NUR350 – EXAM 1 STUDY GUIDE
CHAPTER 1
Pharmacology – study of drugs and their interactions with living systems
Drug – any chemical that can affect living processes
Clinical Pharmacology – study of drugs in humans
Pharmacotherapeutics – use drugs to diagnose, prevent or treat disease or prevent pregnancy
3 Most Important Properties of an Ideal Drug (no drug is ideal):
1. Effectiveness: most important property a drug can have; #1 reason why we take drugs
2. Safety: drug cannot produce harmful effects
3. Selectivity: drug elicits only the response for why it is given
Adverse Effects Examples:
- Certain anticancer drugs can increase risk for infection
o Ex: cyclophosphamide, methotrexate
- Opioid analgesics at high doses can cause respiratory depression
o Ex: morphine, meperidine
- Aspirin and other related drugs (NSAIDs) can cause severe gastric ulceration,
perforation, and bleeding if taken for prolonged periods of time
Additional Properties of an Ideal Drug
- Reversible action antidotes (ex: naloxone is the antidote for all opioids)
- Predictability
- Ease of administration
- Freedom from drug interactions – will it mix with other drugs?
- Low cost
- Chemical stability – is it stable in your body?
- Simple generic name
Therapeutic Objective: MAXIMUM BENEFIT WITH MINIMAL HARM
Factors that Determine Intensity of Drug Responses
1. Administration – dosage size, route, timing
o IV is fastest (5 min onset, 15 min peak) compared to IM, oral
o Medication errors and patient adherence
2. Pharmacokinetics = impact of body on drugs – how much of dose gets to site of action
o 4 major processes: absorption, distribution, metabolism (utilization) & excretion
3. Pharmacodynamics = impact of drugs on body
o Drug-receptor interaction = binding of drug to another
o Patient functional state influences pharmacodynamic processes
o Placebos help determine responses a drug elicits
4. Sources of Individual Variation
, CHAPTER 2
10 Patient Rights:
1. Right Drug
2. Right Patient
3. Right Route
4. Right Dose
5. Right Time
6. Right Assessment
7. Right Documentation
8. Right Evaluation
9. Right to Education
10. Right to Refuse
Nurse Responsibilities with Drugs – proper delivery is only the beginning of responsibilities
- Nurses are the last line of defense
- Must know appropriate meds for each pt and drugs contraindicated
- Ethically and legally unacceptable to administer harmful drugs, even if prescribed
Applying Pharmacology in Patient Care
2 major areas: patient care and patient education
- Pre-administration Assessment – collect baseline data, identify high-risk
- Dosage & administration – some drugs have >1 indication, dosage and route may differ
o DO NOT ADMINISTER DRUG IF YOU DO NOT UNDERSTAND THE REASON FOR USE
- Elevate and promote therapeutic effects – know rationales, promote patient adherence
o Compliance / concordance – pt adheres to medication regimen
- Minimizing adverse effects – all drugs have adverse effects, avoid OTC that interact w Rx
- Making PRN decisions and managing toxicity
Patient Education
Drug name and category
Dosage size and schedule
Route and administration technique
Expected therapeutic and adverse responses
Nondrug measures
Treatment duration
Drug storage
Who to contact
*Educate patient about hazardous drug-drug and drug-food interactions
Ex: Phenelzine and interactions with drugs (amphetamines) and food (figs)
- Phenelzine is MAOI inhibitor – most toxic - MIX WITH NOTHING
, CHAPTER 3
Landmark Drug Legislation
Federal Pure Food and Drug Act, 1906 – first
Comprehensive Addiction and Recovery Act of 2016 – most recent
Stages of New Drug Development
Preclinical Testing
Clinical Testing: Phase I, Phase II & III, Phase IV (post marketing surveillance)
Limitations: limited info on women and children, failure to detect all adverse effects
GENERIC VS. TRADE
Generic – more complicated
Trade – single drug with multiple names
U.S. drugs and drugs in other countries may have same names but different ingredients
Same trade name but different active ingredients (Ex: kaopectate)
*using generic name is safest way to refer to a medication because multiple trade names can
be used for the same medication
OTC DRUGS
- Americans spend $20 billion annually on OTC, 40% take at least one OTC every 2 days
- Accounts for 60% of all doses administered
- 4x as many illnesses are treated by OTC rather than physician
*Schedule I Drugs = highest potential for abuse
*Schedule V Drugs = lowest potential for abuse
CHAPTER 1
Pharmacology – study of drugs and their interactions with living systems
Drug – any chemical that can affect living processes
Clinical Pharmacology – study of drugs in humans
Pharmacotherapeutics – use drugs to diagnose, prevent or treat disease or prevent pregnancy
3 Most Important Properties of an Ideal Drug (no drug is ideal):
1. Effectiveness: most important property a drug can have; #1 reason why we take drugs
2. Safety: drug cannot produce harmful effects
3. Selectivity: drug elicits only the response for why it is given
Adverse Effects Examples:
- Certain anticancer drugs can increase risk for infection
o Ex: cyclophosphamide, methotrexate
- Opioid analgesics at high doses can cause respiratory depression
o Ex: morphine, meperidine
- Aspirin and other related drugs (NSAIDs) can cause severe gastric ulceration,
perforation, and bleeding if taken for prolonged periods of time
Additional Properties of an Ideal Drug
- Reversible action antidotes (ex: naloxone is the antidote for all opioids)
- Predictability
- Ease of administration
- Freedom from drug interactions – will it mix with other drugs?
