Pharmacology Basics for Nurses

Module 1

• Nurses require a strong understanding of basic math in pharmacology to prevent medication errors and ensure safe dosage calculations
• Excretion of a drug is not a factor influencing drug absorption
• The 'first pass effect' refers to the metabolism of orally administered drugs by the liver and intestines before reaching systemic circulation
• Understanding fractions, decimals, and ratios is crucial in healthcare, especially for dosage calculations because many medications/dosages use fractional or decimal formats
• Bioavailability is the amount of drug that remains active and circulates in the bloodstream after administration
• The "right diagnosis" is not one of the 10 Rights of Medication Administration
• Polypharmacy refers to the simultaneous use of multiple medications by a patient, often leading to adverse effects
• Insulin is considered a high-alert medication due to the significant risk of patient harm if used in error
• When calculating medication dosages, the first decimal place to the right of the decimal point is called "Tenths"
• Increased metabolic rate is not typically considered when adjusting medication dosages for older adults
• Pharmacodynamics involves the physiological effects of a drug on the body
• A 'prodrug' is a medication that is metabolized into an active form once inside the body

Module 3

• The primary function of autonomic nervous system (ANS) drugs is to regulate involuntary body functions such as heart rate and digestion
• Acetylcholine is primarily associated with the parasympathetic nervous system (PNS)
• A cholinergic agonist mimics the effects of acetylcholine, triggering a "rest and digest" response
• Metoprolol is an example of a beta-adrenergic blocker
• Adrenergic agonists stimulate the sympathetic nervous system, causing a "fight or flight" response
• Atropine is used to treat bradycardia and works by blocking the parasympathetic nervous system
• In drug calculations, "desired dose" refers to the amount of medication the patient is supposed to receive
• The most common error associated with medication orders is incorrect transcription
• An adrenergic antagonist blocks adrenergic receptors, preventing the effects of the sympathetic nervous system
• Bethanechol is classified as a cholinergic agonist
• The administration of anticholinergic drugs can result in side effects like dry mouth, blurred vision, and urinary retention
• Epinephrine is the most appropriate first-line drug for treating a severe anaphylactic reaction
• "BID" means take medication twice a day, in the context of a prescription for Metoprolol 50 mg PO BID
• Acetylcholine activates the parasympathetic nervous system by acting on nicotinic and muscarinic receptors
• Adrenergic agonists can stimulate a "fight or flight" response by activating adrenergic receptors
• The beta-1 adrenergic receptor is primarily responsible for increasing heart rate
• When calculating a dosage using the formula method, "Q" represents the quantity available on hand
• Anticholinergic drugs mainly block acetylcholine receptors, inhibiting parasympathetic activity
• A nurse administering atenolol should hold the medication if the patient's heart rate is 58 bpm
• Bradycardia is a side effect of beta-adrenergic blockers

Module 4

• The primary function of antibiotics in antimicrobial therapy is to target bacterial infections
• A Culture and sensitivity test helps determine the most effective antibiotic for an infection
• A broad-spectrum antibiotic targets both gram-positive and gram-negative bacteria
• A key risk associated with broad-spectrum antibiotics is an increased risk of superinfection
• A common side effect of antibiotics, when a patient does not complete the full course, is the development of drug-resistant bacteria
• Escherichia coli is a bacteria commonly associated with antibiotic resistance
• Penicillin inhibits cell wall synthesis as the antibiotic's mechanism of action
• A bactericidal antibiotic kills the bacteria
• Cephalosporins should be avoided if a patient is allergic to penicillin
• Aminoglycosides affect bacteria by inhibiting ribosomal function
• A "culture" identifies the type of bacteria causing the infection in diagnosing bacterial infections
• Gram-positive bacteria are most likely to cause skin infections
• Bactericidal drugs kill bacteria, while bacteriostatic drugs inhibit bacterial growth
• Penicillin is classified as a beta-lactam antibiotic
• Completing a full course of antibiotics is important to avoid developing antibiotic resistance
• Diarrhea is associated with Clostridioides difficile (C. diff) infection and can occur after antibiotic use
• A "narrow-spectrum" antibiotic targets a specific subset of bacterial pathogens
• An important nursing consideration for a patient on antibiotics is monitoring for allergic reactions, such as hives and anaphylaxis
• Fluoroquinolones disrupt bacterial DNA synthesis
• A tuberculin syringe should be used for administering a small dose of an antibiotic less than 1 mL

