Nur 324 Lecture 1 Notes

Basic Pharmacology

Nurses 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)