chapter 61 introduction to pharmacology -...

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 61

Introduction to Pharmacology


Pharmacology

• Medication

– Medicinal agent that modifies body functions

• Pharmacology

– Science that deals with the origin, nature, chemistry, effects, and uses of medications

• Doctor of Pharmacy (PharmD)

– Licensed to prepare and dispense medications on the order of a licensed practitioner of medicine


Federal Drug Standards

• Controlled substances

– Protection of controlled substances

• Must be kept in a double-locked area.

– Controlled drug count verification

• The oncoming nurse counts; the outgoing nurse records.

• Medications from other countries may not have the stringent safety precautions of the United States and Canada.


Schedule of Controlled Substances

• Schedule I (C-I)

– High potential for abuse; no accepted medical use

• Schedule II (C-II)

• Schedule III (C-III)

• Schedule IV (C-IV)

• Schedule V (C-V)

– Limited potential for abuse


Client Rights

• To know the name, action, and possible side effects of medications administered to them

• To refuse to take medications, unless a court order gives healthcare workers the right to administer medications without the client’s consent

• To request the generic form of prescribed medications, if available


Drug References

• The Physician’s Desk Reference (PDR)

– PDR Nurse’s Drug Handbook

– Facts and Comparisons

– The United States Dispensatory (USD)

– The United States Pharmacopeia

– National Formulary

– Lippincott’s Nursing Drug Guide, Nursing Drug Reference, Handbook of Drugs for Nursing Practice


Question

Is the following statement true or false?

Physicians, not nurses, are obligated to know the recommended dosage, desired effects, and possible adverse effects of any medication administered.


Answer

False

Nurses are obligated to know the generic and common trade name, classification, use, recommended dosage, desired effects, possible adverse or untoward effects, and route of administration of any medication administered.

Should a client experience an adverse reaction that the nurse does not recognize, a medication error has been committed, just as if the wrong medication had been given.


Route of Administration

• Oral: Administered by mouth

• Topical: Applied to the skin or mucous membranes

• Inhalable: Inhaled or breathed in

• Injectable: Given via a needle

• Transdermal: Applied to and absorbed through the skin


Medication Names

• The chemical name

• The generic name

• The official name

• The trade name or brand name


Medication Actions

• Agonist

• Antagonist

• Synergistic or potentiating effect

• Interactions between certain drugs

• Side effects and adverse responses

• Interactions of prescription medications with herbal supplements and homeopathic remedies


Question


A nurse must stay alert for adverse reactions, even if the client has received the medication previously and not had an allergic reaction to it.


Answer

True

A client usually does not experience an adverse or allergic reaction on first exposure to a medication.

Therefore, the nurse must stay alert for adverse reactions, even if the client has received the medication previously.


Question


The nurse must always check and record if the client takes dietary supplements, herbs, or homeopathic remedies.


Answer

True

The primary care provider may not be aware that the client takes supplements of herbs or homeopathic remedies.

Herbs and homeopathic remedies may have potential drug interactions with a prescribed medication.

Combinations of herbal supplements or of supplements and prescribed medications may also produce life-threatening adverse effects.


Medication Forms

• Liquids: Oral administration, topical administration

• Solids: Orally disintegrating tablets (ODT), powders, and chewing gum

• Semisolids

• Inhaled medications and nasal sprays

• Transdermal medications

• Injectable medications


Dosage

• A dose is a single amount of a medication administered to achieve a therapeutic effect.

• Dosage contains the dose and scheduled times.

– Therapeutic dose

– Minimal dose

– Loading dose

– Maximal dose

– Toxic dose

– Lethal dose


Factors Affecting Medication Prescription

• Age, gender, weight

• Client’s condition

• Disposition and psychological state

• Method of administration

• Distribution

• Environmental factors

• Time of administration

• Elimination


Prescriptions

• Prescription

– Written or verbal formula for preparing and giving a medication

• Legend drug

– Medicine that cannot be dispensed without a prescription from a licensed practitioner

• Over-the-counter (OTC) drugs

– Medications that can be purchased without a prescription


Parts of a Prescription

• Client’s full name

• Date and time of day

• Name of drug

• Dosage/amount of drug

• Time/frequency of dose

• Method/route

• Primary healthcare provider’s signature


Verbal Orders

• In emergencies

– Physicians and other primary providers may give verbal medication orders, either directly or by telephone.

• VORB: Verbal order, read back

• TORB: Telephone order, read back


Question


The nurse who takes a telephonic order must read it back to the provider and document it.


Answer

True

A verbal order must be verified and is documented as VORB, “verbal order, read back,” or TORB, “telephone order, read back.”

The nurse must make sure the order is cosigned by the prescribing person as soon as possible.

Reading back the order helps to ensure that the order as written is the order that was intended. Documentation provides a permanent record of events for reference and protection of clients and healthcare personnel.


Clarification of Orders

• Medication orders must be carried out exactly as written.

• If any questions arise, the prescribing healthcare provider must be consulted for clarification.

• No medication can be given legally without a valid and clear order.

• All medication and other orders must be clear, understandable, and open to only one interpretation before the nurse takes any action.

• The safe administration of medications is one of the nurse’s most important responsibilities.


End of Presentation

chapter 61 introduction to pharmacology -...

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