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NUR 117
Overview of Pharmacology
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Pharmacology
• Pharmacology is the study of the biological effects of
chemicals.
• Nurses deal with pharmacotherapeutics, or clinical
pharmacology.
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Nurse’s Responsibility
• Administering drug
• Assesses for adverse drug effects
• Intervening to make the drug regimen more tolerable
• Providing patient teachings about drugs and the drug
regimen
• Monitoring and prevention of medication errors
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Drug Nomenclature
• Chemical name—identifies drug’s atomic and molecular
structure
• Generic name—assigned by the manufacturer that first
develops the drug (Acetaminophen)
• Official name—name by which the drug is identified in
official publications USP and NF (Often the same as
Generic)
• Trade name—brand name copyrighted by the company
that sells the drug (Tylenol)
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Over-the-Counter Drugs
• Products that are available without prescription for selftreatment of a variety of complaints.
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Drug Legislation
• In 1938 the Federal Food, Drug and Cosmetic Act,
prohibiting adulterated or mislabeled drugs from being
made available.
• The (FDA) Food and Drug Administration enforces this
law.
• The Controlled Substance Act was passed in 1970 this
law regulates distribution of narcotics and other drugs of
abuse. Control over the coding of drugs and the
enforcement of these codes to the FDA and the Drug
Enforcement Agency (DEA), a part of the U.S.
Department of Justice.
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Sources of Drug Information
• Drug Label
– Drug labels have specific information that identifies a
specific drug
– Understanding how to read a drug label is essential
• Package Insert
– Prepared by the manufacturer
– Contains all of the chemical and study information
that led to the drug’s approval
– Difficult to understand and read
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Sources of Drug Information (cont.)
• Reference Books
– Physician’s Drug Reference (PDR)
– Drug Facts and Comparisons
– The United States Pharmacopeia-National Formulary
(USP-NF)
– Lippincott’s Nursing Drug Guide (LNDG)
• Journals
• Internet (reliable sources)
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Drug Preparations
• Oral
– Capsule, pill, tablet, extended release, elixir,
suspension, syrup
• Topical
– Liniment, lotion, ointment, suppository, transdermal
patch
• Injectable
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Types of Medication Orders
• Standing order—carried out until cancelled by another
order
• PRN order—as needed
• Stat order—carried out immediately
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Parts of the Medication Order
• Patient’s name
• Date and time order is written
• Name of drug to be administered
• Dosage of drug
• Route by which drug is to be administered
• Frequency of administration of the drug
• Signature of person writing the order
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7 Rights of Medication Administration
• Right medication
• Right patient
• Right dosage
• Right route
• Right time
• Right reason
• Right documentation
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Medication Supply Systems
• Stock supply
• Individual unit dose supply
• Medication cart
• Computerized automated dispensing system
• Bar code–enabled medication cart
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Computerized Medication Dispensing
System
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Drug Classifications
• Effect on body system (example: antihypertensive)
• Chemical composition
• Clinical indication or therapeutic action
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Mechanisms of Drug Actions
• Drug-receptor interaction—drug interacts with one or
more cellular structures to alter cell function
• Drug-enzyme interaction—combines with enzymes to
achieve desired effect
• Acting on cell membrane or altering cellular environment
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Factors Affecting Drug Absorption
• Route of administration
• Lipid solubility
• pH
• Blood flow
• Local conditions at site of administration
• Drug dosage
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Adverse Effect of Medications
• Iatrogenic disease
• Allergic effects
• Toxic effects
• Idiosyncratic effects
• Drug interactions
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Signs and Symptoms of Drug Allergy
• Rash
• Urticaria
• Fever
• Diarrhea
• Nausea
• Vomiting
• Anaphylactic reaction
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Variables Influencing Effect
of Medications
• Developmental considerations
• Weight
• Sex
• Genetic and cultural factors
• Psychological factors
• Pathology
• Environment, timing of administration
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Pharmacokinetics
• Absorption—drug is transferred from site of entry into
bloodstream
• Distribution—drug is distributed throughout the body
• Metabolism—drug is broken down into an inactive form
• Excretion—drug is excreted from the body
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Systems of Measurement
• Metric—meter (linear), liter (volume), gram (weight)
• Metric is most commonly used and has been
adopted internationally. It is proven to be safer for
measuring drug dosages
• Apothecary—less convenient and concise; basic unit or
weight is grain
• Household—least accurate system; teaspoons,
tablespoons, teacup, and glass used
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Medical Record Documentation
• Name of the medication
• Dosage
• Route and time of administration
• Nurse’s initials
• Intentional or inadvertently omitted drugs
• Refused drugs
• Medication errors
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Type of Medication Errors
• Inappropriate prescribing of the drug
• Extra, omitted, or wrong doses
• Administration of drug to wrong patient
• Administration of drug by wrong route or rate
• Failure to give medication within prescribed time
• Incorrect preparation of a drug
• Improper technique when administering drug
• Giving a drug that has deteriorated
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Medication Errors
• Check patient’s condition immediately; observe for
adverse effects.
• Notify nurse manager and physician.
• Write description of error and remedial steps taken on
medical record.
• Complete special form for reporting errors.
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Three Checks of Medication
Administration
• Read the label:
– When the nurse reaches for the container or unit
dose package
– After retrieval from the drawer and compared with
the CMAR, or compared with the CMAR immediately
before pouring from a multidose container
– When replacing the container to the drawer or shelf,
or before giving the unit dose medication to the
patient
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Oral Medications
• Solid form—tablets, capsules, pills
• Liquid form—elixirs, spirits, suspensions, syrups
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Administration of Oral Medications
• Oral Route—having patient swallow drug
• Enteral route—administering drug through an enteral
tube
• Sublingual administration—placing drug under tongue
• Buccal administration—placing drug between tongue and
cheek
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Administration of Parenteral Medications
• Subcutaneous injection—subcutaneous tissue
• Intramuscular injection—muscle tissue
• Intradermal injection—corium (under epidermis)
• Intravenous injection—vein
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Parts of a Needle and Syringe
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Angles of Insertion for Various Injections
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Sites for Intramuscular Injections
• Ventrogluteal site
• Vastus lateralis site
• Deltoid muscle site
• Dorsogluteal site is no longer recommended
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Criteria for Choosing Equipment
for Injections
• Route of administration
• Viscosity of the solution
• Quantity to be administered
• Body size
• Type of medication
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Preparing Medications for Injection
• Ampules
• Vials
• Prefilled cartridges
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Topical Administration of Medications
• Skin applications
• Eye instillations and irrigations
• Ear instillations and irrigations
• Nasal instillations
• Vaginal applications
• Rectal instillations
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Patient Teaching
• Review techniques of medication administration.
• Remind the patient to take the medication as prescribed
for as long as prescribed.
• Instruct the patient not to alter dosages without
consulting a physician.
• Caution the patient not to share medications.
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Drug Calculation
• Order: Give Demerol 10 mg IM.
• You have a vial with a label that reads: Demerol
25mg/ml.
• What happens if the order is written in grams?
• For example : Give Demerol 0.01 grams IM?
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BREAK TIME
•  Take a 15 break and return to your desk for testing.
• Students are expected to clear all desks of all objects
other than test, pencil and calculator.
• Spread out or move so that each of you are separated to
a minimum of every other seat.
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