BACHELOR OF SCIENCE IN NURSING:
NCMA 416: PHARMACOLOGY
COURSE MODULE COURSE UNIT WEEK Textbooks:
1 1 1
Ashelford, Sarah. (2016). Pathophysiology & Pharmacology for nursing students. Los
Angeles: Sage.
BASIC CONCEPTS IN PHARMACOLOGY
Hochadel, MaryAnne. (2016). Mosby’s drug reference for health professions. St. Louis:
Elsevier.
Katzung, Bertram G., ed (2015). Basic & clinical pharmacology, 13 . New York: McGraw-
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Hill.
Read PEO (Program Educational Objectives) Kee, joyceLeFever. (2015). Pharmacology: A patient-centered nursing process approach,
✓ Read and appraise required learning resources with the study guide before the start of each 8 ed. Singapore: Elsevier.
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session; refer to unit terminologies for jargons Rang, H.P..etal. (2015). Rang and Dale’s Pharmacology.Singapore: Elsevier.
✓ Proactively participate in online discussions
Waller, Derek G. (2014). Medical Pharmacology & Therapeutics, 4 ed. Edinburg:
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✓ Participate in weekly discussion board (Canvas)
Saunders.
✓ Answer and submit course unit tasks
Pharmacology:
At the end of this unit the students are expected to:
Cognitive:
1. Define the basic concepts of Pharmacology, it’s origin and history
2. Understand and enumerate the different branches of Pharmacology
3. Familiarize self in different form of drugs and it’s preparation
4. Apply knowledge on ethico-legal aspects on drug administration
5. List drug structure and the steps in drug evaluation
Affective:
1. Inculcate the right considerations to prevent error in medicine administration
2. Cooperate and listen attentively in class discussions
3. Respect comments and opinion of other and accepts criticism
Psychomotor:
1. Collaborate actively in activities and tasks assigned Pharmacology is the study of drugs and its origin, chemical structure, preparation,
administration, action, metabolism and excretion.
The study of drugs that alter functions of living organisms.
person’s body.
PHARMACY – art of preparing, compounding, and dispensing drugs. It also refers to the place DRUG NAMES
where drugs are prepared and dispensed
PHARMACIST – a person licensed to prepare and dispense drugs to make up prescriptions. > Generic or Nonproprietary Name: name approved by the Medical or Pharmaceutical
Associations in the original country of manufacture and is adopted by all countries.
HISTORY e.g. Paracetamol
Babylonians > Brand name or trade name: name given by the manufacturer of the drug
Earliest surviving “prescriptions” on clay tablets in 3000 B.C. e.g. Adol or Panadol or Biogesic
Chinese > Chemical name: name that describes the atomic or chemical structure
Recorded the Pen Tsao (Great Herbal) – a 40-volume compendium of plant remedies dating to e.g. para-acetylaminophenol
2700 B.C.
Egyptians Sources of Drugs:
Archives of remedies on a document known as Erb’s Papyrus in 1500 B.C.
1. Natural sources -
Pharmacologia sen Manuductio and Materia Medicum
First recorded reference to the word pharmacology a. Plants
Early 1800s
Chemists isolates specific substances from complex mixtures One of the oldest forms of health care, herbal medicine has been practiced in
Pharmacologists then study their effects in animals virtually every culture dating to antiquity.
Fredrich Serturner (first isolated morphine from opium, injected himself and three other friends
The Babylonians recorded the earliest surviving “prescriptions” on day tablets in
with huge doses (100mg))
3000 B.C.
The Chinese recorded the Pen Tsao (Great Herbal), a 40-volume compendium of
DRUGS plant remedies dating to 2700 B.C.
are chemicals that alter physiochemical processes in body cells.
