Bachelor of Science in Nursing 2YA

NCMA216: BSN 2ND YEAR 1ST SEMESTER FINAL 2021

Coverage for Final: o The amount of filtrate being produce per minute is called
• Genito-urinary Agents glomerular filtration rate (GFR) 1-2ml per kg per hour.
• Chemotherapeutic drugs o There is reabsorption of solutes in the proximal convoluted
• Antimicrobial Drugs tubule. Then in the distal tubule, there is reabsorption secretion.
Process of urine formation
• Filipino Cultures, Values, and Practices in Relation to
• Filtration – about 20% of the total blood pumped by the heart
Drug Administration
each minute will enter the kidneys to undergo filtration
• Nursing Core Values as Applied in Pharmacology • Tubular Reabsorption – process that moves solutes and
GENITO-URINARY SYSTEM AGENTS water out of the filtrate and back into the blood stream.
Discussed by Prof. Marivic Ilarde • Tubular Secretion – Potassium, phosphate, hydrogen, and
Organs of the urinary system ammonium ions too large to pass through Bowman’s capsule,
• Kidney enter the urine by crossing from the blood to the filtrate.
• Ureter
• Bladder
• Urethra
o Renal artery carries oxygenated blood to the kidneys.
o Renal veins carry deoxygenated blood away from the kidneys.
o Kidney regulates water content and filters blood.
o Ureter carries urine from the kidney to the bladder.
o Urethra – tube carrying urine out of the body.
o Bladder stores urine.
Anatomy and Physiology of GUT

Functions of Kidneys
Endocrine function:
• Renin – being produce when the BP is low.
• Erythropoietin – responsible for RBC production
• Calcitriol – Vit. B, calcium homeostasis
• Kallikreins – liberating kinins from our blood. Vasodilation
Control of solutes:
• Sodium
o Our blood enters the kidney via renal artery. The renal artery • Potassium
divides into the arteries and arterioles. So, the urine gets into • Calcium
our kidneys through the afferent arterioles. • Chloride
o Arterioles get in contact with the functional unit of kidney
• Phosphate
which are the nephron. Nephrons consist of glomerulus,
Blood pressure control:
bowman's capsule, and the renal tubes.
• Adjust the volume of blood,
o Nephrons is functional unit of arteries. This is where filtration
and urine formation take place. • Excrete H2o
o Filtered blood exits the kidney via renal vein. As the blood Metabolic excretion:
enters the kidney, it will be filtered to the glomerular • Ammonia, urea, creatinine, uric acid amino acids
capillaries. Acid/ base balance:
o After the blood is being filtered, it will be collected into the • Conserve CO3
collecting ducts, and it goes out from our body through urethra. • Excrete H ions
o Each kidney contains million of nephrons. Each nephron can Drug metabolism and excretion:
form urine independently. • Renal excretion is the major route of elimination from the
o Blood enters the bowman’s capsule via the afferent arterioles. body for most drugs.
(Afferent papasok bigger; efferent palabas)
o Efferent – there is increase hydrostatic pressure. This would
cause the solutes to exit the capillaries.

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Terms commonly used to describe urinary dysfunction

• Anuria – A condition in which the body stops making urine.
• Dysuria – Any discomfort associated with urination (related
to UTI)
• Enuresis – Uncontrolled voiding.
• Hematuria – Blood in the urine.
• Nephritis – Inflammation of the kidneys.
• Nocturia – Frequent urination at night.
• Diurnal enuresis: unintended leakage of urine during waking
hours
• Polyuria – Overproduction of urine by the kidneys, resulting
in excessive urination.
• Olyguria – Decreased urine output, <400 ml/day.
• Albuminuria – albumin in the urine.
Renal and Urinary Disorder

Wilm’s tumor

Glomerular disease – it refers to a

set of medical conditions which
affect the glomeruli directly.
Glomeruli are small units present in - Commonly seen in kids from ages 3 to 4 and tends to occur
the kidney the function of which is less frequently after the age of 5. The most common kidney
to clean the blood from any toxins cancer in children.
or other impurities. - Signs and symptoms:
• Swelling in the abdomen.
• Pain in the abdomen.
• Mass in the abdomen which can be felt.
• Fever.
• Hematuria or blood in the urine.
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Renal failure Drugs and used on urinary system

- Decrease in the kidney’s ability to maintain electrolyte and Diuretics
fluid balance and to excrete waste products. - “Water pills” – this would increase the urine output/ volume.
- Diagnosis: - Aquaretic: excretion of water except electrolytes.
• Urinalysis - Treatment of conditions like:
• Computed tomography, sonography, MRI more definitive • Congestive heart failure
• Renal biopsy • Nephrotic syndrome
• GFR - best marker, used to predict the onset and • Hypertension
progression of kidney failure provides an indication of the • Cirrhosis of the liver: Azotemia is an elevation of blood
kidneys to excrete drugs from the body. urea nitrogen (BUN) and serum creatinine levels.
• Decrease GFR, indicates decline in the number of Mechanism of actions:
functioning nephrons Less than 50% of damage nephron -
no symptoms
• More than 50% of damage nephron (less than 30ml) –
GFR fails to less than half its normal value.

1) Thiazide diuretics
- Inhibit reabsorption of sodium (Na+) and chloride (Cl−)
ions from the distal convoluted tubules in the kidneys by
blocking the thiazide sensitive Na+-Cl− symporter.
- It acts directly in the arterioles to cause vasodilation
which can lower the BP. (Used for the hypertension
patient)
- Promotes sodium, chloride and water excretions which
result to the decrease in vascular fluid volume and
concomitant decrease in cardiac output and BP.
- The onset of action: 2 hours
- Peak concentration time: 4
- Duration of action:
• Short acting: < 12 hours,
• Intermediate: 12-24 hours,
• Long acting: > 24 hours
2) Loop diuretics/ high ceiling diuretics
- Act on the thick ascending loop of Henle to inhibit
chloride transport of sodium and potassium into the
circulation and inhibit passive reabsorption of sodium.
- Potassium wasting diuretics
- Onset of Action: 30-60 minutes
- IV onset: 5 minutes
- Duration of Action: shorter than Thiazides

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Site and Mechanisms of Actions of Diuretics

