PHARMACOLOGY CONNECTIONS TO NURSING PRACTICE Second Edition CHAPTER

PHARMACOLOGY CONNECTIONS TO NURSING PRACTICE Second Edition CHAPTER 1 Introduction to Pharmacology: Concepts and Connections Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Learning Outcomes 1. Compare and contrast the terms drug, pharmacology, and pharmacotherapy. 2. Explain the importance of pharmacotherapy to clinical nursing practice. 3. Using specific examples, explain the difference between the pharmacologic and therapeutic methods of classifying drugs. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Learning Outcomes 4. Classify drugs by their chemical, generic, and trade names. 5. Identify the advantages of using prototype drugs to study pharmacology. 6. Assess the responsibilities of the nurse in drug administration. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharm. Fact Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

History of Pharmacology • • • First prescriptions traced to 3000 BC Chinese recorded remedies 2700 BC Egyptians archived remedies 1500 BC Dark Ages recorded little data Viewed as magic and superstition during this time Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacology as Science • With science, pharmacology becomes a discipline • Herbal remedies are first used • Word pharmacology first referenced in 1693 • Modern pharmacology begins in 1800 s • Chemists first isolated active agents • Early drugs are from natural plants Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacology as a Discipline • Established in Estonia in 1847 • University of Michigan first U. S. pharmacology department in 1890 • 20 th century saw great changes and strides in development of drugs • Now able to synthesize drugs in lab • Better understanding of drug effects Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Connection Checkpoint 1. 1 Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacology: The Study of Medicines 1. 2 Pharmacology is the study of medicines. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacology: The Study of Medicine • What is a drug? • Could everything be considered a drug? Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

What is a Drug? • Any substance that is taken to: – Prevent – Cure – Reduce § Symptoms of a medical condition Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Role of the Nurse • Drugs are a form of medical intervention • Nursing designs intervention for desired health goals • Pharmacotherapy is a critical intervention • Nurse administers the drug, assesses the effects and teaches the client about the drug Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Figure 1. 1 Rationale for pharmacotherapy: A partnership between the patient and the health care provider. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacology: The Study of Medicine • The word pharmacology comes from the Greek – Pharmakon = medicine or drugs – Logos = to study • Pharmacotherapy is the application of drugs for prevention or treatment • Pharmacology covers administration, metabolism, and response Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Characteristics of an Ideal Drug 1. 3 The perfect drug is safe and effective. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Characteristics of Drugs • Over 11, 000 brand, generic, and combination agents • Each has its own application, interactions, side effects, and actions • Many have multiple effects on the body • Patient factors can alter responses Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Patient Factors • • • Age Gender Race Body Mass Health Status Genetics Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Drug Actions • New drugs introduced every year • Drugs can improve quality of life • Drug reactions can also cause disability or death • Enormous challenge to stay current and up to date in the application of medications Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Is There a Perfect Drug? • What is the perfect drug? – It would do everything you want – No side effects – Convenient – Inexpensive – No interactions – Quickly eliminated Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Drug Indications • All prescription drugs must have some degree of effectiveness • Drugs are approved by their indications • Every drug has at least one indication • Many drugs have multiple indications • Unapproved indications are unlabelled or off-label Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Clinical Nursing Practice • Nurses need to have an understanding of how a drug works • Drug therapy is a large part of the nursing process • Nurses need to understand how patient variables affect drug therapy • Nurses need to stay up to date Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Classification of Drugs 1. 4 Drugs may be organized by their therapeutic classification or pharmacologic classification. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Classification of Drugs • FDA is the Food and Drug Administration • Orange Book of approved drugs • Classified by therapeutic and pharmacological properties • Therapeutic – what is being treated by the drug Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Classification of Drugs • Pharmacologic – how the drug acts • Used for both prescription and nonprescription medications Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Therapeutic Classifications • Therapeutics is the usefulness in treating a specific disease • A drug may lower blood pressure, but also relieve chest pain • A drug may lower blood glucose and also lower cholesterol • Classification is what condition is being treated by the particular drug Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Table 1. 1 Organizing Drug Information by Therapeutic Classification Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Pharmacologic Classification • Pharmacologic is the mechanism of the drug or how the drug produces its effects in the body • Three different drugs can lower blood pressure, but each differs in its mechanism of action • May use drug’s chemical name Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Table 1. 2 Organizing Drug Information by Pharmacologic Classification Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Classifications • Drugs can have multiple classifications • Dependent on the clinical use of the drug • Important to understand know the different classifications for each drug Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Connection Checkpoint 1. 2 Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Drug Prototypes 1. 5 A prototype drug is the agent to which all other drugs in a class are compared. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Prototype • Single drug from each class • May compare all other medications in the class to the prototype • Usually first drug in its class • Can be combination of traditional and new drugs • Helps with learning pharmacology Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Naming Drugs 1. 6 Drugs have chemical, generic, and trade names. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Chemical Names • Standard nomenclature established by IUPAC • Each drug has only one chemical name • Clear, concise meaning of the nature of the drug • Often difficult to remember and pronounce Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Generic Name • Assigned by United States Adopted Name Council • Less complicated than chemical names • Many organizations use generic names to describe and identify • Easy for students to memorize one name Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Brand Name • Name given by the pharmaceutical company marketing the drug • Tries to be short and easy to remember • Proprietary • Each drug receives period of exclusivity for marketing Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Trade Names • Products with the same drug • May contain one or more active ingredient • Combination drugs have more than one active generic ingredient Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Generic Drugs • Usually less expensive than trade name drugs • Drug formulations may be different • Inert and/or active ingredients may be same or different • This can change the bioavailability Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Table 1. 3 Examples of Generic Drugs Contained in Brand-Name Products Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Naming Drugs 1. 7 Generic drugs are less expensive than brand-name drugs, but they may differ in bioavailability. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Generic Substitution • Laws vary by state • Pharmacists may substitute generic for brand • Pharmacists may have to obtain approval from provider before substituting generic • Can be cost saving for patients • Many pharmacies offer generic lists Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Exclusivity of New Drugs • Pharmaceutical companies market their brand-name drugs • Claim significant difference between brand generic • Consumer advocates argue generic should be available • Cost difference between generic and brand can be significant Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Bioavailability • Defined as the rate and extent to which the active ingredients are absorbed from a drug product and then available at the site of action • May be different between trade and generic Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Connecting Pharmacology to Clinical Nursing Practice 1. 8 Pharmacology is intimately connected to nursing practice and is a key intervention in relieving and preventing human suffering. Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Nursing Practice • Understanding of pharmacology is critical to nursing practice • One of the key interventions in nursing care • The nurse must understand the pharmacotherapeutic principles for all medications • Key to elimination of medication errors Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Nurse’s Responsibilities • • • Name of drug Intended use Effects on body Contraindications and precautions Special considerations Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban

Nurse’s Responsibilities • Why it is prescribed • How to administer the drug • Nursing process considerations related to drug Pharmacology: Connections to Nursing Practice , Second Edition Michael Patrick Adams • Carol Quam Urban