TERMS AND DEFINITION
Pharmacology
v It is the study of drugs, their origin, nature, properties and their effects upon living organism
Pharmacotherapy
v It is the use of drugs to prevent, diagnose, or treat signs, symptoms and disease process.
Pharmacodynamics
v What the drug does to the body
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PHARMACOLOGY
TERMS AND DEFINITION
Pharmacology
v It is the study of drugs, their origin, nature, properties and their effects upon living organism
Pharmacotherapy
v It is the use of drugs to prevent, diagnose, or treat signs, symptoms and disease process.
Pharmacodynamics
v What the drug does to the body
v Involves drug actions on target cells and the resulting alterations in cellular biochemical reactions and functions
Pharmacokinetics
v What the body does to the drug
v Involves drug movement through the body to reach sites of action, metabolism and excretion.
PROCESS OF DRUG TRANSPORT (ADME)
1. Absorption
v Occurs from the time a drug enters the body to the time it enters the bloodstream to be circulated.
Factors Influencing Drug Absorption
Dosage form
Route of administration
Blood flow
GI function
Presence of food or other drugs
2. Distribution
v Transport of drug molecules within the body.
3. Metabolism
v Also known as Biotransformation
v Method by which drugs are inactivated by the body.
4. Excretion
v Refers to the elimination of a drug from the body
v Kidneys, bowel, lungs and skin
v Enterohepatic recirculation
THERAPEUTIC INDEX
Side effects
v Physiologic effects not related to desired drug effects
v Expected and normal
Adverse reactions
v Any undesired responses to drug administration
v More severe than side effects
v Abnormal and reportable
Toxic effects
v Life-threatening effects, emergency
v Result from excessive amounts of drug and
may cause reversible/irreversible damage to body tissues
NURSING RESPONSIBILITIES IN MEDICATION ADMINISTRATION
OBSERVE THE TEN RIGHTS OF MEDICATION
Right route Right to refuse
Right time & frequency Right drug-drug interaction
Right of the patient Right education and information
Right drug Right history and assessment
Right dose Right documentation
1 TOPRANK REVIEW ACADEMY- NURSING MODULE
, NURSING*RADTECH*DENTISTRY*CRIMINOLOGY*MIDWIFERY*MEDTECH
LET*PSYCHOMET*RESPIRATORY THERAPY*CIVIL SERVICE*NAPOLCOM
NCLEX*DHA*HAAD* PROMETRIC* UK-CBT
Be familiar with the medication
v The reason it is being administered
v Desired effect, side effects and adverse effects
v Typical dose and range of safety, if applicable
v Specific safety regulations before administration
v Check the compatibility of the medication with the other drugs and infusions the patient is receiving.
v Do not administer any medication that you did not prepare.
Assess the patient
v Food or drug allergies
v Past medical history and present condition
v Knowledge deficit and health teaching needed
Evaluate Responses
v Evaluate patient for his or her response to the medication, and document if appropriate
v Report any unfavorable or unexpected response
ALLERGIC RESPONSES
Difficulty of breathing
Rashes /pruritus
Nausea / vomiting
Wheezing
Palpitations
TESTING & CLINICAL TRIALS OF DRUGS
v Testing process begins with animal studies. Next step involves Food & Drug Administration (FDA) to review
the data obtained in animal studies.
PHASE I Determine safe dosage, scheduling, and toxicity.
PHASE II Determine effectiveness with specific diseases.
PHASE III Establish if new drug is more effective than the standard drug.
PHASE IV Drug marketed for general use.
Continuous monitoring and further testing of drug
Nursing Considerations in Drug Administration
v Generally, the client should not take an antacid with medication or with milk because the antacid will affect the
absorption of the drug.
v Enteric-coated and sustained-release tablets should not be opened.
v Capsules should not be opened.
v Never adjust or change medication dose or abruptly stop taking the medication without physician’s order.
v Avoid taking any OTC (over-the-counter drug) or any other herbal reparations unless they are approved.
v Avoid smoking and drinking alcoholic beverages while taking specific drug.
v Never administer medication if the order is difficult to read or the dose is not within therapeutic range.