- Low cost
- Chemical stability – is it stable in your body?
- Simple generic name
Therapeutic Objective: MAXIMUM BENEFIT WITH MINIMAL HARM
Factors that Determine Intensity of Drug Responses
1. Administration – dosage size, route, timing
o IV is fastest (5 min onset, 15 min peak) compared to IM, oral
o Medication errors and patient adherence
2. Pharmacokinetics = impact of body on drugs – how much of dose gets to site of action
o 4 major processes: absorption, distribution, metabolism (utilization) & excretion
3. Pharmacodynamics = impact of drugs on body
o Drug-receptor interaction = binding of drug to another
o Patient functional state influences pharmacodynamic processes
o Placebos help determine responses a drug elicits
4. Sources of Individual Variation
, CHAPTER 2
10 Patient Rights:
1. Right Drug
2. Right Patient
3. Right Route
4. Right Dose
5. Right Time
6. Right Assessment
7. Right Documentation
8. Right Evaluation
9. Right to Education
10. Right to Refuse
Nurse Responsibilities with Drugs – proper delivery is only the beginning of responsibilities
- Nurses are the last line of defense
- Must know appropriate meds for each pt and drugs contraindicated
- Ethically and legally unacceptable to administer harmful drugs, even if prescribed
Applying Pharmacology in Patient Care
2 major areas: patient care and patient education
- Pre-administration Assessment – collect baseline data, identify high-risk
- Dosage & administration – some drugs have >1 indication, dosage and route may differ
o DO NOT ADMINISTER DRUG IF YOU DO NOT UNDERSTAND THE REASON FOR USE
- Elevate and promote therapeutic effects – know rationales, promote patient adherence
o Compliance / concordance – pt adheres to medication regimen
- Minimizing adverse effects – all drugs have adverse effects, avoid OTC that interact w Rx
- Making PRN decisions and managing toxicity
Patient Education
Drug name and category
Dosage size and schedule
Route and administration technique
Expected therapeutic and adverse responses
Nondrug measures
Treatment duration
Drug storage
Who to contact
*Educate patient about hazardous drug-drug and drug-food interactions
Ex: Phenelzine and interactions with drugs (amphetamines) and food (figs)
- Phenelzine is MAOI inhibitor – most toxic - MIX WITH NOTHING
, CHAPTER 3
Landmark Drug Legislation
Federal Pure Food and Drug Act, 1906 – first
Comprehensive Addiction and Recovery Act of 2016 – most recent
Stages of New Drug Development
Preclinical Testing
Clinical Testing: Phase I, Phase II & III, Phase IV (post marketing surveillance)
Limitations: limited info on women and children, failure to detect all adverse effects
GENERIC VS. TRADE
Generic – more complicated
Trade – single drug with multiple names
U.S. drugs and drugs in other countries may have same names but different ingredients
Same trade name but different active ingredients (Ex: kaopectate)
*using generic name is safest way to refer to a medication because multiple trade names can
be used for the same medication
OTC DRUGS
- Americans spend $20 billion annually on OTC, 40% take at least one OTC every 2 days
- Accounts for 60% of all doses administered
- 4x as many illnesses are treated by OTC rather than physician
*Schedule I Drugs = highest potential for abuse
*Schedule V Drugs = lowest potential for abuse
