Download N364 Spring 2017 Los Angeles Harbor College Division of Nursing

N364 Spring 2017
Los Angeles Harbor College
Division of Nursing
Nursing Pharmacology
N364
Section ____
Spring 2017 Course Syllabus
Instructor: Professor JP Joson MSN CNS
N364 Spring 2017
Course Title: Nursing 364 –Pharmacology
Faculty Contact Information:
[email protected]
Start Date: 02/09/2016 End Date: 06/01/2016
Office Hours: NU121
Time:
Thursday 0730-0855,
Thursday 1215 to 1430
Classroom:
NU 153 Time:
Thursday 0900-1210
Catalog Description: This course is open to pre-nursing majors, nursing students and
those interested in developing an understanding of medications. This course provides
an understanding of basic pharmacology and the standards, policies, and regulations
involved in mediation administration. A brief review of the math concepts involved in the
calculations of dosages is included. The course focus is on drugs classifications,
pharmacodynamics, chemical interactions, toxicology and the use of the nursing
process in medication administration.
Credit/Contact Hours: 3 Units
Transferability: Conditional
Prerequisites: Admission to LAHC and appropriate registration and payment of fees.
Required Textbooks and Supplies: Adams, M.P., Holland, L.N. & Urban, C.Q. (2017).
Pharmacology for nurses: A pathophysiologic approach (5th Ed.). Pearson. ISBN:
9780134255163
Recommended Textbook: Deglin, J.H., Vallerand, A.H., & Sanoski, C. A. (2011).
Davis’s drug guide for nurses (12th Ed.). F.A. Davis Company.
Scantrons: Will be required for quizzes and the final exam.
Attendance Policy: Class absences are not to exceed one class lecture. If the student
is ill or has an emergency, please contact instructor for the week as soon as possible.
Students are urged not to be absent, and are reminded that the student is responsible
for all information given during class time. Three tardies will be counted as one
absence. Absence that exceeds specified maximum may result in exclusion from the
N364 Spring 2017
course or receiving an “F” grade. Students who know that there is a strong possibility
that they will miss more than one class should not take the course.
Course Credit Challenging Policy: Not applicable.
College and Department Policies: See College Catalog.
Board Policies and Accommodations:
1. Students requiring special accommodations in a course must present official
documentation of the type of accommodations required to the nursing faculty.
2. Board Rule 9803.12. Dishonesty, such as cheating, or knowingly furnishing false
information to the college. Examples of academic dishonesty: A student copies
from another student, to help an academically weaker student by providing
answers to a test or using “crib” notes.
3. Board Rule 9803.14. Obstruction or disruption of classes, administration,
disciplinary procedures, or authorized college activities.
4. Board Rule 9803.19. Alcohol and Drugs. Any possession of controlled
substances which would constitute a violation of Health and Safety Code Section
11350 or Business and Professional Code section 4230, any use of controlled
substance, the possession of which are prohibited by the same, or any
possession or use of alcoholic beverages.
*Please see college catalog for a listing of all District Board Rules. Also, refer to the
Student Discipline Procedure for due process for disciplinary issues, grievances, and
the student appeal process.
Course Grading:
This course has 200 points. There are 12 quizzes worth 10 points each. The lowest quiz
grade will be dropped, resulting in 110 possible quiz points. A 30 point drug group
presentation will be required. There will be a 60 point comprehensive final exam.
There are no scheduled make-up quizzes and group presentation. Students are urged
to contact the instructor if major illness occurs resulting in missing quizzes and/or the
final exam. The grade obtainable for the final taken after the scheduled testing day is
75%. Make-up finals may be multiple choices, fill-in, essay, or a combination of all of the
above. To receive a grade of “W” (withdrawal) for the class, the student must officially
drop the course in admissions by the date published in the class schedule. There will be
no extra credit assignments offered. There will be no grade of Incomplete given for the
class.
N364 Spring 2017
Drug Presentation: See Appendix A for further details.
Grading Scale:
A (90% - 100%)
B (81% - 89%)
C (75% - 80%)
D (60% - 74.9%)
F (Less than 60%)
Learning Resources: College Library, Nursing Learning Lab (over night check-out not
allowed), and Learning Resource Center in College Library.
Method of Instruction: Lecture, Discussion, Related Readings, Presentations, and
Internet.
Evaluation Method: Objective quizzes, comprehensive final exam, and drug card
presentation.
Study Time: The College expects a minimum of two hours of study/preparation by the
student for each hour of lecture.
Plagiarism: Any form of academic dishonesty is not tolerated within the Los Angeles
Community College District and will result in a zero for the assignment in question and
in most cases will result in a fail for the course. Any student with subsequent incident of
plagiarism will be referred to the Vice President of Student Services and may be
expelled from the college. Please refer to the College Catalog for further information.
