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NUR 243 Exam 1 Summarized Notes

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Comprehensive, detailed and Summarized Lecture notes including slideshow notes, in class notes, images, drug charts, etc covering topics of orientation to pharm, nursing responsibilities, stages of drug development, basic principles, pharmacokinetics, pharmacodynamics, drug interactions, adverse re...

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  • September 18, 2024
  • 59
  • 2022/2023
  • Class notes
  • Prof. stout
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Key
regular: slideshow notes
italics: in class notes
gray: not on exam
Chapter 1: Orientation to Pharmacology
● Prototype drugs
○ Individual drugs that represent groups of drugs are called prototypes
○ New drugs are compared to these prototypes
■ May be the first drugs of this group to be developed
● e.g penicillin for antibiotics, morphine for opioid analgesics
■ Diphenhydramine (Benadryl) is the prototype that all other antihistamines
are compared- loratadine (Claritin)
● When loratadine came out it was compared to Diphenhydramine
● Medication classification
○ Drug prototype
■ Drug with similar characteristics group together as a pharmacology class
or family
● Beta Blockers, Calcium channel blockers
○ Therapeutic classification
■ Characterize drugs by therapeutic use
● Antihypertensive, Antibiotics, and Antidepressants
■ Tells us nothing if we do not know the exact medication
■ Can be useful for patients who only want basic understanding of what
medication they are taking
○ Chemical name
■ Chemical makeup
● B-lactam antibiotics, Cardiac glycoside, Thiazide diuretics,
Benzodiazepine
○ Mechanism of action/Pharmacological classification
■ How a drug produces its physiological effect in the body
■ Represents how drugs that share a common molecular mechanism of
action by modulating a specific mechanism in the body or target site in the
body
■ Receptor target
● Antagonist, agonist
○ Angiotensin II receptor antagonist
■ Enzyme target
● Activate or inhibit
○ ACE, PPI, NSAID
○ Mode of action
■ A common cellular mode of action

, ● Diuretics, Cholinergic
● Chapter 1 Objectives
○ Define 4 basic terms
○ Discuss the properties of an ideal drug
○ Identify factors that determine the intensity of a drug response
● Four basic terms
○ Drug
■ Very general term
■ Not always therapeutic or useful
● Alcohol
○ Pharmacology
■ Looking at drugs in mammals
○ Clinical Pharmacology
■ Looking at drugs used in humans
■ Ch 4, 5, 7, 13
○ Therapeutics or Pharmacotherapeutics
■ Something used to treat or prevent an illness, disease, or disorder
■ Therapeutics
● Heat or ice to treat back pain
● Massages
■ Pharmacotherapeutics
● Drugs used to treat illnesses
● Three most important properties of an ideal drug
○ Ideal properties
■ Trying to find drugs that are as close to ideal as possible
○ Effectiveness: Most important property a drug can have
■ Drugs will never be approved without efficacy
○ Safety: Drug cannot produce harmful effects
■ Aiming for as safe as possible
■ Looking for adverse effects
○ Selectivity: Drug elicits only the response for which it is given
■ Trying to have them as selective as possible to only have the desired
response
○ Accessibility: Need to be able to get the drug
■ Location wise
■ Financially
■ Low cost
○ Ease of administration
■ Can you manage drug in your lifestyle
■ Multiple doses per day can decrease ease of administration

, ● Therapeutic objective of drug therapy
○ To provide maximum benefit with minimum harm
○ It is through drug related patient care and patient education that nurses can
promote maximal safety
○ Let patient know the potential side effects so there are no unintended
consequences
■ If patients don’t know oral contraceptives can cause nausea for first few
weeks and not take the pill it can lead to pregnancy
● Factors that determine intensity of drug response
○ Prescribed dose is by licensed provider
○ Concentration will drive intensity
○ IV drug has instant concentration at sight of receptors
■ Intensity is instant




Chapter 2: Evolution of Nursing Responsibilities Regarding Drugs
● Nurses and healthcare providers must participate in a system of checks and balances
designed to promote beneficial effects and to minimize harm to patients
● Evolution of nursing responsibilities regarding drugs
○ The nurse must know
■ What medications are appropriate for the patient
■ What drugs are contraindicated for the patient
■ The probable consequences of the interactions between the drug and the
patient
● Can anticipate problems with certain drugs

, ○ The nurse’s role as advocate
■ Last line of defense for the patient
● We give the medication
● As legally responsible as provider and pharmacist
■ Ethically and legally unacceptable to administer a drug that is harmful to
the patient, even though the medication has been prescribed by a licensed
prescriber and dispensed by a licensed pharmacist
● Malpractice if administer a medication that is harmful to patient
● Application of pharmacology in patient care
○ Two major areas in which pharmacologic knowledge can be applied
■ Patient care
● Giving medications, OLDCART, taking blood pressure, etc
■ Patient education
○ Preadministration assessment
○ Dosage and administration
○ Evaluating and promoting therapeutic effects
○ Minimizing adverse effects
○ Minimizing adverse interactions
○ Making PRN decisions
○ Managing toxicity
● Evolution of nursing responsibilities regarding drugs
○ Right drug
○ Right patient
○ Right dose
○ Right time
○ Right assessment
○ Right documentation
○ Right evaluation
○ Right of patient to education
○ Right of patient to refuse care
● Promoting therapeutic effects
○ Promoting patient adherence
■ Also known as compliance or concordance
■ Extent to which a patient’s behavior coincides with medical advice
○ Implementing nondrug measures
■ Drug therapy can often be enhanced by nondrug measures
■ These include biofeedback, emotional support, smoking cessation, sodium
restriction, etc
● Evaluation of therapeutic effects
○ Evaluating therapeutic responses

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