Diuretics Site of action Mechanism
• Proximal tubules Inhibition of water
- Side effects of loop diuretics: Osmotic
• Loop or Henle and Na+
• Hypokalemia – that might be associated with muscle Diuretic
• Collecting duct reabsorption
weakness and cardiac dysrhythmias, increased Na+ to Carbonic Inhibition of
collecting tubules increases its exchange with K+ Anhydrase Proximal tubules bicarbonate
•  Na+ loass and ECFrenin – aldosterone release. Inhibitor (CA-I) reabsorption
• Metabolic alkalosis – related to hypokalemia. Loop of Henle (Thick Inhibition of Na+,
• Occasional glucose intolerance in pred-diabetic Loop Diuretic
ascending limb) K+, Cl cotransport
patients. Inhibition of Na+,
Thiazide Early distal tubule
• Hyperuricemia (gout attacks) is a frequent because of Cl cotransport
increased PCT solute re-absorption. Inhibition of Na+
3) Potassium-sparing diuretics K+ sparing Late distal tubule
reabsorption and
- Antagonize the actions of aldosterone at distal segment of diuretics Collecting duct
K+ secretion
the distal tubule.
- Mild diuretics Indication and uses of Diuretics:
- If Serum Potassium level is greater than 5.0 mEq/L,
• Loop Diuretics: Edema, Acute pulmonary edema (Acute LVF,
discontinue the drug, restrict foods high in potassium
M.I), Cerebral edema, Hypertension, Hypercalcemia & Renal
- Nareretain un potassium, hindi nailalabas
calcium stone.
- Instruct the client not to eat rich in potassium
• Thiazide: Mild to moderate edema (Cardiac failure, Nephrotic
4) Carbonic anhydrase inhibitors
syndrome), HTN, Diabetes insipidus, Hypercalciuria/ Calcium
- Blocks the action of enzyme carbonic anhydrase needed
stone, Premenstrual tenses.
to maintain the body’s acid-base balance.
- Seldom used, weakest. • Osmotic: Acute renal failure during prolonged surgery or
5) Osmotic diuretics trauma to prevent or treat increase ICP, Glaucoma.
- Increases the osmolality concentration and sodium • Carbonic Anhydrase inhibitor: Glaucoma, Epilepsy, Acute
reabsorption in the proximal tubule and loop of Henle. motion sickness, periodic paralysis.
- Create an osmotic force that pulls water into the nephron • Potassium sparing: Hyperaldosteronism, HTN, CHF, edema,
and increases the excretion of nearly all electrolytes. combine with furosemide, thiazide to reduce potassium loss
- Side effects: produce by these agents.
• Convulsions Contraindication and Precautions of Diuretics:
• Thrombophlebitis • Osmotic: Intracranial bleeding, CHF, Urinary tract obstruction,
• Pulmonary congestion Pulmonary congestion, edema,
• Headache, chest pains, tachycardia, blurred vision, • Loop: Hyponatremia, Severe sodium and water depletion,
chills and fever. Hypokalaemia, Renal failure, Addison's disease.
- Used to prevent: • Potassium: Anuria, Hyperkalaemia, Acute or progressive
• Kidney failure renal insufficiency.
• Decrease ICP (cerebral edema) • Thiazide: severe renal impairment, severe hepatic impairment,
• Decrease IOP (glaucoma) hypersensitivity, pregnancy & lactation.
• Mannitol: potent osmotic diuretic • Carbonic Anhydrase: Pregnancy & lactation, hepatic
• Diuresis occurs within 1-3 hours after IV insufficiency, severe pulmonary congestion.
administration Nursing responsibilities
• Monitor urine output, blood pressure, hourly check for
electrolyte imbalance.
• Obtain vital signs.

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• Monitor laboratory values supply Potassium, sodium (diuretics Anti-diuretic hormone (ADH) and its analogues:
can cause electrolyte imbalance) • Vasopressin
• Observe for changes in level of consciousness, dizziness, • Desmopressin
fatigue, and postural hypotension because reduction in blood • Lypressin
volume due to diuretic therapy may produce changes in level • Terlipressin
of consciousness or syncope.
• Observe for sign of hypersensitivity reaction.
• Monitor hearing and vision (Loop diuretic are ototoxic)
• Instruct the patient to:
1) Immediately report any severe shortness of breath,
profound fatigue, edema in extremities, potential sign of
heart failure, or pulmonary edema.
2) Avoid excessive heat which contributes to fluid loss
through perspiration.
3) Consume adequate amount of plain water. (wag na
magbigay ng electrolyte like sports drinks)
4) Stop medication if severe hypotension exists.
5) Immediately report any change in consciousness,
especially felling faint.
6) Change position slowly. (to prevent the orthostatic
hypotension)
7) Receiving loop or thiazide diuretic to eat food high in
potassium.
8) Receiving potassium - sparing diuretic to avoid foods high
in potassium.
9) To consult which health care provider before using
vitamin/minerals supplements or electrolyte fortified
sports drinks.
10) To report any changes in hearing or vision.
Side effects of Diuretics

- Contraindication & Precautions: Hypersensitivity, impaired

Antidiuretics
- The agents that reduce urine volume, opposing diuresis.
- Mechanism of actions: reduce urine flow by acting
reabsorption of water by kidney tutbules.
- Indication and uses:
• Cranial diabetes insipidus
• Primary nocturnal enuresis (bed wetting)
• Nocturia associated with multiple selerosis. (there is
damage nerve fibers in the CNS, nagkakaroon sila ng
muscle weakness)
renal function, with ongoing diuretic treatment, Caution in CV
disease, edema, hypertension, cystic fibrosis, fluid and
electrolyte imbalance, pregnancy and lactation.
- Adverse effect: Nasal irritation, Rhinitis, Abdominal cramps,
Urge defecate, fluid retention, congestion, Ulceration, nausea,
pallor, Backache in females (due to uterine contraction)
Nursing responsibilities
• Monitor electrolyte imbalance.
• Monitor vital signs and BP regularly.
• Observe for sign of hypersensitivity reactions.
• Monitor laboratory values.
• Stop medication if hypertension exists.
Urinary Antiseptics
- Are oral agents that exert antibacterial activity in the urine but
have little or no systemic antibacterial effects
- Their usefulness is limited to lower urinary tract infections.
- Indications: Prolonged suppression of bacteriuria in chronic or
recurrent UTI’s in which eradication of infection was not
complete after short term systemic therapy.
Urinary Antiseptic Drugs
1) Nitrofurantoin – Furadantin
- Primarily bacteriostatic
- Treatment of UTI limited to E. coli

