NUR 100 Pharmacology Packet-

NUR 100 Pharmacology Packet -2023 -2024 FORTIS INSTITUTE PENSACOLA ASSOCIATE DEGREE OF NURSING PROGRAM NUR100 Pharmacology Packet Mrs. Chris Sproles, MSN, RN Instructor Revised Winter 2016 Prepared by C. Sproles 1.15.2012/Rev. 12.17.2015 2 Table of Contents Safe Medication Administration................................................................................ 3 Lifespan Considerations ............................................................................................ 4-5 Legal and Cultural Considerations ............................................................................ 6-7 Pharmacology Terms ................................................................................................. 8-12 Medication Abbreviations ......................................................................................... 13-14 Drug Class Endings ................................................................................................... 15-17 Selected Herbs and Dietary Supplements............................................................ ...... 18-19 Autonomic Nervous System ...................................................................................... 20-28 Antihypertensives – Adrenergic Agonists and Antagonists ...................................... 29 Opioid Analgesics.......... ............................................................................................ 30 Nonopioid Analgesics................................................................................................ 31 Central Nervous System Stimulants .......................................................................... 32 Central Nervous System Depressants ........................................................................ 33 Miscellaneous & Antiepileptic Drugs ..................................... .................................. 34 Drugs for Neuromuscular Conditions........................................................................ 35 Antidepressants and Mood Stabilizing Drugs ........................................................... 36 Diuretic Agents .......................................................................................................... 37 Drugs Acting on the Renin Angiotensin Aldosterone System (RAAS) .................... 38 IV Therapy – Fluids and Electrolytes ........................................................................ 39 Calcium Channel Blockers and Vasodilators ............... ............................................. 40 Antianginal Agents – NBCs .................................................................................... 41 Other Drugs for Heart Failure................................................................ .................... 42 Vaughan Williams Classification Antidysrhythmic Drugs ....................................... 43 Antilipemics............................................................................................................... 44-46 Antic oagulants ........................................................................................................... 47 Drugs Affecting Coagulation..................................................................................... 48 Nonsteroidal Anti -inflammatory Drugs and Anti-Gout Drugs.................................. 49 Respiratory Drugs ...................................................................................................... 50-53 GI Agents................................................................................................................... 54-57 Insulin ........ ................................................................................................................ 58-59 Antidiabetic Agents ................................................................................................... 60-61 Biologic Response -Modifying Drugs ........................................................................ 62 Endocrine (Thyroid, Adrenal, etc.) Agent s ............................................................... 63-66 Drugs for Women’s Health........................................................................................ 67 Drug s for Acute and Chronic Kidney Disease ......................................................... 67-68 Hematopoietic Drugs ................................................................................................. 68 Immunosuppressant Drugs ........ ................................................................................ 68 Antineoplastic Agents................................................................................................ 69-71 Drugs for Men’s Health ............................................................................................. 72 Antibiotic Agents....................................................................................................... 73-74 Antitubercular Agents................................................................................................ 75 Antiviral Agents (Non -HIV)...................................................................................... 76 Anti-retroviral Drugs for HIV/AIDS ......................................................................... 77 Antifungal Agents...................................................................................................... 78 Drugs for the Skin.................................................... .................................................. 79-80 Drugs for the Eye....................................................................................................... 81-82 Prepared by C. Sproles 1.15.2012/Rev. 12.17.2015 3 NUR100 Pharmacology Safe Medication Administration I. Assessment A. Subjective information – patient drug history, complaints, response to treatment B. Objective information – physical exam, vital signs , laboratory tests II. Complete medication History A. Over the counter (OTC) medications B. Prescription (Rx) medications C. Street drugs D. Herbal supplements E. Allergies i. AKA ii. NKA iii. NKDA F. Diseases G. Growth and development III. Groups prone to adverse drug reactions A. Immunocompromised B. Renal (kidney disease) – know BUN (blood urea nitrogen ) and creatinine C. Hepatic (liver disease, alcoholism) – know LFTs (liver function tests) – ALT, AST, alk phos D. Genetic factors E. Drug allergies F. Pregnancy G. Infants and children (immature organs) H. Elderly (deteriorating organs) IV. Drug Information A. Drug handbook/guide (i.e., Mosby’s Drug Reference) B. Pharmacology textbook (Lilley) C. Physician’s Desk Reference (PDR) D. Drug Manufacturer Insert E. Micromedex (iPhone app) and other online drug formularies F. Only if the above resources are not available, a registered pharmacist may be contacted. V. The 6 rights of medication administration (and then some A. Right drug – verify spelling with drug order (MAR) B. Right dose – verify calculations (ask another RN to double check, if in doubt) C. Right time – one hour before to one hour after time scheduled (note exceptions) D. Right route – do not assume route (verify with prescriber if doubt) E. Right patient – check ID band; have patient state name and date of birth (compare to MAR) F. Right documentation – document on MAR; document PRNs and patient response in chart G. Right education – use every opportunity to teach patient and/or family regarding their meds, nonpharmacologic measures to enhance drug therapy (diet, exercise, lifestyle changes, etc.) H. Right response – an 8th right of medication administration to consider I. Right to refuse – a 9th right of medication administration is the patient’s right to refuse treatment Prepared by C. Sproles 1.15.2012/Rev. 12.17.2015 4 VI. Drugs with similar names A. SALAD – sound -alike look-alike drugs B. LASA – look-alike sound -alike Be careful not to rely on information from your peers or co -workers because YOU are the one responsible for administering the right drug!! Lifespan Considerations I. Drug therapy during pregnancy A. During the trimester of pregnancy the fetus is at the greatest risk for drug -induced developmental defects. The embryonic period (weeks 3 -8) is when expectant mothers must take special care to avoid exposure to teratogens. B. During the trimester the greatest percentage of maternally absorbed drug will get to the unborn baby. Know why! Increased blood flow and lipid soluble drugs cross the placenta the easiest. C. Assume that any drug taken can cross the placenta D. Must use drugs ju diciously, during pregnancy induced hypertension, epilepsy, diabetes, asthma, and infection could seriously endanger both the mother and baby. II. FDA Pregnancy Category Classifications CATEGORY CATEGORY DESCRIPTION A Studies indicate no risk to the human fetus. B Studies indicate no risk to the animal fetus; information for humans not available. C Animal studies w/ adverse effects reported in fetus; no controlled studies in women. D Possible fetal risk in humans has been reported; potential benefit versus risk may warrant treatment in pregnant women (asthma, hypertension, epilepsy, infection). X Absolutely contraindicated. Proven risk of fetal abnormality. No possible benefits. III. Breastfeeding A. A wide variety of drugs easily cross from mother’s circulation to breast milk. B. Dose immediately breast feeding to minimize drug concentrations. C. Avoid drugs with half-lives; choose drug with the smallest effect; avoid hazardous drugs. IV. Neonatal and pediatric considerations A. Dose calculations: height and weight based (kg) on BSA (body surface area); more accurate method B. Calculating the dosage according to body weight is the most commonly used method. Most drug references recommend dosages based on milligrmas per kilogram of body we ight. For example: 5 mg/kg Approximate child’s dose = Body surface area of the child X Adult dose 1.7 m2 BSA of adult X adult dose = estimated child’s dose BSA of child C. Organ system immaturity D. More sensitive to drug effects \ E. Infants are especially sensitive to drugs that affect CNS (blood -brain barrier not fully developed)