BACHELOR OF SCIENCE IN NURSING:

NCMA 416: PHARMACOLOGY

COURSE MODULE COURSE UNIT WEEK
1 1 1

BASIC CONCEPTS IN PHARMACOLOGY

Read PEO (Program Educational Objectives)

✓ Read and appraise required learning resources with the study guide before the start of each
session; refer to unit terminologies for jargons
✓ Proactively participate in online discussions
✓ Participate in weekly discussion board (Canvas)
✓ Answer and submit course unit tasks

At the end of this unit the students are expected to:

Cognitive:
1. Define the basic concepts of Pharmacology, it’s origin and history
2. Understand and enumerate the different branches of Pharmacology
3. Familiarize self in different form of drugs and it’s preparation
4. Apply knowledge on ethico-legal aspects on drug administration
5. List drug structure and the steps in drug evaluation

Affective:
1. Inculcate the right considerations to prevent error in medicine administration
2. Cooperate and listen attentively in class discussions
3. Respect comments and opinion of other and accepts criticism

Psychomotor:
1. Collaborate actively in activities and tasks assigned
Textbooks:

Ashelford, Sarah. (2016). Pathophysiology & Pharmacology for nursing students. Los
Angeles: Sage.

Hochadel, MaryAnne. (2016). Mosby’s drug reference for health professions. St. Louis:
Elsevier.

Katzung, Bertram G., ed (2015). Basic & clinical pharmacology, 13 . New York: McGraw-
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Hill.

Kee, joyceLeFever. (2015). Pharmacology: A patient-centered nursing process approach,

8 ed. Singapore: Elsevier.
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Rang, H.P..etal. (2015). Rang and Dale’s Pharmacology.Singapore: Elsevier.

Waller, Derek G. (2014). Medical Pharmacology & Therapeutics, 4 ed. Edinburg:

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Saunders.

Pharmacology:

Pharmacology is the study of drugs and its origin, chemical structure, preparation,
administration, action, metabolism and excretion.
The study of drugs that alter functions of living organisms.
PHARMACY – art of preparing, compounding, and dispensing drugs. It also refers to the place
where drugs are prepared and dispensed
PHARMACIST – a person licensed to prepare and dispense drugs to make up prescriptions.

HISTORY
Babylonians
Earliest surviving “prescriptions” on clay tablets in 3000 B.C.
Chinese
Recorded the Pen Tsao (Great Herbal) – a 40-volume compendium of plant remedies dating to
2700 B.C.
Egyptians
Archives of remedies on a document known as Erb’s Papyrus in 1500 B.C.
Pharmacologia sen Manuductio and Materia Medicum
First recorded reference to the word pharmacology
Early 1800s
Chemists isolates specific substances from complex mixtures
Pharmacologists then study their effects in animals
Fredrich Serturner (first isolated morphine from opium, injected himself and three other friends
with huge doses (100mg))

DRUGS
are chemicals that alter physiochemical processes in body cells.
They can stimulate or inhibit normal cellular functions.
Used interchangeably with medicines.

Branches of Pharmacology:
>Pharmacodynamics - pharmaco means “medicine” dynamic means “change”.
Refers to how a medicine changes the body the branch of pharmacology
concerned with mechanisms of drug action and the relationships between drug
concentration and responses in the body.
> Pharmacokinetics - pharmaco means “medicine”, kinetic means “movement or
motion”. The study of drug movement throughout the body. How the body deals
with medications. Actions and side effects of medications in patients.
> Pharmacognosy - the branch of knowledge concerned with medicinal drugs
obtained from plants or other natural resources
> Pharmacotherapeutics - the study of the therapeutic uses and effects of drugs.
Beneficial and adverse effects of drugs.
> Pharmacovigilance - the practice of monitoring the effects of medical drugs after
they have been licensed for use especially in order to identify and evaluate
previously unreported adverse reactions.
> Toxicology - the branch of science concerned with the nature, effects, and
detection of poisons.the measurement and analysis of potential toxins,
intoxicating or banned substances, and prescription medications present in a
 person’s body.
DRUG NAMES

