PHARMACOLOGY FOR NURSING (BSN)
Terms
undefined, object
copy deck
- What is pharmacology?
- The study of drugs and how they react with living systems.
- Drug
- Any chemical that can effect a living process.
- Clinical pharmacology
- study of drugs in humans, not just in pt w/ health problems but in healthy individuals as well
- pharmacotherapeutics
- How drugs are used to diagnose prevent or treat disease, also how medications are used to prevent pregnancy (infertility is a disorder so it is under the disease category).
- Most important property of an 'ideal' drug.
- Effective - if it doesn't work nothing else really matters, even if it is safe.
- Ideal Drug
- effective, safe, selective, reversible, predictable, minimal drug interactions, minimal adverse effects, minimal side effects etc...
-
What determines how much of a drug gets to a receptor cite within the body? – several factors determine how moved through body
o Absorption
o Distribution
o Metabolism
o Excretion - pharmacokinetics
- Once drug is at the receptor site, what determines what effect the drug will have on the body?
- pharmacodynamics
- name some roles of nurses in drug therapy...
-
1. preadministrationinistration assessment
2. dosage and
3. administrationinistration
4. evaluating and promoting the therapeutic effects
5. minimize adverse effects – ie. Side effects
6. minimize adverse reactions – ie. Drug interactions
7. making prn decision - What are the 5 rights of drug administration?
-
Right Patient
Right Drug
Right Dose
Right Route
Right Time
oh and if you don't know what it is or what it does - don't give it... - Schedule one
-
opiates
opiate derivatives:like heroin, morphine
hallucinogens: peyote, mescaline, marihuana
there are many listed on fda's website... www.fda.gov/opacom/laws/ - schedule II
-
opium and opium salts,
Coca and all it's derivitives-cocaine
opiates: methadone, fentanyl, dihydrocodeine
methamphetamine injectables - schedule III
- amphetamines, phenmetrazine
- What determines how much of a drug gets to a receptor cite within the body?
-
Pharmacokinetics:
Absorption
o Distribution
o Metabolism
o Excretion - once drug is at the receptor site – what determines what effect the drug will have on the body
- Pharmacodynamics
- What factors influence a drugs intensity?
-
Administration
pharmacokinetics
pharmacodynamics
individual variations - What is the main goal of pharmacologic treatment?
- Provide the maximum benefit with the minimum drug therapy.
- Why are infants under one year at high risk when treating with drugs?
- Their liver and renal systems are not fully matured until about 12 mos.
- Why are the elderly at risk in drug therapy?
- Their organs have begun to deteriorate from age.
- many drugs have more than one use
- ex. Lanoxin and Digoxin lower HR but also effects the squeeze.
- Name some ways to reduce adverse effects
-
ID high risk pt - monitor closely
know the adverse effects and when they will occur
know early warning s/s
intervene when they occur - name some ways to reduce adverse interactions
-
find out what drugs they are on
know the drug interactions
take a THOROUGH drug history
assess allergy history - prn?
-
pro re nata
as needed - educate patient
-
drug's generic and trade name
family of drug
dosage
when to take it
route
technique-any special instrxn
how to store
drug to drug interactions
drug to food interactions - What we have to know on each drug:
-
class
intended therapeutic effect
how effect is achieved
side effects and adverse reactions
contraindications and cautions
examples of drugs - brand & generic
specific nursing axn rt class of drug - controlled drug act of 1970 did what?
- set rule for manufacture and distribution of drugs w/ potential abuse.
- list the 5 schedules for degrees of abuse
-
i- heroin, cocaine, marijuana
ii oxycodone, percoset, morphine
iii benzo's, zanax, hydrocodone
iv tallisan, darvoset
v ? he did not list any... - chemical name
- chemical description of the drug
- generic name
- assigned by the US adopted names council USANC
- trade name
- proprietary or brand name
- statin
- cholesterol med
- pharmacokinetics
- how drugs are moved through the body
- drug moved from site of administration into the blood stream
- absorption
- drug movement from the blood to the interstitial space of tissues and from there into cells.
- distribution
- enzymatically mediated alteration of drug structure
- metabolism = biotransformation
- movement of drugs and their metabolites out of the body
- excretion
- what efects absorption
-
rate of dissolution
surface area
blood flow
lipid solubility
pH partitioning - rate of dissolution
- of more easily dissolved will increase the absorption rate
- absorption rate vs amount...
- Absorption: rate of absorption effects how fast will work Amt. absorbed determines how much effects
- surface area?
- the larger the surface area the faster the rate of absorption (more effective but not faster)– small intestine (30ft of intestine). Oral disintegrating are very fast w/n 8 min. IM takes 15-20 min.
- Blood flow and absorption
- drugs are absorbed faster in areas of high blood flow
- lipid sol and absorption?
-
o Lipid solubility: highly lipid soluble drugs absorbed more rapidly
 Prime example- Diprivan knocks out a pt on a vent – mother’s milk. Titrate it up a little - What does pH have to do w/ absorption?
- o pH partitioning: acid/base attraction increases absorption
- What is enteral?
- GI tract - po
- what is parenteral?
- outside the GI- sc, im, iv
- what is the barrier in PO meds?
- epithelial lining--> capillary walls -->blood stream
- advantages of po?
- easy administration, inexpensive, safer than parenteral, possible to reverse absorption (charcoal)
- disadvantages of po?
-
variable rate
inactivates as it passes through GI
pt requirements: have to be able to take PO... - enteric coating
- saves the absorption until reaches small intestine
- sustained release?
- allows for more consistent drug levels - slowly brks down
- iv - no barrier to absorption -
- advantages of iv: rapid onset, administration of large amt of fluids w/ drug (dilute), complete administration of drug, can regulate easier
- iv disadvantages
- increased cost, diff in administering, fluid overload, IRREVERSIBLE, infection at site, air embolism, sediment can embolize when meds not mixed well,
- How long should all drugs IV be pushed
- over one full minute: dilutes through the blood stream - it takes a minute for the blood to cycle in body. that way you don't over load the heart with a heavy dose of a drug.
- IM barriers
- capillary lining
- IM rate of absorption
- faster than po not as fast as iv
- disadv/adv of IM or SC injxn
-
no embolism, deliver of slow period of time possible - depo
pain, inconvenience, nerve dmg - topical absorption
- absorbed into skin, capillaries then blood.
- inhaled absorption
- fast absorbing b/c air sacs in lungs to capillaries
- suppository absorption
-
faster than PO
considered a PO med - What determines distribution?
- blood flow to tissues, exit the vascular sys, and entering cells