N364 Spring 2017
Schedule of Assignments:
Date
Week 1
02/09/2017
Week 2
02/16/2017
Week 3
02/23/2017
Week 4
03/02/2017
Week 5
03/09/2017
Week 6
03/16/2017
Week 7
03/23/2017
Content
Introduction to Course
Review Syllabus & Textbook
Introduction to Pharmacology
Pharmacokinetics
Pharmacodynamics
Drug Approval & Regulation
Nursing Process in Pharmacology
Principles of Drug Administration
Medication Errors and Risk
Reduction
Drug Dosages and Calculation
Drugs for Seizures
Drugs for Emotional and Mood
Disorders
Drugs for Psychoses
Substance Abuse
Drugs for Anxiety and Insomnia
Drugs for Control of Pain
Drugs for Coagulation Disorders
Drugs for Hematopoietic Disorders
Hypertension
Heart Failure
Angina Pectoris and Myocardial
Infarction
Chapters
Assignments
1,4, 5,
2&6
Appendix B
Quiz #1 (1,2,4,5 &
6)
15, 16,
17
Quiz #2 (3,7,
Dosage &
Calculations)
3, 7,
22,14,18
31,32
26, 27,
28
Quiz # 3 (15, 16,
17)
Group 1 Lorazepam
(Ativan)
Group 2 –
Morphine
(Duramorph)
Quiz #4 (15, 16,
17, 22)
Group 3 – Heparin
Group 4 –
Warfarin
(Coumadin)
Quiz #5
(14,18,31,32)
Group 5 –Prinivil
(Zestril)
Group 6 –
Nitroglycerin(Nitro-
N364 Spring 2017
bid)
Week 8
03/30/2017
Week 9
04/06/2017
Week 10
04/13/2017
Drugs for Asthma and Other
Pulmonary Disorders
Drugs for Bacterial Infections & Viral
Infections
40, 35,
37
Quiz #6 (26,27,28)
Group 7 –
Albuterol
(Proventil)
Group 8 –
Penicillin G
Spring Break
Drugs for Neuromuscular Disorders
Drugs for Bone and Joint Disorders
21, 48
Quiz #7 (40,35,37)
Quiz # 8 (21, 48)
Week 11
04/20/2017
Week 12
04/27/2017
Week 13
05/04/2017
Drugs for Degenerative Diseases of
the Nervous system
Drugs for Diabetes Mellitus
Diuretic Therapy and Drugs for
Renal Failures
Drugs for Fluid Balance, Electrolytes,
and Acid-Base Disorders
Drugs for Peptic Ulcers Disease
Drugs for Bowel Disorders and other
Gastrointestinal Conditions
20, 45
24, 25
41, 42
Group 9 –
Cyclobenzaprine
(Flexeril)
Group 10 –Human
Regular Insulin
(Humulin R,
Novolin R)
Quiz #9 (20, 45)
Group11 –
Furosemide
(Lasix)
Group 12 –
Potassium
Chloride (KCL)
Quiz # 10 (24, 25)
Group 13 –
Ranitidine
(Zantac)
Group 14 –
Psyllium Mucilloid
(Metamucil)
N364 Spring 2017
Week 14
05/11/2017
Week 15
05/18/2017
Week 16
05/25/2017
Drugs for Disorders and Conditions
of the Female Reproductive System
Drugs for Disorders and Conditions
of the Male Reproductive System
Drugs for Autonomic Nervous
System
Drugs for Dysrhythmias
Drugs for Shock
Last day of class
Comprehensive Final
46, 47
12, 13
30, 29
Quiz # 11(41, 42)
Group 15 –
Oxytocin (Pitocin)
Group 16 –
Sildenafil (Viagra)
Quiz # 12 (46, 47)
Group 17 –
Amiodarone
(Cordarone)
Group 18 –
Dopamine
(Dopastat)
Complete Course
Evaluation
(Online)
FINAL = 25 ?’S
( questions on
Final will be on
chapters 12, 13,
30, 29)
N364 Spring 2017
Course Topics & Objectives
Week 1
Introduction to Pharmacology Course
02/09/2017
1. Meet class
2. Introduction to Course
3. Review syllabus & textbook
Introduction to Pharmacology: Drug Regulation and Approval (Chapter 1)
1. Define Pharmacology
2. Therapeutics and Pharmacology
3. Compare and contrast traditional drugs, biologics, and complementary
and alternative modes
4. Therapeutic vs Pharmacologic classes
5. Prototype
6. Mechanism of action
7. Chemical vs Generic vs Trade name
8. Prescription vs OTC
Pharmacokinetics (Chapter 4)
1. Define Pharmacokinetics
2. Identify and recall the four components of pharmacokinetics
3. Describe major processes by which drugs are excreted
4. Explain the applications of a drug’s plasma half-life and therapeutic
range
5. Differentiate between loading and maintenance doses
6. Describe how plasma proteins affect drug distribution
Define and discuss Pharmacodynamics (Chapter 5)
1. Define Pharmacodynamics
2. Compare and contrast the terms potency and efficacy
3. Distinguish between and agonist, a partial agonist, and an antagonist
4. Explain the relationship between receptors and drug action
Week 2
Drug Classes and Schedules (Chapter 2)
02/16/2017
1. Discuss the role of the US Food and Drug Administration (FDA)
2. Explain the four phases of approval
3. Explain the meaning of a controlled substance and teratogenic risk in
pregnancy
4. Identify the five drug schedules and give examples of drugs at each
level
5. Identify the five categories of teratogenic drug classification
Nursing Process in Pharmacology (Chapter 6)
1. Compare and contrast the different steps of the nursing process:
Assessment, Diagnosing, Planning, Implementing, Evaluating
Week 3
Principles of Drug Administration (Chapter 3)
02/23/2017
1. Describe the roles and responsibilities of the nurse regarding drug
administration
N364 Spring 2017
2. State the five rights of drug administration and explain how they affect
patient safety
3. Compare and contrast the three systems of measurement used in
pharmacology
Medication Errors and Risk Reductions (Chapter 7)
1. Define medication error and identify factors that contribute to medication
errors
2. Describe specific categories of medication errors
3. Explain the impact of medication errors on all aspects of a health care
agency
4. Describe strategies that the nurse can implement to reduce medication
errors and incidents
5. Identify patient teaching information that can be used to reduce
medication errors and incidents
Drug Dosages and Calculation (Appendix B)
1. Identify metric units of measurement commonly used in dosage
calculation of oral and parenteral medications
2. State common equivalents in the metric system that are used for
medication administration
3. Convert metric weights and volume within the metric system
