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R epubl i c of the Phi l i ppi nes

CE B U TEC HNOLOG IC AL U NIVE R SITY


Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

NCM 107: PHARMACOLOGY

MODULE 1

INTRODUCTION TO
PHARMACOLOGY

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

DISCLAIMER:

The content of this module are curated from different sources, citations and
references that are indicated in every part of the module.

ACKNOWLEDGEMENT:
Acknowledging the effort of the clinical instructors who work tirelessly for
every module that each students receives. For the Level II Clinical Instructors.

The work of this module was through the approval of the Level II Chairman,
Ms Divina T. Villarin and assistant Level Chairman Mrs. Ma Carmila I Rama.

Ms. Dafhne C Gallendo


Level II Clinical Instructor

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

TABLE OF CONTENTS:

A. Introduction to Nursing Pharmacology:


1.Introduction to drugs
a .Drugs and the body
b. Medication preparation
c. Nursing management
d. dosage calculations

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Assessing the client’s response


to drug therapy is an ongoing nursing responsibility. To adequately assess, plan
and evaluate drug effects, the nurse needs to have knowledge of the
pharmaceutics, pharmacokinetic, and pharmacodynamics phases of drug action
all of which are described in this module. Along with understanding the phases
of drug action, the nursing process and client teaching two other important
functions of nursing practice include application of drug administration
principles and calculations of drug doses.

This module aims to make the recipients to identify the principles of Drug
administration which contains basic learning material for the administration of
the medications, describes the “ten rights” in drug administration, drug orders,
drug distribution, drug charts, drug administration guidelines, and drug
administration routes. (Pharmacology, A nursing process approach, 6th edition)

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

DESIRED LEARNING OUTCOMES

At the end of the module, students should be able to:

1. Differentiate the three phases of drug action


2. Identify the two processes that occur before tablets are absorbed into the
body.
3. Describe the four processes of pharmacokinetics
4. Explain the meaning of pharmacodynamics dose response, maximal
efficacy, the receptor, and nonreceptors in drug action.
5. Describe the nursing implications of pharmacokinetics and
pharmacodynamics.

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

LESSON CONTENT:
generally called excipients, are used
in drug preparation to allow the drug
to take on a particular size and shape
to enhance drug dissolution.

Disintegration is the
breakdown of a tablet into smaller
particles while dissolution is the
dissolving of the smaller particles in
the GI fluid before absorption. Rate
(Click on the link for the video) limiting is the time it takes the drug
to disintegrate and dissolve to
A drug taken by mouth goes through become available for the body to
3 different phases—pharmaceutic absorb it.
(dissolution), pharmacokinetic, and
pharmacodynamics as drug actions
occur.

Pharmaceutic Phase
Also known as dissolution, it
is the first phase of drug action. A
drug in a solid form (tablet or
capsule) must disintegrate into
smaller particles to dissolve into a
liquid, a process known as
dissolution.
Tablets are not 100% drug,
fillers and inert substances,

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Figure 1.1 the two pharmaceutic


phases

Pharmacokinetic Phase

Is the process of drug


movement to achieve drug action.
The four processes are absorption,
distribution, metabolism
(biotransformation), and excretion
(or elimination.

Absorption

Is the movement of drug


particles from the GI tract to body
fluids by passive absorption, active
absorption, or pinocytosis. Passive
absorption occurs mostly by
diffusion (movement from higher Figure 1.2 The Major processes of
concentration to lower pharmacokinetic phase.
concentration) Active absorption
requires a carrier such as an enzyme Drugs given in IM are
or protein to move the drug against a absorbed faster in muscles that have
concentration gradient. (Energy is more blood vessels (e.g. the
required for active absorption), deltoids) than in those have fewer
while Pinocytosis is a process by blood vessels (e.g. the gluteal).
which cells carry a drug across their Subcutaneous tissues has fewer
membrane by engulfing the drug blood vessels, so absorption is
particles. slower in such tissues.

