MEDICATION / PHARMACOLOGY

TERMINOLOGIES:

❖ Pharmacology
Pharmacology is the study of drugs
❖ Drug
A substance, when introduced to the body, causes a physiological
effect.
❖ Pharmacodynamics
The effect (physiological and biochemical) that a drug has on the
human body. Another definition is the body's biological response to
the drug
❖ Pharmacokinetics
Pharmacokinetics is the study of drug movement/action in the body
in terms of absorption, distribution, metabolism, and excretion.
❖ Mechanism of Action
Mechanism of action refers to the biochemical processes in which
yields the drug effect.
❖ Indication
Purpose of administering a certain drug
❖ Contraindication
Reason against administering a certain drug
❖ Absorption
Absorption is the drug movement from the administration site
to bloodstream
❖ Duration
Duration is the length of time that a drug is effective.
❖ Onset
Onset is the time taken for a drug effect to take place after
administration
❖ Peak
Peak is the highest level of drug concentration in the blood
❖ Therapeutic Effect
The therapeutic effect is the response to a drug that is favorable
(good effect).
❖ Adverse Effect
Adverse Effect is the undesirable effect of the drug (bad
effect)
❖ Systemic Effect
Systemic effect is defined as effects that occur in other
tissues that are distant from the administration site
❖ Side Effect
The side effect is the secondary effect of a drug. It may be
therapeutic or adverse
❖ Idiosyncratic effect
An idiosyncratic effect is an unknown effect or cause
❖ Agonist
Agonist drugs bind to a receptor and stimulate the function
of the receptor

❖ Antagonist
Antagonist drugs bind to the receptors and prevent the
the function of the receptor
❖ Hypersensitivity
An undesirable reaction produced by the immune system in
response to an antigen or drug
❖ Metabolism
Metabolism is the chemical alteration of a drug in the body.
10 RIGHTS OF MEDICATION ADMINISTRATION:

Right Drug Right Documentation

Right Patient Right Assessment

Right Dose Right to Refuse

Right Route Right Drug Interaction

Right Time Right Education

CLASSIFICATION OF DRUGS:

 Therapeutic Classification: the drug's therapeutic usefulness

 Anticoagulant: influence blood clotting

 Antihypertensive: lowers blood pressure
 Antianginal: treat angina
 Antihyperlipidemic: lowers blood cholesterol

 Pharmacological Classification: how the drug acts

Diuretics: lowers plasma volume

Calcium Channel Blockers: blocks heart calcium channels

 Drug Name

Chemical Name: chemical composition

Generic Name: indicates drug group
Trade/Brand Name: name registered by the manufacturer

MEDICATION SUMMARY:

 Medication Orders
Date:
Name of Medication:
Dosage:
Time and Frequency:
Route of Administration:
Name and Signature of
Prescriber:
Patient Information:

 FACTORS THAT AFFECT DRUG ABSORPTION

1. Route
2. Dosage Formulation
3. Surface Area
4. Blood Flow
5. Lipid solubility
6. Food and Fluids
Remember: some drugs need to be taken on an empty stomach.
Other drugs should be taken on a full stomach or with food to enhance absorption or minimize gastric irritation.

TYPES OF DRUG ORDER

Routine / Standing Order: Carried out as specified until discontinued

PRN: As needed

Single Order: Directive is carried out only once as specified by physician

Stat Order: A single order carried out at once

Written Order: inscribed by a physician on a prescription pad

Verbal Order: When receiving verbal orders, write the order down exactly as heard, repeat the order back to the
physician, document it, and have the physician cosign

Telephone Order: Many institutions do not accept this order

DRUG SUFFIXES AND PREFIXES

 Cardiac Drugs
-ACE Inhibitors: -pril
-Beta Blockers: -olol
-Calcium Channel Blockers: -ipine
-Loop Diuretics: -semide
-ARBs: -sartan

 Respiratory Drugs
-Xantine: -phylline
-Bronchodilator (beta agonist): -terol
-Antihistamine: - tadine, -iramine
-Corticosteroid: pred-, cort-, -asone, -olone

 GI Drugs
-PPIs: -eprazole, oprazole
-H2 Receptor Antagonists: -tidine
-Antiemetics: -setron
-PEG: peg-

 Antibiotics
Cephalosporin: cef-, ceph-
Penicillin: -cillin
Quinolones: -floxacin
Macrolides: -mycin
Tetracycline: cycline
Antiviral: -vir

 Neuro
Benzodiazepine: -zepam, zolam
SSRIs: -etine
Barbituates: -barbital
Tricyclic Antidepressants: -ipramine

 Pain
-NSAIDs: -fenac, -profen
-Local anesthetic: -caine
-General anesthetic: -ane

