BACHELOR OF SCIENCE IN NURSING

NURSING PHARMACOLOGY
COURSE MODULE COURSE UNIT WEEK
3 14 16
Filipino Culture, Values, Practices, and Beliefs in Relation to Drug Administration

ü Read course and unit objectives

ü Read study guide prior to class attendance
ü Read required learning resources and refer to unit terminologies for jargons
ü Proactively participates in chat room discussions
ü Participate in weekly discussion
ü Answer and submit course unit tasks

ü Module, Reference Books, Laptop, Internet, Headset

At the end of the course unit, learners will be able to:

Cognitive:
1. Apply appropriate concepts of nursing pharmacology holistically and comprehensively.
2. Advocate for responsible citizenship and pride as a Filipino nurse.
3. Exemplify love for country in the service of Filipinos.
4. Customize nursing interventions based on Philippine culture and values.
 5. Discuss the various technological advances in ensuring safe medication administration

Affective:
1. Listen attentively during class discussions
2. Demonstrate tact and respect when challenging other people’s opinions and ideas
3. Accept comments and reactions of classmates on one’s opinions openly and
graciously.
4. Develop heightened interest in studying Nursing Pharmacology.

Psychomotor:
1. Participate actively during class discussions and group activities
2. Express opinion and thoughts during class

Culture – is the total way of life of particular groups of people. It includes everything that a
group of people thinks, says, does and makes — its systems, attitudes and feelings. It is
learned and transmitted from generation to generation.

Drug Administration – it is a route of administration in pharmacology is the path by which a

drug, fluid, or other substance is taken into the body. Routes of administration are generally
classified by the location at which the substance is applied. Common examples include oral
and intravenous administration.

Practice – is the customary, habitual, or expected procedure or way of doing of something.

Values – a person's principles or standards of behavior; one's judgment of what is important in

life.

Pharmaceutical technology – is application of scientific knowledge or technology to

pharmacy, pharmacology, and the pharmaceutical industry.

Filipino Cultures, Values, and Practices in Relation to Drug Administration

As the diversity in the patient population is growing, there is also an increasing number of
diverse caregivers. Among them are the Filipino health care providers, most of whom are
nurses. Understanding the Filipino culture, values, and practices in relation to drug
administration is so important, as it affects the way they assess the needs and provide care for
their clients. Like any other ethnic group, Filipinos have become acculturated at various levels
and the integration of their cultural beliefs, values, and behaviors that affects their care giving
attitudes and practices.

Filipino children tend to cope with illness with the help of their parents. They usually rely on
their parents and will do their best for the well-being of their children. Filipino adult patients
tend to cope with illness with the help of family and friends, and by faith in God. Complete cure
or even the slightest improvement in a malady or illness is viewed as a miracle. Filipino
families greatly influence patients’ decisions about health care. Patients subjugate personal
needs and tend to go along with the demands of a more authoritative family figure in order to
maintain group harmony. Before seeking professional help, Filipino older adults tend to
manage their illnesses by self-monitoring of symptoms, ascertaining possible causes,
determining the severity and threat to functional capacity, and considering the financial and
emotional burden to the family.

They may even resort to utilizing traditional home remedies such as alternative or
complimentary means of treatment. They may discuss their concern with a trusted family
member, friend, spiritual counselor or healer. Seeking medical advice from family members or
friends who are health professionals is also a common practice among Filipino older adults
and their family members, especially if severe somatic symptoms arise.

There are some coping styles common among elderly Filipino in times of illness or crisis that
includes: (1) patience and endurance (Tiyaga) which is the ability to tolerate uncertain
situations even they feel bad and never drink medication; (2) flexibility (Lakas ng Loob) which
is being respectful and honest with oneself and that everything will be turn out fine; (3) humor
(Tatawanan ang problema) which is the capacity to laugh at oneself in times of adversity; (4)
fatalistic resignation (Bahala Na) which is the view that illness and suffering are the
unavoidable and predestined will of God, in which the patient, will not allow to take any
medications and even the physician should not interfere; and (5) conceding to the wishes of
the collective (Pakikisama) to maintain group harmony that make them feel well.