Distribution

Is the process by which the drug


Remember: Blood flow, pain, becomes available to body fluids
stress, hunger, fasting food, and and body tissues. Drug distribution
pH affect drug absorption. Poor is influenced by blood flow, the
circulation as a result of shock, drug’s affinity to the tissue, and the
vasoconstrictor, or disease protein-binding effect.
hampers absorption.
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
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Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

The time it takes for one half of


the drug concentration to be

eliminated. Metabolism and


DISTRIBUTION elimination affect the half-life of a
drug. (E.g. for liver and kidney
dysfunction, the half-life of the
drug is prolonged and less drug is
metabolized and eliminated.)
PROTEIN HALF-LIFE OF 650 mg OF
BINDING ASPIRIN
BODY
BLOOD
TISSUE
FLOW T½ TIME OF DOSAGE PERCENT
AFFINITY ELIMINA- REMAIN- AGE LEFT
TIION (H) ING (mg)

1 3 325 50
PHARMACOLOGIC
EFFECT 2 6 162 25

3 9 81 12.5

4 12 40 6.25
Figure 1.3 Drug Distribution
5 15 20 3.1
Metabolism, (or Biotransformation)
6 18 10 1.55
Drugs can be metabolized in both
the GI tract and liver; however, the A drug goes through several half-
liver is the primary site of lives before more than 90% of the
metabolism. Most drugs are drug is eliminated. If the client takes
inactivated by the liver enzymes and 650 mg of aspirin and the half-life is
are then converted or transformed by 3 hours, it takes 3 hours for the first
hepatic enzymes to inactive half-life to eliminate 325 mg, 6
metabolites or water-soluble hours for the second half-life to
substances for excretion. (Joyce eliminate an additional 162 mg, and
LeFever Kee, Evelyn R. Hayes, so on until the sixth half-life (or 18
Linda E. McCuistion, 2015) hours), when 10 mg is left in the
body.
What is the half-life (t ½) of a drug?
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

urine collection and a blood


sample.


Excretion, (or Elimination)

The main route of elimination is


through the kidneys (urine). Other  Normal creatinine clearance
routes include hepatic metabolism, is 85 to 135 ml/min.
bile feces, lungs, saliva, sweat and
breast milk. The kidneys free Pharmacodynamic Phase
unbound drugs, water-soluble
drugs, and drugs are unchanged. It is the study of drug
Protein bound cannot be filtered concentration and its effects on
through the kidneys. Once the dug the body. A drug effect can cause
is released from the protein it is a a primary or secondary effect or
free drug and is eventually excreted both. (E.g. Diphenhydramine
in the urine. The lungs eliminate {Benadryl}, the primary effect of
volatile drug substances and Benadryl is to treat symptoms of
products metabolized to carbon allergy and the secondary effect
dioxide and water. is CNS depression (Drowsiness)
which should not be given when
the most accurate the patient is more likely to drive
test to determine or operate a machinery.
renal function is
creatinine clearance Dose and Maximal Efficacy
(CLcr). Dose response is the
Creatinine is the byproduct of relationship between the minimal
muscle that is excreted by the versus the maximal amount of
kidneys. drug dose needed to produce the
desired drug response. Some
 Creatinine varies with age patients respond to a lower drug
and gender dose, whereas others need a high
drug dose to elicit the desired
 Lower values are expected response.
in elderly and female clients.
Onset, Peak, and Duration of
 Creatinine clearance test Action
consists of a 12- or 24—hour

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Onset of Action is the time it Nonspecific drugs these drugs


takes to reach the minimum affect various sites and have a
effective concentration (MEC) property of nonspecificity.
after a drug is administered.
Example: Bethanechol (Urecholine)
may be prescribed for post-operative

Peak Action occurs when the urinary retention to increase bladder


drug reaches its highest blood or contraction.
plasma concentration.
Nonselective Drugs these are drugs
Duration of Action is the length that affect various receptors or have
of time the drug has a properties of nonselectivity.
pharmacologic effect.
Example: Chlorpromazine
Time response evaluates three (Thorazine) acts on norepinephrine,
parameters of drug action: the dopamine, acetylcholine, and
onset of drug action, peak action, histamine receptors, and histamine
and duration of action receptors, and a variety of responses
result from action at these receptor
Agonists and Antagonists sites. Epinephrine acts on the
alpha1, beta1, and beta2 receptors.
Agonist drugs that produce a
response Drugs that produce a
response but do not act
Example: Isoproterenol (Isuprel)
on a receptor may act
stimulates beta 1 receptor, and so it
by stimulating or
is an agonist
inhibiting enzyme
Antagonists drugs that block a activity or hormone production.
response

Example: Cimetidine (Tagamet), an


Categories of Drug Action
antagonist which blocks histamine
receptor 2, thus preventing gastric The four categories of drug action:
acid secretion.
1. Stimulation or depression
Nonspecific and Nonselective Drug
Effects  In drug action that
depresses, cell activity and
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

function of a specific specific time. It indicate the rate of


organ. absorption. If the drug is given Per
Orem (PO), the peak time might be
1 to 3 hours after drug

