pharmacological therapys

Drugs

Any chemical that affects the physiologic process of a living organism

Pharmacology

The study or science of drugs

Classification

Drugs are classified according to there chemical structure or therapeutic use

Adverse effects

Think of this as a side effec. It’s any unwanted affect of a drug, and it can be further classified into other effects (such as an allergic reaction

Beta blockers

Slows bp and causes fall risk

Rn role

. Apply the drug therapy

.makw sure it’s appropriate, transcribed correctly, properly administered, monitored and the effects evaluated and documented

The rn is responsible for

Administering the drug

. Providers prescribe and pharmacy dispenses

.patient education

How do you prevent medication error?

9 right of medication administration

Knowing usual dosage range and roles

Nurses should consider

Hypotension leading to fall risk

Nine rights of drug administration

Right drug

Right dose

Right time

Right route

Right patient

Right documentation

Right reason

Right response

Right to refuse

What is time critical medication?

Are those that when administered either 30 minutes before or after the scheduled administration time can cause harm to the client or substranded pharmacological effect

Non time critical medicine

Are defined as medication that can be administered between one and two hours early or late substandard pharmacology effect

What is high alert medication?

Drugs associated with an increase risk of causing considerable harm when they are administered in error

What is a high alert medication

Insulin

Opiates

Narcotics

Intravenous heparin

Injectable potassium chloride

What is a strategy to reduce the risk of harm?

Manual independent double check with two nurses verifying independent information before these drugs are administered

When a provider gives an order you must correctly interpret the order:

If a provider gives a verbal order you will always read it back to them

This is documented by writing RBVO which means read back verbal order.

Students are not allowed to take verbal orders from anyone

A proper medication order must follow a specific pattern

Medication/ dose/ route/ frequency

What is proper medication order:

Acetaminophen 650 mg PO BID

Acetaminophen 1000 mg PO q6 hours PRN moderate pain (4-7)

What is a valid medication order

Pharmacokinetics

How drugs move through the body

ADME

Absorption, distribution, metabolism, excretion

What can result in changes to the pharmacokinetic profile of the drug?

Changes in the route

Absorption

Passage of drug molecules into the blood after administration

How does a drug enter the body?

Absolutely

What can alter absorption?

Skin permeability ( topical drugs: infants vs older adults)

Slow or fast persistent ( if given orally)

Antibiotics need to be administered

Time critically

Anticoagulant are

Time critical

Anti arrhythmia medication

Time critical

Multivitamins and supplements are

Non time critical

Anti hypertensive medications are

Non time critical

Suppository

Non time critical

Proton pump inhibitors

Non time critical

Physiciatric medication

Non time critical

Enteral absorption

Oral

Sublingual

Buccaneers

Rectal

Parenteral

Intravenous

Intramuscular

Subcutaneous

In trademark

Intra-arterial

Intrathecal

Intranrticular

Parenteral means

Situated or occurring outside the intestines

Enteral means

Absorption into systemic circulation through oral or gastric mucosa or through the intestines

BID

Twice a day

PO

By mouth

PRN

As needed

Slowest to fast route

Extended release, tablets, capsules , liquid ( oral (PO) ) topicals ( depends on site), subcutaneous (subcutaneous) ,Intramuscular ( IM), Intravenous (IV)

top

Topical

Subcutaneous

Sub cut

Intramuscular

IM

Intravenous

IV

Distribution

Drugs are brought from the area of absorption to the area where they need to work

What can affect distribution

The amount of portion the body has available

. How ell the heart is pumping blood

. How much flood does the body have on board

What is the chemical makeup of the drug

What is the chemical makeup of a drug ?

Water or lipid soluble

Hydrophobic hydrophilic

Metabolism

How drugs are changed by the body

How are drugs changed by the body

Most are changed from an active form to an inactive form, Some are changes from an inactive form to an active form called pro drugs

Prodrugs are?

Drugs changed from an inactive for, to an active form

Most drugs are metabolized by the

Liver

Thyroxine

Empty stomach

Vomiting can cause

Sub therapeutic effects

The livers enzyme that does work to alter a drug is called

Cytochrome p-450

What things affect drug metabolism?

How health the liver is can be disease altered

Are there enough enzymes múltiple drugs use the same enzyme

How fast a drug metabolizes

How drugs are excreted from the body is called?

Excretion

Iv medicine

Zofran

IM

How are drugs extrected from the body?

Most by the kidneys peed out

Pooped out Hilary excretion or sweated out

What affects excretion

. How healthy the kidneys are

. Is the patient taking in enough fluid

. How fast a drug is excreted determines half life

A patient has been diagnosed with a urinary tract infection and is prescribed the drug Sulfamethoxazole-Trimethoprim (SMX-TMP). The nurse provides the following medication teaching to the patient:

 Take this medication with a full glass of water twice a day at evenly-spaced 12-hour intervals (such as 7 am and 7 pm) until it is completely finished.

 Do not drink cranberry juice or citrus juices while taking this medication.

 Use a backup method of birth control while you are taking this medication.

 Do not drink any alcohol while taking this medication.

 Take this medication with food.

Take this medication with a full glass of water twice a day at evenly-spaced 12-hour intervals (such as 7 am and 7 pm) until it is completely finished.

ABSORPTION / EXCRETION / DISTRIBUTION / Half-Life

To much fluid or to little effects

Distribution

Do not drink cranberry juice or citrus juices while taking this medication.

Metabolism

 Use a backup method of birth control while you are taking this medication.

Metabolism

Do not drink alcohol while taking this medicine

Metabolism

Take this medication with food

Prevention of adverse effects

Drugs can be classified according to

Chemical structure and therapeutic use

serosis of liver due to alcohol affects

Metabolism of a drug can cause more damage to liver

Drugs can have three different names

Chemical name

Generic name

Trade name

In health care drugs are referred by

Generic name

Chemical name

P- isobutyhydratropic acid

Generic name

Ibuprofen

Trade name

Advil, Motrin, middle, ib

gentomyosin

Kills kidneys, damages ears

Paxil and nitroderm

Plavix and nicoderm

Ibuprofen is classified according to it’s therapeutic use

Non steroidal anti- inflammatory drug NSAID

How does classic action of drugs help?

All drug in the same class will behave similar

Adverse effect, mechanisms of effects, therapeutic use

Ibuprofen for pain can cause

gastrointestinal bleeding

What are indications and adverse effects of aspirin the NSAID

Beta blockers

Blood pressure medicine

Ace inhibitors

Anti hypertension

Factor Xa inhibitors

Blood thinners

Long acting insulin

Insulin

Anticholinergic

Nausea medicine

Antihistamine

Allergy medicine

All ACEi’s end in

PRILL

Ace inhibitors

Lower blood pressure

Can cause a dry cough

Good for heart failure

Contradicting in hypotension

If a patient has high blood pressure, what do we want to do?

give a hypotension medicine

What is a possible consequence of giving a drug designed to lower blood pressure?

Hypotension

What if a patient has low blood pressure? What kind of medication should they not get?

Ace inhibitors

What class of drugs lowers blood pressure?

Listinopril, enalapril, captopril, ramipril, benazepril, fosinopril, perindopril

All ace inhibitors are

Contradictory to hypotension

A nurse is about to give a patient their prescribed morning dose of an ACE Inhibitor for hypertension; the morning vital signs are as follows:

BP: 116/72, HR: 72, POX: 97%, RR: 14, Temp: 97.4

Should the nurse hold of give the drug

Hold bp is low

Why is the bp 116/72 in this patient

Taking it everyday, give it because it’ll keep the bp normal