4. Convert body weight from pounds to kilograms
5. Use one of the following methods to accurately calculate medication
dosages:
D x Q
Ration and proportion
H
Week 4
Seizures (Chapter 15)
03/02/2017
1. Compare and contrast the terms seizures, convulsions, and epilepsy
2. Explain the importance of patient drug compliance in the
pharmacotherapy of epilepsy and seizures
3. Describe the nurse’s role in the pharmacologic management of seizures
of an acute nature and epilepsy
4. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
Phenobarbital (Luminal), Diazepam (Valium), Phenytoin (Dilantin),
Valporic Acid (Depakene, Depakote)
Emotional and Mood Disorders (Chapter 16)
1. Identify the two major categories of mood disorders and their symptoms
2. Identify symptoms of attention deficit-hyperactivity disorder
3. Discuss the nurse’s role in the pharmacologic management of patients
with depression, bipolar disorder, or attention deficit-hyperactivity
disorder
4. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Imipramine
(Tofranil), Sertraline (Zoloft), Phenelzine (Nardil), Methylphenidate
(Ritalin)
N364 Spring 2017
Psychoses (Chapter 17)
1. Compare and contrast the positive and negative symptoms of
schizophrenia
2. Explain the importance of drug compliance in the pharmacotherapy of
schizophrenia
3. Explain the symptoms associated with extrapyramidal side effects of
antipsychotic drugs
4. Describe the nurse’s role in the pharmacologic management of
schizophrenia
5. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
Chlorpromazine, Haloperidol (Haldol), Risperidone (Risperdal)
1.
Week 5
Substance Abuse (Chapter 22)
03/09/2017
1. Explain underlying causes of addiction
2. Compare and contrast psychological and physical dependence
3. Compare withdrawal syndromes for the various substance abuse
classes
4. Describe the role of the nurse in delivering care to individuals who have
substance abuse issues
Anxiety and Insomnia (Chapter 14)
1. Identify the major types of anxiety disorders
2. Discuss factors contributing to anxiety and explain some
nonpharmacologic therapies used to cope with this disorder
3. Identify three classes of medication used to treat anxiety and sleep
disorders
4. Explain the pharmacologic management of anxiety and insomnia
5. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of anxiety and insomnia
6. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Escitalopram
Oxalate (Lexapro), Lorazepam (Ativan), Zolpidem (Ambien)
Drugs for Control of Pain (Chapter 18)
1. Relate the importance of pain assessment to effective pharmacotherapy
2. Describe the role of nonpharmacologic therapies in pain management
3. Explain the role of opioid antagonist in the diagnosis and treatment of
acute opioid toxicity
4. Describe the nurse’s role in the pharmacologic management of patients
receiving analgesics and antimigraine drugs
Review prototype drugs including actions and uses, administration alerts,
pharmacokinetics, adverse effects, and interactions: Morphine (Astramorph PF,
Duramorph), Nalaxone (Narcan), Aspirin (Acetylsalicylic Acid, ASA),
Sumatriptan (Imitrex)
N364 Spring 2017
Week 6
Coagulation Disorders (Chapter 31)
03/16/2017
1. Illustrate the major steps of hemostasis
2. Describe thromboembolic disorders that are indicators for coagulation
modifiers
3. Explain how laboratory testing of coagulation parameters is used to
monitor anticoagulant pharmacotherapy
4. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of coagulation disorders
5. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Heparin,
Warfarin (Coumadin), Clopidogrel (Plavix), Alteplase (Activase)
Hematopoietic Disorders (Chapter 32)
1. Describe the process of hematopoiesis
2. Describe Vitamin 12 deficiency (pernicious or megaloblastic anemia)
and Iron deficiency anemia
3. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of hematopoietic disorders
4. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Epoetin Alfa
(Epogen, Procrit), Filgrastim (Neupogen), Cyanocobalamin (Vitamin
B12), Ferrous Sulfate (Feosol)
Week 7
1. Hypertension (Chapter 26)
2. Explain hypertension (HTN) classification
03/23/2017
3. Summarize long-term consequences of untreated hypertension
4. Explain the effects of cardiac output, peripheral resistance, and blood
volume on blood pressure
5. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of patients receiving drugs for hypertension
6. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Enalapril
(Vasotec), Nifedipine (Procardia XL) Hydralazine (Apresoline)
Doxazosin (Cardura)
7. Heart Failure (Chapter 27)
8. Define Heart Failure (HF)
9. Review the blood circulation
10. Relate how the symptoms associated with heart failure may be caused
by weakened heart muscle and diminsihed cardiac output
11. Explain how preload and afterload affect cardiac function
12. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of heart failure
13. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Lisinopril
(Prinivil, Zestril), Furosemide (Lasix), Digoxin (Lanoxin), Metoprolol
(Lopressor, Toprol XL)
14. Angina Pectoris and Myocardial Infarction (Chapter 28)
15. Explain the pathophysiology of myocardial infarction
N364 Spring 2017
16. Describe factors that affect myocardial oxygen supply and demand
17. Describe the nurse’s role utilizing the nursing process in the
18. pharmacologic management of patients with myocardial infarction
19. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Nitroglycerin
(Nitrostat, Nitro-Bid, Nitro-Dur), Atenolol (Tenormin), Dilitiazem
(Cardizem), Retaplase (Retavase)
20.