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- Damage bacterial DNA
- Treatment of uncomplicated lower UTI
- Long term prophylaxis following catheterization,
instrumentation
2) Methenamine
- Prodrug
- Decomposes slowly in acidic urine (<5.5) to release
formaldehyde which inhibits all bacteria.
- For chronic and resistant UTI
- Kapag nagkaroon ng resistant sa microorganisms
3) Nalidixic acid
- Inhibit the replication of bacteria by interfering with the
action of DNA during growth and development.
- 2nd line drug for UTI
- Recurrent cases
4) Phenazopyridine – Pyridium
- Urinary analgesic
- No antibacterial property
- It has local anesthetic effect on urinary tract mucosa.
(mahapdi un pag ihi)
- For burning sensation, dysuria
Nursing Management:
• Assess for vertigo, headache, and drowsiness.
• In case of long-term therapy – check CBC.
• Take medicine with food or milk.
• Advise patient that drug may cause urine color to become red
or orange.
• Increase fluid intake to avoid crystallization in the kidney.
(Crystalluria)
Drugs for Prostate BPH (Benign Prostatic Hypertrophy)
Alpha blockers – Tamsulosin HCL (Tamsolin)
- Indication: Treatment of benign prostatic hyperplasia to
relieve symptoms of urinary obstruction
- Action: relaxes the bladder muscles, these medications relax
the muscle of the prostate and bladder neck, which allows
urine to flow more easily.
- There are at least five medications in this category:
• Terazosin (Hytrin)
• Doxazosin (Cardura)
• Tamsulosin (Flomax)
• Alfuzosin (Uroxatral)
• Silodosin (Rapaflo)
- Nursing Consideration:
• Take 30 minutes following meals, do not open, chew, or
crush
• Take blood pressure, contraindicated to patient with
history of orthostatic hypotension
- Adverse reaction: headache, chest pain, dizziness, insomnia,
decreased libido, erectile disorder.
5a-Reductase inhibitor
- Also known as dihydrotestosterone blockers
- A type of drug that has antiandrogenic effects
- Used primarily in the treatment of enlarged prostate (benign
prostatic hyperplasia) and male pattern hair loss.
- Drugs:
• Finasteride (marketed as Proscar) [finasteride 5 mg]
• Propecia [finasteride 1 mg]
• Dutasteride (marketed as Avodart)
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Finasteride (Proscar)
- Indication: used primarily to patient with benign prostatic
hyperplasia in men with enlarged prostate.
- Action:
• Blocks the action of an enzyme called 5a-reductase –
changes testosterone to another hormone that cause the
prostate to grow or loss in male
• It decreases prostate size and the effect only last if the
medicine is taken.
- Administration: can be given with or without food
- Contraindication: pregnancy, children
- Side effects:
• Impotence
• Abnormal ejaculation
• Dizziness
• Swelling in hands or feet
• Weakness
• Headache
• Skin rash
- Nursing Consideration:
• Can be given with or without food
• Advise patient to notify health care professional promptly
if changes in breasts (lumps, pain, and nipple discharge)
occur.
• Inform patient that there is an increased risk of high-grade
prostate cancer in men taking this drug.
• Caution patient that finasteride poses a potential risk to a
male fetus.
Antimuscarinic drugs
- Reduce the symptoms of incontinence by reducing bladder
muscle spasms.
Trospium chloride
- Treat an overactive bladder.
- By relaxing the muscles in the bladder, trospium improves the
ability to control your urination.
- It helps to reduce leaking of urine, feelings of needing to
urinate right away, and frequent trips to the bathroom.
- Administration:
• Take tablet 1 hour before meals or on an empty stomach
at least 1 hour before meal
• Alcohol should not be consumed within 2 hours of
administration
- Nursing Consideration:
• Take tablet 1 hour before meals or on an empty stomach
at least 1 hour before meal
• Alcohol should not be consumed within 2 hours of
administration
• Obtain a complete health history including cardiovascular
disease, diabetes, and pregnancy.
• Evaluate laboratory findings such as electrolytes, glucose,
complete blood count, renal function studies
• Obtain baseline weight, vital signs especially blood
pressure and pulse.
• Assess for adverse effects such as hypotension,
palpitations, dizziness, abdominal cramps, diarrhea,
headache, nausea, and vomiting.
• Teach the patient to rise from lying or sitting, to standing
slowly to avoid dizziness or falls.
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021

• Teach the patient, family, or caregiver how to monitor

pulse and BP, ensure the proper use and functioning of
any home equipment obtained.
• Instruct the patient to stop taking the medication if BP is
90/60 mmHg or below the parameters set by the health
care provider. And promptly notify the provider.
• Instruct patient who is taking potassium-wasting diuretics
(Thiazide), loop-diuretics (Furosemide) to consume foods
high in potassium: fresh fruits such as strawberries and
bananas, dried fruits apricots and prunes, vegetables such
as tomatoes, dried beans, orange juice and other fruit
juices.

CHEMOTHERAPEUTIC DRUGS
Discussed by Prof. Carmencita Pacis
Chemotherapy
- Treatment of cancer by means of chemicals that kill cancer
cells.
- These “anticancer” drugs destroy cancer cells by stopping
their growth and reproduction.
- Types of chemotherapy:
• Cytotoxic – kill
• Cytostatic – prevent the growth and reproduction
- The normal healthy cells have an organized cell structure and
repair mechanisms in place. (Not only the cancer cells will be
affected but also the healthy cells)
- This results in them being able to reproduce new normal tissue
after chemotherapy.
o Antimetabolites – will be to decrease the dihydrofolate
Cell cycle reductase
o G0 “resting phase” – nagpapahinga muna un cancer cells after o Folate responsible for metabolism of the cell, pag create ng
manganak nucleic acid. (More folate, you will produce more nucleic acid
o G1 – growth ng cancer cells, magpapalakas sya at that will synthesize more DNA, and more DNA will result to
magpapalaki, so that I could enter the S phase “Synthesis of more protein, and more protein will result to more replication
DNA” of cells)
o S – DNA replication (The more DNA that we have, more code o Alkylating agents – it will alter the structure and function of
will be produce and this code will be the information needed DNA by cross linking or fragmenting DNA. (binebreak nila
to start the protein synthesis) ung strand) so, if the DNA strands break, it will not produce a
o G2 – kailangan ng protein kase nagpapalaki ng cancer cells. code.
For preparation of mitosis. o Antibiotics – L-asparaginase – to shrink the tumor
o Vinca alkaloids – prevent polymerization. (small molecule, it
will create larger chain molecules)
o Etoposide – topoisomerase II – magkaroon ng chain, double
strand

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Classification of Chemotherapeutic

- Not only the cancer cell but the healthy cells also will affect.
- Constitute the largest class of anticancer drugs
- Act directly on cancer cells to cause their death
- Cytotoxic agents have both anti-cancer activity and the
potential to damage normal tissue.
Mechanism of Cytotoxic Action
- Disrupts processes related to synthesis of DNA or its
precursors (precursors – folate, responsible also for DNA
synthesis)
- Cell-Cycle Phase-Specific Drugs:
• Toxic only to cells that are passing through a particular
phase of the cell cycle
• Cells in “resting” phase (G0) will not be harmed
• Known as “schedule-dependent drugs”
- Cell cycle specific drugs
1) Antimetabolites – Methotrexate, 5 Flourouracil
2) Antibiotics – Bleomycin
3) Vinca alkaloids – Vinblastine, Vincristine

o Cell cycle phase specific – the medication will work only on a

specific cell phase. (sa G1 phase lng sya, or S phase etc)
o Cell cycle phase nonspecific – they could work anywhere on
the cell cycle phase.
Cytotoxic Agents
- Drugs that kill cells directly, work by interrupting cells at
places in the growth cycle.
- Drugs that result in cell kill and eventual tumour shrinkage
- Cytotoxic T cells – are part of the immune system, which
searches for, finds, and destroys cells infected by viruses as
well as cancer cells.
Methotrexate
- Generic Name: methotrexate
- Drug Class: Immunosuppressants; Antineoplastics,
Antimetabolite, Immunomodulators.
- MOA - inhibition of enzymes responsible for nucleotide
synthesis including dihydrofolate reductase, thymidylate
synthase, aminoimidazole caboxamide ribonucleotide
transformylase and amido phosphoribosyl transferase. (These
are all precursors of DNA synthesis)