Administration. If the drug is given


IV (Intravenous) the peak time
2. Replacement
might occur in 10 minutes.
 Drugs such as insulin
Trough drug level is the lowest
replace essential body
concentration of a drug, and it
compounds.
measure the rate at which the drug is
3. Inhibition or killing of eliminated. Trough levels are drawn
organisms immediately before the next dose of
drug is given, regardless of route of
 Drugs that inhibit or kill administration.
organisms interfere with
bacterial cell growth (E.g.
Penicillin exerts its
bactericidal effects by
blocking the synthesis of
the bacterial cell wall) NEED TO KNOW:

4. Irritation

 Example: Laxatives irritate ANTICONVOLSANTS: THERAPEUTIC


the inner wall of the colon, RANGES AND TOXIC LEVEL
thus increasing peristalsis
and defecation
DRUG THERAP TOXIC
(Joyce LeFever Kee, Evelyn R. Hayes, EUTIC LEVEL
Linda E. McCuistion, 2015)
RANGE (mcg/ml)
Peak and trough drug Levels (mcg/ml)

The safety of drugs is major Carbamazepine 6-12 >12-15


concern.

Peak drug level is the highest Ethosuximide 40-80 >80-100


plasma concentration of drug at a
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
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Tel. Nos. +63-032 – 3161987 or 3165128
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interchangeably in the literature and


Phenytoin 10-20 >30 in speaking, but they are different.

Adverse reactions are more severe


Primidone 5-10 >12-15 than side effects. They are a range of
untoward effects (unintended and
Valproic acid 50-100 >100 occurring at normal doses) of drugs
that cause mild to severe side
effects, including anaphylaxis
(cardiovascular collapse). Adverse
reactions are always undesirable.

Loading Dose

It is a large initial dose when Adverse effects must always be


immediate drug response is desired. reported and documented because
A loading dose of drug is given to they represent variances from
achieve a rapid minimum effective planned therapy.
concentration in the plasma.
Toxic effects, or toxicity, of a
Example: Digoxin, a digitalis drug can be identified by monitoring
preparation requires a loading dose the plasma (serum) therapeutic range
when first prescribed. (Joyce of the drug. However, for drugs that
LeFever Kee, Evelyn R. Hayes, have a wide therapeutic index, the
Linda E. McCuistion, 2015) therapeutic ranges are seldom given.
For drugs with a narrow therapeutic
Side Effects, Adverse Reactions, and index, such as aminoglycoside
Toxic Effects antibiotics and anticonvulsants, the
therapeutic ranges are closely
Side effects are physiologic effects monitored. When the drug level
not related to desired drug effects. exceeds the therapeutic range, toxic
effects are likely to occur from
In some health problems, side
overdosing or drug accumulation.
effects may be desirable (E.g. the
use of Benadryl at bedtime when its Pharmacogenetics
side effect of drowsiness is
beneficial). At times, however, side Is the scientific discipline studying
effects are called adverse reactions. how the effect of a drug action
The terms side effects and adverse varies from a predicted drug
reactions are sometimes used

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

response because of genetic factors


or hereditary influence.

Placebo effect

Is a psychological benefit from a


compound that may not have the
chemical structure of a drug effect.
A placebo is effective in
approximately one third of persons
who take a placebo compound.
(Joyce LeFever Kee, Evelyn R. Hayes, Linda E.
McCuistion, 2015)

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Figure 1.4 the Three Phases of Drug Action

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Figure 1.5 Determinants that affect drug therapy

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Evaluation

 Evaluate the determinants


that affect drug therapy
according to figure 1.5.
 Assess for signs and
symptoms of drug toxicity
when giving two drugs that
are highly protein-bound.
The drugs for protein-
binding sires, and
displacement of drugs
occurs. More free drug is
in circulation because there
are not enough protein-
binding sites. Too much of
a free drug can result in
drug toxicity.
 (Joyce LeFever Kee, Evelyn R.
Hayes, Linda E. McCuistion, 2015)

**End of Part 1**

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Experience indicates that five


additional rights are essential to
professional nursing practice:

PART II: 6. The right assessment


7. The right documentation
PRINCIPLES OF DRUG 8. The client’s right to
ADMINISTRATION education
9. The right evaluation
Administration of medications is a 10.The client’s right to refuse
basic activity in nursing practice.
Nurses are accountable for the safe
administration of medications.
Nurses must know all the
components of a drug order and
question those orders that are not
complete, unclear, give a dosage
outside a recommended range, or are 1. The right client
contraindicated by client allergy or The right client determination
laboratory test results. is important. The Joint
Commission requires two forms
The “five-plus-five Rights” of of identification prior to the
drug administration administration of the medication.