Week 8
Asthma and Other Pulmonary Disorders (Chapter 40)
1. Identify major functions of the lower respiratory tract
03/30/2017
2. Compare the advantages and disadvantages of using the inhalation
route of the drug administration for pulmonary drugs
3. Describe the nurse’s role utilizing the nursing process in the
pharmacologic treatment of lower respiratory tract disorders
Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Albuterol
(Proventil), Ipratropium (Atrovent), Beclomethasone (Qvar)
Montelukast(Singulair)
Bacterial Infections (Chapter 35)
1. Explain how bacteria are described and classified
2. Explain how resistance can develop to an anti-infective drug
3. Explain the importance of culture and sensitivity
4. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of bacterial infections
5. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Penicillin G,
Cefazolin(Ancef, Ketzol), Tetracycline(Sumycin,others)
Erythromyci(Eryc, Erythrocin, others), Gentamycin (Garamycin),
Ciprofloxacin (Cipro), Trimethoprim-sulfamethoxazole (Bactrim, Septra),
Isoniazid(INH)
Viral Infections (Chapter 37)
21. Identify viral infections that benefit from pharmacotherapy
22. Explain the purpose and expected outcomes of HIV pharmacotherapy
23. Explain the advantage of HAART in the pharmacotherapy of HIV
infection
24. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of patients receiving antiretroviral and
antiviral drugs
25. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Zidovudine
(Retrovir, AZT), Acyclovir (Zoviraz)
Week 09
Spring Break
04/06/2017
Week 10 Neuromuscular Disorders (Chapter 21)
04/13/2017
1.
Discuss nonpharmacologic therapies used to treat muscle
spasms and spasticity
N364 Spring 2017
2.
Explain the goals of pharmacotherapy with skeletal muscle
relaxants
3.
Describe the nurse’s role in the pharmacologic management of
muscle spasms
4.
Review prototype drugs including actions and uses,
administration alerts, pharmacokinetics, adverse effects, and
interactions: Cyclobenzaprine (Flexeril), Dantrolene Sodium (Dantrium)
Bone and Joint Disorders (Chapter 48)
1.
Describe the role of calcium in the body in maintaining
homeostasis in the nervous, muscular, and nervous systems
2.
Explain the pharmacotherapy of hypocalcemia, osteomalacia,
osteoporosis, rickets, osteoarthritis, rheumatoid arthritis, and gout
3.
Describe the nurse’s role in the pharmacologic management of
disorders related to bones and joints
Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Calcium
Salts, Calcitrol (Calcijex, Rocaltrol), Alendronate (Fosamax), Raloxifene
(Evista), Hydroxycholorquine (Plaquenil), Allopurinol (Lopurin)
Week 11 Degenerative Diseases of the Nervous System (Chapter 20)
1. Describe symptoms of Parkinson’s disease and Alzheimer’s disease
04/20/2017
2. Explain the goals of pharmacotherapy for Alzheimer’s disease and the
efficacy of existing medications
3. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of Parkinson’s disease and Alzheimer’s
disease
Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Levodopa,
Carbidopa, Benztropine (Cogentin), Donepezil (Aricept)
Diabetes Mellitus (Chapter 45)
1. Describe the endocrine and exocrine functions of the pancreas
2. Compare and contrast type 1 and type 2 diabetes mellitus
3. Compare and contrast types of insulin
4. Describe the signs and symptoms of insulin overdose and underdose
5. Describe the nurse’s role in the pharmacologic management of diabetes
mellitus
Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Human
Regular Insulin (Humulin R, Novolin R), Metformin (Fortamet,
Glucophage, Glumetza)
Week 12 Diuretic Therapy and Drugs for Renal Failures (Chapter 24)
1. Explain the role of the kidneys in maintaining fluid, electrolyte, and acid
04/27/2017
base balance
2. Describe the adjustments in pharmacotherapy that must be considered
n patients with renal failure
3. Identify indications for diuretics
4. Describe the general adverse effects of diuretic pharmacotherapy
N364 Spring 2017
5. Compare and contrast the loop, thiazide, and postassium-sparing
diuretics
6. Describe the nurse’s role in the pharmacologic management of renal
failure, and in diuretic therapy
7. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
Furosemide(Lasix), Hydrochlorothiazide(Microzide),
Spironolactone(Aldactone)
Fluid Balance, Electrolytes, and Acid-Base Disorders (Chapter 25)
1. Describe conditions for which IV fluid therapy may be indicated
2. Explain the pharmacotherapy of sodium and potassium imbalances
3. Discuss common causes of alkalosis and acidosis and the medications
used to treat these disorders
4. Describe nurse’s role utilizing the nursing process in the
pharmacological management of fluid balance, electrolyte, and acidbase disorders
Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Dextran 40,
Sodium Chloride (NaCl), Potassium Chloride (KCl), Sodium Bicarbonate
Peptic Ulcers Disease (Chapter 41)
1. Describe major anatomical structures of upper GI tract
2. Identify common causes, signs, and symptoms of peptic ulcer disease
Describe nurse’s role utilizing the nursing process in the
pharmacological management of patients with peptic ulcer disease
3. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Ranitidine
(Zantac), Omeprazole (Prilosec), Aluminum Hydroxide
Bowel Disorders and Other Gastrointestinal Conditions (Ch. 42)
1. Identify major anatomic structures of lower GI tract
