NRS 150 Pharmacology Basics
drug -
any chemical that affects physiologic processes of a living organism
pharmacology -
study or science of drugs
pharmaceutics -
science of preparing and dispensing drugs, including dosage form design
nursing responsibilities regarding drugs -
right patient
right drug
right dose
right time
right route
right reason
right assessment
right documentation
right evaluation
right of patient to education
right of patient to refuse care
this is critical to follow-- if not followed, med errors happen
correct administration without additional interventions, cannot endure that treatment will
result in the therapeutic objective--proper delivery is only the beginning of a nurses
responsibility
system of checks and balances -
nurses and HCPs must participate in a system of this, designed to to promote
beneficial effects and to minimize harm to patients
regarding nursing responsibilities, the nurse must know: -
what medications are appropriate for the patient
what drugs are contraindicated for the patient
the probable consequences of the interactions between the drug and the patient
the nurses role as an advocate -
last line of defense for the patient
ethically and legally unacceptable to administer a drug that is harmful to the patient, even
though the medication has been prescribed by a licensed prescriber and dispensed by a
licensed pharmacist
2 major areas in which pharmacologic knowledge can be applied -
patient care
patient education
this occurs in:
preadministration assessment
1|Page
,dosage and administration
evaluating and promoting therapeutic effects
minimizing adverse effects
minimizing adverse interactions
makingPRN decision
managing toxicity
preadministration assessment -
collecting baseline data (get VS before)
-needed to evaluate therapeutic responses and adverse effects
identifying high risk patients
-liver (metabolization) and kidney (excretion) impairment. in the case of impaired
liver/kidney, have to think about lowering dosage
-genetic factors
-drug allergies
-pregnancy. most meds cross the placenta--think about developing fetus and
lactating/breastfeeding patients as well
-older adult or pediatric age group- meds. organs not mature enough to handle certain meds
or dosing. geri- organs are aged, not as efficient
-tools: pt hx, physical examination, and lab results
dosage and administration -
certain drugs have more than one indication. THE DOSAGE MAY DIFFER
DEPENDING ON THE INDICATION FOR WHICH THE DRUG IS BEING USED
many drugs can be administered by more than one route. THE DOSAGE MAY DIFFER
DEPENDING ON THE ROUTE SELECTED
certain IV agents can cause severe local injury if extravasation occurs (something we deliver
by IV 100% bioavailability, oral may only have 70% bioavailability)
checks for administration -
read the order carefully
verify the identity of the pt
read the medication label carefully
verify dosage calculations
implement any special handling that the drug may require
do not administer any drug if you do not understand the reason for its use
evaluating and promoting therapeutic effects -
-one of the most important aspects of drug therapy
-must know the rationale for tx and the nature and time course of thee intended response
-cannot effectively evaluate a drug with multiple applications if the intended use is not known
promoting patient adherence/compliance/concordance -
-extent to which a patients behavior coincides with medical advice
implementing non-drug measures -
-drug therapy can often be enhanced by non-drug measures
these include biofeedback, emotional support, smoking cessation, sodium restriction, and so
on
2|Page
, the 3 G's-- prolong bleeding -
garlic, gingko, ginger
minimizing adverse effects -
always know:
major adverse effects drug can produce
times when reactions are likely to occur
early signs that adverse rxn is developing
interventions that minimize discomfort/harm
take thorough drug hx
advise patient to avoid OTC drugs that can interact with medication
monitor for adverse interactions that are known to occur
be alert for as-yet-unknown interactions
prn (pro re nata) -
as needed
making prn decisions -
the nurse has discretion regarding how much drug to give and when to give it
know the reason for the drugs use
be able to asses the patients medication needs
know when to make the decision as the situation may require/according to circumstances
application of pharmacology in patient education -
drug name and therapeutic category
dosage size
dosing schedule
dosing schedule
route and technique of admin
expected therapeutic response and when it should develop
nondrug measures to enhance therapeutic responses
duration of treatment--take for full prescribed time
method of drug storage
symptoms of major adverse effects and measures to minimize discomfort and harm
major adverse drug-drug and drug-food interactions (gingko, garlic, ginger... grape fruit, dark
veggies, milk, iron needs to be taken with OJ)
home to contact in the event of therapeutic failure, severe adverse reactions, or sever adverse
interactions
promoting therapeutic effects -
NATURE AND TIME COURSE of expected beneficial effects
recognizing tx failure; allow for timely alternative therapy implementation
minimizing adverse effects examples -
insulin overdose
anticancer and infection
some side effects are benign but disturbing, especially if they are unknown to the patient
teaching dosage and administration -
give the patient the following information:
