owing to migration and global movement

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What is assimulation?

Assimilation occurs when a less powerful group changes its ways to blend in with the dominant cultural group.

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What is complimentary Health practices?

The combination of traditional Health care practices and main stream healthcare practices

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What are alternative Health Care practices?

When a dominant group adopts health practices from a nondominant group

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What are the 6 cultural phenomena that Giger and Davidhizar decribed?

Communication
Space
Social organization
Time
Environmental control
Biologic variations

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Nursing Process: Assessment

Assess ethnocultural and racial background

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Nursing Process: Planning

Collaborate with client to reduce high-risk health behaviors

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Nursing Process: Nursing Interventions

Incorporate nonharmful traditional and folk practices with biomedical prescriptions

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Nursing Process:Education

Involve family in teaching about prescriptive therapies

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Nursing Process: Evaluate

Client correctly demonstrates understanding of prescriptive therapies and treatments

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Timeliness for appointments may be especially important for some members of which ethnocultural group?

European Americans

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Research shows that some African Americans....

A.are less responsive to beta blockers than are European Americans.

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Peoples of European Descent

Peoples of European Descent

Prefer direct eye contact.

Use moderate to loud vocal volume.

Use many words to describe symptoms.

Uncomfortable with periods of silence.

Prefer a large amount of personal space.

Value privacy.

Exhibit a low to moderate amount of touching among group members.

Small, nuclear families.

Extended family members often live a far distance away.

High degree of individualism.

Primarily future- oriented.

Secondarily present-oriented.
Primarily believe that healthy behaviors prevent illness.

Secondarily believe that illness is caused by cosmic forces.

Believe in being united with a deity in the afterlife.

Poor metabolizers of tricyclic antidepressants and isoniazid (INH), which can lead to toxicity.

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Peoples of African Descent

Peoples of African Descent

Prefer direct eye contact.

Use moderate to loud vocal volume.

Uncomfortable with periods of silence.

Comfortable with a smaller amount of personal space.

Exhibit moderate amount of touching among group members.

Small, nuclear families in America but

may classify nonrelated persons as family. Important to recognize these members of the social group.

Primarily present-oriented.

Secondarily future-oriented.

Spiritually oriented. Important to include clergy in care.

Believe in being united with a deity in the afterlife.

May have diminished therapeutic effects from beta blockers, ACE inhibitors, and warfarin sodium (Coumadin).

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Peoples of Latin American or American Indian Descent

Peoples of Latin American Descent and Native Americans

Not likely to make direct eye contact with persons perceived to be in authoritative positions.

Varying degrees of comfort with silence.

Comfortable with a small amount of personal space.

Latin Americans value touching.

Native Americans use touch lightly.

Large, extended families.

Important to include family members in care.

Primarily present-oriented.

Secondarily future-oriented.

Spiritually oriented. Followers of Christian religions derive comfort from religious artifacts such as rosary beads.

There may be multiple deities in indigenous religions.

Native Americans have high incidence of lactose intolerance resulting in low calcium diets. Also exhibit enhanced vasomotor responses to alcohol.

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Peoples of Asian descent

Peoples of Asian Descent

Not likely to make direct eye contact with persons perceived to be in authoritative positions.

Use low vocal volume.

Comfortable with periods of silence.

Comfortable with a small amount of personal space.

Little touching in public among group members.

Family size varies.

Extended family valued.

Important to include family members in care.

Primarily present-oriented.

Secondarily future-oriented.

Some groups are past oriented.

Many followers of non-Christian religions. There may be multiple deities in indigenous religions. Reincarnation may be part of belief system.

May have diminished therapeutic effects from codeine.

Are rapid metabolizers of isoniazid (INH).