CHAPTER 35 MEDICATIONS
developed to ensure uniform quality.
Medications – a substance administered for the
diagnosis, cure, treatment or relief of a
symptom or for prevention of disease.
Drug – also has the connotation of an illicitly
obtained substance such as heroin, cocaine, or
amphetamines.
Prescription – written direction for the
preparation and administration of a drug
Four Kinds of Name of a Drug
1. Generic name – assigned by the United
States Adopted Names (USAN) Council
and is used throughout the drug’s
lifetime
2. Trade name (Brand Name) – given by
the drug manufacturer and identifies it
as property of that company. It is
usually short and easy to remember.
3. Official name – name under which a
drug is listed in one official publication
4. Chemical name – name by which a
chemist knows it. This name describes
the constituents of the drug precisely.
Pharmacology – the study of effect of drugs on
living organisms
Pharmacy – art of preparing, compounding, and
dispensing drugs
Pharmacist – prepares, makes, and dispenses
drugs as ordered by a physician, dentist, nurse
practitioner, or physician assistant.
Drugs may have natural sources or they may be
synthesized in the laboratory.
Drugs vary in strength and activity
Drugs derived from plants vary in strength
according to the age of the plant, the variety,
the place in which it is grown, and the method
by which it is preserved.
Drug standards have therefore have been
Drugs are described according to their source,
physical and chemical properties, tests for
purity and identify, method of storage, assay,
category, and normal dosages.
Pharmacopoeia – a book containing a list of
products used in medicine, with descriptions of
the product, chemical tests for determining
identity and purity and formulas and
prescriptions.
Nurses not only administer thousands of
medications but also responsible for assessing
their effectiveness and recognizing
unfavourable reactions to drugs
Nurses are responsible for their own actions
regardless of whether there is a written order. A
nurse who administers the written incorrect
dosage is responsible for the error as well as the
primary care provider. Therefore nurses should
question any order that appear unreasonable
and refuse to give the medications until the
order is clarified.
Controlled substances are kept in a locked
drawer, cupboards, medication cart or
computer controlled dispensing system.
The information required in recording when
getting a controlled substance usually includes,
the name of the client
 Date and time of administration
 The name of the drug
 The dosage
 The signature of the person who prepared
and gave the drug
 The name of the primary care provider
who ordered the drug may also be part of
the record
In most agencies, counts of controlled
substances are taken at the end of each shift
EFFECTS OF DRUGS An allergic reaction can occur anytime from a
few minutes to 2 weeks after the
Therapeutic effect of a drug also referred as the administration.
desired effect, is the primary effect intended
that is the reason the drug is prescribed. Anaphylactic reaction is a severe allergic
reaction usually occurs immediately after the
THERAPEUTIC ACTIONS OF DRUGS administration of the drug. This response can be
DRUG TYPE DESCRIPTION fatal if the symptoms are not noticed
Palliative Relieves symptoms of a immediately and treatment is not obtained.
disease but not affect the
disease itself The earliest symptoms are a subjective feeling
Curative Cures a disease of swelling in the mouth and tongue acute
Supportive Supports body function shortness of breath, acute hypotension, and
Substitutive Replaces body fluids tachycardia.
Chemotherapeutic Destroys malignant cells
Restorative Returns the body to COMMON MILD ALLERGIC RESPONSES
health SYMPTOMS DESCRIPTION
Skin rash Either an intraepidermal
Side effect or secondary effect, a drug is one vesicle rash or typified by
that is unintended. It is usually predictable and an urticarial wheal or
may either harmless or potentially harmful. macular eruption;
Some side effects are tolerated for the drug’s generalized over the body
therapeutic effect; Pruritus Itching of the skin with or
without rash
Adverse effects are more severe side effects or Angioedema Edema due to increased
reactions that may justify the discontinuation of permeability of the blood
a drug. capillaries
rhinitis Excessive watery