> Generic or Nonproprietary Name: name approved by the Medical or Pharmaceutical

Associations in the original country of manufacture and is adopted by all countries.
e.g. Paracetamol
> Brand name or trade name: name given by the manufacturer of the drug
e.g. Adol or Panadol or Biogesic
> Chemical name: name that describes the atomic or chemical structure
e.g. para-acetylaminophenol

Sources of Drugs:
1. Natural sources -
a. Plants
One of the oldest forms of health care, herbal medicine has been practiced in
virtually every culture dating to antiquity.
The Babylonians recorded the earliest surviving “prescriptions” on day tablets in
3000 B.C.
The Chinese recorded the Pen Tsao (Great Herbal), a 40-volume compendium of
plant remedies dating to 2700 B.C.
The Egyptians followed in 1500 B.C. by archiving their remedies on a document
known as Eber’s Papyrus.
e.g morphine, colchicine, cocaine - At that time, chemists were making
remarkable progress, isolating specific substances from complex mixtures, this
enabled scientists to isolate the active agents from scarce natural sources,
ex. morphine.
Cocaine from - cocoa leaves
b. Animals - Biologic - are agents naturally produced in animal cell, by
microorganisms, or by the body itself.
e.g. hormones, monoclonal antibodies, natural blood products,
Interferons and vaccines.
others.

DRUG USES SPECIES

Crestor high cholesterol Rats, rabbits, dogs

Diovan High blood pressure Rats, rabbits

Lantus Type 1 & 2 Diabetes Dogs, guinea pigs

 2. Inorganic compounds
e.g. Lithium carbonate
Cisplatin
3. Synthetic
e.g Ecstasy or Molly - stimulants that mimic the effect of cocaine

DRUG EVALUATION
= a series of scientific tests to evaluate the actual therapeutic and toxic effects of chemicals
STEPS:
PRECLINICAL TRIAL
= testing done on laboratory performed in animals
= tests efficacy and toxicity, at different doses, it predicts whether the drug will cause harm to
humans.
= do not always reflect the way a human responds, testing may overestimate or underestimate
the actual risk to humans.

ORPHAN DRUG
= are drugs that have been discovered but are not financially viable and therefore have not
been “adopted” by any drug company
= may be useful in treating a rare disease, or they may have potentially dangerous adverse
effect
= are often abandoned after preclinical trials or phase I studies.
Criteria:
> lack therapeutic activity
> too toxic
> Teratogenic
> have a small margin of safety
e.g. Zavesca (miglustat), Trisenox (arsenic trioxide injection), Aldurazyme (Laronidase), Glivec
(Imatinib mesylate), Fabrazyme (Agalsidase beta), Ventavis (iloprost),Litak (cladribine).
PHASE I
> chemicals cleared for human testing, there are significant therapeutic benefits.
> testing done on healthy male subjects
> companies begin developing a brand name
ORPHAN DRUG
> are chemicals that are discarded Phase I
> will not participate in the next phase
Criteria:
> lack therapeutic activity in humans
> too toxic
> produce unacceptable side effects
> teratogenic
PHASE II
> chemicals cleared for limited clinical studies
> some may not further proceed with the evaluation due to the following criteria
> less effective than expected
> are too toxic
> produce unacceptable side effects
> have a low benefit-to-risk ratio
> are not as effective as available drugs
PHASE III
> chemicals cleared for large-scale clinical studies
> some chemicals may not advance further in the next phase due to the following criteria:
> produce unacceptable side effects
> produce unexpected responses
PHASE IV
> drugs approved for marketing by FDA
> continues evaluation

DOSAGE FORMS OF DRUGS: ( Sir include this po, describe, better with pictures )
A. SOLID FORMS
 1. TABLET :
a. scored.
b. layered.
c. enteric-coated.
d. chewable.
e. sustained released

