Pharmacology - Learning Objectives

 Generic must have the same strength of the active ingredient, use the same dosage form (tablet, capsule, or liquid), the same route (oral, topical, or injectable), contain safe ingredients, and safe packaging/storage.  Equally safe as brand name, more cost-effective o Over-the-Counter Drugs:  Products that are available without prescription for self-treatment of a variety of complaints. Safe and useful for patients without the need of a prescription  Nurse Considerations:  Taking these drugs could mask the signs and symptoms of underlying disease, making diagnosis difficult  Taking with prescriptions could result in drug interactions  Not taking as directed could result in serious overdoses  Explain the benefits and risks associated with the use of over-the-counter drugs. o OTC drugs are available without a prescription and are deemed safe when used as directed o Taking these drugs can mask the signs & symptoms of underlying disease, making diagnosis difficult o Taking these drugs with prescription medications could result in drug interactions and interfere with drug therapy Chapter 2: Drugs and the Body  Describe pharmacodynamics and pharmacokinetics. o Pharmacodynamics: the study of the interactions between the chemical components of living systems and the foreign chemicals, including drugs, that enter living organisms; the way a drug affects a body o Pharmacokinetics: the way a medication travels through the body, including absorption, distribution, biotransformation, and excretion; how the body acts on a drug  Describe how body cells respond to the presence of drugs that are capable of altering their function. o Drugs usually work in one of four ways:  To replace or act as substitutes for missing chemicals  To increase or stimulate certain cellular activities  To depress or slow cellular activities  To interfere with the functioning of foregin cells, such as invading microorganisms or neoplasm that cause cell death (drugs that act in this way are called chemotherapeutic agents ) o Drugs are thought to work by reacting with specific receptor sites or by interfering with enzyme systems in the body  Outline the process of dynamic equilibrium that determines the actual concentration of a drug in the body. o Several processes:

 During biotransformation: one drug stimulates or blocks the metabolism of the other drug  EX: warfarin (coumadin), an oral anticoagulant, is biotransofrmed more quickly if it is taken at the same time as barbiturates, rifampin, or many other drugs  During excretion: one drug competes for excretion with the other drug, leading to accumulation and toxic effects of one of the drugs  At the site of action: one drug may be an antagonist of the other drug or may cause effects that oppose those of the other drug, leading to no therapeutic effect o Alternative therapies such as herbal products, act as drugs in the body and can cause these same interactions o Drug-Food : when the drug and the food are in direct contact in the stomach  Some foods increase acid production, speeding the breakdown of the drug molecule and preventing absorption and distribution of the drug  In most cases, oral drugs are absorbed fastest when taken on an empty stomach; however, for many medications, the absorption speed is not clinically relevant so people can eat and drink normally when taking the medications o Drug-Laboratory: administration of a particular drug may alter results of tests that are done on various chemical levels or reactions as part of a diagnostic study  Define critical concentration. o Involves a dynamic equilibrium among the processes of drug absorption, distribution, metabolism or biotransformation, and excretion Chapter 3: Toxic Effects of Drugs  Define the term adverse drug reaction and explain the clinical significance of this reaction. o Adverse drug reaction: undesired effects that may be unpleasant or even dangerous  The drug may have other effects on the body besides the therapeutic effect  The patient may be sensitive to the drug being given  The drug’s action on the body may cause other undesirable or unpleasant responses  The patient may be taking too much or too little of the drug, leading to adverse effects o Nursing:  Stay constantly alert for signs of drug reactions of various types  Patients and their families need to be taught what to look for when taking drugs at home  Define primary and secondary actions. o Primary: can be extensions of the desired effect

 Weight, age, physical parameters related to disease or drug effects o Nursing Interventions:  Drug administration  Provision of Comfort Measures  Placebo effect, managing adverse effects, & lifestyle adjustment  Patient/Family Education  All the information necessary to ensure safe and effective drug therapy  Describe key points to incorporate into the assessment of a patient receiving drug therapy. o Medical History:  Chronic conditions, drug use, allergies, education, social, financial support o Examination:  Weight, age, health concerns  Describe types of nursing interventions involved in drug therapy. o Drug Administration:  The three checks and the rights of medication administration  Preparing unit-dose packaged medications  Administering oral medications  Administering eye drops  Administering eardrops  Administering a subcutaneous injection  Administering an intramuscular injection  Administering IV medications by Piggyback Infusion via an Electronic Infusion Device o Provision of comfort measures:  Placebo Effect  Anticipation that a drug will be helpful (placebo) has proven to have tremendous impact on the actual success of drug therapy o EX: back rub, a kind word, & a positive approach may be as beneficial as the drug itself  Managing Adverse Effects  Interventions include environmental control (e.g., temperature, light), safety measures (e.g., avoiding driving, avoiding the sun, using side rails), and physical comfort measures (e.g., skin care, laxatives, frequent meals)  Lifestyle Adjustment  Lifestyle changes are quite difficult for patients to accomplish, and therefore, adherence with drug therapy requires a great deal of support, education, and encouragement o Patient/family education:  Patients and family are given written information on medications to ensure safe and effective drug therapy at home

 The nurse is called upon to answer questions, reassure the public, offer educational programs, and serve on emergency preparedness committees o Opioid Crisis:  Regulations regarding prescriptions are stricter, so deaths from prescription medications have decreased, but deaths caused by use of illicit opioids have increased  Taken steps including, tightening the controlled substance class of opioids, making reversal agents readily available to first responders and the public, research into safer delivery of these opioids, research into better ways to treat chronic pain, and research into more effective and more readily available rehabilitation  Discuss the health care ramification of the COVID-19 pandemic. o Increased transition to telehealth for many outpatient visits o Uncertainty regarding the pharmaceutical supply chain including the manufacturers, distributors, pharmacies (physical and mail order), and tens of thousands of workers to distribute about 6 billion prescriptions in the US each year o Our responses to infection have changed the health care system and decreased many people’s health care resources.