Pharmacology Quiz on Drug Classifications

Introduction II to Pharmacology

• This is a nursing pharmacology course for 2025.
• The course is taught by Matshediso Matome.

Learning Objectives (Lessons 1 & 2)

• Students should be able to understand the interaction between drug knowledge and patient factors to optimize treatment effects and minimize side effects.
• Define pharmacology terms.
• Identify major drug classifications and their mechanisms.
• Know the various drug administration routes.
• Understand the drug development process and drug supply regulations in Botswana.
• Understand medication safety protocols (Six Rights).
• Recognize ethical and legal responsibilities in medication administration.
• Summarize the role of pharmacology in patient care, particularly in nursing practice.
• There will be a group exercise.

Approach to BNS 200 - Clinical Pharmacology and Therapeutic

• Focus on drug therapy management by nurses, emphasizing potential interactions between drug knowledge and patient variables.
• Goal is to: maximize therapeutic effects, minimize adverse effects, provide patient and family education, and evaluate therapy effectiveness.

Core Drug Knowledge Variables

• Core drug knowledge covers key aspects of pharmacological agents, including:
  • Pharmacotherapeutics (why drugs are prescribed)
  • Pharmacokinetics (what the body does to the drug)
  • Pharmacodynamics (what the drug does to the body)
  • Contraindications and precautions
  • Understanding the difference between contraindication and precaution
  • Adverse effects
  • Drug interactions
  • Appropriate drug administration

Exercise: Core Drug Knowledge - Aspirin

• Students choose the correct drug variable related to aspirin for different patient situations (e.g., Asthma, Corticosteroids, Elderly, Analgesia, Peptic Ulceration, Tinnitus).

Core Patient Variables

• Consideration of patient variables interacting with drug knowledge. Key variables include:
  • Health status (acute/chronic illnesses, allergies, drug history)
  • Lifespan (age, developmental stage)
  • Gender
  • Lifestyle (OTC use, alternative therapies, ability to afford therapy)
  • Environment and setting
  • Culture
  • Inherited traits

Nursing Assessment in Drug Therapy

• Nurses should conduct assessments related to patient drug therapy. This includes:
  • Health and drug history
  • Lifespan assessment
  • Examination of medical records (laboratory findings, other diagnostic findings)

Naming of Drugs

• Chemical name: The name known by chemists (e.g., N-acetyl-para-aminophenol).
• Generic name: The official name (e.g., Paracetamol/Acetaminophen).
• Trade/brand name: The name given by the manufacturer (e.g., Panado).

Brand vs Generic Drugs

• Similarities between brand and generic drugs
• Differences between brand and generic drugs.
• Public perception and protection

Therapeutic and Pharmacological Classification of Drugs

• Therapeutic classification: Based on the drug's usefulness in treating diseases.
• Pharmacological classification: Based on the drug's mechanism of action.

Therapeutic and Pharmacological Classification Table

• Provides examples of therapeutic and pharmacological classifications for specific drug effects (e.g., blood clotting, blood cholesterol, blood pressure, cardiac agents).

Drug Orders and Time Schedules - Non-Routine Orders

• STAT: Immediately (5 minutes)
• ASAP: Urgent (within 30 minutes)
• PRN: As needed

Drug Orders and Time Schedules - Routine Orders

• gtt: drop
• pc: after meals
• Hs, nocte: bedtime
• ac: before meals
• qd: daily
• qod: every other day
• qid: four times a day
• bd: twice a day
• tid: three times a day
• tds: three times a day

Lo 2: Definition of Terms

• Pharmacology: The study of how drugs affect the body.
• Pharmacopeias: Official publications listing drugs and their properties.
• Formulary: A list of approved drugs within a specific health system.
• therapeutic effect: This is why a drug is prescribed.
• Therapeutic Indication: The condition a drug is approved to treat.
• Off-Label Use: A drug used for a condition it is not officially approved for.

Lo 2: Definition of Terms - Continued

• Side effect: An unintended, expected effect of a drug (can be harmless or harmful).
• Adverse Effect: An unwanted, harmful reaction to a medicine that occurs at a normal dosage or from misuse or overdose.
• Dose-related / Time-related adverse reactions: Specific adverse reactions that are either dependent on the dose, time, or both.
• Drug toxicity: Deleterious effects on an organism from overdose.
• Drug allergy: An immunologic reaction to a drug.
• Therapeutic Threshold: The minimum dose needed for the desired effect.
• Tolerance: A decreased response to a drug requiring a higher dose for the same effect. This happens with repeated use or treatment.
• Drug interaction: When one drug affects the action of another resulting in either the opposite effect or similar effect of one or both drugs.
• Drug misuse: Improper use of a drug resulting in acute or chronic toxicity.
• Drug abuse: An inappropriate intake of different substances that may be either continual or periodic.
• Drug Dependence: Is the reliance on a drug or substance

Lo 2: Definition of Terms - Continued

• Illicit drug: An illegal drug.
• Physiological dependence: A reliance on a medicine because of body changes—the body requires the substance for normal function.
• Psychological dependence: An emotional need to use a medicine.
• Potentiation: When one medicine enhances the effect of another.
• Synergism: When the effect of two medicines combined is stronger than the effect of either one alone.
• Pharmacokinetics: The study of how the body affects the drug.
• Pharmacodynamics: The study of how the drug affects the body.
• Pharmacotherapeutics: The clinical use of drugs in patients.
• Pharmacognosy: The study of natural sources of drugs.

