Ateneo de Zamboanga University

College of Nursing
School Year 2020-2021

Learning Packet in Level 1- NCM 106 NURSING PHARMACOLOGY

Name:SANAANI, NUR-FATIMA, M. Date:OCT/16/2020
Level and Section:BSN-2H Learning Packet No:___#1___

Topic: Fundamental Concept of Pharmacology Semester: First

Learning Materials:
 Laptop, computer desktop or android phone
 Ballpen
 Paper
 Video clips
I. INTRODUCTION
What is this about ?

This packet is about “Pharmacology is the study of drugs and their effect on the
human body “….

What will you learn?

The basics of pharmacology including pharmaceutics, pharmacokinetics, and

pharmacodynamics.:
 Drug reactions in relation to side and adverse effects; hypersensitivity reactions; drug tolerance,
cumulative effects and drug toxicity; drug interactions; precautions and contraindications, are also
addressed to provide the nurse with a comprehensive understanding of the knowledge needed for safe
medication administration.

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 Learning Competencies and Objectives

At the end of module 1 the student will be able to:

1. Define common terms used in pharmacology.
2. Analyze the relevance of the four aspects of pharmacokinetics that include absorption
distribution metabolism and excretion.
3. Discuss the various routes of administration and related effect on the pharmacokinetics
of a drug.
4. Describe factors that can affect the pharmacokinetics of a drug.
5. Analyze the various chemical changes that take place in the body as a result of the
pharmacodynamics of the drug.
6. Discuss drug-drug and drug-food interactions and their relationship to the development
of adverse effects and toxicity.
7. Explore precipitating factors related to the occurrence of side and adverse effects.
8. Analyse the etiology of hypersensitivity reactions, including anaphylaxis, and actions
taken to manage them.
9. Differentiate between drug tolerance, cumulative effects of drugs, and drug toxicity.
10. Review precautions that should be taken when giving a medication and contraindications
that can make administering a drug dangerous or detrimental to the patient.
11. Verbalize understanding of the general concepts/principles such as pharmaceutics,
pharmacokinetics, and pharmacodynamics and their application in drug therapy and the
nursing process.
12. Demonstrate an understanding of the various drug dosage forms as related to drug
therapy and the nursing process.
13. Discuss the relevance of the five aspects of pharmacokinetics (Liberation, absorption,
distribution, metabolism, excretion) to professional nursing practice as related to drug
therapy for a variety of patients and health care settings.
14. Develop a nursing care plan that considers general pharmacologic principles, specifically,
pharmacokinetic principles, as they relate to the nursing process.

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 II.LEARNING EXPERIENCE
A. Can you do this?

Activity: An Orientation
Directions: Interview 5 people at home and let them give one word that represent
each terminology:
Terminology #1 #2 #3 #4 #5
PHARMACOLOGY Drugs Toxicity Medicatio Suppleme Pills
n nt
PHARMACODYNAMI Cells Tissue Binding Receptor System
CS
PHARMACOKINETICS Enterin Eliminatio Orals Circulation Metabolis
g n m
PHARMACEUTICS Health Effects Healing Reaction Body

Don’t Forget Putting it All Together

Pharmacology is the study of drugs and their effect on the human body.
Drugs can have a positive effect on the body which is called the therapeutic effect,
they can have non-therapeutic effects on the body called side effects, or they can
have negative effects on the body which are called adverse effects.

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 B. Let’s start!
Four aspects of Pharmacokinetics
Analyze the four aspects of Pharmacokinetics. Fill in the blanks with the correct
answer and place them into order in each column (for the 4 aspects seen given
above box) and describe the function of each below.

distribution absorption
excretion
metabolism

FIRST SECOND THIRD FOURTH

PHARMACOKINETIC
S
absorptio distribution metabolism
n

FUNCTION Refers to as what It involved in the Metabolism, also The elimination of

happened to movments of a called drugs from the body
drugs from the drugs to the body biotransformation, is is called excretion.
time it is tissues, also their are the process After the liver
introduced to the some factors that by which a drug is renders drugs
body until it affects the converted by the liver inactive, the kidney
reaches the distibution of the to inactive excretes the
circulating fluids dugs. Some drugs compounds inactive compounds
and tissues, travel by binding to through a series of from the body.
drugs can be protein (albumin) in chemical reactions. Also,
absorbed from the blood. Patients some drugs are
many different Drugs bound to with liver disease excreted unchanged
factor, such as protein are may require lower by the kidney
routes of pharmacologically dosages of a drug without
administration, inactive. detoxified by the liver involvement.
solubility of Only when the liver, or the primary Patients with
drugs, and protein molecules care provider may kidney disease may
certain condition release the drug can select a drug that require a dosage
of the body. the drug diffuse into does not undergo a reduction and
the tissues, interact biotransformation by careful monitoring
with receptors, the liver. Frequent of
and produce a liver function texts kidney function.
therapeutic effect. are necessary when Children have
liver disease is immature kidney
present. The kidneys, function
lungs, plasma, and and may require
intestinal mucosa dosage reduction
also aid in the and kidney function

