Pharma Lecture 3 and 4.pdf

NCM 106: PHARMACOLOGY LECTURE inability to metabolize a drug due to genetic LESSON 3 deficiency of an enzyme. D...

NCM 106: PHARMACOLOGY LECTURE inability to metabolize a drug due to genetic LESSON 3 deficiency of an enzyme. Drug Tolerance - when the client developed a FUNDAMENTAL PHARMACOLOGICAL PRINCIPLES resistance to the effects of the drug and requires 1. Drugs do not create new cellular functions but a need to increase the dose or frequency of the rather alter existing ones. drug to attain its therapeutic effect. Ex. Laxatives - increases peristalsis Drug Dependence - is also termed as addiction 2. Drugs may interact with the body in several or habituation. It could be Physical - when the different ways. body cannot function normally without the drug. Ex. Some drugs may act by altering the Psychological - drugs become the center of the chemical components like antacids or may person’s thoughts, emotions and activities. accumulate to certain group of tissue like Drug Toxicity - a drug effect usually related to anesthetics. the dosage administered. All drugs are capable 3. Drugs could be agonist, antagonist and partial of producing toxic effects. This could be agonist measured by the use of TI or Therapeutic Index Ex. Narcan/Naloxone which is expressed in ratio. 𝐿𝐷50 (𝑙𝑒𝑡ℎ𝑎𝑙 𝑑𝑜𝑠𝑒: 𝑑𝑟𝑢𝑔 𝑡ℎ𝑎𝑡 𝑘𝑖𝑙𝑙𝑠 50% 𝑜𝑓 𝑎𝑛𝑖𝑚𝑎𝑙𝑠) 4. Different drugs with molecules that precisely fit TI = 𝐸𝐷50 (𝑒𝑓𝑓𝑒𝑐𝑡𝑖𝑣𝑒 𝑑𝑜𝑠𝑒: 𝑎 50% 𝑡ℎ𝑒𝑟𝑎𝑝𝑒𝑢𝑡𝑖𝑐 𝑒𝑓𝑓𝑒𝑐𝑡 𝑡𝑜 𝑎𝑛𝑖𝑚𝑎𝑙𝑠) into given receptor can be expected to elicit a comparable drug response, those that do not fit the receptor may produce only a weak or no DRUG STANDARDS AND CONTROL response at all. Republic Act No. 3720 - also known as Food, 5. All drugs when administered go through Drug and Cosmetic Act which ensure the absorption, distribution, metabolism and safety and purity of food, drugs and cosmetics excretion or pharmacokinetics. being made available to he public. Republic Act No. 9711 - also known as Food DRUG ACTION and Drug Administration Act of 2009 that Desired action / Therapeutic effect - desirable aims to protect and promote the right to health of or intended action of the drug. the Filipino people and to establish and maintain Side effect - secondary effects that maybe an effective health products regulatory system. desirable or undesirable. These effects are Republic Act No. 9165 - also known as the usually predictable and occur even in correct Comprehensive Dangerous Drugs Act of dosage and administration. 2002 which safeguard the integrity of its territory Allergic reaction - a hypersensitivity reaction and the well-being of its citizenry from the that occurs to a person who has been previously harmful effects of dangerous drugs exposed to a drug and has developed antibodies to it *local allergy NURSING PRACTICE ACT Anaphylactic reaction - a severe Is a set of rules and regulations established by life-threatening reaction that may cause the state boards of Nursing. respiratory distress and cardiovascular collapse. It is a solid foundation for beginning practice. This is a medical emergency *systemic allergy Nurses must be familiar with the established Carcinogenic effect - ability of a drug to induce rules, policies, and procedures of the agency the living cells to mutate and become It requires a passage of a written test to attest cancerous. knowledge and skills in Medicine Teratogenic effect - induces birth defects or Approved list of IV solutions and medications even abortion during the first trimester of that the nurse could administer pregnancy. A list of restricted medicines Idiosyncratic effect - an abnormal or unusual Before a nurse could administer a drug to a reaction of a person when a drug is first patient, she should have the ff. administered. This is because of the patient’s NCM 106: PHARMACOLOGY LECTURE 1. License to practice the profession 2. Clean policy statement that authorizes the act NURSE’S RESPONSIBILITIES UPON RECEIVING AN 3. Medication order signed by a licensed ORDER practitioner 4. Knowledge of the actions dosage and effects of 1. Verification the drug - The nurse interprets and makes 5. Understanding of the patient’s condition professional judgement on its 6. The ability to consult the authority when in doubt acceptability. 