2. CAPSULE

:
a. soft gel.
 b. hard gel

3. LOZENGES

4. SUPPOSITORY
B. LIQUID

FORMS

1. SYRUP
2. SUSPENSION

3. ELIXIR
 4. EMULSION

5. INHALANTS
C. TOPICAL FORMS
1. CREAM

2. OINTMENT
 3. LOTION

4. PATCH

5. GELS
PRINCIPLES OF DRUG ADMINISTRATION

MEDICATIONS
✓ Are substances administered for the diagnosis, cure, treatment, or relief of symptom or
prevention of disease

PRACTICE GUIDELINES
✓ RNs are responsible for own actions, illegible order should be questioned or clarified
✓ RNs should be knowledgeable about the medication
✓ If the RN is uncertain about the calculation, ask another nurse to double check
✓ What you prepare, you administer
✓ Do not leave medications at bedside
✓ If the client vomits, report to charge nurse, MD, or both.
✓ When error is made, assess the patient first and report to MD immediately
✓ Correct identification of the patient:
✓ ID band or ID bracelet (BEST: Kozier)
✓ Ask the patient’s name
✓ Avoid: calling the client in NAME
✓ May answer “YES” to the wrong name

✓ OBSERVE THE TEN RIGHTS

✓ Right Client
✓ Right Medication
 ✓ Right Dose
✓ Right Time
✓ Right Route
✓ Right Client Education
✓ Right Documentation
✓ Right to Refuse
✓ Right Assessment
✓ Right Evaluation

Right client – can be measured by checking the client identification bracelet by having and by
having the client state her or his name
Right drug – means that the client receives the drug that was prescribed, check at least three
times prior to administration
Right time – is the time at which the prescribed dose should be administered
Right route – is necessary for adequate or appropriate absorption
Right assessment – requires the appropriate data be collected before administration of drugs
Right documentation – requires that the nurses immediately record the appropriate information
about drug administered
Right to educate – requires that the client received accurate and thorough information about
the medication and how it relates to his or her situation
Client teaching also includes therapeutic purpose, possible side effect of the drugs, any dietary
restriction or requirements skills administration, and laboratory monitoring
Right evaluation – requires that the effectiveness of the medication be determined by the client
response to medication
Right to refuse – client can and do refuse to take medication
It is the nurses responsibilities to determine when possible the reason for refusal and to take
reasonable measure to facilitate the client taking the medication

ORAL MEDICATION

Most common route

✓ CONTRAINDICATIONS:
Client is vomiting
Client with intestinal or gastric suction
Unconscious Client
Inability to Swallow
✓ Tablet or Capsules
✓ (+) difficulty in swallowing
✓ Crush and mix with small amount of water
✓ Avoid Crushing
✓ Enteric Coated
✓ Buccal and Sublingual tablets
✓ Liquid Medication
✓ Mix before pouring
✓ Place medication cup on flat surface at eye level
✓ Fill the cup with the desired level using the BOTTOM of the meniscus

