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
Categories
Site news

Interrupting a Nurse Makes Medication Errors More Likely

Distracting an airline pilot during taxi, takeoff or landing could lead to a critical error. Apparently the same is true of nurses who prepare and administer medication to hospital patients.

A new study shows that interrupting nurses while they’re tending to patients’ medication needs increases the chances of error. As the number of distractions increases, so do the number of errors and the risk to patient safety.

“We found that the more interruptions a nurse received while administering a drug to a specific patient, the greater the risk of a serious error occurring,” said the study’s lead author, Johanna I. Westbrook, director of the Health Informatics Research and Evaluation Unit at the University of Sydney in Australia.

For instance, four interruptions in the course of a single drug administration doubled the likelihood that the patient would experience a major mishap, according to the study, reported in the April 26 issue of the Archives of Internal Medicine.

Experts say the study is the first to show a clear association between interruptions and medication errors.

It “lends important evidence to identifying the contributing factors and circumstances that can lead to a medication error,” said Carol Keohane, program director for the Center of Excellence for Patient Safety Research and Practice at Brigham and Women’s Hospital in Boston.

“Patients and family members don’t understand that it’s dangerous to patient safety to interrupt nurses while they’re working,” added Linda Flynn, associate professor at the University of Maryland School of Nursing in Baltimore. “I have seen my own family members go out and interrupt the nurse when she’s standing at a medication cart to ask for an extra towel or something [else] inappropriate.”

Julie Kliger, who serves as program director of the Integrated Nurse Leadership Program at the University of California, San Francisco, said that administering medication has become so routine that everyone involved — nurses, health-care workers, patients and families — has become complacent.

“We need to reframe this in a new light, which is, it’s an important, critical function,” Kliger said. “We need to give it the respect that it is due because it is high volume, high risk and, if we don’t do it right, there’s patient harm and it costs money.”

About one-third of harmful medication errors occur during medication administration, studies show. Prior to this study, though, there was little if any data on what role interruptions might play.

For the study, the researchers observed 98 nurses preparing and administering 4,271 medications to 720 patients at two Sydney teaching hospitals from September 2006 through March 2008. Using handheld computers, the observers recorded nursing procedures during medication administration, details of the medication administered and the number of interruptions experienced.

The computer software allowed data to be collected on multiple drugs and on multiple patients even as nurses moved between drug preparation and administration and among patients during a medication round.

Errors were classified as either “procedural failures,” such as failing to read the medication label, or “clinical errors,” such as giving the wrong drug or wrong dose.

Only one in five drug administrations (19.8%) was completely error-free, the study found.

Interruptions occurred during more than half (53.1%) of all administrations, and each interruption was associated with a 12.1% increase, on average, in procedural failures and a 12.7% increase in clinical errors.

Most errors (79.3%) were minor, having little or no impact on patients, according to the study. However, 115 errors (2.7%) were considered major errors, and all of them were clinical errors.

Failing to check a patient’s identification against his or her medication chart and administering medication at the wrong time were the most common procedural and clinical glitches, respectively, the study reported.

In an accompanying editorial, Kliger described one potential remedy: A “protected hour” during which nurses would focus on medication administration without having to do such things as take phone calls or answer pages.

The idea, Kliger said, is based on the U.S. Federal Aviation Administration’s “sterile cockpit” rule. That rule, according to the Aviation Safety Reporting System, prohibits non-essential activities and conversations with the flight crew during taxi, takeoff, landing and all flight operations below 10,000 feet, except when the safe operation of the aircraft is at stake.

Likewise, in nursing, not all interruptions are bad, Westbrook added.

“If you are being given a drug and you do not know what it is for, or you are uncertain about it, you should interrupt and question the nurse,” she said.

Source on net: http://www.medicinenet.com/script/main/art.asp?articlekey=115738