They can stimulate or inhibit normal cellular functions. The Egyptians followed in 1500 B.C. by archiving their remedies on a document
Used interchangeably with medicines. known as Eber’s Papyrus.
e.g morphine, colchicine, cocaine - At that time, chemists were making
Branches of Pharmacology: remarkable progress, isolating specific substances from complex mixtures, this
>Pharmacodynamics - pharmaco means “medicine” dynamic means “change”. enabled scientists to isolate the active agents from scarce natural sources,
Refers to how a medicine changes the body the branch of pharmacology ex. morphine.
concerned with mechanisms of drug action and the relationships between drug Cocaine from - cocoa leaves
concentration and responses in the body.
> Pharmacokinetics - pharmaco means “medicine”, kinetic means “movement or b. Animals - Biologic - are agents naturally produced in animal cell, by
motion”. The study of drug movement throughout the body. How the body deals microorganisms, or by the body itself.
with medications. Actions and side effects of medications in patients. e.g. hormones, monoclonal antibodies, natural blood products,
> Pharmacognosy - the branch of knowledge concerned with medicinal drugs Interferons and vaccines.
obtained from plants or other natural resources
others.
> Pharmacotherapeutics - the study of the therapeutic uses and effects of drugs.
Beneficial and adverse effects of drugs.
> Pharmacovigilance - the practice of monitoring the effects of medical drugs after DRUG USES SPECIES
they have been licensed for use especially in order to identify and evaluate Crestor high cholesterol Rats, rabbits, dogs
previously unreported adverse reactions.
> Toxicology - the branch of science concerned with the nature, effects, and Diovan High blood pressure Rats, rabbits
detection of poisons.the measurement and analysis of potential toxins,
intoxicating or banned substances, and prescription medications present in a Lantus Type 1 & 2 Diabetes Dogs, guinea pigs
> chemicals cleared for human testing, there are significant therapeutic benefits.
2. Inorganic compounds > testing done on healthy male subjects
e.g. Lithium carbonate > companies begin developing a brand name
Cisplatin ORPHAN DRUG
3. Synthetic > are chemicals that are discarded Phase I
e.g Ecstasy or Molly - stimulants that mimic the effect of cocaine > will not participate in the next phase
Criteria:
DRUG EVALUATION > lack therapeutic activity in humans
> too toxic
= a series of scientific tests to evaluate the actual therapeutic and toxic effects of chemicals > produce unacceptable side effects
STEPS: > teratogenic
PRECLINICAL TRIAL PHASE II
= testing done on laboratory performed in animals > chemicals cleared for limited clinical studies
= tests efficacy and toxicity, at different doses, it predicts whether the drug will cause harm to > some may not further proceed with the evaluation due to the following criteria
humans. > less effective than expected
= do not always reflect the way a human responds, testing may overestimate or underestimate > are too toxic
the actual risk to humans. > produce unacceptable side effects
> have a low benefit-to-risk ratio
> are not as effective as available drugs
ORPHAN DRUG PHASE III
= are drugs that have been discovered but are not financially viable and therefore have not > chemicals cleared for large-scale clinical studies
been “adopted” by any drug company
> some chemicals may not advance further in the next phase due to the following criteria:
= may be useful in treating a rare disease, or they may have potentially dangerous adverse
effect > produce unacceptable side effects
= are often abandoned after preclinical trials or phase I studies. > produce unexpected responses
Criteria: PHASE IV
> lack therapeutic activity > drugs approved for marketing by FDA
> too toxic
> Teratogenic > continues evaluation
> have a small margin of safety
e.g. Zavesca (miglustat), Trisenox (arsenic trioxide injection), Aldurazyme (Laronidase), Glivec
(Imatinib mesylate), Fabrazyme (Agalsidase beta), Ventavis (iloprost),Litak (cladribine). DOSAGE FORMS OF DRUGS: ( Sir include this po, describe, better with pictures )
PHASE I A. SOLID FORMS
1. TABLET : b. hard gel
a. scored.
b. layered.
c. enteric-coated.
d. chewable.
e. sustained released
2. CAPSULE
3. LOZENGES
:
4. SUPPOSITORY
a. soft gel.