THERAPEUTIC DRUG LEVEL/ANTIDOTE

Therapeutic Drug Levels

Digoxin: 0.5-2 ng/mL
Theophylline: 10-20 mcg/mL
Phenobarbital: 15-40 mcg/mL
Lithium: 0.8-1.5 mmol/L
Carbamazepine: 4-10 mg/L
Phenytoin: 10-20mg/L
Lidocaine: 1.5-5mg/L

Drug: Antidote
Opioids: Naloxone
Warfarin: Vit K
Heparin: Protamine
Cholinergic: Atropine
Acetaminophen: Acetylcysteine
Benzodiazepines: Flumazenil
Insulin: Glucagon
Digoxin: Digoxin Immune Fab
 DRUG CALCULATION
MEDICATION ADMINISTRATION ROUTES
PO: by mouth/orally
SubQ: Subcutaneous -25-27 gauge, 45-90 degree angle
IM: Intramuscular - 18-27 gauge, 90 degree angle
ID: Intradermal - 26-27 gauge, 10-15 degree angle
IV: Intravenous - 16-24 gauge, 15-30 degree angle
SL: Sublingual
PR: per rectum
NG: Nasogastric tube
GT: Gastrostomy tube
IVP: IV push
IVPB: IV piggyback

Route Abbreviation Description

Intracerebroventricula i.c.v. Into the ventricles of the brain

r

Intra-arterial i.a. Into the lumen of an artery

Intracerebral i.c. Into the brain

Intradermal i.d. Into the dermal layer of the skin

Intramuscular i.m. Into a skeletal muscle

Intragastric i.g. Into the stomach

Intraperitoneal i.p. Into the peritoneal cavity

Intrathecal i.t. Into the spinal canal

Intravenous i.v. Into a vein

Oral p.o. By mouth / Per Orem

Subcutaneous s.c. Under the skin

Topical – Onto the surface, such as the skin or the eye

Systemic – In the periphery (not in the CNS)

TYPES OF DRUG PREPARATION

Tablet: tab(s)
Drop: gtt
Suspension: susp
Suppository: supp
Enteric-coated: EC
Elixir: elix
Controlled release: CR
TIMES OF MEDICATION ADMINISTRATION

Before meals: ac
After meals: pc
Twice a day: bid
Three times a day: tid
Four times a day: qid
Every day: daily
Every hour: qh
Every two hours: q2h
Every four hours: q4h
Every six hours: q6h
As needed: prn
As desired: ad lib
At bedtime (hour of sleep): hs

CONVERSION FACTORS

CONVERSION BASED ON VOLUME WEIGHT

1 mg = 1,000mcg 1 kg = 2.2lbs
1 g = 1,000mg 1 lb = 16 oz
1 oz = 30mL
8 oz = 1cup
1 oz = 2tbsp Calculation:
1 tsp = 5mL pounds to kg = divide by 2.2
1 tbsp = 15mL
1 tbsp = 3tsp kg to pounds = multiply by 2.2
1 mL = 1cc
1 mL = 5gtts
1L = 1,000mL

Safe nursing care mandates accuracy in the calculation of dosages and solution rates. In medication calculations, there
is no room for mistakes.

MEASUREMENT SYSTEMS
Three measurement systems are used in dosage calculation/pharmacology:
-Metric system: gram (g), milligram (mg), microgram (mcg), kilogram (kg), milliliter (mL) and milliequivalent (mEq)
-Apothecary system: minim (min), pint (pt), dram, ounces (oz), grain (gr)
-Household system: teaspoon (tsp), tablespoon (tbsp), gallon (gal), pounds (lb), cups

BASIC VOLUME-RELATED FORMULA

TABLET

PEDIATRIC DOSES
Remember:
Pediatric dosage calculations are based on body weight(kgs). Always convert pounds to Kg.
The formula below is used for a safe dose range.

Weight per Kg X Dose per Kg = Amount to Administer

Calculate the drug dose in mLs for a child weighing 22 lb. The dose required is 40 mg/kg/day divided BID and
the suspension comes in a concentration of 400 mg/5 mL.

Step 1. Convert pounds to kg: 22 lb × 1 kg/2.2 lb = 10 kg

Step 2. Calculate the dose in mg: 10 kg × 40 mg/kg/day = 400 mg/day
Step 3. Divide the dose by the frequency: 400 mg/day ÷ 2(BID) = 200 mg/dose BID
Step 4. Convert the mg dose to mL: 200 mg/dose ÷ 400 mg/5mL = 2.5 mL BID

IV FLOW RATE CALCULATION

CALCULATING: gtt/min (drops/min)

CALCULATING: REMAINING TIME OF INFUSION

INSULINS
PREVENTING MEDICATION ERRORS
*Read labels 3 times and compare with MAR.
* Use at least 2 patient identifiers.
* Double-check all calculations.
* Follow the 10 rights of medication administration.
* Document all medications as soon as they are given.