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Bleomycin Alkylating agents

- Bleomycin is an antibiotic which has been shown to have - Keep the cell from reproducing (making copies of itself) by
antitumor activity. Bleomycin selectively inhibits the synthesis damaging its DNA.
of deoxyribonucleic acid (DNA). - These drugs work in all phases of the cell cycle (non-specific)
- Decrease the size of tumor. - Examples of alkylating agents include: Altretamine,
- Has major effects in G2 and M phases Bendamustine, Busulfan, Carboplatin, Carmustine,
Chlorambucil
Vincristine Vinblastine Paclitaxel
Indicated for:
Indicated for:
ovarian, non-small
Hodgkin’s and non
cell
hodgkin’s Indicated for:
lung cancer,
lymphomas, acute Kaposi’s sarcoma
AIDS- related
lymphocytic Hodgkin’s and non
Kaposi’s
leukemia, Wilm’s hodgkin’s
sarcoma, breast,
tumor, lymphomas,
head & neck
rhabdomyosarcoma, carcinoma of breast
cancer,
Kaposi’s sarcoma, and testes
adenocarcinoma
breast cancer,
of the upper GI
bladder cancer
tract, leukemias
Administered IV
Administered IV Administered IV either 3 hour or 24
hour infusion Carboplatin
Decreased reflexes, Hypotension, - Drug class - Antineoplastics, Ankylating; Antineoplastics,
weakness, urticaria, Platinum Analog.
Less neurotoxicity,
sensory loss, bradycardia, - MOA - undergoes activation inside cells and forms reactive
n&v, alopecia,
constipation, heart block, platinum complexes that cause the intra- and inter-strand
stomatitis
urinary myocardial cross-linkage of DNA molecules within the cell. This modifies
hesitancy infarction the DNA structure and inhibits DNA synthesis. This may
affect a cell in all the phases of its cycle.
- Act during the M phase to prevent cell division Mitotic inhibitor
- Two groups: - Also called plant alkaloids
1) Vinca alkaloids – derived from Vinca rosea (periwinkle - Work by stopping cells from dividing to form new cells, but
plant) can damage cells in all phases by keeping enzymes from
2) Taxanes – acts during late G2 and M phase making proteins needed for cell reproduction.
- They act during the M phase to prevent cell division.
Vincristine
- The mechanism of action of vincristine sulfate has been
related to the inhibition of microtubule formation in mitotic
spindle, resulting in an arrest of dividing cells at the metaphase
stage
Antitumor Antibiotics
- Antitumor antibiotics treat cancer by affecting the genetic
material within cancerous cells.
- This prevents cancer cells from growing and spreading.
- Antracyclines – Doxorubicin, Epirubicin
Doxorubicin
- It slows or stops the growth of cancer cells by blocking an
enzyme called topo isomerase 2.

Common side effect of Chemotherapy

Cell-Cycle Phase-Nonspecific Drugs:

- Act on any phase of the cell cycle, including G0
- Can increase cell kill when combined with phase specific
drugs.
- Among the phase-nonspecific drugs are the alkylating agents
and most antitumor antibiotics.
- Bleomycin antitumor antibiotics is the only one working on a
specific phase but the rest antitumor antibiotics are nonspecific
drugs.
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- Based on their spectrum of action: (gaano kalawak ang effect

ng antibiotic)
• Broad- spectrum
• Narrow spectrum

ANTIMICROBIAL DRUGS Bacteriostatic

Discussed by Prof. Carmencita Pacis
- Chemical substances that either kills or inhibit the growth of
microorganism.
- 2 functions:
• Kill the microorganism
• Prevent the growth of microorganism
- Classification:
• Antibiotics/ antibacterial – against bacteria
• Antivirals – against viruses
• Antiparasitic agents – against parasites
• Antifungals – against fungi
Definitions
• Antibiotic
- Chemicals that are produced by microorganism that have
the capacity to inhibit (static) the growth of, or to kill
(cidal), bacteria and other microorganisms.
- Patayin ung m.o or pigilan ung pagdami ng m.o.
• Antifungal agent
- That kills and inhibits the growth of fungi.
• Antiviral agent
- That kills or inhibits the growth of virus.
• Anti-infective agents
- An agent natural or synthetic that inhibits microorganism
or another infective organism.
- Pineprevent nya mag cause ng sakit ung microbe na yon.
• Selective toxicity
- The ability of the antibiotic to kill or inhibit the
pathogenic microorganism without affecting the patient
cell, this can be achieved when the antibiotic has a
specific mechanism of action (specific target) not present
in humans and it is effective at very low concentration.
- Narrow spectrum antibiotics
Antibiotics
- An antibiotic is a type of antimicrobial substance active
against bacteria.
- The word antibiotic means “against life” because we want to
kill or inhibit this living bacteria that is causing disease in your
body.
- Based on mode of action: (anong gagawin ng antibiotic sa
bacteria)
• Bacteriostatic
• Bactericidal
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- Drugs that inhibit the growth of bacteria
- Static – stay
- Pinipigilan nila ung pagdami at paggalaw
- Erythromycin is a broad spectrum, macrolide antibiotic with
antibacterial activity.
- Erythromycin diffuses through the bacterial cell membrane
and reversibly binds to the 50S subunit (ribosome) of the
bacterial ribosome. This prevents bacterial protein synthesis.
- Protein synthesis – protein is the one providing the structure,
function and regulation. Sa protein kinukuha ung fuel or
oxygen ng cells.
- More protein, mas malakas at malaki ang cells natin. So kapag
pinerevent ung pag dami ng protein, maliit at mahina lang din
ung bacteria cells.
Bactericidal
- Drugs that kill bacteria.
- Cidal – suicidal
- Aminoglycosides are potent bactericidal antibiotics that act by
creating fissures in the outer membrane of the bacterial cell.
- Potent – mataas or matapang
- Sinusugatan nila ung covering ng bacterial cell. Kaya kapag
nagcreate ng sugat or fissure ung bacterial cells, sumasabog
sila at namamatay.
- Examples:
• Streptomycin
• Gentamicin
• Amikacin
Broad spectrum
- Against larger group of bacteria
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021

