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Introduction to Nursing Pharmacology Nursing Pharmacology

Drug Therapy in the 21st Century

Drug Therapy in the 21st Century

Changes in Health Care in the 21st Century

  • Access to medical and pharmacologic information is available from many sources
  • Consumers are taking steps to demand specific treatments and considerations
  • Alternative therapies are being offered and advertised
  • Financial pressures are leading to early discharge
  • Patient teaching and home care provisions are vital

Federal Guidelines—Drug Advertising

  • When the advertisement states the indication, it must also include:
    • Contraindications
    • Adverse effects
    • Precautions

Internet Sources for Drug Information

  • Pharmaceutical company information sites
  • Chat rooms with other people who are taking the drug
  • Online pharmacies
  • Lists of government regulations
  • Research reports about the drug and its effectiveness

Internet Site Evaluation

  • Navigation
    • Is the site easy to access and navigate or confusing?
  • Contributor
    • Who prepared the site and what are his qualifications? Is it reviewed, or is it purely commercial?
  • Dates
    • Is the site updated frequently?
  • Accuracy/reliability
    • Is the information supported by other sites, accurate, and in agreement with other sources you have reviewed? Are other links listed?

Problems Associated With OTC Medications

  • Can mask the signs and symptoms of disease
  • Can interact with prescription drugs
  • Can be taken in greater than the recommended dose, leading to toxicity

Over-the-Counter Drugs

  • Drugs that were “grandfathered” in
  • Former prescription drugs that have been tested and found to be safe for the general public if used as directed

Alternative Therapy Drawbacks

  • The active ingredient has not been tested by the FDA
  • Incidental ingredients are unknown
  • Patients do not always mention these therapies to their health care providers
  • Drug–alternative therapy interactions may occur

Controls for Alternative Therapy

  • Herbal medications and alternative therapies are not controlled or tested by the FDA
  • Advertisement for these drugs is not restricted because they are considered dietary supplements
  • No regulation by any industry

Off-Label Medications

  • Definition
    • The use of a drug for an indication that is not approved by the FDA
  • Occurrence
    • Commonly takes place in groups of patients for whom there is little premarketing testing
    • Used with pediatric and geriatric populations

Health Care in Crisis

  • Skyrocketing cost of medical care and drugs
  • Huge research and equipment requirements to meet consumer demands
  • Rising cost of health insurance
  • Earlier discharge from hospitals

Measures to Protect the Public From Bioterrorism

  • Emergency preparedness at all levels of the government

Treatments for Exposure to Biological/Chemical Weapons

Recommended Treatments for Biological/Chemical Weapons Exposure
Recommended Treatments for Biological/Chemical Weapons Exposure
Recommended Treatments for Biological/Chemical Weapons Exposure
Recommended Treatments for Biological/Chemical Weapons Exposure
Categories
Introduction to Nursing Pharmacology Nursing Pharmacology

Introduction to Drugs

Nurses’ Responsibility

  • Administering drug
  • Assessing for adverse drug effects
  • Intervening to make the drug regimen more tolerable
  • Providing patient teaching about drugs and the drug regimen
  • Monitoring and prevention of medication errors

Pharmacology

  • Pharmacology is the study of the biological effects of chemicals
  • Health care providers focus on how chemicals act on living organisms

Pharmacotherapeutics

  • A branch of pharmacology that uses drugs to treat, prevent, and diagnose disease
  • Pharmacotherapeutics focuses on:
    • The drug’s effect on the body
    • The body’s response to the drugs
  • Drug effects
    • Therapeutic
    • Adverse

Sources of Drugs

  • Plants
  • Animal products
  • Inorganic compounds
  • Synthetic sources

Plants

Focus on Drugs Derived From Plants
Focus on Drugs Derived From Plants

Animal Products

  • Animal products are used to replace human chemicals
  • Used less frequently due to genetic engineering
  • Synthetic preparations are considered safer

