Pharmacology Pharmacology is the study of the biological effects of chemicals. Drugs are chemicals that are introduced into the body to cause some sort of change. Health care providers focus on how chemicals act on living organisms. Nurses deal with pharmacotherapeutics, or clinical pharmacology. Some drug effects are therapeutic, or helpful, but others are undesirable or potentially dangerous (adverse effects)
Nurse’s Responsibility Administering drug Assessing drug effects Intervening to make the drug regimen more tolerable Providing patient teachings about drugs and the drug regimen Monitoring the overall patient care plan to prevent medication errors
Sources of Drugs #1 Natural Sources o Plants Synthetic version of the active chemical found in a plant Main component of the growing alternative therapy movement
Sources of Drugs #2 Natural Sources (cont.) o Animal products Used to replace human chemicals that are not produced because of disease or genetic problems Genetic engineering Many of these preparations are now created synthetically
Sources of Drugs #3 Natural Sources (cont.) o Inorganic compounds Salts of various elements can have therapeutic effects in the human body Synthetic Sources o Genetic engineering alter bacteria to produce chemicals that are therapeutic and effective o Original prototypes
Drug Evaluation Preclinical Trials o Chemicals tested on laboratory animals Phase I Studies o Chemicals tested on human volunteers Phase II Studies o Drug tried on informed patients with the disease Phase III Studies o Drug used in vast clinical market Phase IV Studies o Continual evaluation of the drug
Rationale: These technological advances have led to the
development of groups of similar drugs, all of which are derived from an original prototype, but each of which has slightly different properties, making a particular drug more desirable in a specific situation.
Controlled Substances #1 The Controlled Substances Act of 1970 o Control over the coding of drugs and the enforcement of these codes to the FDA and the Drug Enforcement Agency (DEA), a part of the U.S. Department of Justice. Prescription, distribution, storage, and use of these drugs are closely monitored. Local policies and procedures might be even more rigorous.
Generic Drugs Chemicals that are produced by companies involved solely in the manufacturing of drugs Bioavailability of the drug “Dispensed as written” o Important in drugs that have narrow safety margins
Orphan Drugs Drugs that have been discovered, but are not financially viable and therefore have not been “adopted” by any drug company The Orphan Drug Act of 1983
Over-the-Counter Drugs #1 Products that are available without prescription for self- treatment of a variety of complaints. o Some of these agents were approved as prescription drugs. o Later were found to be very safe and useful for patients (example: loratidine). o Many of these drugs were “grandfathered.”
Nurses should consider several problems related to OTC
drug use: o Taking these drugs could mask the signs and symptoms of underlying disease, making diagnosis difficult. o Taking these drugs with prescription medications could result in drug interactions and interfere with drug therapy. o Not taking these drugs as directed could result in serious overdoses.
Sources of Drug Information #1 Drug Label o Drug labels have specific information that identifies a specific drug o Understanding how to read a drug label is essential Package Insert o Prepared by the manufacturer o Contains all of the chemical and study information that led to the drug’s approval o Difficult to understand and read
Sources of Drug Information #2 Reference Books o Physician’s Drug Reference (PDR) o Drug Facts and Comparisons o AMA Drug Evaluations o Lippincott’s Nursing Drug Guide (LNDG) Journals Internet
Question #2 Drug labels are a source of information. What information might a drug label provide? A. The manufactured date B. The expiration date C. When the patent expires D. The binding properties of the drug
Answer to Question #2 B. The expiration date Rationale: Drug labels have specific information that identifies a specific drug. For example, a drug label identifies the brand and generic names for the drug, the drug dosage, expiration date, and special drug warnings. Some labels also indicate the route and dosage for administration.