2. Explain the pathogenesis of constipation and diarrhea
Week 13
3. Discuss conditions in which the pharmacotherapy of bowel disorders is
05/04/2017
indicated
4. Explain conditions in which pharmacotherapy of nausea/vomiting (N/V)
is indicated
5. Describe nurse’s role utilizing the nursing process in the
pharmacological management of bowel disorders, N/V, and other GI
conditions
6. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Psyllium
mucilloid (Metamucil), Diphenoxylate with Atropine (Lomotil),
Metoclopramide (Reglan), Ondansetron (Zofran),
Prochlorperazine(Compazine)
Week 14 Disorders and Conditions of the Female Reproductive System (Chapter
05/11/2017 46)
1. Describe the role of the hypothalamus, pituitary, and ovaries in
maintaining female reproductive function
N364 Spring 2017
2. Explain the mechanisms by which estrogens and progestins prevent
conception
3. Explain how drugs may be used to provide emergency contraception
and to terminate early pregnancy
4. Describe the role of drug therapy in the treatment of menopausal and
postmenopausal symptoms
5. Discuss the use of progestins in the therapy of dysfunctional uterine
bleeding
6. Compare and contrast the use of uterine stimulants and relaxants in the
treatment of antepartum and postpartum patients
7. Explain how drug therapy may be used to treat female infertility.
8. Describe the nurse’s role in the pharmacologic management of
disorders and conditions of the female reproductive system
9. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions: Estradiol
and Norethindrone (Ortho-Novum), Conjugated Estrogens (Cenestin,
Enjuvia, Premarin), Medroxyprogesterone (Depo-Provera), Ocytocin
(Pitocin)
Disorders and Conditions of the Male Reproductive System
(Chapter 47)
1. Describe the role of the hypothalamus, pituitary, and testes in regulating
male reproductive system
2. Describe the misuse and dangers associated with the use of anabolic
steroids to enhance athletic performance
3. Explain the role of medications in the treatment of male infertility
4. Describe the etiology, pathogenesis, and pharmacotherapy of erectile
dysfunction
5. Describe the pathogenesis of benign prostatic hyperplasia
6. Describe the nurse’s role in the pharmacologic management of
disorders and conditions of the male reproductive system
7. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
Testosterone, Sildenafil (Viagra), Finasteride (Proscar)
Week 15 Autonomic Nervous System (Chapter 12 & 13)
05/18/2016
1. Identify the basic functions of the nervous system: central nervous
system and peripheral nervous system
2. Compare and contrast the actions of the sympathetic and
parasympathetic divisions of the autonomic nervous system
3. Describe the nurse’s role utilizing the nursing process in the
pharmacologic management of patients receiving drugs affecting the
autonomic nervous system
4. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
Bethanechol(Urecholine), Atropine (atro-pen), Phenylephrine (NeoSynephrine), prazosin(Minipress)
N364 Spring 2017
Week 16
05/25/2016
Dysrhythmias (Chapter 30)
1. Explain how rhythm abnormalities can affect cardiac function
2. Illustrate flow of electrical impulses through normal heart
3. Classify dysrhythmias based on their location and type of rhythm
abnormality
4. Describe nurse’s role in the pharmacological management of patient
with dysrhythmias
5. Review prototype drugs including actions and uses, administration
alerts, pharmacokinetics, adverse effects, and interactions:
procainamide, propranolol(Inderal), amiodarone (Cordarone),
verapamil(Calan, Covera-HS, Isoptin SR, Verelan)
Shock (Chapter 29)
1. Compare and contrast different types of shock
2. Relate general symptoms of shock to their physiologic causes
3. Explain initial treatment priorities for a patient who is in shock
4. List drugs used in the pharmacotherapy of anaphylaxis
Review prototype drugs including actions and uses, administration alerts,
pharmacokinetics, adverse effects, and interactions: Normal Normal Serum
Albumin (Albuminar, Plasbumin), Norepinephrine (Levophed), Dopamine
(Dopastat, Intropin), Epinephrine (Adrenalin)
Comprehensive Final
N364 Spring 2017
Appendix A
Drug Presentation
The purpose of this assignment is to provide students with an opportunity to actively
participate in their learning, teach others what they have learned, and practice the art of
public speaking in a safe and supportive environment.
Objectives:


To familiarize students with common prototype drugs related to each body
system as specified by instructor
To gain an understanding of drug classification, pharmacodynamics, chemical
interactions, and toxicology in medication administration
Assignment: Students will be divided into groups of 4 or 5 students each. Each group
will be provided with a prototype drug to research and present the following key
elements:
Trade name/genetic name
Classification of Medication
Indications
Actions
Pharmacokinetics
Contraindications/Precautions
Common Adverse Reactions/Side Effects
Dosages and Calculations
Patient and Family Teaching
Students will select the following choices to present the assigned drug: Powerpoint
Presentation, Teaching Brochure, Game, Website, Situational Role Play, and
Educational Workshop. Students may utilize any source of instructional media as
needed to convey required information to class. Examples may include, but is not
limited to internet media, books, lap tops, handouts, props, etc.
