Class notes
Nur 324 Lecture 1 Notes
- Course
- NUR 324
- Institution
- Gwynedd Mercy University
NUR 324 lecture 1 - Basic pharmacology, Pharmacokinetics and Pharmacodynamics, Inflammatory Response. *Essential Study Material!!
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Basic PharmacologyNurses check lab work and monitor blood pressure before administering certain medications
Patient education – if patient asks question and the nurse answers
Monitor for allergic reaction, hypersensitivity
Nursing process – assessment is the first step
Never give a medication to a patient you are unfamiliar with, look it up first to prevent any errors
Make sure the patient you are administering the medication to is the correct patient
If patient does not want medication ask why, if patient continues to refuse medication, document it and
notify the physician
The Patient’s Responsibility
Know the name and dose of the medication they are taking
Have complete and accurate list of meds – ensure there is no double dosing
Read labels and follow directions
Store drugs properly and safely – do not store in bathroom because there’s moisture and easy
access
Patients should always ask questions to ensure they know why they are taking their meds and
how to take their meds correctly
Medication Reconciliation
Drug-drug interaction
Vitamins and supplements can interact with medication
Medication Errors
Nurses will make errors but it is important to admit to it to ensure the error is fixed or so the
patient can be informed and monitored
High Alert Medications
Chemotherapy drugs
Insulin
Opioids
Potassium – IV
Parenteral nutrition
, Anticoagulants
Look-Alike/Sound-Alike Medications
Abbreviations
o Should be avoided to lessen chance of error
o Write out all directions
Bringing a New Drug to Market
Cell studies/lab studies
Many medications never get further than this stage
Animal studies
Look to see if there are any adverse effects
Drug research is stopped at any time if:
Does not work
Too toxic
Carcinogenic
Teratogenic
Small safety margin
Clinical Trial: Phase 1
Safety is main concern
Goals of phase 1 are
o To find the highest dose of the new treatment that can be given safely
without causing severe side effects
o Helps to decide on best way to give treatment
o To determine what the drug does to the body and what the body does
with the drug
Clinical Trial: Phase 2
Done at major medical centers
Continue to gather info about side effects
Clinical Trial: Phase 3
Typically done on about 3000 participants
Evaluates how the medication works in comparison to existing medications for the same
condition
Looks at new indications, formulations, patient populations
Drug companies can apply for FDA approval upon completion of Phase 3 trial
Fast tracking – process expedited – may lead to missed problems
,Clinical Trial: Phase 4
Post marketing – drug already approved by FDA
Studies may involve thousands of people
Safest type of clinical trial
These studies look at other aspects of the treatment
Package insert
Contains all information on drug
This information can also be found online by searching the specific drug name
Where to find package insert – Micromedex, in the box of medication
Off- Label Use
Medication is used for an indication other then what it was approved for
o Often supported in literature but not FDA approved
Ex Gabapentin
OTCs
Real medications with adverse effects
Dangers
o Can mask symptoms of disease
o Hidden meds
o Increasing dose
o Drug interactions
Orphan Medications
Medication developed specific to treat a rare condition
The Orphan Drug Act was passed in 1983
The Controlled Substance Act
The statute establishing federal US drug policy under which the manufacture,
importation, possession, use, and distribution of certain substances
Controlled Substance Schedules
Schedule 1: heroin, LSD, marijuana, ecstasy
Schedule 2: opioids
Schedule 3: low doses of hydromorphone, Tylenol with codeine, anabolic steroids
Schedule 4: benzodiazepines and tramadol
Schedule 5: Phenergan, codeine cough syrup
Challenges to Drug Therapy
Patients are the consumers
They should not know more than you
They need to understand what they know
, Other factors:
o Cost/ medical needs
o Illicit drug use
o Insurance issues
o Pre-conceived beliefs about medications
Why are Drugs so Expensive
Pharmaceutical companies invest a lot of money into new drugs and set the prices higher to
make up for any losses
Pharmacokinetics and Pharmacodynamics
Drug classification
o Classified by effects on:
Particular body system (opioids are a CNS depressant)
Therapeutic uses (antidepressants)
Chemical Characteristics (Beta-adrenergic blockers or benzodiazepines which
work on GABA)
Drugs can fall into multiple categories
o Prototype
Usually the first medication in a class standard in which other drugs are
compared in the class
Morphine
Fluoxetine (Prozac)
Captopril
Drug Names
o Generic name
Official name of medication
Never changes
Must meet same FDA standards
Helps indicate what class the drug falls into:
Examples: “pril” “olol” “statin”
o Trade or Brand Name
Decided and patented by the manufacturer
Can be several different brand names
Example:
o Prinivil and Zestril (Lisinopril)
o Advil (Ibuprofen)
Pharmacodynamics
o Interaction between the living system (person) and the foreign chemical
o How a drug affects the body
Replace or act as a substitute for missing chemicals (insulin)
Increase or stimulate certain cellular activities (beta agonists)
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