Pharmacology - Chipola College
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Transcript Pharmacology - Chipola College
Pharmacology
Ch 4-9
Drug Controls
Federal Food & Drug Act – 1906
Durham-Humphrey Amendment – 1951
Required identification of dangerous or
addictive drugs
Prescription vs non-prescription drugs
Controlled Substance Act – 1970
Promotes drug education & prevention of
abuse
Legal & Ethical Considerations
Nursing Responsibilities
Do no harm = nonmaleficence
Do what is best for patient = beneficence
http://www.nursingworld.org/ethics/chcode.ht
m
How ? ? ?
Know
Classification
Effects & adverse
effects
Safe dosages
Actions of drug
Laws governing
administration
Testing
Invitro tests done initially
Extensive testing on animals before
humans
Investigational New Drug (IND) status is
next on VOLUNTEER human subjects
Informed Consent must be obtained first
Phases of Development
4 Phases
I - small numbers of healthy subjects
To
determine optimal dosage ranges
Determine pharmacokinetics
II - small numbers of afflicted volunteers
Monitored
for effectiveness & side effects
Adjustments to therapeutic dosages done
Phases, con’t.
III – large numbers of afflicted patients
Patients
are followed by researchers
Studies include placebo-controlled and doubleblind
IV – voluntary studies after being marketed
Done
by pharmaceutical companies
Documents proof of effectiveness
Results gathered for 2 years after release
Ethical Issues
Consideration of ethnicity
Cultural consideration
Be cognizant of genetic factors
Legal Issues
5 Rights
Dose (amount)
Drug (medicine)
Route (po, IM, IV, SC, cutaneous, PR)
Patient (name, ID band)
Time
Legal con’t.
Nurse Practice Acts
Guide the nurses in a given state
State & Federal laws
Facility regulations (policy & procedures)
Medication Errors
May involve any person in the med
administration system
Prescriber (physician or NP)
Transcriber (nurse writing v.o. or t.o.)
Pharmacy staff (drug preparation)
Ancillary staff (perhaps involved in transport)
Preventing Errors
Minimize telephone and verbal orders
Repeat order, speak clearly
Get another nurse to listen in
Spell out loud the name of the drug
List the reason the pt will take the drug,
i.e. promethezine 12.5 mg prn nausea
Use only approved abbreviations
Safeguards
Never ‘assume’ anything
ALWAYS clarify unclear orders/writing
Read label 3 times
ALWAYS use 0 before a decimal ( 0.25)
Check for pt allergies, update pt info
Acknowledge/check on pt concerns
Contributing Factors
Interpersonal relationships
Assertiveness vs lack of it
Sense of powerlessness (new nurses)
Fear or embarrassment of being wrong
Nurse-patient ratios
Too busy
Too tired
Fear of disciplinary actions
Patient Understanding
Consider developmental stage of patient
Erikson’s stages, p 70
Consider chronological age of patient
Is pt old enough to understand
Is pt having difficulty with thought processes
or sensory input
Consider ethnic or cultural influences
Herbals
or alternative medicines
Understanding con’t.
Ensure that pt knows what medicines will
best treat the health problem
If pt wants to use herbal remedies, discuss
the expected and potential effects
Also ensure pt is aware of possible
interactions with prescription meds