- They will target more types of bacteria, but they could affect - Penicillin
the harmful and harmless bacteria. (pati ung good bacteria - Cephalosporins
nadadamay) - Carbapenems
Narrow spectrum - Monobactams
- Against limited group of bacteria. - Vancomycin
- May specific lng na tinatarget. - Daptomycin
- Polypeptides
• Inhibition of nucleic acid – nag cecreate ng more DNA and
RNA
- Inhibit DNA gyrase +/- topoisomerase IV: quinolones
(super coiling, mas matibay sya)
- Inhibits folate synthesis: trimethoprim /
sulfamethoxazole (folic acid)
- Create free radicals: Metronidazole, Nitrofurantoin
• Inhibition of cell wall synthesis
- Inhibit 50S subunit
o Macrolides
Mechanism of action of antibacterial drugs o Clindamycin
• Cell wall o Linezolid
- Blocks production of peptidoglycan, inhibiting cell wall o Streptogramins
biosynthesis o Chloramphenicol
- Nagpoprotect ng cells natin. - Inhibit 30S subunit
- Peptidoglycan – a mesh-like layer outside the plasma o Aminoglycosides
membrane of most bacteria, forming the cell wall. o Tetracyclines
- Kaya kung konti or mababa ung peptidoglycan mo, o Tigecycline
manipis lang ang cell wall. • Kapag nainhibit na yang tatlo, maiinhibit na rin ung…
• DNA synthesis disruption of cell membrane function and block pathways of
- Inhibits DNA synthesis, blocking cell replication. inhibit metabolism.
• RNA synthesis Agents that inhibit bacterial cell wall synthesis
- Block transcription - MOA: inhibits cell wall sysnthesis  celllysis – bactericidal
• Plasma membrane - binding of the drug to specific receptors in the bacterial
- Interferes with bacterial cell membrane or membrane
lipopolysaccharide in gram negative outer membrane. - Inhibiting transpeptidase enzymes involve in forming cell wall
- Major outer covering - Transpeptidase enzymes forming rigid cell wall. (dikit dikit
- LPS – most abundant antigen on the cell surface of most ung mga cell wall, matibay) Kaya nagbigay ng antibiotic,
Gram-negative bacteria (E. coli and salmonella) naiinhibit ung transpeptidase enzyme, magiging manipis ang
• Ribosomes cell wall.
- Binds to 70s ribosome, blocking protein synthesis. - Activation of autolytic enzymes that cause lesions in the
- A ribosome is a cellular particle made of RNA and protein. bacterial cell wall
- Site of protein synthesis. - Autolytic enzyme – digest the cell which it is produce. Kung
- 70s – combination ng 30s and 50s, inside the cytoplasm. saan sya nag produce, kakain nya rin yon.
- The "S" stands for svedbergs, a unit used to measure how - Cephalosporins possess a mechanism of action identical to
fast molecules move in a centrifuge. penicillins: inhibition of bacterial cell wall peptidoglycan
- Ang effect nya ay sa loob, structure that is inside. Dito synthesis by inhibition of penicillin-sensitive enzymes.
nagkakaroon ng decoding ng messages or formation of (nagiging manipis ung cell wall)
peptide bonds. Basic structure:
- DNA – nag poprovide ng code • Beta-lactam ring – responsible for antibacterial activity
- RNA – nag coconvert ng code into protein • Bacteria may produce beta-lactamases – responsible for
• Metabolic pathways resistance
- Compete with bacterial metabolic enzymes. - Kapag dumadami ung beta lactamase, dumadami at
- Stops synthesis of product. mas kumakalat ung bacteria. Kaya kapag uminom ka
- Folic acids – essential nutrient necessary for protein and ng antibiotic, pineprevent nyang kumalat or dumami
nucleic acid synthesis. Kaya kapag mas marami kang folic ung bacteria na may beta lactamase.
acid, you are creating more protein and nucleic acid. More
nucleic acid, more RNA. Kaya mas maraming maeencode
or madedecode na messages from the DNA to make more
protein.
Main:
• Inhibition of protein synthesis
- Beta lactams

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 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021

Types of Penicillin’s • Nephrotoxicity – hematuria, proteinuria (s/s: Fatigue,

a) Narrow-spectrum (basic penicillins) Nausea, Chest pain, swelling in ankles/feet)
- penicillinase-susceptible • Neurotoxicity
- limited spectrum: gram (+) organisms
- examples: Penicillin G, Penicillin V
- food decreases absorption (take 2hrs after meals)
- MOA - Penicillin G binds to and inactivates the penicillin
binding proteins (PBPs) located inside the bacterial cell
wall. Inactivation of PBPs interferes with the cross-
linkage of peptidoglycan chains necessary for bacterial
cell wall strength and rigidity.
b) Very narrow spectrum (anti-Staphylococcal penicillins)
- penicillinase-resistant
- very limited spectrum: Staphylococcus aureus
• Not effective against gram (-) organisms
• Less effective against gram (+) organisms
- examples: oral preparations: cloxacillin (Prostaphlin-A) Inhibition of Protein Synthesis
dicloxacillin parenteral preparation: methicillin, nafcillin; - Aminoglycosides
oxacillin (Prostaphlin, Stafcil) - MOA: binds to the 30s ribosomal subunit – interferes with
c) Broad-spectrum penicillins (aminopenicillin) protein synthesis.
- treat gram (+) and gram (-) bacteria - Must be given parenterally (not absorbed after oral
- penicillinase-susceptible administration)
- examples: ampicillin (Ampicin, Amplivacil, Unasyn) - Can also be given topically
amoxicillin (Amoxil, Himox, Sumoxil, Augmentin) • Amikacin
bacampicillin (Penglobe) • Gentamycin
d) Extended-spectrum penicillin (anti-pseudomonal penicillin)
- spectrum includes gram (+) and gram (-) organisms • Streptomycin
- particularly Pseudomonas aeruginosa • Neomycin
- penicillinase-susceptible - Clinical uses:
- examples: carbenicillin, mezlocillin, piperacillin • Primary use: treatment of infections caused by aerobic
(Tazocin), ticarcillin (Timentin) gram (-) bacteria – nabubuhay sa oxygen (e.g., E. coli,
- for penicillinase-susceptible → add with betalactamase Enterobacter, Klebsiella, Proteus, Pseudomonas
inhibitors • Other use:
- Beta-lactamase inhibitors: clavulanic acid, sulbactam, - Neomycin – used only topically or locally because of
tazobactam imipenem, aztreonam toxicity
- used in combination with: amoxicillin, ampicillin, - Streptomycin – irreversibly binds to the 16S rRNA
piperacillin, ticarcillin and S12 protein within the bacterial 30S ribosomal
- examples: amoxicillin-clavulanic acid (Augmentin), subunit. As a result, this agent interferes with the
ampicillin-sulbactan (Unasyn), piperacillin-tazobactam assembly of initiation complex between mRNA and
(Tazocin), ticarcillin-clavulanic acid (Timentin) the bacterial ribosome, thereby inhibiting the
Nursing Interventions: initiation of protein synthesis.
- Side effects/ toxicities:
• Send sample from infected area for culture and sensitivity.
• Ototoxicity – auditory or vestibular damage
(You must know the specific microorganism that cases your
disease) • Nephrotoxicity – proteinuria, hematuria
• Check for s/sx of superinfection (e.g. stomatitis, • Neuromuscular blockade – respiratory paralysis (high
doses)
• genital discharge, anal itching, genital itching)
• Skin reactions, N/V, tremors, tinnitus, pruritus, muscle
• Check for allergic reaction
cramps
Alteration of Cell Membrane Permeability
- MOA: interferes with cell membranes → cell death
- Permeability – pag absorb ng mga nutrients
- Bactericidal against gram (-) bacteria
- Alters permeability leading to leakage of cell and cell death.
- polymyxin and gramicidin
- Polymyxins interact with lipopolysaccharide (LPS – major
covering) of the outer membrane of Gram-negative bacteria
- Not absorbed from the Gl tract and must be given parenterally
(but associated with more side effects, renal dysfunction)
- Because of toxicity → limited to topical therapy against gram
(-) infections. (pinapahid or pinapatak)
- SE/AR: usually seen if given parenterally