N364 Spring 2017
*Groups are set and final. It is possible that students may withdraw from the course.
Therefore, the remaining members of the group will still be responsible for all required
elements of the assignment.
*See Appendix C and Appendix D.
N364 Spring 2017
Appendix B
Medication Dosage and Calculation
I.
Systems of Medication Measurements
A. Metric System
The metric system is the commonly used system of measurement for
prescribing and administering medications. The metric system is a decimal
system based on multiples of ten. Numbers to the left of the decimal are
whole numbers and numbers to the right of the decimal are fractions of
whole numbers. Each number has a place value. The value of each place
is ten times the value of the place immediately to its right.
The first number after the decimal point is the tenth place.
0.1 is read as one tenth (1/10).
The second number after the decimal point is the hundredth place.
0.01 is read as one hundredth (1/100).
The third number after the decimal point is the thousandth place.
0.01 is read as one thousandth (1/1000).
Because each place is a multiple of ten, moving a decimal point one place
produces a 10-fold change in the number. A medication error involving a
misplaced decimal point can result in serious under or overdosages of a
medication. For example, if a nurse gives 12ml of a medication instead of
1.2ml, the patient will receive 10 times the dose!
The metric system has three basic units of measure: meter (length), liter
(volume), and gram (weight). Metric units important in dosage calculations
are liter (L) and gram (gm). Common prefixes are used to indicate the
value of each unit of length, volume, or weight.
N364 Spring 2017
The following indicate smaller parts than the basic unit of measure:
Prefix
to Basic Unit
deci
centi
milli
micro
=
=
=
=
Kilo =
greater
Value
Decimal Equivalent
one tenth
= 0.1
one hundredth
= 0.01
one thousandth = 0.001
one millionth
= 0.000001
Relationship
(meter, liter, gram)
10 times smaller
100 times smaller
1,000 times smaller
1,000,000 times smaller
=
=
=
=
One prefix indicates a larger unit than the basic unit of measure:
one thousand
= 1000.0
=
1000 times
It is helpful to memorize some of the common metric unit abbreviations and their
equivalents used in clinical dosage calculations (Table 1).
Table 1. Metric Equivalents
WEIGHT
1 kilogram (kg)
=
1000 grams (g)
1 gram (g)
=
1000 milligrams (mg)
1 milligram (mg)
=
1000 micrograms
(mcg)
VOLUME
1 liter (L)
=
1000 milliliters (mL)
or
1000 cubic centimeters
(cc)
1 milliliter (mL)
=
1 cubic centimeter (cc)
*The cubic centimeter (cc) is the amount of space the 1mL occupies. The two measures
are interchangeable.
As shown above, each of the common units of measure used in dosage calculations
differs from the next by 1000. Since each place is a multiple of ten and each zero
represents one place value, to convert between these units of measure the decimal
point is moved three places. The direction the decimal point is moved is dependent on
whether the value is moving down to a smaller unit of measure or moving up to a larger
unit of measure. If moving down in value, the quantity becomes larger so the decimal
point is mover three places to the right (Table 2). If moving up in value, quantities
become smaller and the decimal point is moved three places to the left (Table 3). Being
able to convert these common units is important when calculating dosages.
N364 Spring 2017
Table 2. Moving down in value. Example:
0.5 gm is equivalent to how many milligrams?
0.5gm
0.500
=
500mg
We converted down the scale. Milligrams are a smaller unit of measure than grams. To
convert grams to milligrams, move the decimal point three places to the right and
change the units of measurement to milligrams. In order to do this, two zeros must be
added.
Another method to convert grams (large) to milligrams (small) is to multiple by 1000.
0.5gm x 1000 = 500mg
Table 3. Moving up in value. Example:
2500mL is equivalent to how many liters?
2500mL
2.500
=
2.5L
We converted up the scale. A liter is a larger unit of measure than a milliliter. To convert
mL to L, move the decimal point three places to the left and change the units to L. Once
done, it is possible to drop two zeros as retaining them does not change the value.
Another method to convert milliliters (small) to liters (large) is to divide by 1000.
2500mL ÷ 1000 = 2.5L
Errors in metric system dosage calculations occur more frequently when the dosage
contains a decimal. Whenever possible, perform the conversions to eliminate the
decimal point. It is also important to always place a zero in front of decimal fractions
(Table 4).
N364 Spring 2017
Table 4. Proper Notation.
.3 mg is an improper notation
0.3mg is the correct notation
B. Other systems of medication measurement.
Unit –Medications are sometimes measured in units. A unit measures
a medication in terms of its action rather than its weight. There are
three major medications measured in units: Heparin, Penicillin, and
Insulin.
Milliequivalents –Milliequivalents (mEq) are the number of grams of a
medication contained in a mL of solution. Milliequivalents are used to
designate measurement in a variety of solutions, especially
electrolytes.
Percentage –Percentages (%) are parts per hundred. Specifically,
percentages represent the number of grams of medication per 100mL
of solution. Please note, the higher the percentage strength, the
stronger the mixture. Percentages, as a unit of measure, are used in
solutions, topical ointments and other medications. The following
illustrates the concentration of medications expressed as percentages:
Lidocaine 2%
D10W
=
=
2gm of medication per 100mL of solution
10gm of dextrose per 100mL of water
Notice that the denominator is always 100, and the numerator shows
how many parts out of 100 (Table 5).
