NR 293 Pharmacology for Nursing
I I I I
Content IAreas Ito IReview Ifor IExam I1
All IReading IAssignments, I(ATI), ILecture IMaterials, Ihandouts Iare Iall Itestable Imaterial. IBe Iprepared Ifor
Imath Iquestion Isuch Ias Idosage Icalculations. I
Apply INursing IConsiderations I(to Ithe Idrugs/drug Iclasses Ilisted Ibelow)
• Assessments Ito Iinclude Ivital Isigns, Iphysical Iassessment, Ilabs
• Drug Iadministration: Isafety, Iroute Iconsiderations
• Drug Itoxicity I(signs/symptoms) Iand Iantidote Iif Iapplicable
• Patient Iteaching I(ex. Inutrition, Iadverse Ieffects, Iinfusion Iconsiderations, Ilaboratory Ireviews)
• Health Icare Icollaboration
• Nursing Iprocess
Things Ito IConsider:
- Know Ithe IGENERIC Inames - IGrapefruit Ijuice Iis Iusually Ia Igood Ibet
- Common ISide IEffect I= IHEADACHE/ IGI IUPSET
- herbal Isupplements Ithat Istart Iwith IG I(ex. Igarlic, Iginger, Igingko Ibiloba) I𝖳 Irisk Iof Ibleeding
- most Imeds Iare Icontraindicated Ifor Ipregnancy
- pt Ishould Inot Istop Imeds Isuddenly I& Iif Idose Iis Imissed Idon’t Idouble Idose
- alcohol Ishould Inot Ibe Iconsumed Iw/ Imost Imeds - Igram I+ I= Istaph I& Istrep
Chapter 1: The Nursing Process and Drug Therapy
I I I I I I I
**5-9 IRights Iof IMedication IAdministration Iwith Iability Ito Idetermine Iwhich I“right” Iwas Inot Ifollowed.
Right IClient I(uses I2 Ipatient Iidentifiers Iex. Iname, IDOB, IMR Inumber)
Right IMedication Right IRoute Right IDose Right ITime I Right IDocumentation I(after Iadmin)
Right Ito IRefuse
Chapter 2: Pharmacological Principles and Chapter 5: Medication Errors
I I I I I I I I
*4 IPhases Iof IPharmacokinetics:
1. Absorption I- Idepends Ion Iroute Iof Iadministration
EX. IOral Imeds I(takes Ia Iwhile) Iconsiderations I= Ifood Iin Istomach, IpH Iof IGI, Iliquid Iform Ivs
Ienteric-coated Iaka Iextended Irelease
& I*first Ipass Ieffect I(oral Imeds Iare Iinactivated Ion Itheir I1st Ipass Ithrough Iliver, Imay
Ineed Ito Igive Ipt Ihigher Idose
Sublingual Iabsorbs Ivery Iquickly, Ipt Ishould Iwait Iuntil Iits Icompletely Iabsorbed
Inhalation Iabsorbed Ivery Iquickly, Itravels Ithrough Ialveoli
I
Intradermal/Topical Islow I& Igradual Irate Iof Iabsorption
, IM Iabsorption Idepends Ion Isolubility Iof Ithe Imed IV Iis Iimmediate Iabsorption
2. Distribution I(med Itravels Ito Isite Iof Iaction) I- Ibinding Iproteins Iare Ireq. I[ex. Ialbumin]
3. Metabolism I(med Iis Iactivated Ior Ibroken Idown) I- Idue Ito Ienzymes; Iprimarily Ihappens Iin Iliver I&
Ikidneys, Ilungs, Ibowel, Iblood
Infants I- Iorgans Iare Iimmatures Iso Imetab. Idoesn’t Ihappen Ieffectively I= Ihigh Irisk Iof
Itoxicity
Older Iadults’ Iliver/kidneys Idysfunction Iimpacts Imetab. I& Islows Iit Idown Ialso Ihigher
Irisk Ifor Itoxicity
4. Excretion I- Iprimarily Ihappens Ithrough Ikidneys
Minimum IEffective IConcentration I(MEC) I/Therapeutic IIndex
