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Pharmacologic Principles. Chapter 1, 2, 3. Understanding. Nurses must understand both + and – effects of drugs Pharmacotherapeutics use of drugs and the clinical indications for drugs to prevent and treat diseases Pharmacodynamics study of what the drug does to the body

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Presentation Transcript
understanding
Understanding
  • Nurses must understand both + and – effects of drugs
  • Pharmacotherapeutics
    • use of drugs and the clinical indications for drugs to prevent and treat diseases
  • Pharmacodynamics
    • study of what the drug does to the body
  • Pharmacognosy
    • natural drug sources
drug names
Drug Names
  • Chemical
  • Trade
    • Patented
    • Belongs to a company
  • Generic
    • Commonly known
    • Less expensive
phases of activity
Phases of Activity
  • Pharmaceutical
    • Administered
    • Dissolves or disintegrates
  • Pharmacokinetic
    • Absorbed
    • Sent to tissues
    • Metabolized (used)
    • Excreted (disposed of)
  • Pharmacodynamic
    • Ways drug affects the body
first pass effect
First-Pass Effect
  • metabolism of a drug by the liver before its systemic availability
  • AKA Bioavailability
  • Amount of the drug that makes it into circulation
drug transport
Drug Transport
  • How does the drug get from point A to point B?
  • Parenteral Liver Circulation
  • OR
  • Gastric Liver Circulation
action curve
Action Curve
  • Time from delivery to start of therapeutic effect = Onset of Action
  • From delivery to maximum therapeutic effect = Peak Effect
  • Total amount of time therapeutic effect is notable = Duration of Action
mechanism of action
Mechanism of Action
  • Receptor
    • Designated site accepts drug
  • Enzyme
    • Chemical reaction “glues” drug to site
  • Nonspecific
    • Drug stimulates changes in cell to allow it in
chemical bonds
Chemical Bonds
  • Agonists
  • Antagonists
  • Partial-agonist or Agonist-Antagonist
drug excretion
Drug Excretion

Organs: liver, kidneys, intestines

Kidneys have primary responsibility

Breakdown by liver makes kidney’s job easier

Some drugs are eliminated through bowels

considerations
Considerations
  • Therapeutic Index – difference between good & dangerous effects
  • Amount of drug circulating = concentration
  • Patient condition – liver & kidney health, age, GI function
  • Tolerance or Dependence
  • Interactions
drug misadventures
Drug Misadventures
  • Adverse Drug Event (ADE)
    • Adverse Drug Reaction (ADR)
      • Caused by factors inside patient’s body
      • Allergy, unknown, kidney or liver disease
      • Not able to be controlled
    • Medication Error
      • Most common type of event
      • Related to administration, dispensing, prescribing
life span
Life Span
  • Pediatrics
    • Very young have immature livers - can’t process drugs as well
    • Adult drugs may be passed through breastmilk – check safety if mother is breastfeeding
    • Dosage based on mg/kg for safety
life span con t
Life Span, con’t.
  • Adult
    • Careful of interactions with
      • Other drugs
      • Herbal substances
    • Risk for noncompliance d/t ‘undesirable’ effects
life span con t1
Life Span, con’t.
  • Elderly
    • Be aware of possible diminished:
      • liver or kidney function – monitor lab tests
      • Cardiac function – be aware of test results
      • Digestive changes
    • Assess ability to read labels & open containers
    • Assess for potential safety issues – meds may cause drowsiness or diminished response
nursing process
Nursing Process
  • Assess
    • Patient needs
    • Patient & family understanding
    • Patient (and family) physical abilities
  • Plan (Goal)
    • Include patient & family
    • Tailor to patient/family needs
    • Include social services, prn
nursing process con t
Nursing Process, con’t.
  • Implement
    • Regular re-assessments
    • Monitor for changes
    • Observe for therapeutic affects
  • Evaluate
    • Is plan working?
    • Does it need modifying?
    • What can change?
5 rights
5 Rights
  • Basic to medication administration
    • Right Drug
    • Right Dose
    • Right Time
    • Right Route
    • Right Patient
errors
Errors
  • IF a med error occurs
    • Admit the error – don’t try to cover it up
    • Notify physician
    • Take emergency/first aid measures, prn
    • Complete proper reporting form
  • NEVER record terms “by mistake”, “on error”, “unintentionally”
  • DO NOT record error in patient chart
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