Table 5. Changing percent (%) to fraction.
1.
2.
3.
4.
Drop the % sign
Write the number as the numerator
Write 100 as the denominator
Reduce to lowest terms
Example:
Dextrose 5% = 5gm = 1gm
100 20mL
N364 Spring 2017
II.
Dosage Calculations
Tablets and capsules each contain a specific amount of medication (Table 6).
Most tablets and capsules come in multiples of the ordered dosage. When
necessary, scored tablets may be divided. Most orders requiring giving ½ to 3
tablets. If a nurse’s calculation results in an unusual number, this could be a
warning that a calculation mistake has been made. Liquid medication
preparations contain a specific amount of medication in a certain volume of
solution.
Table 6. Medication Preparations. Example:
One medication may come in a tablet and
liquid preparation.
Tablet = 250mg tablet
Liquid = 250mg/5mL
When the dosage ordered is different from what is available, dosage
calculations are necessary. There are several different ways to calculate
medication dosages. The following section will present two common methods
of dosage calculations for preparing oral and parenteral medications,
dimensional analysis and ratio and proportion (Table 7). Practice the
medication calculations using each method presented. Then select one
method and work the study questions.
A. Medication calculation using dimensional analysis
Dimensional analysis is a method to calculate medication doses using
fractions. With dimensional analysis, the problem is set up according to
the following:
D
H
x Q
D represents the desired dosage or what the physician has ordered
H represents the dosage on hand or the strength available
Q represents the quantity that contains the available dose
X represents the volume desired and is the unknown value
N364 Spring 2017
Table 7. Steps to calculate medication dosages using dimensional analysis
1. Ensure all units are in the same size. Convert if necessary in a manner
that will eliminate the decimal point. When converting be sure to convert
to units of the available medication
2. Estimate what would be a reasonable amount to administer
3. Place all the information into the correct position in the formula
4. Calculate the answer
Examples:
#1
Order:
600 mg PO
Available: 300 mg tablets
Step 1: Units are already in the same size (mg), no conversion in
necessary
Step 2: A reasonable estimate is that more than 1 tablet will be given
because the dosage ordered is larger than the dosage on hand
Step 3: (D)600 mg x
(Q)1 tablet =
X
(H)300 mg
Step 4: 600 mg
x
1tab =
2 tablets
300 mg
#2
Order:
0.025 mg PO
Available: 50 mcg scored tablets
Step 1: Convert to like units. Convert mg to mcg, to eliminate the decimal
point. To do this, multiple by 1000 or move the decimal point 3 places to
the right and change units to mcg: 0.025 mg = 25 mcg
Step 2: A reasonable estimate is that less than 1 tablet will be given
because the dosage ordered is less than the dosage on hand
Step 3: (D) 25 mcg x
(Q)1 tablet =
X
(H) 50 mcg
Step 4: 25 mcg
=
½ tab
50 mcg
#3
Order:
50 mEq PO
Available: 20 mEq/15mL
Step 1: Units are already in the same size, no conversion is necessary
Step2: A reasonable estimate is that more than 15mL will be given
because the dosage ordered is more than the dosage on hand
N364 Spring 2017
Step 3: (D) 50 mEq x
(H) 20 mEq
Step 4: 50 mEq
x
20 mEq
(Q) 15 mL
=
X
15 mL =
75
2
=
37.5 mL
B. Medication calculations using ratio and proportion method
A ratio is a comparison of two numbers which are somehow related to
each other. A medication dosage ratio can be used to show the amount of
medication contained in one tablet. A dosage ration can also be used to
show the amount of medication in a given volume of solution. These
relationships (ratios) are expressed by either placing a colon between the
numbers or writing the numbers in fraction form (Table 8).
Table 8. Expression of a ratio.
A medication is available in a dose of 250mg per 5 mL. The ration is
expressed as:
5mL: 250mg or 250mg
5ml
A proportion is used to prove that two ratios are equal (Table 9 and 10). A
proportion me be separated by an equal sign (=) or double colon (::).
Table 9. Expression of a proportion written as a fraction
250 = 500
1
2
Read as 250 is to 1 as 500 is to 2
Table 10. Expression of a proportion written as a ratio
250 : 1 : 500 : 2
Read as 250 is to 1 as 500 is to 2
Means
250 : 1 :: 500 : 2
Extremes
Proof of the ratios in a proportion being equal is demonstrated by cross
multiplication. When expressed as a fraction, the numerator (top number)
of each ratio is multiplied by its opposite denominator (bottom number).
When expressed as a ratio, the inside numbers are multiplied, then the
outside numbers are multiplied. The products in a true proportion are
equal. In the above example in Table 9, the product (answer) of the
numerator in the ratio on the left “250” multiplied by the denominator in the
ratio on the right “2” is “500”. The product of the numerator in the ratio on
N364 Spring 2017
the right “500” multiplied by the denominator in the ratio on the left “1” is
“500”. Thus, these ratios are equal. In Table 10, proof of the ratios being
equal is evident by multiplying the means (1 x 500 = 500) and multiplying
the extremes (250 x 2 = 500).