3|Page
drug -
any chemical that affects physiologic processes of a living organism
pharmacology -
study or science of drugs
pharmaceutics -
science of preparing and dispensing drugs, including dosage form design
nursing responsibilities regarding drugs -
right patient
right drug
right dose
right time
right route
right reason
right assessment
right documentation
right evaluation
right of patient to education
right of patient to refuse care
this is critical to follow-- if not followed, med errors happen
correct administration without additional interventions, cannot endure that treatment will
result in the therapeutic objective--proper delivery is only the beginning of a nurses
responsibility
system of checks and balances -
nurses and HCPs must participate in a system of this, designed to to promote
beneficial effects and to minimize harm to patients
regarding nursing responsibilities, the nurse must know: -
what medications are appropriate for the patient
what drugs are contraindicated for the patient
the probable consequences of the interactions between the drug and the patient
the nurses role as an advocate -
last line of defense for the patient
ethically and legally unacceptable to administer a drug that is harmful to the patient, even
though the medication has been prescribed by a licensed prescriber and dispensed by a
licensed pharmacist
2 major areas in which pharmacologic knowledge can be applied -
patient care
patient education
this occurs in:
preadministration assessment
1|Page
,dosage and administration
evaluating and promoting therapeutic effects
minimizing adverse effects
minimizing adverse interactions
makingPRN decision
managing toxicity
preadministration assessment -
collecting baseline data (get VS before)
-needed to evaluate therapeutic responses and adverse effects
identifying high risk patients
-liver (metabolization) and kidney (excretion) impairment. in the case of impaired
liver/kidney, have to think about lowering dosage
-genetic factors
-drug allergies
-pregnancy. most meds cross the placenta--think about developing fetus and
lactating/breastfeeding patients as well
-older adult or pediatric age group- meds. organs not mature enough to handle certain meds
or dosing. geri- organs are aged, not as efficient
-tools: pt hx, physical examination, and lab results
dosage and administration -
certain drugs have more than one indication. THE DOSAGE MAY DIFFER
DEPENDING ON THE INDICATION FOR WHICH THE DRUG IS BEING USED
many drugs can be administered by more than one route. THE DOSAGE MAY DIFFER
DEPENDING ON THE ROUTE SELECTED
certain IV agents can cause severe local injury if extravasation occurs (something we deliver
by IV 100% bioavailability, oral may only have 70% bioavailability)
checks for administration -
read the order carefully
verify the identity of the pt
read the medication label carefully
verify dosage calculations
implement any special handling that the drug may require
do not administer any drug if you do not understand the reason for its use
evaluating and promoting therapeutic effects -
-one of the most important aspects of drug therapy
-must know the rationale for tx and the nature and time course of thee intended response
-cannot effectively evaluate a drug with multiple applications if the intended use is not known
promoting patient adherence/compliance/concordance -
-extent to which a patients behavior coincides with medical advice
implementing non-drug measures -
-drug therapy can often be enhanced by non-drug measures
these include biofeedback, emotional support, smoking cessation, sodium restriction, and so
on
2|Page
, the 3 G's-- prolong bleeding -
garlic, gingko, ginger
minimizing adverse effects -
always know:
major adverse effects drug can produce
times when reactions are likely to occur
early signs that adverse rxn is developing
interventions that minimize discomfort/harm
take thorough drug hx
advise patient to avoid OTC drugs that can interact with medication
monitor for adverse interactions that are known to occur
be alert for as-yet-unknown interactions
prn (pro re nata) -
as needed
making prn decisions -
the nurse has discretion regarding how much drug to give and when to give it
know the reason for the drugs use
be able to asses the patients medication needs
know when to make the decision as the situation may require/according to circumstances
application of pharmacology in patient education -
drug name and therapeutic category
dosage size
dosing schedule
dosing schedule
route and technique of admin
expected therapeutic response and when it should develop
nondrug measures to enhance therapeutic responses
duration of treatment--take for full prescribed time
method of drug storage
symptoms of major adverse effects and measures to minimize discomfort and harm
major adverse drug-drug and drug-food interactions (gingko, garlic, ginger... grape fruit, dark
veggies, milk, iron needs to be taken with OJ)
home to contact in the event of therapeutic failure, severe adverse reactions, or sever adverse
interactions
promoting therapeutic effects -
NATURE AND TIME COURSE of expected beneficial effects
recognizing tx failure; allow for timely alternative therapy implementation
minimizing adverse effects examples -
insulin overdose
anticancer and infection
some side effects are benign but disturbing, especially if they are unknown to the patient
teaching dosage and administration -
give the patient the following information:
3|Page