LO3: Routes of Drug Administration

• Systemic: Drugs circulate throughout the body.
• Local: Drugs act at the administration site.
• Enteral Routes: Drugs are administered through the digestive tract (Oral, Buccal, Sublingual, Rectal).
• Parenteral Routes: Drugs are injected (IM, IV, SC, ID,Intrathecal, Intrapleural,Intraosseous,Epidural,Intraarticular).
• Topical Routes: Drugs are applied to the skin or mucous membranes (Skin, Eyes, Ears, Nose, Lungs [inhalation], Vagina).

Oral Medication Advantages/Disadvantages

• Advantages: Easy and convenient to administer, cost-effective.
• Disadvantages: Can be inappropriate if the patient has nausea/vomiting, disagreeable taste, can cause irritation of the gastrointestinal tract, can be aspirated. First-pass metabolism.

Sublingual Medication - Advantages/Disadvantages

• Advantages: Fast acting, more readily absorbed into the bloodstream.
• Disadvantages: Must dissolve under the tongue until fully absorbed, may be ineffective if swallowed.

Buccal Medication - Advantages/Disadvantages

• Pertaining to the cheeks

Rectal Medication - Advantages/Disadvantages

• May be given when the drug has an objectionable taste or via other routes aren't practical, effective for patients with nausea and vomiting.
• Disadvantages: can be contraindicated in case of lack of consent, recent rectal/anal surgery, abnormalities and trauma.
• Rectal administration is not suitable for all drug forms.

Parenteral Routes of Administration - Overview

• Routes to administer drugs that bypass the digestive tract.
• Common Parenteral Routes: Intramuscular (IM), Intravenous (IV), Subcutaneous (SC), Intradermal (ID)
• The IV route provides rapid onset of action.
• Medication given subcutaneously and intramuscularly acts more slowly.

Intramuscular (IM) Injection - Overview

• Advantage: Useful for larger volumes of medication; pain is minimized from administering irritating drugs; drug is rapidly absorbed, can be used for depot formulas.
• Disadvantages: Breaks the skin barrier; can be anxiety inducing for patients.

Intradermal (ID) Injection - Overview

• Generally used for testing allergies.
• It is administered just beneath the epidermis.

Intravenous (IV) Injection - Overview

• Advantages: Immediate onset of action; useful for administering larger volumes.
• Disadvantages: Requires specialized equipment and training, poses greatest risk among all administration routes, may carry greater risks of drug toxicity due to the rapid action and effect of medication.

Specialized Infusion, including Intrathecal, Intrapleural, Intraosseous

• Specific routes for administering drugs into certain locations.
• Intrathecal: injected into the CSF.
• Intrapleural: injected into the pleural cavity.
• Intraosseous: injected into the bone marrow.
• Epidural and Intraarticular injections to the bony structures.

Parenteral routes of Administration: Nursing Considerations

• Aseptic techniques are essential.
• Proper materials and equipment are essential.
• Correct anatomical sites must be used.
• Safely disposing of hazardous equipment

Types of IV Administration

• Large volume infusion
• Intermittent infusion
• IV bolus administration

Dosage Forms

• Solid dosage forms: tablets, capsules, powders.
• Liquid dosage forms: solutions, suspensions, elixirs, tinctures.
• Other dosage forms.

Dosage Forms Exercise

• Selecting appropriate dosage forms for a description.
• Considering lipid-soluble drugs that undergo extensive first-pass metabolism and route choice.

Properties of Ideal Drug - Safety

• An ideal drug is safe even at high concentrations.
• Real-world drugs may have side effects or be habit-forming.

Properties of Ideal Drug - Selectivity

• An ideal drug affects only the targeted cells/systems.
• Real-world drugs may have side effects impacting unrelated body systems.

Additional Properties of Ideal Drug

• Ease of administration,
• Freedom from drug interactions,
• Low costs (but this isn’t always possible, especially for patients with chronic illness).

But No Medicine is Ideal

• Limitations exist for the best medications available.

The Dose

• Providing the correct drug amount to achieve the desired effects without side effects is important as well.
• The therapeutic index (TI) is a measure of the relative safety of a drug.
• Therapeutic range is the amount of a drug that is safe to administer. This should be within the therapeutic index range.

Other Drug Properties: Bioavailability

• The extent to which a drug reaches the bloodstream unchanged, expressed as a fraction of the administered dose.
• IV administration typically has higher bioavailability compared to oral administration.

Therapeutic Objective

• To maximize beneficial effects while minimizing harm from medications
• Variables influencing drug response intensity include administration (dosage, route), pharmacokinetics, pharmacodynamics, and individual variations. A patient's response to drugs may vary from other patients.

Exercise - Legal Responsibilities and Ethical Dilemmas

• Nurses have responsibilities regarding medication administration, including thorough documentation (HFD).
• Discussing an ethical dilemma scenario related to a medication error. A nurse gave a medication in a double dose in the medication administration.
• Key ethical issues like non-maleficence vs. accountability are relevant in this situation.

Reflection

• Reflecting on how pharmacology applies to the student's current or future nursing roles regarding medication administration