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 metabolism of drugs. tests. Similarly,
older adults have
diminished kidney
function and require
careful monitoring
and lower
dosages. Other
drugs are
eliminated by
sweat, breast
milk, breath, or by
the gastrointestinal
tract in the feces.

C. Think about these

Try to make a drug study out of the drug Paracetamol. And use the
following given indicated concepts. Put your answers in each column
MECHANISM OF CONTRAINDICAT SIDE ADVERSE NURSING
NAME OF DRUG INDICATIONS
ACTIONS IONS EFFECTS REACTION CONSIDERATIONS
Generic: Phenyltoloxam ( Acetaminophen) Pervious Discom GI: Assess overall
ine- Inhibits the hypersensitivity, bobulati hepatic health status and
Acetaminophe synthesis of product contain on, failure/ alcohol usage
n prostaglandins that alcohol, sleepine hepatotoxi before
Brand Name: Biogesic may serve as aspartame, ss, city(overd administering
medicatiors of saccharin, sugar, stoppag ose), acetaminophen,
pain and fever, or e, GI:renal patients who are
primarily in the tartrazine(FDC stomach failure(hig
malnourished or
CNS. Has no yellow dye #5) resentfu h
Classification: chronically abuse
(antipyretics/n significant anti- should be l, doses/chro
avoided in obscure nic use) alcohol are at
onopioid inflammatory
properties or GI patient with, d vision, HEMAT: higher risk of
analgesics )
toxicity hypersensitivity or dry neutropeni developing
or intolerance to mouth/n a/ hepatotoxicity
Dosage: Biogesic these compound ose/thro pancytope with chronic use
Tablet, If you (USE at may nia/ of usual doses of
are taking CAUTIOUSLY happen. leukopeni this drug
extended- IN): In the a
release Hepatic event DERM:
capsules, disease/renal that any rash,
swallows them disease(lower of these urticaria
whole. Do not chronic doses impacts
crush or chew recommended), persever

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 extended- chronic alcohol e or
release use/abuse, decline,
capsules or malnutrition tell your
tablet primary
Frequency: care
Adults and physicia
children 12 n or
years and drug
older usually specialis
take 1 to 2 t
500mg tablets instantly
orally every 4 . In the
to 6 hours. It event
is not that
recommended your
to take more primary
than 4g (8 care
500mg tablets) physicia
of n has
Paracetamol in recomm
a span of 24 ended
hours because this
this can lead drug,
to overdose. recall
that the
person
in
question
has
Take this decided
Preparation: medication that the
by mouth with advanta
or without food ge to
or as directed you is
by your doctor. more
If stomach ups promine
et occurs, you nt than
may take this the
medication danger
with food or of
milk. s results.
Numero
Take this us
medication individu
Route: als
by mouth
utilizing
this
drug
don't
have
genuine
results.

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Activity: Video Clip Viewing

3-2-1 Reflect

3- things you have learned from

the video clips

2- interesting things about the

video clips

1-Question that you like to ask

about the video

D.Think about these

Activity: Think, Pair and Share

Work with your partner and try to answer the guide questions.

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1. Mr. Lim is admitted to the trauma unit with multisystem injuries from an
automobile accident. He arrived at the unit with multiple abnormal
findings, including shock from blood loss, decreased cardiac output, and
urinary output less than 30mL/hr. which route of administration would
you expect to be the best choice for this patient? Explain your answer.
- the route of administration would be appropriate to the patient that had
an automobile accident would be intravenous therapy due to
multisystemic injuries that had occur during the accident patients act of
action should be route through intravenous to be appropriate because it
allows immediate access by the drug to the blood stream

2. You are administering medications to a patient who had an enteral tube

inserted 2 days earlier for continuous feedings. As you review the
medication list, you note that one drug is an enteric-coated tablet
ordered to be given twice a day. What is the best action regarding giving
this drug to this patient?
-Squashing an enteric-covered tablet may cause interruption of the
covering that is intended to shield the stomach lining from the nearby
impacts of the prescription, or it might make the medication be rashly
annihilated by stomach corrosive. Along these lines, the attendant
needs to counsel the drug specialist to get some information about the
accessibility of the medication in a fluid structure that can be given
securely thought the enteric cylinder. On the off chance that
fundamental, the authorized prescriber may, must be reached to modify
the drug a fitting structure

3. Explain the following graphic based on what you learned from Prescription to Patient
Health – mapping the medicine to the patient.

