better than you

are so that you

can be made
better by it.

-St. Agustin
References:
I. Readings
•
• Textbooks Pharmacology: Patient Centered Nursing Process Approach 9th
Edition by Linda E. Mc Cuistion
• Nurses Drug Handbook Copyright Date 2002
• Nursing Pharmacology by Marcia and Blicharz Copyright Date B. and Stock Y.
Copyright Date 1993 1994
• Basic Pharmacology for Nurses St. Louis: Mosby and Clayton

• Pharmacology

• Administering Medications Pharmacology for Health Careers Donna F.

Gauwitz

• Pharmacology Note Cards by Mosky

• Expanded Medicine Blue Book

 Course Content
Fundamental Concept of Pharmacology

1.Drug definition and classifications

a) drug uses c)history
b) drug sources d)drug names
2. Drug Standards and Drug Information
3. Pharmacodynamics
1. time, onset, peak, duration 0f action
2. therapeutic index and therapeutic range 3.
Graded Dose Response Relationship and Therapeutic
Response
3. Potency and Efficacy
4. Cellular Receptor and Drug Action
5. Types of Drug Receptor Interactions
D. Pharmacokinetics (LADME)
1. Liberation
2. Absorption
3. Distribution
4. Metabolism (Biotransformation)
5. Excretion

E. Factors Influencing Responsive to

Drug

F. Drug Legislation Controlled

Substances, generic Drugs Orphan
Drugs and Over-the-Counter-Drug
Nursing Process in Pharmacology
A. Assessment
B.Planning
C.Intervention
D. Client Education
E. Evaluation
F. Recording and Reporting
Unit 1- PHARMACOLOGY
Definition of Pharmacology
-is the study of drugs, their uses, preparation, routes & laws.

Pharmacology:
▪ includes of how drugs affect the human body and the drugs therapeutic
effect.
▪ Attempts to describe a drug’s desirable or undesirable effects apart from
the primary reason for giving of the drug which is called the side effects.
▪ Focuses on the on the proper amount of drugs to give and how to give
them.
▪ knowledge of the law and responsibilities surrounding drug use, along the
practical experience in giving medications.
•Drugs – A chemical substance use to:

❖ Prevent
❖ Treat
❖ Cure
❖ Diagnose-radiopaque dye
SOURCE OF DRUGS
1. Plants-used since prehistoric times
ex. Digitalis treat Cardiac Disorder strengthen & slow heartbeat
(purple fox glove plant)
Morphine & Codeine –potent analgesics from (poppy plant
marijuana leaves)
Castor oil- laxative to ease bowel movement (psyllium seeds)
2. Animal Products - insulin (Diabetes) obtain from cow and pig
pancreas tissue
3. Inorganic compounds and minerals - salt of various elements
Ex. Aluminum , flouride, Iron
4. Synthetic sources or Synthroid or Chemical – genetic engineering
to alter bacteria to produce chemicals that are therapeutic and effective

