Pharmacology Exam 1
Assessing Pain and pain management
Defining goals- The goal of the drug therapy is to produce maximum
benefit with minimum harm. That is, drugs in such a way as to maximize
therapeutic responses while preventing or minimizing adverse reactions and
interactions should be employed. The objective of planning is to formulate
ways to achieve this goal.
Identifying- The heart of planning is the identification of nursing
interventions. For medication purposes, these interventions can be divided
into four major groups
~Drug administration
~interventions to enhance therapeutic effects
~interventions to minimize adverse effects and interactions
~patient education (which encompasses information in the first three
groups).
Evaluation- Over the course of drug therapy, the patient must be evaluated
for
~ therapeutic
~adverse drug reactions and interactions
~adherence to the prescribed regimen
~satisfaction with treatment. How frequently evaluations are performed
depends on the expected time course of therapeutic and adverse effects.
Like assessment, evaluation is based on laboratory tests, observation of the
patient, physical examination, and patient interviews. The conclusions drawn
during evaluation provide the basis for modifying nursing interventions and
the drug regimen.
Drug Names:
Generic: Chemical name of a drug
Proprietary: “Brand” name
Over the Counter Meds
~Assessment
~Education
~Medication food interactions
Major Pharmacokinetics Processes:
Pharmacokinetics is derived from two Greek words, pharmakon (drug or
poison) and kinesis (motion)
a. Medication absorption
~Absorption is defined as the movement of a drug from its site of
administration into the blood.
b. Medication distribution is defined
~Distribution is defined as drug movement from the blood to the interstitial
space of tissues and from there into cells.
c. Medication Metabolism (biotransformation) is defined as the
enzymatically mediated altercation of drug structure.
d. Medication excretion is the movement of drugs and their metabolites
out of the body. The combination of metabolism plus excretion is called
elimination. The four pharmacokinetic processes, acting in concert,
determine the concentration of a drug at its sites of action.
Drug levels
a. Half-life
b. First-pass effect
c. Renal Medication excretion
d. Therapeutic Index
Drug half-life is defined as the time required for the amount of drug in the
body to decrease by 50%. A few drugs have half-lives that are extremely
short-on the order of minutes. In contrast, the half-lives of some drugs
exceed 1 week. Drugs with short half-lives leave the body quickly. Drugs with
long half-lives leave slowly.
First-pass effect-too much of the drug is absorbed by the liver-there is not
enough left in circulation to be effective.
--First- pass effect (rapid hepatic activation of certain oral drugs) when drugs
are absorbed from the GI tract, they are carried directly to the liver via the
hepatic portal vein.
-- If the capacity of the liver is extremely high that drug can be completely
inactivated on its first pass through the liver (nitroglycerine PO is example of
a drug that you will see a therapeutic action being exerted before the drug is
exposed to hepatic enzymes.
Therapeutic index is a measure of a drug’s safety and determined using
laboratory animals. Drugs with a narrow therapeutic index are more difficult
to administer safely, whereas drugs with a high or wide therapeutic index is
safer to administer.
Drug to Drug interactions
a. Adverse effects
b. Therapeutic effects
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