Health beliefs and practices are oriented towards protection of the body by some Filipinos such
as: (1) flushing which is the body is thought to be a vessel or container that collects and
eliminates impurities through physiological processes such as sweating, vomiting, expelling
gas, or having an appropriate volume of menstrual bleeding; (2) heating which adapts the
concept of balanced between “hot” and “cold” to prevent occurrence of illness and disorders;
and (3) protection which safeguards the body’s boundaries from outside influences such as
supernatural and natural forces.

One way by which culture and religion intersect is by way of prescription medication. For
example, a patient may go to the doctor. The doctor may diagnose them with something like
high blood pressure and then tell them they need to take prescription blood pressure
medication for a very long time in order to prevent complications like heart disease or kidney
damage. Well, that may be a problem because some cultures or religious beliefs prohibit or
limit the use of modern medication. Instead, some cultures rely more on traditional or folk
remedies like herbs, certain body positions, or acupuncture points. But some really follow their
doctors for them to feel well.

For example, people with an Asian background are more likely to believe that modern
medication is harmful and even addictive. In their view, this type of medication should be
avoided. In contrast, people with a European background are more likely to believe that
modern medication is beneficial and should be used when necessary. However, this is an
oversimplification. People who have an Asian cultural background will definitely use modern
medicine for sudden or serious events like emergency surgery, but compared to Europeans,
they are more likely to rely on traditional or folk medicine for anything that requires the use of
medication for a long time, as per high blood pressure.

The human body functions through a complicated series of chemical reactions and processes.
Drugs are chemicals that are introduced into the body to cause a biological effect. When drugs
are administered, there are a sequence of processes that handle the new chemicals including
the breakdown and elimination of the drugs from the body. For many reasons, understanding
how drugs act on the body to cause changes and applying that knowledge in the clinical
setting are important aspects of nursing practice. For example, patients often follow
complicated drug regimens and receive potentially toxic drugs. In addition, some drugs interact
with other drugs and some foodstuffs. Many patients also manage their own care at home.
Therefore, the nurse is in a unique position regarding drug therapy because nursing
responsibilities include the following: (1) administering drugs; (2) assessing drug effects; (3)
intervening to make the drug regimen more tolerable; (4) providing patient teaching about
drugs and the drug regimen; and (5) monitoring the overall patient care plan to prevent
medication errors.

There are Filipino practices that everybody must be taught and be aware that before giving or
administering medication, practice asepsis by washing hands before and after preparing
medications. Nurses who administer medications are responsible for their own actions. Same
way with the clients taking medication they have to be very careful on taking medications
without prescription, Some medications are giving patients hypersensitivity reaction if taking
without proper prescription by the doctor leading to worst scenario. The nurse or the client may
question any order that they think is incorrect, unclear or inappropriate. Filipinos nurses and
even clients, especially, that they must be knowledgeable on the medications that they are
giving or taking. A fundamental rule of safe drug administration is never administers an
unfamiliar medications. Use only medications that are clearly labeled containers. Re-labeling of
drugs is the responsibility of the pharmacist.

Some examples are when giving an unfamiliar medication, it is best to read a drug handbook
first before administration. Check for drug incompatibilities especially when giving it through
the intravenous route. This is important because some parenteral medications are not
compatible to be administered in an IV line with ongoing drug incorporation. In cases such as
these, you might need to start another IV line. In crushing medications, pediatric and geriatric
patients usually have difficulty swallowing medications. Before crushing drugs and mixing them
in applesauce, make sure that this practice is not contraindicated to the drug’s efficacy.
Sustained-release tablets, chemo drugs and capsules should NOT be crushed as their efficacy
can be altered.