Inorganic Compounds

Focus on Elements Used for Their Therapeutic Effects
Focus on Elements Used for Their Therapeutic Effects

Synthetic Sources

  • Genetic engineering is used to alter bacteria to produce chemicals that are therapeutic and effective
  • Changes in chemical structure can make drugs more potent, more stable, and less toxic

Drug Evaluation

  • Preclinical trials
    • Chemicals tested on laboratory animals
  • Phase I studies
    • Chemicals tested on human volunteers
  • Phase II studies
    • Drug tried on informed patients
  • Phase III studies
    • Drug used in vast clinical market
  • Phase IV studies
    • Continual evaluation of the drug

Legislation

Focus on Federal Legislation Affecting the Clinical Use of Drugs
Focus on Federal Legislation Affecting the Clinical Use of Drugs

Pregnancy Category

FDA Pregnancy Categories
FDA Pregnancy Categories

Controlled Substances

DEA Schedules of Controlled Substances
DEA Schedules of Controlled Substances

Drug Names

  • Chemical name
  • Generic name
  • Trade name

Drug Name

  • Chemical name
    • (+/-)-2-(p-isobutylphenyl) propionic acid
  • Generic name
    • Ibuprofen
  • Trade name
    • Motrin®, Advil®
Mosby Items and Derived Items
Mosby Items and Derived Items

Types of Drugs

  • Over-the-counter drugs
  • Prescription drugs

Over-the-Counter Drugs

  • Drugs considered very safe and useful to patients without a prescription
  • Drugs may previously have been prescription medications (eg, loratadine)

Concerns With OTC Medications

  • OTC drugs can mask the signs and symptoms of underlying disease
  • Taking OTC drugs with prescription medications can result in drug interaction
  • Taking prescription medication incorrectly with OTC drugs could result in serious overdose

Sources of Drug Information

  • Reference books
  • Journals
  • Internet

Chapter 1
Introduction to Drugs
Nurses’ Responsibility
Administering drug
Assessing for adverse drug effects
Intervening to make the drug regimen more tolerable
Providing patient teaching about drugs and the drug regimen
Monitoring and prevention of medication errors
Pharmacology
Pharmacology is the study of the biological effects of chemicals
Health care providers focus on how chemicals act on living organisms
Pharmacotherapeutics
A branch of pharmacology that uses drugs to treat, prevent, and diagnose disease
Pharmacotherapeutics focuses on:
The drug’s effect on the body
The body’s response to the drugs
Drug effects
Therapeutic
Adverse
Sources of Drugs
Plants
Animal products
Inorganic compounds
Synthetic sources
Plants
Animal Products
Animal products are used to replace human chemicals
Used less frequently due to genetic engineering
Synthetic preparations are considered safer
Inorganic Compounds
Synthetic Sources
Genetic engineering is used to alter bacteria to produce chemicals that are therapeutic and effective
Changes in chemical structure can make drugs more potent, more stable, and less toxic
Drug Evaluation
Preclinical trials
Chemicals tested on laboratory animals
Phase I studies
Chemicals tested on human volunteers
Phase II studies
Drug tried on informed patients
Phase III studies
Drug used in vast clinical market
Phase IV studies
Continual evaluation of the drug
Legislation
Pregnancy Categories
Controlled Substances
Drug Names
Chemical name
Generic name
Trade name
Drug Name
Chemical name
(+/-)-2-(p-isobutylphenyl) propionic acid
Generic name
Ibuprofen
Trade name
Motrin®, Advil®
Types of Drugs
Over-the-counter drugs
Prescription drugs
Over-the-Counter Drugs
Drugs considered very safe and useful to patients without a prescription
Drugs may previously have been prescription medications (eg, loratadine)
Concerns With OTC Medications
OTC drugs can mask the signs and symptoms of underlying disease
Taking OTC drugs with prescription medications can result in drug interaction
Taking prescription medication incorrectly with OTC drugs could result in serious overdose
Sources of Drug Information
Package insert
Reference books
Journals
Internet