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 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021
- Choramphenicol, Licomycin, Erythromycin, Clindamycin
- MOA: binds the 50s ribosomal subunit of bacteria and inhibits
peptidyl transferase (forming rigid wall)
- Chloramphenicol is an antibacterial agent with a broad
spectrum of activity against gram-positive bacteria, gram-
negative bacteria, and Rickettsia. Its mechanism of action is by
inhibition of bacterial protein synthesis by binding with
ribosomes.
- Clinical use:
• Reserved for severe infections caused by Salmonella and
Haemophiles, pneumococcal meningitis and penicillin –
sensitive persons.
• Can also be used for rickettsia diseases, anaerobic
infection – nabubuhay sa walang oxygen (bacteroid
fragilis)
- Side effects:
• GI disturbances- due to direct irritation (N/V) and
superinfection (Candidiasis)
• bone marrow disorder- aplastic anemia
• Gray Baby Syndrome: abdominal distention (paglaki ng
spleen), cyanosis, vasomotor collapse and death
Inhibition of Nucleic Acid Synthesis
- DNA Effects – (Replication)
- Quinolones – Inhibit DNA gyrases or topoisomerases required
for supercoiling of DNA.
- Metronidazole – Metabolic cytotoxic byproducts disrupt DNA
Metronidazole diffuses into the organism, inhibits protein
synthesis by interacting with DNA and causing a loss of
helical DNA structure and strand breakage. (kapag hindi
nabuo ung coiling nila, walang code na mapoproduce)
Antibiotics: Nursing Implications
1) Before beginning therapy, assess drug allergies, hepatic, liver,
and cardiac function, and other lab studies.
2) Be sure to obtain thorough patient health history including
immune status.
3) Assess for conditions that may be contraindications to
antibiotic use or that may indicate cautious use.
4) Assess for potential drug interactions.
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FILIPINO CULTURES, VALUES, AND PRACTICES IN
RELATION TO DRUG ADMINISTRATION
Discussed by Prof. Marivic Ilarde
Common Practices of Filipinos on Drug Administration
1) Utilization of traditional home remedies, alternative and
complementary means of treatment.
- Traditional Medicine:
• Babylan/Shamans – woman mystic who is specialist
in the fields of culture, religion, medicine and all
kinds of theoretical knowledge about the
phenomenon of nature. They are believed to be a
woman who is possessed by a spirit. Have
encountered life altering experiences. Or inherit role
to become mystical woman from their elderly
babylan. Function is leader, warrior, community
defenders, preach, healers. There are also male
dressed up like female.
• Albularyo – general practitioners and the primary
dispenser of health care in the hierarchy of traditional
cook doctor in the ph.
• Hilot/Ablon – uses massaging technique to sprain
fructures and other similar conditions that affect the
skeletal system and musculatory system like
ligaments. Integrate uses of herbs, plants and oils.
They have pekkel in Ilocano pisil in Tagalog use
hands to massage an area
• Magtatawas – determines cause and nature of illness
through the use of potassium alum or tawas, egg,
mirror, paper, and candle.
• Faith healers – like esperitista. Give prayers lalo na
kapag may super natural beings.
- Healing Traditions:
• Suob – use of steam para mawala dw toxins.
• Ventosa or suction cupping – involves special heated
cups that form a seal or vacuum to help ease sore
muscles
• Herbalism – use of leafs “tapal”
- Complementary Treatment:
• Acupuncture involves the insertion of very thin
needles through the skin at strategic points on the
body
• Aromatherapy is a holistic healing treatment that uses
natural plant extracts and oils to promote health and
wellbeing, it's called essential oil therapy like
lavander (sleeping therapy) or eucalyptus (for
breathing)
• Chiropractic treatment focuses on the relationship
between the body's main structures – the skeleton, the
muscles and the nerves—and the patient's health
2) Discuss their concern with a trusted family members, friend,
spiritual counselor, or healer.
3) Seeking medical advice from family members or friends who
are health professionals
4) Relying on their faith in God – says may awa ang Dios, bahala
na ang Dios
Coping Styles of Eldelry Filipinos
- Little is knowmn of how filipino senior citizens cope with
their unmet needs. Coping mechanisms are their strategies in
the face of adversities to help them manage painful and
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021
challenging life events while maintain their psychological
wellbeing.
1) Patience and endurance (tiyaga) – ability to tolerate
uncertain situations even if they feel sick or not drinking
medicine
2) Courage (lakas ng loob) – “magiging ok din ang lahat,
malaks ako”
3) Humor (tatawanan ang problema) – capacity to laugh at
oneself kahit na may sakit
4) Fatalistic resignation (bahala na) – view of illness and
suffering are unavoidable and predestined will of god in
w/c the pt. Will not take medications and physician should
not intervere “kagustuhan ito ng dios sa kanila”
5) Conceding to the wishes of the collective (pakikisama) –
to maintain group harmony to make them feel well.
“mawawala din ito, baka kulang lang sa exercise”
Health Beliefs and Treatment Concepts
• Flushing: eliminates impurities – body is thought to be a
vessel or container that collect and eliminate impurities
through physiological process like pag papawis, pagsusuka,
pagdurugo, pag fart.
• Heating: adapts the concept of balanced between “hot” and
“cold” to prevent occurrence of illness and disorders – like
suob
• Protection: safeguards the body’s boundaries from outside
influences such as supernatural and natural forces – like
anting-anting, buntot ng paging, bala na ginawang pendant.
New Technologies Related to Drug Administration
- Health service to be effective drug and technology should be
available efficacious of high quality safe and rationally use. It
is health systems role to achieve this object in balance with
other sources.
- Advancement of technology such as new drugs can improve
heath outcomes and health care system so there is continues
advancement of equipment.
- Habang gunaganda ang technology nag increase din ang
babayaran ng patient.
Tech Advancements in Pharmaceuticals to Reinvent Healing
Precision Medicine
- Also called individualized or personalized medicine
- Is "an emerging approach that takes into account individual
variability in genes, environment, and lifestyle for each
person."
- Allows treatment based on a genetic understanding of their
disease. Pag aaralan genes or lifestyle ng pt.
- Ex. A pt who needs blood transfusion is not given blood from
a randomly person instead ung ka match niya.
mHealth Sensors
- Well, known as mobile health sensors, which are used in the
practice of medicine and public health supported by mobile
devices
- Used to help patient monitor their physiologic data without
visiting the doctor (like measuring steps and vs)
3D Printing
- Medical 3-D printing is an emerging area of technology that
explores how 3-D printing can be used to replace or support an
existing biological structure.
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- A related area of 3-D printing called bioprinting, involves
printing human tissue and organs by layering living cells
instead of plastic or titanium.
Nanotechnology
- Employ nanoparticles to deliver drugs, heat, light or other
substances to specific types of cells (such as cancer cells)
- Particles are engineered so that they are attracted to diseased
cells, which allow direct treatment of those cells.
- It reduces damage to healthy cells in the body and allows for
earlier detection of disease.
Nanobots
- Also known as nanomedibots
- These machines will be able to repair damaged or diseased
tissues at the molecular level.
- Serve as miniature surgeons which can be used to repair
damaged cells or entirely replace intracellular structures
Synthetic 3D Tumor
- A 3D cell culture is an artificially created environment in
which biological cells are permitted to grow or interact with
their surroundings in all three dimensions.
- Accurately mimic some features of solid tumors
Microenvironment
- The microenvironment of a tumor is an integral part of its
physiology, structure, and function. Monitoring tumor
environment via molecular and cellular profiles would be vital
for identifying cell or protein target for cancer prevention and
therapy.
- It is an essential part of the tumor, since it supplies a nurturing
condition for the malignant process.
- Modulating the microenvironment of the tumor enhances the
tumor nanomedicine delivery
Advance instrumentation
- Intelligent sensors. Deals with measurement and automation.
• Smart transducer – convert electrical energy to mechanical
energy like ultrasound and measure temperature.
• Bluetooth technology
• Intelligent sensors – can inc. intelligence of medical
equipments like medicalmimplants
• MEMS Micro-ElectroMechanical Systems are chips that
combine electronic functions and mechanical actions. Like
pedometers, BP, ECG, hearing aids, DNA analysis.
Endoscopy with “lab on a pill”
Bioinformatics
- The science of collecting and analyzing complex biological
data such as genetic codes.
- Allows the identification and analysis of more and more
biological drug targets
- Para mapadali ang pag develop ang mga gamot
Medication therapy management (MTM)
- A distinct service or group of services provided by health care
providers to ensure the best therapeutic outcomes for patients.
- Five core elements:
• Medication therapy review
• A personal medication record
• A medication-related action plan
• Intervention or referral
• Documentation and follow-up
Localized drug delivery
- Refers to technology used to limit the presentation of a drug to
a desired body site for its release and absorption, or the
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021
subsequent transport of the active ingredients across the
biological membranes to the site of action.
- It aims to improve the bioavailability of the drug at the site of
disease, reduce dosing frequency, and minimize systemic side
effects.
Supercomputer Utilization
- Recreates 3D images on screen.
- Simulate cell division within a cancerous cell
- Creates a virtual model in order to analyze its potential to
damage