Everyone must observe the 10 rights of drug administration to ensure safe drug administration.
The nurse must always practicing and sharing this to the clients prior going out of hospital. (1)
Right patient by checking the person who will take the medication; (2) Right medication by
checking the name of the medication, whether it is generic or branded. Check the expiry date
and check the prescription if there’s a need to replace or to update. Make sure medications,
especially antibiotics, are reviewed regularly. (3) Right dose by checking the prescription and
confirm appropriateness of the dose to the doctor or when buying in the drugstore or with local
guidelines. If necessary, calculate the dose and ask the help of the doctor or nurse on how the
dose is given. (4) Right route, again check the order and appropriateness of the route
prescribed. Confirm that the patient can take or receive the medication by the ordered route.
(5) Right time by checking the frequency of the prescribed medication. Double-check that you
are giving or taking the prescribed medication at the correct time. Confirm when the last dose
was given. (6) Right patient education, the nurse must check if the patient really understands
what the medication is for. Make them aware they should contact a healthcare professional if
they experience side-effects or reactions. (7) Right documentation, can be done by nurse to
ensure that the nurse have signed for the medication after it has been administered. Ensure
the medication is prescribed correctly with a start and end date if appropriate. Patient may also
do the documentation for them to ensure proper intake of drugs and never been forgotten. (8)
Right to refuse ensures that the nurse consent the patient to administer medications. It is right
of a Filipino patient to practice autonomy and independence but be aware that patients do
have a right to refuse medication if they have the capacity to do so. (9) Right assessment is
the practice of the nurse by checking patient actual needs of the medication. As a nurse, check
for contraindications and baseline observations if required. (10) Right evaluation to ensure the
medication is working the way it should. Ensure medications are reviewed regularly and
ongoing observations if required.

New Technologies Related to Drug Administration

Drugs and technology

For health services to be effective, drugs and technology must be available, efficacious, of high
quality, safe and rationally used. It is a health system’s role to achieve these objectives in
balance with other necessary resources. Advances in technology – such as new drugs or
diagnostic equipment – can improve health outcomes and the overall performance of a health
care system. But innovations also present challenges because their introduction alters the
balance between resources and often, increases the cost of care. In the past few decades,
revolutionary advances in medicine and technology have altered the roles of hospitals and
primary health and community care facilities. Responsive health systems examine these
changes in the light of their priorities and consider what changes, if any, to make.
Poor countries have only limited possibilities for investing in modern medical technologies or
paying for the latest medicines, lest they sacrifice essential, life-saving primary level services.
Wealthy countries also need to balance the needs of the general population against demands
for hi-tech medicine and its tendency to escalate the cost of health care overall. Prices for
many drugs and technologies are set not by local but rather by international markets.

Hence, the technological advancement in pharmaceutical helps in increasing the life of people.
It brings hope to the patients to live more. It helps in curing very complex diseases such as
cancer, tumors etc. with less pain and harm.

There are 16 Tech Advancements in Pharmaceuticals to Re-invent Healing

1. Precision medicine. It is an approach that merges clinical and molecular information to

understand the biological basis of disease. This information can be obtained by transforming
DNA into data. The process of converting DNA into data is called genome sequencing. Later
on, this information is used by the researchers to identify the specific gene abnormalities, or
biomarkers to understand the effectiveness of drugs on a different type of patients.

2. mHealth sensors. Pharma research institutes are doing research on developing the
healthcare with the use of smartphones. Smartphones with advanced sensors and powerful
processors can take measurements, track movement and record information are being used
by the researchers to improve healthcare. Apple has several mHealth apps for clinical
research on iPhones. The apps are targetting the diseases such as diabetes, asthma,
cardiovascular disease and breast cancer.

3. 3D printing. 3D printing builds the pill by spreading layers of the drug on the top of one
another until it reaches to the right dose. It allows the pill to deliver a higher dose of medicine
up to 1000 mg. It is porous enough to dissolve quickly. It is beneficial for patients who have
difficulty swallowing their medication.

4. Nanotechnology. It is the microscopic technology that ranges on the scale of between 1 to

100 nanometers. Nanoparticles can easily travel around the human body in the bloodstream.
The nanoparticles help in the delivery of anti-cancer drugs and to reduce toxicity.
Nanotechnology can track patients take their medication to encourage increased adherence.

5. Nanobots. The medical research institutes are also researching the potential use of
microscopic robots. These robots are known as nanobots. Nanobots are made up of two
different words i.e. nanotechnology and robots. It can be consumed by the patient in form of
pills or injections.

6. Synthetic 3-D tumors. the synthetic 3D tumors provide a better look at how tumors behave
and a more accurate measure of how they respond to treatment. Synthetic 3D tumors can help
the researchers to study the development, metastasis, invasion, and treatment of cancer cells
from patients. They can also use this model to test the safety and efficacy of new cancer
treatment therapies and drugs.
7. Microenvironments. Researchers have developed a chip that is capable of simulating a
tumor’s microenvironment and plan to use the new system to test the effectiveness of
nanoparticles and drugs that target cancer.