- Iwe Iwant Ito Iattempt Ito Ikeep Iplasma Ilevels Ibetween Ithe Iminimum Ieffective Iconcentration I& Itoxic
Iconcentration
- Icertain Imeds Ihave Ia Ihigh Itherapeutic Iindex I(TI) Iaka Ibig Irange Ibetween IMEC I& Itoxic Iconcentration
-other Imeds Ihave Ilow ITI Imaking Itherapeutic Ilevel I& Itoxic Ilevel Ivery Iclose Itogether I(ex. Ivancomycin)
Ithere’s Ia I𝖳 Irisk Ifor Itoxicity Iso Iblood Idraws Iare Ireq. Ito Icheck Itrough I& Ipeak Ilevels
Iassuring Iyou’re Inot Igetting Iinto Itoxic Irange
1/2 ILife I= Iperiod Iof Itime Ineeded Ifor Imed Ito Ibe Ireduced Iby I50%
if Imed Ihas Ilonger I½ Ilife I(stays Iin Ibody Ilonger) Ihave I𝖳 Irisk Iof Itoxicity
*Agonists Ivs. IAntagonist IMeds
Agonist I= Ihelps Iproduce Ian Iaction I[ex. Imorphine Ibinds Iw/ Iopioid Ireceptors]
Antagonist I= Iblocks Inormal Ireceptor, Iopposing Iaction
Routes Iof IAdministration I& INursing IConsiderations
Oral IMed I= Ipt Isitting Iupright I(Fowler’s Iposition) Imay Ineed Ito Imix Iin Iapplesauce Ito Ifacilitate Iswallowing
- never Ichew Ienteric Icoated Imeds - Iavoid Igrapefruit Ijuice - Iadminister Ion Iempty
Istomach
- liquid Iform Iof Imeds Imay Ifacilitate Iswallowing
Sublingual I= Imake Isure Imed Iis Ifully Iabsorbed Ibefore Ipt Ieats Ior Idrinks, Ido Inot Iswallow
I Transdermal I= Iassure Iskin Iis Ihairless, Iclean I& Ithoroughly Idry; Ialso Irotate Isites I(prevents Iirritation)
Eye IMed I= Iuse Isurgical Iaseptic Itechnique; Idrop Imed Iin Icenter Iconjunctival Isac Iw/ Igentle Ipressure Ifor
I30-60 Isec I@ Inasolacrimal Iduct
Ear IMed I= Ilay Ipt Ion Iunaffected Iside I*Rem. Ifor IAdults Ipull Iauricle I𝖳 I& I⟶ I(out) I Kids I is I I and I I(back)
NG/G ITube I= Iflush Itubing Ibefore Iand Iafter Ieach Imed Iw/ I15mL Iof Isterile Iwater
I
I I I I
Content IAreas Ito IReview Ifor IExam I1
All IReading IAssignments, I(ATI), ILecture IMaterials, Ihandouts Iare Iall Itestable Imaterial. IBe Iprepared Ifor
Imath Iquestion Isuch Ias Idosage Icalculations. I
Apply INursing IConsiderations I(to Ithe Idrugs/drug Iclasses Ilisted Ibelow)
• Assessments Ito Iinclude Ivital Isigns, Iphysical Iassessment, Ilabs
• Drug Iadministration: Isafety, Iroute Iconsiderations
• Drug Itoxicity I(signs/symptoms) Iand Iantidote Iif Iapplicable
• Patient Iteaching I(ex. Inutrition, Iadverse Ieffects, Iinfusion Iconsiderations, Ilaboratory Ireviews)
• Health Icare Icollaboration
• Nursing Iprocess
Things Ito IConsider:
- Know Ithe IGENERIC Inames - IGrapefruit Ijuice Iis Iusually Ia Igood Ibet
- Common ISide IEffect I= IHEADACHE/ IGI IUPSET
- herbal Isupplements Ithat Istart Iwith IG I(ex. Igarlic, Iginger, Igingko Ibiloba) I𝖳 Irisk Iof Ibleeding
- most Imeds Iare Icontraindicated Ifor Ipregnancy
- pt Ishould Inot Istop Imeds Isuddenly I& Iif Idose Iis Imissed Idon’t Idouble Idose
- alcohol Ishould Inot Ibe Iconsumed Iw/ Imost Imeds - Igram I+ I= Istaph I& Istrep