- Increases efficiency across many sectors of scientific research
Drug experimentation on simulation models
- Computer models predicts potential impact of the medication
or treatment given
- Wireless brain sensors
• Devices that can detect the pressure inside the brain, brain
temperature, pH and brain activity in the form of 'brain
waves' reflecting the electrical transmission within the
brain.
- Cell-free fetal DNA testing
• A test that can determine if a woman has a higher chance
of having a fetus with Down syndrome (trisomy 21),
trisomy 18, trisomy 13 or an abnormality in the sex
chromosomes (X and Y chromosomes).
• With this test, a sample of the woman's blood is taken
after 10 weeks of pregnancy.
- Robotic assisted surgery
• Associated with minimally invasive surgery —
procedures performed through tiny incisions.
• Surgeon will sit at a computer console and use controls to
manipulate the robot
NURSING CORE VALUES AS APPLIED IN
PHARMACOLOGY
Discussed by Prof. Marivic Ilarde
- Values are goals and beliefs that establish a behavior and
provide a basis for decision making.
- In a profession, values are standards for action that are
preferred by experts and professional groups and establish
frameworks for evaluating behavior.
- Nursing is a profession rooted in professional ethics and
ethical values, and nursing performance is based on such
values.
- The core ethical values are generally shared within the global
community, and they reflect the human and spiritual approach
to the nursing profession. However, the values in the care of
patients are affected by cultural, social, economic, and
religious conditions dominating the community, making it
essential to identify such values in each country
Core Nursing Values Essential to Baccalaureate Education
• Human dignity: right to be valued and respected
- The recognition that human beings possess a special value
intrinsic to their humanity and as such are worthy of
respect simply because they are human beings.
• Integrity: moral uprightness & Honesty: truthfulness
- Ang mga nurses ay dapat matapat.
• Autonomy: self-governing/self determination
- Autonomy in nursing is the ability of the nurse to assess
and perform nursing actions for patient care based on
competence, professional expertise, and knowledge.
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- The nurse is expected to practice autonomously,
exercising independent judgment within the context of
interdisciplinary and multidisciplinary approaches to
patient care.
- In emergency, dapat alam mo na agad ano ang gagawin
mo. (independent)
- Autonomy is the right to self-determination. We should
plan patient care based on what we have observe or our
knowledge.
• Altruism: self-sacrifice, unselfish
- Altruism is concern for the welfare and wellbeing of
others. In professional practice, altruism is reflected by
the nurse’s concern and advocacy for the welfare of
patients, other nurses, and healthcare providers.
- Gnagawa natin un trabaho natin, hindi lang para sa salary,
kundi may concern tayo sa mga pasyente natin.
• Social justice: fairness as it manifests in society
- Social justice is the view that everyone deserves equal
rights and opportunities, this includes the right to good
health.
The 6 C’s in nursing
- The purpose of the 6Cs is to ensure patients are looked after
with care and compassion, by competent workers who
communicate well, dare to make changes that improve care
and can commit to delivering this all day, every day.
Care
- Treat patients correctly, preservation of human dignity.
- According to Watson’s theory, caring is the moral ideal of
nursing whereby the end is protection, enhancement, and
preservation of human dignity. It is the dynamic essence of
nursing.
- Human caring involves values, a will and a commitment to
care, knowledge, caring actions, and consequences.
Compassion
- Care based on empathy, respect, and dignity
- Empathy is seeing, understanding, and sharing other’s
viewpoints without judgement.
- Empathy has emotional, cognitive, and behavioral
implications and it’s based upon respect for the dignity of our
patient and appreciation of their independent and self-
actualization.
- Kapag nagtanong ang pasyente sayo na kung para saan un
gamot, we should answer them with confident and compassion.
- Dapat laging nakasmile kapag kakausapin si pasyente. (pacute
cute lang hehe char) kasi kapag nakikita ng pasyente na
nakangiti ka at mabait, naeencourage or nabibigyan din sila ng
lakas ng loob. (Parang ikaw, makita mo lang ngiti ni crush,
buo na araw mo ehehe anuebe)
Competence
- Ability and skill to provide care
- Combination of skill, knowledge, attitude, values, and ability
to bring about an effective or high performance in the
provision of nursing care.
- Maintain and enhance competency through:
• Education
• Professional organizations
• Networking
• Conferences
• Webinars
• Continuing nursing education (CNE) modules
• Certification
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021
Communication
- Exchange of thoughts.
- Good communication between nurses and patients is essential
for the successful outcome of individualized nursing care of
each patient.
- Communication skills:
• Speech, Signals, Writing
• Behavior during patient assessment, as well as the
planning, implementing, and evaluating of nursing care.
• It is essential for nurses not to commit mistakes in giving
medications.
Courage
- To do the right thing for the people we care for to speak up
when we have concerns, and to have the personal strength and
vision to innovate and to embrace new ways of working.
- Nurses need moral courage in all areas and at all levels of
nursing. Core attributes of moral courage were identified: true
presence, moral integrity, responsibility, honesty, advocacy,
commitment and perseverance, and personal risk.
- In the nursing profession, advocacy means preserving human
dignity, promoting patient equality, and providing freedom
from suffering. It's also about ensuring that patients have the
right to make decisions about their own health.
- It allows us to be brave and do the right thing for the people
that we are caring for. Being courageous helps nurses identify
poor practice and speak up reinforcing strategies to increase
the best standard of care for patients.
- Example: ung pasyente, resistant sya sa antibiotic pero yun
ung inorder ni doctor. So dapat wag tayo mahiya or sabihin
agad kay doc na resistant sya sa gamot na yon para mapalitan
agad ni doc un antibiotic. Hindi natin pwede hayaan nlng like
“bahala na, utos naman to ni doc” ganern.
Commitment
- Dedication to our profession.
- Provide optimum care
- Improve care and experience of patients
- Awareness of the challenges ahead and working to overcome
these for the sake of your patient and your team.
- Accepting that your social life may, at times, be secondary to
the needs of your patients.
- Maintain own health to be the very best role model.
- Promote the nursing profession
- Patient advocate – protect a patient’s rights
Teaching
- Nurses are the last barrier between any drug and their patient.
We are the last line of defense and the last person with the
ability to catch a medication error before it happens. Therefore,
it is so important to be knowledgeable when it comes to drug
uses, doses, side effects, and contraindications.
- In addition to the obvious benefit of protecting our patients
and fulfilling our oath to do no harm, it benefits all nurses to
know and be well versed in the drugs they are administering to
protect themselves and their nursing licenses.
- Methods:
• One on one
• Group Teaching
• Written materials
• Computer
• Internet Resources
- Role of the Nurses as Educator:
J.A.K.E 16 of 17
• Nurses play a major role in patient education
• Nurses must be trained in instructional skills to have
successful education program
• Some suggest that education should be done only by
specialized nurses, or nurses who have a higher level of
education
• Nurses must have a solid foundation in the principles of
teaching and learning
Critical Thinking
- This is applied by nurses in the process of solving problems of
patients and decision-making process with creativity to
enhance the effect.
- It is an essential process for a safe, efficient, and skillful
nursing intervention.
- To be an effective nurse, it's important to step back and see the
bigger picture. Critical thinking in nursing helps you analyze
your patient's condition and current treatments to predict
outcomes and identify potential issues.
- “Clinical eye”
• Observation – the ability to notice and predict
opportunities problems and solutions.
• Analysis – the gathering, understanding, and interpreting
of data and other information.
• Interference – drawing conclusions based on relevant
data, information and personal knowledge and experience
• Communication – sharing and receiving information
with others verbally, nonverbally and in writing
• Problem Solving – the process of gathering, analyzing
and communication information to identify and
troubleshoot solutions.
Psychomotor skills
- Psychomotor learning is the relationship between cognitive
functions and physical movement, and it involves
demonstration of physical skills such as movement,
coordination, dexterity, grace, strength, and speed.
- These are actions which demonstrate the fine motor skills such
as the use of precision instruments or tools, or those actions
which evidence gross motor skills such as the use of the body
in dance, musical or athletic performance.
Applied Therapeutics
- The competent application of safe administration of drugs
knowledge also involves its use in health and wellness, as well
as when new technologies related to drug administration is
concern
Ethical Consideration
- Code of ethics for nurses.
- A nurse plans, provides, and evaluates nursing care guided by
specific ethical and legal boundaries. We believe the Code of
Ethics for Nurses provides the ideal framework for safe and
correct practices and behavior.
- Ethical behavior also involves accountability, responsibility,
confidentiality, truthfulness, fidelity, and justice. Nurses who
clarify their values are enhanced in their ability to practice
ethically.
- Purpose of the Code:
• Serves as an ethical framework for a nurses practice
 PHARMACOLOGY – BSN 2ND YEAR 1ST SEMESTER FINAL 2021