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-Organization of the medication by the picked course requires a treatment plan, figured in a solution,
adherence to that arrangement and depiction of the states of organization, that is, the thing that as a matter
of fact occurred. It ought to be noted at this point that adherence, not typically viewed as a
pharmacokinetic variable, is a significant clinical issue that can be promptly measured utilizing
pharmacokinetic information. An exact portrayal of medication organization is likewise fundamental to
the understanding of pharmacokinetic information, that is, how much, by what course, and at wha time
was the medication directed to the patient. Bioavailability is the division of managed drug entering the
foundational course [Rowland and Tozer, 2011]. For orally regulated medications, bioavailability is made
out of retention and first pass digestion. The pace of medication entering the foundational flow decides
the most extreme fixation and the time at which this happens, yet, it doesn't influence consistent state
focus or then again decide upkeep portion. Leeway is made out of digestion and discharge of the dynamic
medication. Leeway, along with degree of bioavailability, decides normal consistent state fixation and
henceforth upkeep portion. The leeway of the pharmacologically dynamic medication moieties is the
clinically significant quantifier of medication leaving the foundational flow. The destiny of latent
medication moieties is to a great extent immaterial.Dissemination of the medication to its site of activity
is the portrayal of the differential circulation of the drug inside the body. Appropriation is simpler to
consider after bioavailability and freedom have characterized The ABCD of clinical
pharmacokinetics(absorption, appropriation, digestion, and discharge) restorative Advances in Drug
Safety consistent state focus in the fundamental dissemination. Significantly, the focus inclination
between the fundamental flow and the site of activity is frequently dictated by transport measures. In spite
of the fact that medication transport is critical to bioavailability also, freedom, it sits all the more serenely
under the heading of dissemination. The pace of dispersion is especially pertinent to bolus dosing,
however in consistent dosing, rate is best thought to be after degree. Retention in ADME is dissonant with
bioavailability furthermore, thus varyingly applied. For model, hepatic first-pass digestion is conflictingly
included or avoided under this heading. All the more as of late, drug sectioon over the gut divider is being
examined regarding instruments of retention, digestion and transport. The incessant incorporation of both
the degree of medication ingestion furthermore, the pace of medication ingestion under one term likewise
creates turmoil. Appropriation, when thought about after retention, centers consideration around the pace
of medication gathering in fringe compartments as opposed to the degree (the consistent state fixation at
the site of activity relative to the focus in the course). Digestion is the most significant part of freedom yet
not by any means the only segment. Digestion is additionally fundamental to the bioavailability of orally
directed medications. Moreover, digestion initiates favorable to drugs and some of the time produces
dynamic metabolites. Discharge is much of the time mistook for disposal of the dynamic medication, and
these terms are much of the time utilized reciprocally in the writing. Discharge is 'the irreversible loss of
artificially unaltered compound' while disposal is 'the irreversible loss of medication from the site of
estimation', that is, discharge in addition to digestion [Rowland and Tozer, 2011]. Besides, drug discharge
is frequently announced regarding inert metabolites leaving the body, while disregarding the destiny of
the dynamic medication. Most of medication use is for the treatment of persistent sickness; subsequently
consistent state fixation of medication at the site of activity is integral to clinical pharmacokinetics. The
ABCD abbreviation permits legitimate portrayal of the dynamic medication in space (degree) and time

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(rate) and gives a basic beginning stage for considering the factors that influence drug fixation at the site
of activity.

Discuss your answer with your partner

( pre-determined classmate assigned to you)

Feedback
Now , let’s check how you are doing so far in the Think, Pair and Share activity
4- Outstanding
3- Very Satisfactory
2- Satisfactory
1- Unsatisfactory
E.Do you know?