Chapter 1: The Nursing Process and Drug Therapy
I I I I I I I
**5-9 IRights Iof IMedication IAdministration Iwith Iability Ito Idetermine Iwhich I“right” Iwas Inot Ifollowed.
Right IClient I(uses I2 Ipatient Iidentifiers Iex. Iname, IDOB, IMR Inumber)
Right IMedication Right IRoute Right IDose Right ITime I Right IDocumentation I(after Iadmin)
Right Ito IRefuse
Chapter 2: Pharmacological Principles and Chapter 5: Medication Errors
I I I I I I I I
*4 IPhases Iof IPharmacokinetics:
1. Absorption I- Idepends Ion Iroute Iof Iadministration
EX. IOral Imeds I(takes Ia Iwhile) Iconsiderations I= Ifood Iin Istomach, IpH Iof IGI, Iliquid Iform Ivs
Ienteric-coated Iaka Iextended Irelease
& I*first Ipass Ieffect I(oral Imeds Iare Iinactivated Ion Itheir I1st Ipass Ithrough Iliver, Imay
Ineed Ito Igive Ipt Ihigher Idose
Sublingual Iabsorbs Ivery Iquickly, Ipt Ishould Iwait Iuntil Iits Icompletely Iabsorbed
Inhalation Iabsorbed Ivery Iquickly, Itravels Ithrough Ialveoli
I
Intradermal/Topical Islow I& Igradual Irate Iof Iabsorption
, IM Iabsorption Idepends Ion Isolubility Iof Ithe Imed IV Iis Iimmediate Iabsorption
2. Distribution I(med Itravels Ito Isite Iof Iaction) I- Ibinding Iproteins Iare Ireq. I[ex. Ialbumin]
3. Metabolism I(med Iis Iactivated Ior Ibroken Idown) I- Idue Ito Ienzymes; Iprimarily Ihappens Iin Iliver I&
Ikidneys, Ilungs, Ibowel, Iblood
Infants I- Iorgans Iare Iimmatures Iso Imetab. Idoesn’t Ihappen Ieffectively I= Ihigh Irisk Iof
Itoxicity
Older Iadults’ Iliver/kidneys Idysfunction Iimpacts Imetab. I& Islows Iit Idown Ialso Ihigher
Irisk Ifor Itoxicity
4. Excretion I- Iprimarily Ihappens Ithrough Ikidneys
Minimum IEffective IConcentration I(MEC) I/Therapeutic IIndex
- Iwe Iwant Ito Iattempt Ito Ikeep Iplasma Ilevels Ibetween Ithe Iminimum Ieffective Iconcentration I& Itoxic
Iconcentration
- Icertain Imeds Ihave Ia Ihigh Itherapeutic Iindex I(TI) Iaka Ibig Irange Ibetween IMEC I& Itoxic Iconcentration
-other Imeds Ihave Ilow ITI Imaking Itherapeutic Ilevel I& Itoxic Ilevel Ivery Iclose Itogether I(ex. Ivancomycin)
Ithere’s Ia I𝖳 Irisk Ifor Itoxicity Iso Iblood Idraws Iare Ireq. Ito Icheck Itrough I& Ipeak Ilevels
Iassuring Iyou’re Inot Igetting Iinto Itoxic Irange
1/2 ILife I= Iperiod Iof Itime Ineeded Ifor Imed Ito Ibe Ireduced Iby I50%
if Imed Ihas Ilonger I½ Ilife I(stays Iin Ibody Ilonger) Ihave I𝖳 Irisk Iof Itoxicity
*Agonists Ivs. IAntagonist IMeds
Agonist I= Ihelps Iproduce Ian Iaction I[ex. Imorphine Ibinds Iw/ Iopioid Ireceptors]
Antagonist I= Iblocks Inormal Ireceptor, Iopposing Iaction
Routes Iof IAdministration I& INursing IConsiderations
Oral IMed I= Ipt Isitting Iupright I(Fowler’s Iposition) Imay Ineed Ito Imix Iin Iapplesauce Ito Ifacilitate Iswallowing
- never Ichew Ienteric Icoated Imeds - Iavoid Igrapefruit Ijuice - Iadminister Ion Iempty
Istomach
- liquid Iform Iof Imeds Imay Ifacilitate Iswallowing
Sublingual I= Imake Isure Imed Iis Ifully Iabsorbed Ibefore Ipt Ieats Ior Idrinks, Ido Inot Iswallow
I Transdermal I= Iassure Iskin Iis Ihairless, Iclean I& Ithoroughly Idry; Ialso Irotate Isites I(prevents Iirritation)
Eye IMed I= Iuse Isurgical Iaseptic Itechnique; Idrop Imed Iin Icenter Iconjunctival Isac Iw/ Igentle Ipressure Ifor
I30-60 Isec I@ Inasolacrimal Iduct
Ear IMed I= Ilay Ipt Ion Iunaffected Iside I*Rem. Ifor IAdults Ipull Iauricle I𝖳 I& I⟶ I(out) I Kids I is I I and I I(back)
NG/G ITube I= Iflush Itubing Ibefore Iand Iafter Ieach Imed Iw/ I15mL Iof Isterile Iwater
I