• Provides a nurse with direction in respect to their ethical - Follow the 10 RIGHTS of medication preparation.
relationships, nursing responsibilities, appropriate - Check that the medication has not expired.
behavior and in making day to day choices in their - Complete necessary focused assessments, lab values, and/or
practice. vital signs, and document on MAR.
- Provide patient education as necessary.
Professionalism - If a patient question or expresses concern regarding a
- It involves the characteristics of a nurse that reflects his or her medication, stop and do not administer.
professional status. These characteristics involve behaviors
with regard to self, patients, others, and the public as they
reflect the values of the nursing profession.
- Professional personas are knowledgeable in their subject
matter, conscientious in their actions, and responsible for
themselves and others.
- Written standards for practice and professional performance
guide the behaviors of professional practitioners.
- We believe nurses enhance their professionalism by
understanding history, educational choice, professional
research and theory, and their professional organizations and
standards.
- Professionalism in Nursing Attributes:
• Knowledge
• Spirit of inquiry – a persistent sense of curiosity that
informs both learning and practice. A nurse infused by a
spirit of inquiry will raise questions, challenge traditional
and existing practices, and seek creative approaches to
problem-solving.
• Accountability – to be answerable to oneself and others
for one’s action.
• Autonomy
• Advocacy
• Innovation and visionary
• Collegiality and collaboration

Institutional Policies and Guidelines on Safe Drug

Administration
- Florence Nightingale’s Pledge is the Hippocratic Oath of
nurses
“I solemnly pledge myself before God and in the presence of this
assembly, to pass my life in purity and to practice my profession
faithfully. I will abstain from whatever is deleterious and
mischievous and will not take or knowingly administer any
harmful drug. I will do all in my power to maintain and elevate the
standard of my profession.”
Drug Administration
- policies and guidelines on safe drug administration is
instituted to prevent further occurrence of medication related
errors in the country
Medication Error
• Medications with similar names or similar packaging
• Medications that are not commonly used or prescribed
• Commonly used medications to which many patients are
allergic (e.g., antibiotics, opiates, and nonsteroidal anti-
inflammatory drugs)
• Medications that require testing to ensure proper (i.e.,
nontoxic) therapeutic levels are maintained (e.g., lithium, Konting push nlng tapos na un 1st sem natin guysss!! Goood
warfarin, theophylline, and digoxin) luckkk satinnn lahaaaat <3 – Aki
Safe Medication Administration
- Safety considerations:
- Plan medication administration to avoid disruption• Prepare
medications for ONE patient at a time.
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