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Detailed Outline: Nursing
Pharma
I. Medication Administration
A. Basic Concepts
- Definition of Medication
- A medication is a substance administered for the diagnosis, cure, treatment, or relief of a symptom or for prevention of disease.
- Prescription - A prescription is the written direction for the preparation and administration of a drug.
- Drug Names - A drug can have multiple names: ● Generic name (pre-official): Given before a drug becomes official. ● Official name (listed in official publications): The name under which it is officially recognized. ● Chemical name (describes constituents) : Describes the drug's chemical composition. ● Trademark or brand name (given by manufacturers): The name assigned by the **drug manufacturer.
- Related Terms**
- Pharmacology (study of drug effects on living organisms)
- Pharmacy (art of preparing, compounding, and dispensing drugs) - Pharmacist (licensed to prepare and dispense drugs) - Importance of questioning unreasonable orders
II. Types of Drug Preparations
● Aerosol Spray or Foam ○ A liquid, powder, or foam deposited in a thin layer on the skin by air pressure. ● Aqueous Solution ○ One or more drugs dissolved in water. ● Aqueous Suspension ○ One or more drugs finely divided in a liquid such as water. ● Caplet ○ A solid form, shaped like a capsule, coated and easily swallowed. ● Capsule ○ A gelatinous container to hold a drug in powder, liquid, or oil form. ● Cream ○ A non-greasy, semisolid preparation used on the skin. ○ Creams contain contain less oil than water, making it easy for absorption. It is due to their high water content that they are absorbed faster into your skin. ● Elixir
○ A sweetened and aromatic solution of alcohol used as a vehicle for medicinal agents. ● Extract ○ A concentrated form of a drug made from vegetables or animals. ● Gel or Jelly ○ A clear or translucent semisolid that liquefies when applied to the skin. ● Liniment ○ A medication mixed with alcohol, oil, or soapy emollient and applied to the skin. ● Lotion ○ A medication in a liquid suspension applied to the skin. ● Lozenge (Troche) ○ A flat, round, or oval preparation that dissolves and releases a drug when held in the mouth. ● Ointment ○ A semisolid preparation of one or more drugs used for application to the skin and mucous membrane. ○ Ointments, on the other hand, contain more oil and less water. Ointments are best suited to treat dry skin conditions. ● Paste ○ A preparation like an ointment, but thicker and stiffer, that penetrates the skin less than an ointment. ● Pill
○ One or more drugs mixed with a cohesive material, in oval, round, or flattened shapes. ● Powder ○ A finely ground drug; some are used internally, others externally. ● Suppository ○ One or several drugs mixed with a firm base such as gelatin and shaped for insertion into the body; the base dissolves gradually at body temperature releasing the drug. ● Syrup ○ An aqueous solution of sugar often used to disguise unpleasant tasting drugs. ● Tablet ○ A powdered drug compressed into a hard small disc. ● Tincture ○ An alcoholic or water-and-alcohol solution prepared from drugs derived from plants. ● Transdermal Patch ○ A semipermeable membrane shaped in the form of a disc or patch that contains a drug to be absorbed through the skin over a long period of time.
III. Effects of Drugs A. Therapeutic Effects - Desired primary effects.
● Curative : Cures a disease or condition. ○ Antibiotics like penicillin for infection ● Supportive : Supports body function until other treatments or the body’s response can take over. ○ Norepinephrine bitartrate for low blood pressure ○ aspirin/biogesic for high body temperature ● Substitutive : Replaces body fluids or substances. ○ After thyroidectomy – they don’t have thyroid to supply thyroid hormones, so to substitute, they take thyroxine. ○ Thyroxine for hypothyroidism, insulin for DM ○ Hydrides for pedia ● Chemotherapeutic : Destroys malignant cells. ○ Busulfan for leukemia. Doxorubicin and cisplatin ● Restorative : Returns the body to health. ○ Vitamin, mineral and supplements
V. Drug Misuse and Dependence
A. Drug Misuse - Improper use leading to acute and chronic toxicity. Doesn't know B. Drug Abuse - Inappropriate intake, continual or periodic. Know C. Drug Habituation - Mild form of psychological dependence; the individual develops the habit of taking the substance and feels better after taking it.
D. Illicit Drugs / Street Drugs - Illegally sold substances.
- Cocaine, Marijuana, Ecstacy E. Drug Dependence - reliance to take drug / substance
- Physiologic dependence is due to biochemical changes in body tissues, especially the nervous system; withdrawal symptoms occur when the drug is stopped.
- Psychologic dependence is emotional reliance on a drug to maintain a sense of well-being, accompanied by cravings for the drug.
- Pseudo effect: either nocebo or placebo
VI. Actions of Drugs on the Body A. Onset of Action ● Refers to the time after administration when the body initially responds to the drug. ● Oral: About 15 mins ● Sublingual: ● IV: fast B. Peak Plasma Level ● The highest plasma level achieved by a single dose when the elimination rate of a drug equals the absorption rate. ● Example: if 100 mg of a drug has a half– life of 60 minutes, the following estimate: 60 minutes after administration, 50 mg remains. 120 minutes after administration, 25 mg remains.
C. Drug Half-Life ● The time for the elimination process to reduce the concentration of the drug to one-half of what it was at initial administration.
Potassium: should be diluted in IV bolus (if undiluted, Patient will feel it warm)
VII. Pharmacodynamics
● Study of drug mechanism and effects on the body. ● Action-effect relationship and dose-effect relationship. ● Agonist : intensify
VIII. Pharmacokinetics
● Study of drug absorption, distribution, biotransformation, and excretion. A. Absorption ● The process by which a drug passes into the bloodstream ; requires the correct drug form for the intended route. B. Distribution ● The transportation of a drug from its site of absorption to its site of action. C. Biotransformation (Metabolism or Detoxification)
● The process by which a drug is converted to a less active form ; most biotransformation takes place in the liver. (Acetaminophen, water solubility) D. Excretion ● The process by which metabolites and drugs are eliminated from the body. ● Example: urine, sweat, feces, tears
IM wt blood- discard whole med
IX. Types of Medication Orders A. Stat Order ● Indicates that the medication is to be given immediately and only once (e.g., Demerol 100 mg IM stat). B. Single Order (One-Time Order) ● For medication to be given once at a specified time (e.g., Seconal 100 mg hs before surgery). C. Standing Order ● May or may not have a termination date; may be carried out indefinitely until an order is written to cancel it or for a specified number of days. ● Antibiotic - minimum of 7, maximum of 10 days ■ On 10th day, change to higher dose D. PRN Order (As Needed Order)
XII. Calculating Dosages
● Formula: Desired (D) / Stock dose (S) x Quantity on hand (Q) ● Example: Dr. Tsunade ordered 5,000 units of heparin to be incorporated in 1 liter of PNSS. Heparin comes in 10,000 units per milliliter in
one vial. How many mL of Heparin nurse Sakura should administer? ● (5 000 U ÷ 10 000 U) × 1 mL = ½ mL or 0.5 m
Classifications of Drugs
Oral-15 mins