7. Accurate calculation, preparation and drug - She evaluates the method of administration administration in relation to the patient’s 8. A complete assessment of the patient including physical condition, medication history, untoward reactions to the drug and ability of the patient to tolerate the 9. An evaluation of the response of the patient to dose form. the drug given - If unsure, the order must be clarified 10. Well planned health teachings for the patient with the one who wrote the order. and his family before discharge 2. Patient’s Safety - Is of primary importance. If the drug Prescriptions should not be given notify the doctor - Used for outpatient care and medication orders immediately or the immediate superior are used in institutional care. 3. Transcription - Is copying the order into the Kardex, Medication Orders computer or send a copy of the order to - Used to order medications for patients in the pharmacy. Label the unit dose and hospitals, nursing homes, and other institutions. stored in the medication room or - May also contains orders for laboratory test, and patient’s drawer or cart. discharge instructions. Rules in Transcribing Medication Orders Parts of a Medication Order 1. Never leave a decimal point naked. Name of client or patient 2. Never place a decimal point and zero (0) after a Date and time of the written order whole number. Name and dosage of the medication 3. Avoid using decimals whenever whole numbers Medication route can be used as alternatives. Time and frequency of administration 4. Whenever possible, use Metric system. Signature of the person prescribing 5. Always spell out the word units. Types of Medication Orders MEDICATION ADMINISTRATION Stat Order - The drug should be given at once - Assess medication order or as soon as possible - Ask client about a history of allergies Single Order - The drug is given at a certain - Assess client’s current condition and the time but only once and is not on emergency purpose for the medication or intravenous basis. solution Standing Order - this order indicates that the - Determine client’s understanding regarding the medication is to be given for a specified number purpose of the prescribed medication or need for of doses intravenous solution PRN Order - The drug is given if needed. This - Teach client about the medication and order allows the nurse to judge whether the self-administration at home medication should be given or not. - Identify and address concerns (social, cultural, Verbal orders / Telephone Orders - Orders religious) that the client may have about taking made verbally and / or through phone. It must be the medication countersigned by the physician within 24 hrs. NCM 106: PHARMACOLOGY LECTURE - Assess the need for conversion when preparing If client’s mucous membranes are dry, offer a sip a dose of medication for administration to the of water client For Pediatric Patients - Assess the different rights and vital signs before administration If drugs are being mixed with food or liquid, use - Document properly only small amount Medicine can also be given through nipples or For Eye medication droppers Position: supine or sitting position with forehead Toddlers: allow to choose on method of tilted back slightly delivery-spoon, dropper, syringe, and allow to Medication is administered into the conjunctival help sac Position: Semi-Fowler’s or sitting For ointments, apply from inner to outer Instruct client to place tablets/ capsules at the canthus ending it with a twisting motion back of the throat and to follow with enough For liquid medications, press firmly liquid nasolacrimal duct for at least 30 sec Administer liquid medications after pills If medication temporarily affects vision, instruct Remain with the client until all the medications client not to move until vision is clearer are taken. Check the client’s mouth Lift side rails and place call light within reach Check client 30-60 minutes later for effects of medication. For Ear (Otic) Instillation Wash ear if excess wax is noted MEDICATION ERRORS Position: Side-lying, sitting, or semi-Fowler’s - Any preventable event that may cause or lead to position inappropriate medication use or patient harm For adults: pull auricle of ear up and back while the medication is in the control of the the For children: down and back (