Module 5

• Biguanides (Metformin) are the preferred first-line treatment for Type 2 Diabetes
• Insulin promotes the uptake of glucose into cells
• Rapid-acting insulin (Lispro) has the fastest onset of action
• Regular insulin can be administered intravenously in emergency situations
• Using tuberculin syringes instead of insulin syringes is a common medication error related to insulin administration
• A key nursing consideration when administering metformin in clients undergoing imaging with contrast media is to hold metformin on the day of the test and for 48 hours afterward
• Regular Insulin is clear and should appear colorless upon inspection before administration
• The peak action time for short-acting insulin is 2-3 hours
• A sliding scale insulin regimen typically uses rapid-acting or short-acting insulin
• Glucagon stimulates the liver to release glucose to treat hypoglycemia
• Levothyroxine is commonly used for thyroid hormone replacement in clients with hypothyroidism
• Propylthiouracil (PTU) is primarily indicated for the treatment of hyperthyroidism
• Tachycardia is a key symptom of hyperthyroidism
• When administering antithyroid medications like Propylthiouracil (PTU), it is important to monitor for signs of liver dysfunction
• Cold intolerance and weight gain are clinical signs of hypothyroidism
• Iodine is a necessary dietary element for the synthesis of thyroid hormones T3 and T4
• A major complication of untreated hypothyroidism during pregnancy is fetal developmental issues
• Oxytocin is secreted by the posterior pituitary gland
• It typically takes 3-6 weeks for Levothyroxine to show full effects in treating hypothyroidism
• The negative feedback loop in thyroid hormone regulation inhibits further secretion of thyroid hormones when levels are adequate

Module 6

• Heparin inhibits clotting factors Xa and IIa
• Heparin is classified as an anticoagulant
• A situation for heparin use is to prevent deep vein thrombosis (DVT)
• A serious adverse effect of heparin is thrombocytopenia
• Protamine sulfate is the antidote for heparin overdose
• Partial Thromboplastin Time (PTT) is the most commonly monitored lab test on heparin therapy
• A history of heparin-induced thrombocytopenia is a contraindication when administering heparin
• 10,000 units/mL is the strength of heparin used for subcutaneous administration to prevent DVT
• Low-molecular-weight heparin (LMWH) has a longer half-life and fewer dosing errors compared to unfractionated heparin
• Heparin is classified as a "high-alert" medication because it carries a significant risk of causing serious harm or death

Routine Immunizations

• Acquired (adaptive) immunity is developed through vaccination
• A live attenuated vaccine uses a weakened form of the pathogen
• Transfer of antibodies from mother to child through breast milk is an example of passive immunity
• Booster vaccinations prolong immunity by increasing antibody titers
• Tetanus, Diphtheria, Pertussis (Tdap) vaccine is safe to administer during pregnancy
• Elderly individuals require more frequent vaccinations to boost immunity
• An antigen triggers the body's immune response within a vaccine
• Immunocompromised conditions is a contraindication for the administration of live attenuated vaccines
• Toxoid is composed of a toxin produced by a bacterium
• Recording the lot number of a vaccine when administering it is important for safety tracking in case of a recall or adverse event

Important pharmacology concepts for nurses, including drug absorption, bioavailability, and the 'first pass effect'. Covers essential math skills like fractions, decimals, and dosage calculations. Also covers the concept of polypharmacy and high-alert medications.