To provide safe drug Nursing implications include the


administration, the nurse should following:
practice the “rights” of drug
administration.  Verify client by checking
the identification bracelet
The traditional five rights are:  Distinguish two clients
with the same last name.
1. The right client  Some institutions have ID
2. The right drug bracelets coded for allergy
3. The right dose status, or other risks.
4. The right time
5. The right route
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Note: A telephone order or verbal


order for medications must be
cosigned by the prescribing health
care provider within 24 hours.

The components of a drug order are


as follows:
 Date and time the order is
written
 Drug name
 Drug dosage
 Route of administration
 Frequency and duration of
administration (E.g. x7 day, x
3 doses)
Example of institutional bracelets  Any special instructions for
withholding or adjusting
 When clients doesn’t wear a dosage based on nursing
bracelet (school, occupational assessment, drug
health department, etc.) the effectiveness, or laboratory
nurse also has the results
responsibility of accurately  Physicians signature
identifying the individual
when administering a
medication.

2. The right drug

The right drug means that the


client receives the drug that was
prescribed.

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
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C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
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Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Example of a prescription pad in THE FOUR MAIN


PH CATERGORIES OF DRUG
ORDERS:

The following is an example of a 1. Standing order


drug order and its interpretation: 2. One-time (Single)
3. PRN (As needed)
30/08/20 8:21A Lasix 40 4. STAT (Once)
mg, PO, daily (signature)
Interpretation: Give 40 mg of 3. The right dose
Lasix by mouth daily
The right dose is the dose
To avoid drug error the drug label prescribed for a particular client.
should be read three times: Nurses must calculate each drug
1. At the time of contact with the dose accurately, considering the
drug bottle or container variables: drug availability and he
2. Before pouring the drug prescribed drug dose.
3. After pouring the drug The client weight is an important
consideration in multiple contexts
such as pediatrics and many
medical, surgical, and critical
care situations.

Stock drug method and unit dose


method are the two most
frequently used methods of drug
distribution.

Stock drug method, the


drugs are dispensed to all
clients from the same
containers.
Unit dose method,
drugs are individually
wrapped and labeled for
single doses.
CATEGORIES OF DRUG ORDER
Category Description
PHARMACOLOGY CCMC-CN LEVEL II
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Standing May be an ongoing order


Orders or may be given for
specific number or doses
or days
(Digoxin 0.25 mg PO
Daily)
May have special
instructions to base
administration on
laboratory values
(Colace 100 mg PO Daily
PRN))
May include PRN Orders
One-time Given once and usually at
or single a specific time
orders (Versed 2 mg IM at 7 Am
on 31/08/2020s
PRN Given at a client’s request
orders (Tylenol 650 mg q3 to 4H
PRN for headache)
Stat Given once, immediately
orders (Morphine 2mg IV Stat)

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
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Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

potassium and aspirin with


food.

 Drug administration
schedule may
sometimes be adjusted
to fit the schedule of the
client’s lifestyle,
activities, tolerances, or
preferences.
 It is the nurse’s
responsibility to check
whether the client is
scheduled for any
diagnostic procedures
An Example of Computerized such as endoscopy or
medication management system fasting blood test that would
contraindicate the
4. The right time administration of medications.
Is the time at which the prescribed Check the institutions policy.
dose should be administered.  Check the expiration date.
Nursing implications are as follows: Discard the medication or
 Administer drugs at the return it to the pharmacy
specified times. Drugs may be (depending on hospital policy)
given 30 minutes before or if the date has passed.
after the time prescribed if the  Antibiotics should be
administration interval is administered at even intervals
>2hours. Refer to agency (e.g. q8h rather than TID)
policy. throughout a 2-hour period so
 Administer drugs that are therapeutic blood levels are
affected by food maintained.
(Tetracylcine) before meals.
 Administers drugs that can 5. The right route
irritate the stomach (gastric It is necessary for adequate or
mucosa) for example appropriate absorption.

More common routes of absorption:


PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

6. The right assessment


 Oral It requires appropriate data be
 Buccal collected before administration of
 Sublingual the drug.
 Inhalation
 Suppository 7. The right documentation
 Parenteral It requires the nurse to
immediately record appropriate
Nursing implication include the
following: Information about the drug
administered. Which includes:
 Assess the client’s ability to
1. The name of the drug
swallow before the
2. The dose
administration of oral
3. The route (injection sire if
medications.
applicable)
 Do not crush or mix
4. The time and date
medications in other
5. The nurses initials or
substances before consultation
signature
with a pharmacist. Do not mix
Documentation of the client’s
medications with sweet
response to the medication is
substances to the “tricks” with
required with a variety of
children into taking
medications:
medications. Do not mix
1. Narcotics (how effective was
medications in an infant’s
the pain relief)
formula feeding
2. Nonnarcotic analgesics
 Use aseptic technique when 3. Sedatives
administering drugs. Sterile 4. Antiemetic
technique is required with the 5. Unexpected reactions to the
parenteral routes. medication such as GI
 Administer the drugs at the irritation or signs of
appropriate sites. sensitivity.
 Stay with the client until oral
drugs have been swallowed. 8. The right education
 If it is necessary to combine This require that clients receive
medication with another accurate and thorough information
substance, explain this to the about the medication and how it
client. relates to their particular situation.