The nurse should monitor for dose related side discharge from the nose
or adverse effects and report these to the Lacrimal tearing Excessive tearing
health care provider who may discontinue the Nausea, vomiting Stimulation of these
medication or change the dosage centers in the brain
Wheezing and Shortness of breath and
Drug toxicity are harmful effects of a drug on an dyspnea wheezing on inhalation
organism or tissue, it results from over dosage, and exhalation due to
ingestion of a drug intended for external use, or accumulated fluids and
build up of the drug in the blood because of swelling of respiratory
impaired metabolism or excretion (cumulative tissues
effect) Diarrhea Irritation of the mucosa of
the large intestine
Drug Allergy is an immunological reaction to a
drug. When a client is first exposure to a foreign Drug tolerance exists in a person who exhibits
substance (antigen), the body may react by an unusually low physiological response to a
producing antibodies. Allergic reactions can be drug and who requires increases in the dosage
either mild or severe. A mild reaction has a to maintain a given therapeutic effect. Drugs
variety of symptoms, from skin rashes to commonly produce tolerance are opiates,
diarrhea. barbiturates, and ethyl alcohol.
Cumulative effect is the increasing response to
repeated doses of a drug that occurs when the
rate of administration exceeds the rate of
metabolism or excretion. As a result, the
amount of drug builds up in the client’s body
unless the dosage is adjusted. Toxic symptoms
may occur.
Idiosyncratic effect is one that is unexpected
and may be individual to client. Underresponse
and overresponse to a drug may be
idiosyncratic.
Drug interaction occurs when the
administration of one drug before at the same
time as , or after another drug alters the effect
of one or both drugs.
Drug interaction may be beneficial or harmful
 Potentiating Effect – the effect of one or
both drugs are increased
It can be,
Additive – when two of the same type of
drugs increase the action of each other
Synergistic – two different drugs increase
the action of one or another drug
 Inhibiting Effect – the effect of one or both
drugs are decreased
Latrogenic Disease – disease caused by
unintentionally by medical therapy, can be a
result of drug therapy.
DRUG MISUSE
Drug misuse is the improper use of common
medications in ways that lead to acute and
chronic toxicity.
Drug abuse is the inappropriate intake of a
substance,either continually or periodically.
Drug use is abusive when society considers it
abusive.
Drug abuse has two main facets
1. Drug dependence – is a person’s
reliance on need to take a drug or
substance. There are two types of
dependence,
 Physiological dependence is due to
biochemical changes in body tissues,
especially the nervous system. These
tissues come to require the
substance for normal functioning. A
dependent person who stops using
the drug experiences withdrawal
symptoms.
 Psychological dependence – is
emotional reliance on a drug to
maintain a sense of wellbeing
accompanied by feelings of need or
cravings for that drug.
2. Drug habituation denotes a mild form
of a psychological dependence. The
individual develops the habit of taking
substance and feels better after taking
it
Illicit drugs also called street drugs are those
sold illegally. It is often taken because of their
mood altering effect; that is they make the
person feel happy or relaxed.
There are two types
 Drugs unavailable for purchase under
any circumstances
 Drugs normally available with a
prescription that are being obtained
through illegal channels.
ACTIONS OF DRUGS ON THE BODY
The action of a drug in the body can be
described in terms of its half time, the time
interval required for the body’s elimination
processes to reduce the concentration of the
drug in the body by one half.
Example if the drug’s half life is 8hrs, then the
amount of drug in the body is as follows:
Initially 100%
After 8 hrs 50%
After 16hrs 25%
After 24hrs 12.5%
After 32hrs 6.25%
Because the purpose of most drug therapy is to
maintain a constant drug level in the body,
repeated doses are required to maintain that
level.

When an orally administered drug is absorbed

from the GI tract into the blood plasma, its
concentration in the plasma increases until the
elimination rate equals the rate of absorption.

Peak plasma level:

ELIMINATION RATE = RATE OF ABSORPTION