2. SUSPENSION
B. LIQUID
FORMS
3. ELIXIR
1. SYRUP
4. EMULSION
C. TOPICAL FORMS
1. CREAM
5. INHALANTS 2. OINTMENT
PRINCIPLES OF DRUG ADMINISTRATION
MEDICATIONS
3. LOTION
✓ Are substances administered for the diagnosis, cure, treatment, or relief of symptom or
prevention of disease
PRACTICE GUIDELINES
✓ RNs are responsible for own actions, illegible order should be questioned or clarified
✓ RNs should be knowledgeable about the medication
✓ If the RN is uncertain about the calculation, ask another nurse to double check
✓ What you prepare, you administer
4. PATCH ✓ Do not leave medications at bedside
✓ If the client vomits, report to charge nurse, MD, or both.
✓ When error is made, assess the patient first and report to MD immediately
✓ Correct identification of the patient:
✓ ID band or ID bracelet (BEST: Kozier)
✓ Ask the patient’s name
5. GELS ✓ Avoid: calling the client in NAME
✓ May answer “YES” to the wrong name
✓ OBSERVE THE TEN RIGHTS
✓ Right Client
✓ Right Medication
✓ Right Dose ✓ Avoid Crushing
✓ Right Time ✓ Enteric Coated
✓ Right Route ✓ Buccal and Sublingual tablets
✓ Right Client Education ✓ Liquid Medication
✓ Right Documentation ✓ Mix before pouring
✓ Right to Refuse ✓ Place medication cup on flat surface at eye level
✓ Right Assessment ✓ Fill the cup with the desired level using the BOTTOM of the meniscus
✓ Right Evaluation
PARENTERAL MEDICATION
Right client – can be measured by checking the client identification bracelet by having and by
having the client state her or his name ✓ Intradermal
Right drug – means that the client receives the drug that was prescribed, check at least three ✓ SITE
times prior to administration
Right time – is the time at which the prescribed dose should be administered ✓ Inner lower arm
Right route – is necessary for adequate or appropriate absorption ✓ Upper chest
Right assessment – requires the appropriate data be collected before administration of drugs
Right documentation – requires that the nurses immediately record the appropriate information ✓ Anterior chest
about drug administered ✓ Upper back beneath the scapula
Right to educate – requires that the client received accurate and thorough information about
the medication and how it relates to his or her situation ✓ Angle : almost parallel to the skin 10 - 15 degrees
Client teaching also includes therapeutic purpose, possible side effect of the drugs, any dietary ✓ Gauge: #25, #26, #27
restriction or requirements skills administration, and laboratory monitoring
Right evaluation – requires that the effectiveness of the medication be determined by the client ✓ Length: ⅜”, ⅝”, ½”
response to medication
✓ Max cc: 0.1 to 0.2 ml
Right to refuse – client can and do refuse to take medication
It is the nurses responsibilities to determine when possible the reason for refusal and to take ✓ Subcutaneous
reasonable measure to facilitate the client taking the medication
✓ SITE
✓ Outer aspect of the upper arms
ORAL MEDICATION
✓ Anterior thighs
Most common route ✓ Abdomen
✓ CONTRAINDICATIONS: ✓ Upper back
Client is vomiting
Client with intestinal or gastric suction ✓ Ventrogluteal
Unconscious Client ✓ Dorsogluteal
Inability to Swallow
✓ Angle: 45-degrees (1 inch of tissue can be grasped)
✓ Tablet or Capsules
90-degrees (2 inches of tissue can be grasped)
✓ (+) difficulty in swallowing ✓ Gauge: #25, #26, #27
✓ Crush and mix with small amount of water ✓ Length: ⅜”, ⅝”, ½”
✓ Max cc: 1-3 ml ✓ Length: 1”, 1 ½”, 2”
✓ Intramuscular ✓ Max. cc: Push 10 ml
✓ SITE Infusion: 4L in 24 hrs.