8. Advanced instrumentation. It is another important aspect that brings the advancement in the
pharmaceutical industry. Nowadays, pharmaceutical research centers are introducing new and
advanced instruments which help in healthcare and fine treatment for various diseases.

9. Bioinformatics. A recent study reveals that the researchers will involve the use of informatics
to drive the development of therapies to bring value to the healthcare system and patients at
low cost. The social media programs become one of these technology drivers. In this Patients
will connect online to share their experiences with different diseases.

10. Medication Therapy Management. The MTM services include drug use review, drug dose
adjustment, comprehensive medication reviews, order and review lab tests, immunizations etc.
The medication therapy management will enhance medication use and patient outcomes in
patients suffering from chronic diseases. It will cut the cost and improve the quality of care and
patient safety.

11. Localized drug delivery. A pharmaceutical research institute has developed two drug
delivery technologies i.e. microcapsules and nanocoating for delivering the drug. The
microcapsule technology involves the use of microcapsules that can be injected or delivered in
a fine mist spray directly to the site of injury. In nanocoating technology, a nanocoating of
interleukin-12 is directly applied to pain pumps, pacemakers, artificial limbs and other
biomedical devices.

12. Utilization of supercomputers to make complex decisions. Taking medical decisions with
the help of artificial intelligence using the power of supercomputers will restructure everyday
medicine. IBM Watson has been used in different ways to analyze huge data, not only in
research but also in biotechnology. A machine can analyze the data with greater speed and
accuracy than a human being.

13. Drug experimentation on simulation models. Earlier the drug experimentation is done on
animals or human beings but now the research institutes are doing research on simulation
model drug testing. Drugs will be tested on simulating models physiology of the human body
with the use of supercomputers. By using simulating model drug testing no one would get hurt
in the drug testing process.

14. Cell-free fetal DNA testing. Pregnant women need fetus testing to identify chromosomal
defects like down syndrome and Edwards syndrome. This test has a risk of miscarriage and it
increases the stress of pregnant women. The test requires the collection of cell that is quite
harmful to the unborn baby. But with the advanced technology in the pharmaceutical industry,
this test can be done by using the mother’s blood. It is a cell-free fetal DNA test. It is not
harmful to the baby and the mother as well.
15. Robotic surgery. This is another important advancement in the pharmaceutical sector. It is
set to grow in the upcoming years. Using this technology, surgeons can perform complex and
delicate surgery procedures that are difficult using other methods.

16. Wireless brain sensors. The advancement in technology allows the doctors and scientists
to create bioresorbable electronics that can be placed in the brain and they can easily dissolve
when they are not required. This device will helps doctors to measure pressure and
temperature within the brain. Since the sensors are able to dissolve there is no need for
additional surgery.

McCuistion, Linda E…et al. (2018). Pharmacology: a patient-centered nursing process

approach, 9th ed. St. Louis, Missouri: Elsevier.

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

Boyd, Claire. (2016). Nursing calculations & IV therapy for dummies. West Sussex, UK.: John
Wiley & Sons

Ford, Susan M. (2018). Roach's introductory clinical pharmacology, 11th ed. Philadelphia:
Wolters Kluwer

Hochadel, MaryAnne. (2016). Mosby’s drug reference for health professions. St. Louis:
Elsevier.
Laguna-Bedia, Marie Gabrielle…et al. (2016). Pharmacology for allied health professions, 1st
ed. Manila: APD Educational Publishing House.

Journals:
Sciencedirect.com

Websites:
www.aphanet.org
www.drugtopics.com
www.pharmaweb.net

Can access to YouTube, Google and other electronic nutrition books available
https://geriatrics.stanford.edu/
https://www.newgenapps.com/blog/tech-advancements-in-pharmaceuticals-to-re-invent-
healing
https://nurseslabs.com/category/nursing-notes/nursing-pharmacology/
https://www.nursebuff.com/category/lists/nursing-pharmacology-lists/

Study Questions

• Download a research article on the topic about new technology related to

drug administration from ScienceDirect. Submit a 200-300-word essay
reflection.
• List and comment on some Filipino cultures, values and practices related
to drug administration that you encountered during your duty in non-
pathologic and pathologic maternal nursing. (100-200 words)