1. Meet & Greet

3. Welcome Objectives: 1. Review the core terminology used in pharmacology. 2. Discuss the features of the “perfect” drug. 3. Examine the factors that determine the intensity of drug responses

4. A science that draws on information from multiple disciplines, including: * Anatomy * Physiology * Psychology * Chemistry * Microbiology

5. Drug Any chemical that can affect living processes

7. Pharmacology * Study of drugs and their interactions with living systems * The study of the physical and chemical properties of a drug and its biochemical and physiological effect * Knowledge of history, sources, use of drug, and knowledge of drug absorption, distribution, metabolism, and excretion

8. Clinically relevant

9. Clinical Pharmacology Study of drugs in humans

10. Therapeutics * The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy * Also known as pharmcotherapeutics * The medical use of drugs

12. 1.Effectiveness 2.Safety 3.Selectivity

13. * The medication elicits the response that it was designed to * Most important property of a drug

14. * A drug that can not produce harmful effects – even if administered in very high doses and for a very long time.

15. * No such thing as a safe drug * All drugs have the potential to cause injury * Risks reduced by proper drug selection and proper dosing

16. * A drug that elicits the response only the response for which it is given

17. * Reversible action * Predictability * Ease of administration * Freedom from drug interactions * Low cost * Chemical stability * Simple generic name But because no drug is ideal …

18. Provide maximum benefit with minimum harm

19. * Administration * Pharmacokinetics * Pharmacodynamics * Sources of individual variation

21. * Important determinants of drug responses: dosage size, route, timing * Medication errors * Patient adherence

22. * Determining how much of administered dose gets to its sites of action * Impact of the body on drugs * Four major pharmacokinetic processes: Drug absorption Drug distribution Drug metabolism Drug excretion

23. * Impact of drugs on the body * Drug-receptor interaction Binding of the drug to its receptor * Patient’s functional state Influences pharmacodynamic processes * Placebo effects Also help determine the responses a drug elicits

24. * Physiologic variables Age, gender, weight * Pathologic variables Diminished function of kidneys and liver * Genetic variables Can alter metabolism of drugs and predispose patient to unique interactions * Drug interactions

25. * There is no such thing as a safe drug; all drugs can cause harm. * There is no such thing as a selective drug; all drugs can cause side effects. * The objective of drug therapy is to provide maximum benefit with minimum harm. * Because all patients are unique, drug therapy must be tailored to each individual.

27. Use to be 5Rs ….

28. Right documentation added

31. * Likely first member of the team to observe and evaluate the effects of the medication * First to intervene if necessary * Patient advocate * YOU are the patient’s last line of defense against med errors * Legal and ethical obligations

32. 1. Preadministration Assessment 2. Dosage and Administration 3. Evaluating and Promoting Therapeutic Effects 4. Minimizing Adverse Effects 5. Minimizing Adverse Interactions 6. Making PRN Decisions 7. Managing Toxicity

33. Assess the patient first Collect baseline data Identify high risk patients Patient’s capacity for self care

34. * Many drugs have more than one indication for use * Many drugs can be administered in more than one route * Certain IV drugs can cause great damage locally if IV becomes extravasated

35. * Read the order carefully – clarify if necessary * Verify the identity of the patient – comparing the name on the wristband with the name on the order * Read the medication label carefully – verify the identity of the drug, the amount per pill, tsp, etc and suitability for the patient

36. * Verify drug calculations * Handle as directed * Do not give a medication that you do not understand the reason for its use

37. * One of the most important aspects of drug therapy * Tells us whether the drug is doing anything useful * Nurses often in the best position to evaluate therapeutic response * Must know rationale for use and characteristics of the drugs

38. * Evaluation may make some allowances if desired effect is achieved * Can only evaluate for intended purpose

39. * Adherence is essential * Medications improperly administered can have negative outcomes * Requires active and informed participation by the patient * Implement non-drug measures Breathing exercises, exercise, support, weight reduction, smoking cessation, etc.

40. In order to minimize adverse effects you must know the following about the drug you are working with; * The major adverse effects the drug can produce * When the reactions are likely to occur * Early warning signs * Interventions that can minimize discomfort or harm

41. Any two drugs (or more) taken by the same person creates the potential for an adverse interaction Tips to minimize; Take a thorough medical history Counsel patients to avoid OTC Monitor for common adverse interactions Be alert for not yet know adverse interactions

42. PRN – pro re nata (as needed/as the occasion arises) To make a PRN decision; Must know the reason the drug has been prescribed Assess the patient’s medication needs Expand your knowledge base

43. * Must be recognized and responded to quickly * Nurse must know what the signs of toxicity are before he/she can recognize the presentation

44. The nurse must educate the patient on the following; * Medication name and therapeutic category * Dose size * Dosing schedule * Route & technique of administration * Expected therapeutic response and when it should occur * Nondrug measures to enhance response

45. * Duration of treatment * Method of drug storage * Symptoms of major adverse effects, and measures to minimize discomfort and harm * Major adverse drug-drug & drug-food interaction * Who to contact in the event of therapeutic failure, major adverse effect or severe adverse interactions

46. Chemical name Generic name Trade name The three types of drug names:

47. Use of drug names Written and oral communication about medicines Labeling medication containers

49. Generic products versus brand-name products Are generic products and brand-name products therapeutically equivalent? Would a difference between brand-name and generic products justify the use of trade names?

50. * Americans spend about $20 billion annually on OTC drugs. * OTC drugs account for 60% of all doses administered. * 40% of Americans take at least one OTC drug every 2 days. * Four times as many illnesses are treated by a consumer using an OTC drug as by a consumer visiting a physician.