Basic Pharmacology For Nurses 01
Basic Pharmacology For Nurses 01
Basic Pharmacology For Nurses 01
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Chapters:
1,2,3,7,8,9,10,11,12,14,16,20,23,25,27,29,30, 33,34,35, 36, 42,46,48
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Chapter 1
Definitions, Names, Standards, and Informational Sources Foundations of Pharmacology
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CHEMICAL NAME
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Therapeutic Choices
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Foundations of Pharmacology
Drug review process
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Chapter 2
Principles of Drug Action and Drug Interactions
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Basic principles
A strong understanding of the human bodys processes are important to grasp drug actions and drug interactions in the body
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Examples:
Antagonistbeta blockers
Agonistepinephrine
Partial agonistpentazocine
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HalfHalf-life of Drugs
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Chapter 3
Drug Action Across the Life Span
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Title of Stage Premature Newborn, neonate Infant, baby Young child Older child Adolescent Adult Older adult Elderly The aged The very old
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Drug Distribution
Depends on pH, body water concentrations,
presence and quantity of fat tissue, protein binding, cardiac output, and regional blood flow
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Drug Distribution
Highly fat-soluble drugs take longer to act
and accumulate in fat tissues, increasing potential for toxicity
P Protein bi di i binding
Drugs that are relatively insoluble are transported in circulation by binding to plasma proteins
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Drug Distribution
Age considerations Some drugs have lower protein binding in
neonates and require larger loading dose
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Drug Metabolism
Drug metabolism
Process by which the body inactivates medicine Affected by genes, diet, age & maturity of enzyme systems Liver weight and hepatic blood flow decrease with age
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Evaporation: through skin Exhalation: from the lungs Secretion: in saliva & breast milk
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Drug Excretion
Metabolites of drugs (and sometimes the
drug itself) eventually excreted
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Weight variation affects dosage g g Aspirin never to be administered to children Allergic reactions occur rapidly in children,
most commonly to antibiotics
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Drug therapy
Take thorough drug history and nutritional assessment Determine whether new symptoms have y p been induced by existing medicines Gradually taper dosage when discontinuing drug Start at one third to one half normal dosage when initiating therapy; gradually increase Review regimen periodically
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Discuss all medications with physician Take medicine immediately after breastfeeding or just before infants longest sleeping period
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Chapter 7
Principles of Medication Administration
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The Kardex
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Medication Errors
Prescribing errors Transcription errors Dispensing errors Administration errors Monitoring errors
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Nurse Responsibilities
Verification
Nurse makes professional judgment regarding acceptability and safety of the drug order, including type of drug, dose and dose preparation, therapeutic intent, route, potential allergic reactions, or contraindications
Transcription
Nurse is responsible for verification of orders transcribed by others
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2. Right time g
Standard abbreviations Standardized administration times Maintenance of consistent blood levels Maximum drug absorption Diagnostic testing PRN medications
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4. Right patient
Bracelet checking Pediatric and older adult patients
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6. Right documentation
Safety/ethical considerations Legal considerations Always include date/time, drug name, dose, route, site of administration
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Chapter 8
Percutaneous Administration
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Includes:
Topical application of ointments, creams, lotions, lotions or powders to the skin Inhalation of aerosolized liquids or gases Installation of solutions into the mucous membranes of the mouth, eye, ear, nose, or vagina
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Percutaneous Administration
Premedication assessment and explanation Patient teaching
Hygiene requirements Proper application techniques and timing Cautions particular to drug or drug administration Side effects When to contact physician
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Percutaneous Administration
Documentation
Date, time, drug, dosage, route Record ongoing assessment data, including signs of adverse drug effects
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Patch left in place for 48 hours Site aired for 15 minutes, then read Emergency equipment must be available in
case of anaphylactic response
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Patch Testing
Wash hands, put on gloves,position patient Clean the area Wear gloves g Apply dose-measuring applicator paper Do not rub in ointment Cover area with plastic wrap
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Wash hands,put on gloves,position patient Apply topical disk or patch Application frequency depends on drug Wash hands after application Label disk with time, date, nurse initials
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Topical Powders
Particles of medication in a talc base Wash hands, put on gloves Position the patient Wash and thoroughly dry area Apply powder, smooth over area for even
coverage
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Nose spray
Patient is upright Block one nostril Shake bottle and insert tip into nostril Spray while patient inhales
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Metered-dose inhalers
Follow instructions on inhaler
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Vaginal Medications
Wash hands, put on gloves Fill applicator Place patient in lithotomy position, elevate
hips with pillow
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Chapter 9
Enteral Administration
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Perform premedication assessment in all cases All techniques follow FIVE RIGHTS procedure:
RIGHT patient RIGHT drug RIGHT route of administration RIGHT dose RIGHT time of administration
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Three methods for checking NG tube location Follow procedure for administering
medication di i
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Formula should be fully labeled Discard unused formula every 24 hours Follow the guidelines specific for patients
receiving general nutrition via intermittent or continuous feedings Follow FIVE RIGHTS
RIGHT patient, RIGHT drug (formula), RIGHT route of administration, RIGHT dose (amount, dilution, strength), RIGHT time
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Verify tube placement and initiate feeding Flush, then clamp tube Proceed with tube feeding technique
Intermittent: use Toomey syringe y y g Continuous: use disposable feeding container and enough formula for a 4-hour period
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Equipment is simple:
Finger cot or disposable glove Water-soluble lubricant Prescribed suppository P ib d it
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Parenteral Administration
Parenteral means drug administration by any
route other than the gastrointestinal tract
Parenteral route
Intradermal Subcutaneous Intramuscular (IM) Intravenous (IV)
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Chapter 10
Parenteral Administration: Safe Preparation of Parenteral Medications
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Vials
Glass containers that contain one or more doses
Mix-O-Vials
Glass containers with one dose, two compartments
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Mix thoroughly to dissolve powder Change needle to correct gauge and length
to administer the medication to the patient
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Remove the plastic lid protector Push firmly on the diaphragm-plunger Mix thoroughly Cleanse the rubber diaphragm and remove
drug using syringe to administer to patient
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Special Preparations
Occasionally two medications may be drawn
into the same syringe for a single injection
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