PARENTERAL MEDICATION

✓ Intradermal
✓ SITE
✓ Inner lower arm
✓ Upper chest
✓ Anterior chest
✓ Upper back beneath the scapula
✓ Angle : almost parallel to the skin 10 - 15 degrees
✓ Gauge: #25, #26, #27
✓ Length: ⅜”, ⅝”, ½”
✓ Max cc: 0.1 to 0.2 ml
✓ Subcutaneous
✓ SITE
✓ Outer aspect of the upper arms
✓ Anterior thighs
✓ Abdomen
✓ Upper back
✓ Ventrogluteal
✓ Dorsogluteal
✓ Angle: 45-degrees (1 inch of tissue can be grasped)
90-degrees (2 inches of tissue can be grasped)
✓ Gauge: #25, #26, #27
✓ Length: ⅜”, ⅝”, ½”
 ✓ Max cc: 1-3 ml
✓ Intramuscular
✓ SITE
✓ Ventrogluteal
✓ > 1 y/o and adult
✓ No large nerve or blood vessels
✓ Sealed off by bone
✓ Contains less fat than buttocks
✓ Vastus Lateralis
✓ Site of choice for 1 y/o and younger
✓ Infants with fully developed gluteal muscles
✓ SITE
✓ Dorsogluteal
✓ For adults and children with well developed gluteal muscles
✓ CONTRAINDICATED:
children under 3 y/o
✓ Increased risk of striking the SCIATIC NERVE
✓ DELTOID
✓ Small muscle, very close to the radial nerve and artery
✓ Rapid absorption for adults
✓ Cannot administer more than 1 ml.
✓ Recommended site for Hepa B vaccine administration
✓ RECTUS FEMORIS
✓ Can be used for self administration
✓ Disadvantage: causes discomfort
✓ Gauge: #24, 23, 22, 21, 20
✓ Length: 1”, 1 1/2”, 2”
✓ Max. cc: 2-5 ml
✓ Angle: 90 degrees
✓ INTRAVENOUS/INTRAVASCULAR
✓ Gauge: #24, 23, 22, 21, 20
 ✓ Length: 1”, 1 ½”, 2”
✓ Max. cc: Push 10 ml
Infusion: 4L in 24 hrs.
TOPICAL MEDICATIONS
✓ Transdermal Patch
✓ SITE
✓ Trunk or lower abdomen
Areas that are: hairless
(+) hair (clip, do not shave)
Avoid: cuts, burns, abrasions, distal extremity
OPHTHALMIC MEDICATIONS
✓ Preparation:
✓ Clean the eyelid and lashes from inner to outer canthus
✓ Instruction before administration
Look up

✓ Where and How to Apply:

LIQUID:
Instill correct number of drops
Outer third of the lower conjunctival sac
✓ Instruction after Instillation
Do PUNCTAL OCCLUSION for 30 seconds
OINTMENT:
Discard the first bead
Squeeze 2 cm on the lower conjunctival sac
✓ Instruction after Instillation
CLOSE but not SQUEEZE the eyelid
OTIC MEDICATIONS
✓ Preparation:
✓ Clean the pinna and the meatus of the ear canal
✓ Warm the medication:
In between hands
Place in warm water
✓ Straighten The Auditory Canal:
Adult: (>3 y/o): Pull the Pinna UPWARD and BACKWARD
Child: (<3 y/o): Pull the Pinna DOWNWARD and BACKWARD
✓ INSTILL THE MEDICATION:
Along the side of the canal
 ✓ ACTIONS AFTER:
Gently press the TRAGUS
Insert small piece of cotton fluff loosely
✓ Instruction After:
Remain in side-lying for 5 minutes

Drug Name - The systematic naming of drug used in Pharmacology

Oral Medication - preparations are taken by mouth, swallowed with fluid, and absorbed via
the gastrointestinal tract.
Parenteral Medication - can be defined as a sterile drug product, suitable for administration
by injection.
Ophthalmic Medication - a medication comes in form of drops gel or oinment
Topical Medication - a drug suitable for administration applied to a particular body part most
often applied to surfaces such as skin and mucous membrane.
Otic Medication - drug products used to treat conditions of the external and middle ear.

Philippine Journal of Nursing

European Journal of Pharmacology

Journal of Pharmacology and Pharmaceutics

Websites:

www.aphanet.org

www.drugtopics.com

www.pharmaweb.net

http://evolve.elsevier.com/KeyHayes/pharmacology/
Study Questions

＞ What is Pharmacology? It’s significance to the nursing profession?

＞ How did Pharmacology started?
＞ Define the different drug names
＞ What are the different drug preparations? What are the nursing considerations before and
after administration?

Doctor’s order:

Give Furosemide (Lasix) 40 mg. IV now, then 20 mg IV q 8 hrs. To patient with heart failure.
The ampule contains 10 mg/ml for a total of 2 ml/ ampule. How many ml will the nurse aspirate
and how many ampule will he/she open? What are your consideration before you administer
Furosemide? In a given order, what is the generic name, the brand name, dosage, and route
of administration?

Kee, joyceLeFever. (2015). Pharmacology: A patient-centered nursing process approach,

8 ed. Singapore: Elsevier.
th