Genetic Engineering – process of altering DNA: scientist to produce

human insulin making product a better one without impurities from
animal products
HISTORY OF PHARMACOLOGY
2700 B.C – records of drug use in the middle East and China
1550 B.C – Egyptians wrote their empirical observation of drug
therapy on what is now known as “Ebers Medical Papyrus”
GALEN – Roman Physician and Writer 131-201 A.D
- consider an authority in medicine and pharma for hundreds of
years.
- initiated common use of prescriptions and used several
ingredients to treat specific illness
After fall of Roman Empire – Medicine and Pharmacy returned
to the realms of folklore and tradition
1240 A.D – Arab doctors formulated first set of drug standard and
measurements ( grain, drams, minims) known as “Apothecary
system” and later change to “Metric System”
16th Century- Paracelsus, known as father of Pharmacology
HISTORY OF PHARMACOLOGY
18th Century – break through drug where introduce as
Vaccine for small fox
Vit. C from citrus to strengthen or boost immune system
Digitalis (from purple foxglove plant)for strengthening and slowing the
heartbeat
19th Century
- Morphine and Codeine extracted from opium
- Atropine, bromides, iodine were introduced
- Amylnitrate use to treat pain from Angina
- Anesthetics ether and nitrious oxide discovered
Early 1940’s
- Antibiotics ( Penicilline, Tetracycline, Stryptomycin)
- Antihistamine, Cortisone
1950’s
- Antipsychotic drugs, Antihypertensives, Oral Contraceptives,
Polio Vaccine
Drug Standards and
Legislation
Drug Standards
• The set of drug standards used in the United States is the USP-NP or
United States Pharmacopeia National Formulary source for drug
standards revised every 5 years by experts, have met standards for
therapeutic use, clients safety, quality, packaging safety, and dosage
form. Drugs that meet these standards have initials USP following their
official name or generic name.
Ex. International Pharmacopeia
Federal Legislation
The public is protected from drugs that are impure, toxic, ineffective,
or not tested before public sale. The purpose is to ensure safety.
❖ 1906 Federal Pure Food and Drug Act
❖ FOOD DRUG AND COSMETIC ACT (1938) – Monitor and regulate the
manufacture and marketing of drugs
❖ Durham- Humphrey Amendments (1952) – Distinguished between
drugs that can be sold with or without prescription and those that
should not be refilled with out a new prescription
❖ KEFAUVER-Harris Amendment (1962)
-KEFAUVER: Thalidomide tragedy of the 1950’s in which pregnant
European women who took- the sedative during the first trimester of
pregnancy gave birth to infants with extreme limb deformities. With
this incident this act tightened controls on drug safety, especially
experimental drugs which includes testing methods used by
manufacturers before marketing.
Table 1.2 Drug Classification Under the Controlled Substances Act
of 1970
Drugs Characteristics
Schedule 1 Drugs High potential for abuse
severe physical and
psychological dependence .
No accepted medical use to
be used for research only not
to be prescribed: unsafe in
treatment.
Schedule II drugs High potential for abuse
severe physical and
psychological dependence .
Acceptable medical uses ,
with restrictions Dispensed by
prescription only . No refills
without new written
prescription from physician
Example
Alfintanil, fenethylline,
hashish, heroin,lysergic acid
diethylamide (LSD), marijuana
metha-aqualone(Quaalude)
peyote, psilocybin
Amphetamines, cocaine,
meperidine HCI (Demerol),
methadone, methylphenidate
hydrochloride (Ritalin),
morphine, opium,
pentobarbital (Nembutal),
anabolic steroids,
hydromorphone
hydrochloride (Dilaudid)
Table 1.2 Drug Classification Under the Controlled Substances Act of
1970
Drugs Characteristics
Schedule III Drugs Moderate potential for
abuse , high psychological
dependence, low physical
dependence
Acceptable medical uses
By prescription only;
maybe refilled five times in
6 months if authorized by
physician
Schedule IV Drugs Lower potential for abuse
than Schedule III drugs;
limited psychological and
physical dependence.
Acceptable medical uses
By prescription only; may
be refilled five times in 6
months if authorized by
physician
Example
Barbiturates, butabarbital
(Butisol), glutethimide
(Doriden), secobarbital
(Seconal), Tylenol with
codeine.
(Dalmane), exazepam
(Serax), phenobarbital,
propoxyphene HCI
(Darvon), lorazepam
(Ativan, meprobamate
(Equanil), pentazocine HCI
(Talwin), alpazolum
(Xanax)
Table 1.2 Drug Classification Under the Controlled
Substances Act of 1970
Drugs Characteristics
Schedule V Drugs Low potential for abuse
Acceptable medical uses
OTC narcotic drugs, but
sold only by registered
pharmacist , buyers must be
18 years and show ID
Example
Cough syrups with codeine.
e.g., guaifenesin (Naldecon
DX) and Cheracol with
codeine, diphenoxylate HCI
with atrophine sulfate
(Lotomil), Novahistine
expectorant, Parepectolin
Federal Legislation
❖ 1978 Drug Regulation & Reform Act
❖ 1983 Drug Enforcement Administration of the Department of
Justice or Orphan Drug Act
❖ 1992 Drug Relations Act drug used to treat AIDS and cancer
❖ 1997 FDA Moderation Act
❖ 2003 Health Insurance Probability & Accountability Act
(HIPAA)
• Pediatric Research Equity Act
• Medicare Prescription Drug Improvement & Modernization
Act (MMA)
 DRUG NAMES
CHEMICAL NAME – describes chemical composition and molecular
structure of the drug
Ex. Acetylsalicylic acid
GENERIC or NON-PROPRIETARY NAME or OFFICIAL NAME –
name assigned by manufacturer of the drug base on the chemical name
Ex.
Paracetamol
Ibuprofen
Mefenamic
TRADE NAME, BRAND, PRODUCT NAME, OR PROPRIETARY
/DRUG NAME – name under which the drug is sold by specific
manufacturer.
Ex. Paracetamol
BIOGESIC
NSAID Non-Steroidal Anti-inflamatory
Drugs
Generic Name Trade Name Characteristics Complications
Paracetamol Biogesic Antipyretic Less toxic, not to be
Medicol Analgesic used for a week

Naprex

Generic Name Trade Name Characteristics Complications

Acetaminophen Panadol Antipyretic Toxic to the liver
Tylenol Analgesic
Anacid
Tempra
Midol
NSAID Non-Steroidal Anti-inflamatory
Drugs
Generic Name Trade Name Characteristics Complications
Mefenamic Revalan Anti-inflammatory Renal impairment
Ponstan Analgesic in prolonged use

Dolfenal

Generic Name Trade Name Characteristics Complications

Ibuprofen Motrin Anti-inflammatory Sodium retention
Advil Analgesic Peptic ulcer
Alaxan Antirheumatic Intrinsic
Antiplatelet coagulation
defects
 THE PRODUCT INSERT
Product insert- is a detailed description of a drug product that is
required to be included in the package

Parts of the Product Insert

• Brandname
• Generic
• Description
• Clinical Pharmacology
• Indication and Usage
• Contraindication
• Warnings
• Precautions
• Overdosage
• Dosage and Administration
• How Supplied
 Drug Resources
American Hospital Formulary Service (AHFS) Drug
Information
Physician Desk Reference (PDR)
Drug Facts and Comparison (F &C)
United States Pharmacopiea – Drug Information (USP-DI)

Other Resources:
• The Medical Letter
• Prescriber’s Letter
• Handbook on Injectable Drug
• Saunders Nursing Drug HAndbook
• Nursing Drug Guide
• Internet