PHARMACOLOGY –the study or science of drugs; pharmacokinetics-the study

of drug distribution among various body compartments after a drug has
entered the body, including the phases of absorption, distribution, metabolism
and excretion; pharmaceutics- the science of dosage form design.
The nurses’ role in drug therapy and the nursing process is more than just
memorization of the names of drugs, their uses, and associated interventions.
It involves a thorough comprehension of all aspects of pharmaceutics,

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 pharmacokinetics, and pharmacodynamics and the sound application of this
knowledge to a variety of clinical situations.

II. LEARNING VALUES

During the time of pandemic. We are facing an invisible enemy. To keep our self,
our family and others safe. We are bound to follow quarantine rules.
Just like in our lessons of Pharmacology when we will give medicines to our
patients we too are doing certain actions. Sometimes, we can’t do things on our
own. We also ask and need help from others. Whatever actions we make, these
actions will always have outcomes and consequences. Therefore, we need to be
responsible with our actions.
Guide Questions:
What are the quarantine rules that may be applied when taking care of the
client taking medications?
What do you think are the rules as a student in our class, in the hospital or
in the community that you need to follow?
What do you think will happen if we will not follow these rules?

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Activity: Thought shapes
Directions: Write down inside each shape: what you learned, what you enjoyed,
what you felt and what were your thoughts .
The most important thing I have learned…

 the principle of the pharmacology

 Types of administration route
 The pharmacokinetics
1. Absorption
2. Distribution
3. Metabolism
4. Excretion
 The pharmacodynamics
1. alternation in cellular function
2. change in cellular environment
3. change in enzymatic action
4. drug interaction
5. therapeutic/side/adverse drug effects
6. hypersensitivity reaction
7. drug tolerance/cumulative effects/drug toxicity
8. precaution/contraindication
What I enjoyed most……….

 To be able to know the different types o route of the drugs and the different types of
drugs form and how it affects on absorption in the systemic
 The what are the types of administration of drugs
1. Oral
2. Bucal/sublingual
3. Rectal/vaginal
4. Intradermal/topical drugs
5. Subcutaneous/intramuscular/intravenous drugs
How I feel about using the skills and ideas have learned…

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  i will be able to apply the different factors that affects the absorption, and as well the
excretion of the drugs in the body
 what types o drugs form and how fast and slow those these drugs absorbed on the
systemic of the body
The thoughts still going around in my head are …
 Unable to understand the metabolic and also the distribution of the drugs in the body(i want to
be specific and have video presentation to be recapped on my memory ).

!V.EVALUATION
Multiple Choice . Write the letter of your choice on the blank provided
before the number
_______1.An elderly woman took a prescription medicine to help her to sleep; however, she felt
restless all night and did not sleep at all. The nurse recognizes that this woman has experienced
which type of reaction or effect?
a. Allergic reaction
b. Idiosyncratic reaction
c. Mutagenic effect
d. Synergistic effect

_______2While caring for a patient with cirrhosis or hepatitis, the nurse knows that
abnormalities in which phase of pharmacokinetics may occur?
e. Absorption
f. Distribution
g. Metabolism
h. Excretion

_______3.A patient has just received a prescription for an enteric-coated stool softener. When
teaching the patient, the nurses should include which statement?
i. Take the tablet with 2 to 3 ounces of orange juice.
j. Avoid taking all other medications with any enteric-coated tablet.
k. Crush the tablet before swallowing if you have problems with swallowing.
l. Be sure to swallow the tablet whole without chewing it.

______4.The nurse is reviewing the various forms of topical medications. Which of these are
considered topical drugs? (select all that apply)
m. Rectal ointment for hemorrhoids
n. Eyedrops for inflammation
o. Sublingual tablet for chest pain

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 p. Inhaled medication for asthma
q. Intradermal injection for tb testing

You are done! Congratulations for actively participating and

answering all the activities in the learning packet, see you on your next
packet.j

Do you have questions? Concerns?

Do you need help about the topic?

I am available at our e-class chat room or I am just a text away.

Sources:

1. Wintgerton Edmunds, M. (2016) Introduction to Clinical Pharmacology. St.

Louis, MO: Elsevier.
2. Frandsen, G. & Smith Pennington, S. (2018) Abram’s Clinical
Drug
Therapy: Rationales for Nursing Practice. Philadelphia, PA: Wolters Kluwer
3. Lilley, L.L., Rainforth Collins, S. & Snyder, J.S. (2017) Pharmacology and
the Nursing Process. St. Louis, MO: Elsevier.

Prepared By:

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Cathleen Marie G. Carpio, Edwin Abu, Maria Rosario M. Romero
College of Nursing, Clinical Instructor
Ateneo de Zamboanga University

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