Hepatotoxic drugs Acetaminophen Ototoxic drugs Aminoglycosides
Erythromycin Aspirin
Iron overdose Chloroquine
Isoniazid Loop diuretics
Rifampicin Drug that can be Macrodantin
Sulfonamides cause staining Iron
Nephrotoxic drugs Acetaminophen Lugol’s solution
Acyclovir Tetracycline
Aminoglycosides Teratogenic Fluoroquinolones
Amphotericin B Aminoglycosides
Ciprofloxacin Tetracycline
Rifampicin Ace inhibitor
Sulfonamides Lithium
Tetracycline Oral hypoglycemic
Contrast medium Agents
2 TOPRANK REVIEW ACADEMY- NURSING MODULE
ORGAN SYMPA PARASYMPA
Eye Mydriasis Miosis
Bronchioles Bronchodilate Bronchoconstrict
Heart Inc. HR Dec HR
Blood vessel Vasoconstriction Vasodilation
GI tract Dec. Peristalsis Inc. Peristalsis
Urinary Bladder Bladder Relaxation Bladder Contraction
Contracts Sphincter to Prevent Urination Relaxes Sphincter to Permit Urination
Sweat glands Inc. Secretion None
Salivary glands Dec. Secretion Inc. Secretion
Adrenal glands Inc. Secretion of Epinephrine & None
Norepinephrine
SYMPATHETIC NERVOUS SYSTEM
v Also termed as adrenergic thoracolumbar system
v Fight or flight system
v Responsible for preparing the body to respond to stress
v Epinephrine and norepinephrine are the major neurotransmitters
Adrenergic receptor organ cells
v Alpha 1
• Found in the blood vessels, iris and urinary bladder
v Alpha 2
• Found on nerve membranes and act as modulator of NE release
v Beta 1
• Cardiac tissue
v Beta 2
• Bronchi, smooth muscles in the blood vessels, uterine muscles
Drug that mimic the effect of the norepinephrine
v Sympathomimetics
v Adrenergic agonists
Drug that block the effect of norepinephrine
v Sympatholytics
v Adrenergic Antagonist
PARASYMPATHETIC NERVOUS SYSTEM
v Also termed as cholinergic/ craniosacral system
v Acetylcholine is the major neurotransmitter
Drugs that mimic acetylcholine
v Parasympathomimetics
v Cholinergic agonists
drugs that block acetylcholine
v Parasympatholytics
v Cholinergic anatagonists
COMPARISON BETWEEN SYMPATHETIC AND PARASYMPATHETIC RESPONSES
Adrenergic Drugs
v Epinephrine
• Used in emergencies
• Treats Allergic reaction, anaphylaxis, bronchospasm & cardiac arrest
• Potent inotropic drug
v Norepinephrine
• Potent vasoconstrictor that increases BP and cardiac output
v Albuterol
• Selective for beta-2 adrenergic receptors
• Response: bronchodilation
• Used to treat bronchospasm, asthma: bronchitis
• Should not be given with MAOI (can cause hypertensive crisis)
v Isoproterenol
• Acts on B1 & B2 receptors
• Response: bronchodilation
v Ephedrine
• Used to treat hypotensive state, bronchospasm
• Relief of hay fever, sinusitis and allergic rhinitis
v Clonidine
• Selective Alpha 2 adrenergic drug
• Used to treat hypertension
v Dopamine
• Drug of choice for shock
v Dobutamine
• Used in treatment of CHF as it increased contractility without changes in rate or increase in O2 demand
Adrenergic Drugs Nursing Responsibilities
v Record baseline VS
v Assess other drugs' that the client is taking to avoid drug-to-drug interaction
v Check urinary output and assess for bladder distention
v Phentolamine mesylate = antidote for NE and dopamine overdose
Adrenergic Blockers
v Inhibit or block stimulation of the sympathetic nervous system
1. Alpha Adrenergic Blockers
v Drugs that block or inhibit a response at the alpha-adrenergic receptor sites
Non-selective Alpha Blockers (Al, A2)
v Phentolamine
Selective Alpha Blockers (A1)
v Doxazosin
v Prazosin
2.Beta-adrenergic Blockers
Non-selective Beta-adrenergic Blockers
v Propranolol
v Nadolol
v Timolol
Caution when giving Non-selective Beta-Adrenergic Blockers:
v COPD
v Bronchial Asthma
v DM
4 TOPRANK REVIEW ACADEMY- NURSING MODULE
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