Ratio and proportion can be used to calculate dosages when only one
complete ratio is known and the second is incomplete. If three numbers of
the ratio are known, the fourth can be determined. In the ratio and
proportion method of dosage calculation, the unknown number is
represented by X. When setting up a proportion, remember the following
key points:

Ratio for known equivalent = ration for unknown equivalent. Keep
the “known” information on the left.
X Set up the equation according to the following:
If using fractions, set up like this:
dosage on hand
=
dosage desired
amount on hand
amount desired (X)
If using ratio, set up like this:
Dosage on hand : amount on hand : dosage desired : amount desired
(X)
X Label the units and sure the units in the numerators match and the
units in the denominators match
Example (fraction):
Example (ratio):
Order:
150 mg
Available:
100mg/2 mL
Order:
150 mg
Available: 100 mg/ 2 mL
Units on left of the ratio are the
same
Numerators are the same
100 mg : 2 mL : 150 mg : x mL
Units on right of the ratio are the
same
100 mg = 150 mg
2mL
x mL
Denominators are the same
N364 Spring 2017
Table 11. Steps to calculate medication dosages using ratio and
proportion method
1. Ensure all units are in the same size, converting if necessary.
When converting be sure to convert to the units of the available
medication
2. Estimate what would be a reasonable amount to administer
3. Set up the problem as a proportion
4. Calculate the answer by multiplying and solving for X
Example:
#1
Order:
600mg PO
Available: 300 mg tablets
Step 1: No conversion necessary
Step 2: A reasonable estimate is that more than one tablet will be given because
the dosage ordered is more than the dosage on hand
Step 3: 300 mg = 600 mg
1 tablet
X tablet
Step 4: Cross multiply, keeping X on the left side of the equation
300 mg
1 tablet
= 600mg
X tablet
300X
= 600
Solve for X by dividing the number on the right side of the equation by the
number in front of X.
300X
= 600
300
300
X
=
2 tablets
#2 same problem, but in this example, the equation is set up using ratios
Step 1: No conversion necessary
Step 2: A reasonable estimate is more than 1 tablet will be given because the
dosage ordered is more than the dosage on hand
Step 3: 300 : 1 :: 600 : X
Step 4: Multiply means and extremes
multiply
300X = 600
300: 1: : 600: X
multiply
N364 Spring 2017
Solve for X by dividing the number equation by the number in front of X
3#
300X =
300
600
300
X
2 tablets
=
Order:
0.025 mg Po
Available: 50 mcg scored tablets
Step 1: Convert to like units. To convert mg to mcg, move the decimal point 3
places to the right and change the units to mcg: 0.025 mg = 25 mcg
Step 2: A reasonable estimate is that less than 1 tablet will be given because the
dosage ordered is less than the dosage on hand
Step 3: 50 mcg
1 tab
=
25 mcg
X tablet
Step 4: Cross multiply and solve for X
#4
50 mcg
1 tablet
=
50X
=
25
50X
50
X
=
25
50
0.5 or ½ tablet
=
25 mcg
X tablet
Order:
50mEq PO
Available: 20 mEq/ 15 mL
Step 1: Units are already in the same size, no conversion is necessary
Step 2: A reasonable estimate is that more than 15 mL will be given because the
dosage ordered is more than the dosage on hand
Step 3: 20 mEq
=
50mEq
145 mL
X mL
N364 Spring 2017
Step 4: Cross multiply and solve for X
20mEq
15mL
=
50mEq
X mL
20X
=
750
20X
20
X
=
750
20
37.5 mL
=
N364 Spring 2017
Appendix C
Grading Rubric for Drug Card Presentation
Content / Development
Points Earned
20 Points
XX/20
Additional Comments:









All key elements of the assignment
are covered in a substantive way:
Provided generic (or official name)
and common trade name(s) (as
applicable)
Provided accurate classification of
medication
Demonstrated knowledge of different
drug indications for use
Described adequately actions and
therapeutic effects selected drug
Defined the key components of
pharmacokinetics including
absorption, distribution,
metabolism/excretion, and half-life
Explained sufficiently drug
contraindications and precautions
Listed 3-5 adverse reactions and
side effects
Provided accurate and common
adult dosages and calculations
Mechanics
Points Earned
5 Point
XX/5
Additional Comments:



Followed rules of grammar, usage,
and punctuation
No spelling noted
Sentences were complete, clear,
N364 Spring 2017
and concise
Overall Presentation/Peer Review
Points Earned
5 Points
XX/5
Additional Comments:



Presentation was given in 15-30
minutes
Group was well prepared and
organized for presentation
Group was communicated
thoroughly and accurately about
selected drug
Total
Points Earned
30 Points
XX/30
Overall Comments:
N364 Spring 2017
Appendix D
Study Group Peer Evaluation
Name & Drug: _________________________ Date: ________________
Objectively evaluate the team’s performance on the following questions. Students
attempt to rate without regard to positive or negative feelings that you may have for
individual members. Must submit on scheduled presentation day to receive credit.
Using the scale below, individually rate each member of your group, including yourself.
1= No Participation 2= Slight Participation 3= Moderate participation
4= Significant Participation 5= Outstanding Participation
Study Group
Member
Preparedness
(Research,
reading, and
assignment
complete)
Attendance
(On-time and
stayed for
duration)
Participation
(Contributed best
academic ability)
Communication
between
meetings
(Initiates and
responds
appropriately)
Overall
Contribution
N364 Spring 2017