Lectures 1-2 - Pharmacology in Nursing Practice

‭ harmacology:‬‭The study of drugs and their interactions‬‭with living systems‬ P ‭Drug:‬‭Any chemical that can affect any living process‬‭(positive or negative)‬ ‭Medication:‬‭A drug used to treat a disease (positive)‬ ‭Pharmacotherapeutics:‬‭The use of drugs to diagnose,‬‭prevent, or treat diseases (medical use of‬ ‭drugs)‬ ‭Big Three Properties of a Good Drug‬ ‭1.‬ ‭Effective‬ ‭2.‬ ‭Safe‬ ‭3.‬ ‭Selective‬ ‭Additional Properties‬ ‭●‬ ‭Reversible‬ ‭●‬ ‭Predictable‬ ‭●‬ ‭Easy to administer‬ ‭●‬ ‭Minimal drug interactions‬ ‭●‬ ‭Economical‬ ‭●‬ ‭Stable‬ ‭●‬ ‭Name that is easy to remember/pronounce‬ ‭Role of Nurses in Drug Therapy‬ ‭●‬ ‭Paying attention to individual pt characteristics‬ ‭○‬ ‭Why they need the drug‬ ‭○‬ ‭What could cause them to react differently to the drug‬ ‭●‬ ‭Being the last line of defense and advocating for patient safety‬ ‭○‬ ‭Understanding the pt and if there is a contraindication‬ ‭●‬ ‭Patient education‬ ‭○‬ ‭Why they are taking the drug‬ ‭○‬ ‭What they should expect from the drug‬ ‭○‬ ‭What the therapeutic response would be‬ ‭○‬ ‭Potential adverse effects of the drug‬ ‭5 Rights of Drug Administration‬ ‭1.‬ ‭Right drug‬ ‭2.‬ ‭Right patient‬ ‭3.‬ ‭Right dose‬ ‭4.‬ ‭Right route‬ ‭5.‬ ‭Right time‬ ‭●‬ ‭Also includes:‬ ‭○‬ ‭Assessment (history)‬ ‭‬ ○ ‭○‬ ‭○‬ ‭○‬ ‭ ocumentation (before and after)‬ D ‭Evaluation‬ ‭Education‬ ‭of refusal‬ ‭ uestion:‬‭Which of the following is essential in the‬‭nurse’s pre-administration patient‬ Q ‭assessment?‬ ‭a.‬ ‭Evaluate therapeutic response‬ ‭b.‬ ‭Minimize adverse effects‬ ‭c.‬ ‭Collect baseline data‬ ‭d.‬ ‭Decide if medication in a PRN order‬ ‭Nursing Process in Pharmacology‬ ‭●‬ ‭Assessment (pre-administration)‬ ‭○‬ ‭Baseline data‬ ‭○‬ ‭Useful in evaluating therapeutic and‬ ‭adverse effects‬ ‭○‬ ‭Identify those of a high-risk‬ ‭●‬ ‭Analysis/diagnosis‬ ‭○‬ ‭Analyze baseline data to determine if‬ ‭administration of a drug is‬ ‭appropriate/safe‬ ‭○‬ ‭Understand the pt, drug action, pt history,‬ ‭and contraindications of the drug‬ ‭○‬ ‭Identify potential adverse reactions and‬ ‭drug interactions‬ ‭●‬ ‭Planning/implementing‬ ‭○‬ ‭Goal: Maximum benefit with least amount‬ ‭of harm‬ ‭○‬ ‭Consider dosage, route of administration, timing‬ ‭○‬ ‭Promote therapeutic effects‬ ‭○‬ ‭How adverse effects can be avoided‬ ‭○‬ ‭Education‬ ‭●‬ ‭Evaluation‬ ‭○‬ ‭Therapeutic response‬ ‭○‬ ‭Adverse reaction‬ ‭○‬ ‭Satisfaction with tx‬ ‭Adverse Reactions‬ ‭●‬ ‭Side Effect:‬‭A predictable secondary drug effect that‬‭could occur with a therapeutic dose‬ ‭‬ T ● ‭ oxicity:‬‭The severity of physiologic damage due to excessive dosage‬ ‭●‬ ‭Allergic Reaction:‬‭An immune response that occurs‬‭when the immune system is‬ ‭sensitized to the drug; not affected by dosage‬ ‭●‬ ‭Idiosyncratic Effect:‬‭Uncommon drug response due to‬‭genetic predisposition‬ ‭●‬ ‭Paradoxical Effect:‬‭Occurs when a drug elicits an‬‭opposite effect of what is expected‬ ‭●‬ ‭Iatrogenic Disease:‬‭Disease caused by medication or‬‭treatment‬ ‭●‬ ‭Physical Dependence:‬‭An adaptation of bodily dependence‬‭on a drug‬ ‭●‬ ‭Carcinogenic Effect:‬‭The ability of certain medicines‬‭and substances to cause cancer‬ ‭●‬ ‭Teratogenic Effect:‬‭A birth effect caused by drug‬‭use‬ ‭Medication Errors‬ ‭●‬ ‭An error (of commission or omission) at any step along the pathway that begins when a‬ ‭clinician prescribes a medication and ends when the pt actually receives the medication‬ ‭●‬ ‭Can happen anywhere in distribution:‬ ‭○‬ ‭Prescribing (provider)‬ ‭○‬ ‭Repackaging (pharmacy)‬ ‭○‬ ‭Dispensing (giving to the pt)‬ ‭○‬ ‭Administering (nurse)‬ ‭○‬ ‭Monitoring‬ ‭●‬ ‭More than 100,000 reports each year in the U.S. for a suspected medication error‬ ‭●‬ ‭Medication errors account for 7,000-9,000 deaths each year‬ ‭●‬ ‭Medication errors occur in approximately 5% of in-hospital admissions‬ ‭●‬ ‭Estimated cost of $10 billion/year‬ ‭Types of Medication Errors‬ ‭●‬ ‭Patient‬ ‭●‬ ‭Drug‬ ‭●‬ ‭Route‬ ‭●‬ ‭Time‬ ‭●‬ ‭Dose‬ ‭●‬ ‭Technique/delivery‬ ‭ uestion:‬‭Among‬‭fatal medication errors‬‭, involving‬‭drug administration, the‬‭most common‬ Q ‭types include all of the following except…‬ ‭a.‬ ‭Overdose‬ ‭b.‬ ‭Wrong route of administration‬ ‭c.‬ ‭Wrong drug‬ ‭d.‬ ‭Wrong time‬ ‭Common Causes of Errors‬ ‭●‬ ‭Poor communication‬ ‭○‬ ‭Medical abbreviations‬ ‭○‬ ‭Poor handwriting‬ ‭○‬ ‭Drugs with similar-sounding names‬ ‭●‬ ‭Ambiguities in product names, directions for use‬ ‭●‬ ‭Poor procedure or techniques in administration‬ ‭●‬ ‭Pt misuse or poor understanding of the drug‬ ‭Nurse as Last Line of Defense‬ ‭●‬ ‭Check the order and pt‬ ‭●‬ ‭Ensure that their illness corresponds with the tx‬ ‭●‬ ‭Focusing on one pt at a time‬ ‭●‬ ‭Patient education and confirming the order‬