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

This right is a principle of


informed consent, an informed
client/family is critical to preventing
medication errors.

9. The right evaluation


This requires that the effectiveness
of the medication be determined but

the client’s response to the


medication. FORMS AND ROUTES FOR
DRUG ADMINISTRATION
10. The right to refuse
The client has the right to refuse
to take a medication. It is the nurse’s
responsibility to determine, when
possible, the reason for the refusal
and to take reasonable measures to
facilitate the client’s taking the
medication.
Explain to the client the risk for
refusing to take the medication, and
reinforce the reason for the
medication.
Classwork 1: In
2005, The Joint
Commission
(formerly known
as JCAHO) issued
a new list of
abbreviations that
should not be used
but written out to avoid
misinterpretation. Compile the
abbreviations commonly used in an
institution/hospital.

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

Cholinergic receptors are located in the bladder, heart, blood vessels, stomach,
bronchi, and eyes

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

PART III: MEDICATION CALCULATIONS AND EXERCISES

INSTRUCTION: A SEPARATE POWER POINT


PRESENTATION IS PROVIDED IN YOUR
STREAM BOARD/TAB.

ADDITIONAL
POWERPOINT
PRESENTATION IS
ATTACHED TO YOUR
STREAM BOARD FOR:

MEDICATION
PREPARATIONS
AND SUPPLIES

CLICK OR COPY THE LINK FOR THE FINAL VIDEO

**END OF PHARMACOLOGY INTRODUCTION**


PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

ROUTES OF
SUPPLLEMENTAL VIDEOS ADMINISTRATION

PHARMACOKINETICS-INTRO
PHARMACOLOGY
(PHARMACOKINETICS)
MADES EASY

PHARMACOKINETICS-
ABSROPTION

PHARMACODYNAMICS
(MADE EASY)
PHARMACOLOGY CCMC-CN LEVEL II
R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

PHARMACOKINETICS-
METABOLISM

SUPPLEMENTAL VIDEOS

PHARMACOKINETICS-
DISTRIBUTION

PHARMACOKINETICS-
DISTRIBUTION

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

LEARNING ACTIVITIES:

1. CLASSWORK 1: In 2005, The Joint


Commission (formerly known as JCAHO)
issued a new list of abbreviations that should not be used but written out to
avoid misinterpretation. Compile the abbreviations commonly used in an
institution/hospital with their corresponding meaning.

Use the general format for the classwork

2. CLASSWORK 2: More Practice Understanding Medication Orders

A file will be uploaded in the classwork tab


Use the general format for your answers

3. CLASSWORK 3: Drug Calculations

Worksheets will be uploaded in your classwork tab


Use the general format as your answer sheet

PHARMACOLOGY CCMC-CN LEVEL II


R epubl i c of the Phi l i ppi nes
CE B U TEC HNOLOG IC AL U NIVE R SITY
Mai n Campu s
i n consort i um wi t h
C EB U C ITY ME D IC AL CE NTER - C OLLEG E OF NU R SING
N. Bacalso Avenue corner Panganiban Street, Cebu City, Cebu, 6000 Philippines
Tel. Nos. +63-032 – 3161987 or 3165128
Email address: ctuccmc_cn@ymail.com

REFERENCES AND
SUPPLEMENTARY
REFERENCES:

TEXTBOOK:

(Joyce LeFever Kee, Evelyn R. Hayes, Linda E. McCuistion, 2015)

INTERNET SOURCE:

https://drive.google.com/file/d/1sYYJ8mAbUtrCHdw2iF7gc3D2FpE9VXe6/
view?fbclid=IwAR1laLEA8McnkQAEpvueugfX0qMIDMOGp-
ht92HURbhdHMgryd22IlEXuzk

https://www.ted.com/talks/
celine_valery_how_does_your_body_process_medicine#t-12242

**END OF MODULE 1 INTRODUCTION TO PHARMACOLOGY**

PHARMACOLOGY CCMC-CN LEVEL II

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