Download Introduction to Pharmacology

Meet & Greet
Welcome
Objectives:
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Review the core terminology used in pharmacology.
Discuss the features of the “perfect” drug.
Examine the factors that determine the intensity of
drug responses
A science that draws on information from
multiple disciplines, including:
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Anatomy
Physiology
Psychology
Chemistry
Microbiology
Drug
• Any chemical that can affect living processes
Pharmacology
* Study of drugs and their interactions with living
systems
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The study of the physical and chemical
properties of a drug and its biochemical and
physiological effect
Knowledge of history, sources, use of drug, and
knowledge of drug absorption, distribution,
metabolism, and excretion
Clinically relevant
Clinical Pharmacology
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Study of drugs in humans
Therapeutics
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The use of drugs to diagnose, prevent, or treat
disease or to prevent pregnancy
Also known as pharmcotherapeutics
The medical use of drugs
1. Effectiveness
2. Safety
3. Selectivity
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The medication elicits the response that
it was designed to
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Most important property of a drug
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A drug that can not produce harmful
effects – even if administered in very
high doses and for a very long time.
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No such thing as a safe drug
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All drugs have the potential to cause
injury
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Risks reduced by proper drug selection
and proper dosing
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A drug that elicits the response only the
response for which it is given
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Reversible action
Predictability
Ease of administration
Freedom from drug interactions
Low cost
Chemical stability
Simple generic name
But because no drug is ideal …
Provide maximum benefit
with minimum harm
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Administration
Pharmacokinetics
Pharmacodynamics
Sources of individual variation
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Important determinants of drug responses:
dosage size, route, timing
Medication errors
Patient adherence
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Determining how much of administered dose
gets to its sites of action
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Impact of the body on drugs
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Four major pharmacokinetic processes:
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Drug absorption
Drug distribution
Drug metabolism
Drug excretion
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Impact of drugs on the body
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Drug-receptor interaction
• Binding of the drug to its receptor
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Patient’s functional state
• Influences pharmacodynamic processes
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Placebo effects
• Also help determine the responses a drug elicits
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Physiologic variables
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Pathologic variables
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Diminished function of kidneys and liver
Genetic variables
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Age, gender, weight
Can alter metabolism of drugs and predispose
patient to unique interactions
Drug interactions
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There is no such thing as a safe drug; all drugs
can cause harm.
There is no such thing as a selective drug; all
drugs can cause side effects.
The objective of drug therapy is to provide
maximum benefit with minimum harm.
Because all patients are unique, drug therapy
must be tailored to each individual.
Use to be 5Rs ….
Right documentation added
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Likely first member of the team to
observe and evaluate the effects of the
medication
First to intervene if necessary
Patient advocate
YOU are the patient’s last line of defense
against med errors
Legal and ethical obligations
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Preadministration Assessment
Dosage and Administration
Evaluating and Promoting Therapeutic
Effects
Minimizing Adverse Effects
Minimizing Adverse Interactions
Making PRN Decisions
Managing Toxicity
Assess the patient first
Collect baseline data
Identify high risk patients
Patient’s capacity for self care
*Many
drugs have more than one
indication for use
*Many
drugs can be administered in more
than one route
*Certain
IV drugs can cause great damage
locally if IV becomes extravasated
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Read the order carefully – clarify if necessary
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Verify the identity of the patient – comparing
the name on the wristband with the name on
the order
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Read the medication label carefully – verify the
identity of the drug, the amount per pill, tsp, etc
and suitability for the patient
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Verify drug calculations
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Handle as directed
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Do not give a medication that you do not
understand the reason for its use
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One of the most important aspects of drug
therapy
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Tells us whether the drug is doing anything
useful
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Nurses often in the best position to evaluate
therapeutic response
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Must know rationale for use and characteristics
of the drugs
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Evaluation may make some allowances if
desired effect is achieved
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Can only evaluate for intended purpose
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Adherence is essential
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Medications improperly administered can have
negative outcomes
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Requires active and informed participation by
the patient
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Implement non-drug measures
Breathing exercises, exercise, support,
weight reduction, smoking cessation, etc.
In order to minimize adverse effects you must
know the following about the drug you are
working with;
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The major adverse effects the drug can
produce
When the reactions are likely to occur
Early warning signs
Interventions that can minimize discomfort or
harm
Any two drugs (or more) taken by the same
person creates the potential for an adverse
interaction
Tips to minimize;
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Take a thorough medical history
Counsel patients to avoid OTC
Monitor for common adverse interactions
Be alert for not yet know adverse interactions
PRN – pro re nata (as needed/as the occasion arises)
To make a PRN decision;
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Must know the reason the drug has been prescribed
Assess the patient’s medication needs
Expand your knowledge base
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Must be recognized and responded to quickly
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Nurse must know what the signs of toxicity are
before he/she can recognize the presentation
The nurse must educate the patient on the
following;
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Medication name and therapeutic category
Dose size
Dosing schedule
Route & technique of administration
Expected therapeutic response and when it
should occur
Nondrug measures to enhance response
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Duration of treatment
Method of drug storage
Symptoms of major adverse effects, and
measures to minimize discomfort and harm
Major adverse drug-drug & drug-food
interaction
Who to contact in the event of therapeutic
failure, major adverse effect or severe adverse
interactions
The
three • Chemical name
types • Generic name
of drug • Trade name
names:
Use of drug names
• Written and oral communication about
medicines
• Labeling medication containers
Generic products versus brand-name
products
• Are generic products and brand-name products
therapeutically equivalent?
• Would a difference between brand-name and
generic products justify the use of trade names?
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Americans spend about $20 billion annually on
OTC drugs.
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OTC drugs account for 60% of all doses
administered.
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40% of Americans take at least one OTC drug
every 2 days.
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Four times as many illnesses are treated by a
consumer using an OTC drug as by a consumer
visiting a physician.