TOPICAL MEDICATIONS
✓ Ventrogluteal
✓ Transdermal Patch
✓ > 1 y/o and adult
✓ SITE
✓ No large nerve or blood vessels
✓ Trunk or lower abdomen
✓ Sealed off by bone Areas that are: hairless
✓ Contains less fat than buttocks (+) hair (clip, do not shave)
Avoid: cuts, burns, abrasions, distal extremity
✓ Vastus Lateralis OPHTHALMIC MEDICATIONS
✓ Site of choice for 1 y/o and younger ✓ Preparation:
✓ Infants with fully developed gluteal muscles ✓ Clean the eyelid and lashes from inner to outer canthus
✓ SITE ✓ Instruction before administration
✓ Dorsogluteal Look up
✓ For adults and children with well developed gluteal muscles ✓ Where and How to Apply:
✓ CONTRAINDICATED: LIQUID:
children under 3 y/o Instill correct number of drops
✓ Increased risk of striking the SCIATIC NERVE Outer third of the lower conjunctival sac
✓ Instruction after Instillation
✓ DELTOID
Do PUNCTAL OCCLUSION for 30 seconds
✓ Small muscle, very close to the radial nerve and artery OINTMENT:
✓ Rapid absorption for adults Discard the first bead
Squeeze 2 cm on the lower conjunctival sac
✓ Cannot administer more than 1 ml. ✓ Instruction after Instillation
✓ Recommended site for Hepa B vaccine administration CLOSE but not SQUEEZE the eyelid
✓ RECTUS FEMORIS OTIC MEDICATIONS
✓ Preparation:
✓ Can be used for self administration
✓ Clean the pinna and the meatus of the ear canal
✓ Disadvantage: causes discomfort
✓ Warm the medication:
✓ Gauge: #24, 23, 22, 21, 20
In between hands
✓ Length: 1”, 1 1/2”, 2” Place in warm water
✓ Max. cc: 2-5 ml ✓ Straighten The Auditory Canal:
Adult: (>3 y/o): Pull the Pinna UPWARD and BACKWARD
✓ Angle: 90 degrees
Child: (<3 y/o): Pull the Pinna DOWNWARD and BACKWARD
✓ INTRAVENOUS/INTRAVASCULAR ✓ INSTILL THE MEDICATION:
✓ Gauge: #24, 23, 22, 21, 20 Along the side of the canal
✓ ACTIONS AFTER: Study Questions
Gently press the TRAGUS
Insert small piece of cotton fluff loosely ＞ What is Pharmacology? It’s significance to the nursing profession?
✓ Instruction After: ＞ How did Pharmacology started?
Remain in side-lying for 5 minutes ＞ Define the different drug names
＞ What are the different drug preparations? What are the nursing considerations before and
after administration?
Drug Name - The systematic naming of drug used in Pharmacology Doctor’s order:
Oral Medication - preparations are taken by mouth, swallowed with fluid, and absorbed via
the gastrointestinal tract. Give Furosemide (Lasix) 40 mg. IV now, then 20 mg IV q 8 hrs. To patient with heart failure.
Parenteral Medication - can be defined as a sterile drug product, suitable for administration The ampule contains 10 mg/ml for a total of 2 ml/ ampule. How many ml will the nurse aspirate
by injection. and how many ampule will he/she open? What are your consideration before you administer
Ophthalmic Medication - a medication comes in form of drops gel or oinment Furosemide? In a given order, what is the generic name, the brand name, dosage, and route
Topical Medication - a drug suitable for administration applied to a particular body part most of administration?
often applied to surfaces such as skin and mucous membrane.
Otic Medication - drug products used to treat conditions of the external and middle ear.
Philippine Journal of Nursing Kee, joyceLeFever. (2015). Pharmacology: A patient-centered nursing process approach,
8 ed. Singapore: Elsevier.
th
European Journal of Pharmacology
Journal of Pharmacology and Pharmaceutics
Websites:
www.aphanet.org
www.drugtopics.com
www.pharmaweb.net
http://evolve.elsevier.com/KeyHayes/pharmacology/
