CAPITOL MEDICAL CENTER COLLEGES

V.A.B. CAMATO

PHARMACOLOGY |
MILDRED T. CASTILLO, RN, RM, RPh, MAN Advanced practice nurses
DEFINITION OF TERMS
→ is the art of preparing, compounding and
→ "pharmakon" (drug); dispensing drugs
→ "logos" (study) is the study of effects of drugs on → it refers to the place where drugs are prepared
living organisms and dispensed

→ is a substance prescribed by medical → a person licensed to prepare and dispense

practitioners drugs to make up a prescription
→ e.g., doctors, dentists
o To treat/cure disease → study of drug dosages
o To prevent disease
o To diagnose a disease
o For relief of symptoms → study of drug overdose

→ Chemicals that are produced by companies → is the computed dose of a drug in a given
that just manufacture drugs kilogram per body weight

→ drugs that have been discovered but are not → is the uncomputed dose of a drug
financially viable and therefore have not been
"adopted" by any drug company → treating thru the application of drugs

→ Drugs that are available without prescription → drugs used to destroy foreign bodies or
for self-treatment of a variety of complaints microorganisms without destroying the host

Ex .Cancer drugs
 Make diagnosis difficult
 ( can mask the signs & symptoms of underlying → is the lowest concentration of the drug that can
disease) produce the desired pharmacologic effect
 Could result in drug interactions & interfere with
drug therapy
 Not taking drugs as directed could result in → is the highest concentration of the drug that
serious overdoses can produce the desired pharmacologic effect

→ set of standards to ensure drug uniformity in → is the finished dosage form of the drug
strength, purity, containing the active ingredient
→ efficacy, safety and bioavailability Tablet
o USP (United States Pharmacopeia) Capsule
o NF (National Formulary) Suppository
o British Pharmacopeia (British)
o Canadian Formulary (Canada) → is the chemical substance that is responsible for
the claimed therapeutic effect of the drug
→ refers to any health care provider who is product (Main Ingredient)
authorized to prescribe medications
Physicians (doctors) → Is the state of decreased drug responsiveness
Dentists
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V.A.B. CAMATO

→ Is a reaction in which antigens binds with → is a sequence that change a drug to a less
basophils on surface of mast cells with release active form after it enters the body
of histamine, leukotrienes, serotonins & → (liver- major organ for metabolism)
prostaglandins
→ Severe allergic reaction
→ is the process in which drug is eliminated from
the body (kidney - major organ for excretion)
→ specific cell, tissue or organ where a drug works
→ readiness to produce a drug effect
→ portion of a cell whose site of action is
occupied by a drug
→ requires the collaborative effort of many health
care providers with specialized knowledge,
→ drug that mimics the effects of endogenous judgment, and nursing skill based on the
compound principles of pharmacology.

→ drug that competitively or non-competitively → prescribe meds

inhibit or counteract receptor activity
→ prepare and dispense meds
→ measures the safety and usefulness of a drug
→ TI = LD 50/ED 50
→ administer meds
→ "The higher is the value, the safer the drug is"

→ identify possible food and drug interactions

→ "What the drug does to the body"

→ To assist the student in applying knowledge of

→ "What the body does to the drug"
pharmacology and in acquiring skills in the safe
→ involves 4 processes/steps:
administration of medications
A - bsorption
D- istribution DRUG NOMENCLATURE
M- etabolism
E-xcretion → is a precise description of the drug's
composition ( Chemical Formula)
→ passage of a drug from the site of
administration into the bloodstream as → is the name assigned by the U.S. Adopted
affected by different factors Names Council to the manufacturer who first
develops the drug

→ name of the drug when approved; same as

non-proprietary name
→ is the movement of drugs from the blood into
various body fluids and tissues → is the name marketed by the pharmaceutical
companies
o Blood Flow
o Cell Membrane Permeability
o Protein Binding Capacity
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V.A.B. CAMATO

DRUG ACTION
→ is the drug's ability to combine with a particular → women because they usually have more fatty
receptor which is based on the half-life of a pads than men
drug.

½ → men have more body fluids than women

→ refers to the time it takes the body to eliminate
half of the blood concentration level of the → a client may be abnormally sensitive to a drug
original drug dose. or may metabolize a drug differently from others
o Ex. 6 hours- 50% of drug's original dose is present
in blood 12 hours- 25% " " " "
→ drug action is altered in clients with circulatory,
> "Because of the drug's half-life, repeated doses liver or kidney dysfunction
are often required to maintain the drug level over
a 24-hour interval. " → Oral medications are absorbed more quickly if
the stomach is empty but if gastric irritant, needs
→ is the highest blood concentration of a single to be given after a meal.
drug dose before the elimination rate equals
DRUG EFFECTS
the rate of absorption
→ applies to skin only
→ is the lowest blood serum concentration of a
drug immediately before the next scheduled → reaches blood circulation
dosage
→ is the possible effect of a drug
→ helps adjust dosage to prevent toxicity or build-
up
→ are the non-therapeutic effect that are not
hazardous
→ is the time it takes the body to respond to drug → expected clinical manifestations or signs and
after administration symptoms after taking the therapeutic dose
→ affected by route of administration and
pharmacokinetic factors
→ unexpected and potentially hazardous effect
of drug
→ is the time a drug remains in the system in a
therapeutic concentration
→ skin rash, urticaria, headache, nausea or
vomiting
→ is the blood concentration level maintained
after a series of scheduled drug doses is
→ is an immediate , life-threatening reaction to a
administered
drug characterized by respiratory distress,
FACTORS INFLUENCING DRUG ACTION sudden severe bronchospasm, and
cardiovascular collapse
→ usually very young and elderly requires less doses → (In case of emergency, Give: Epinephrine,
because they are highly responsive to drug bronchodilators, antihistamines)

→ the greater the body weight, the greater the → is an antigen-antibody immune reaction that
dose required occurs when an individual who has been
previously exposed to drug has developed
antibodies against the drug
→ it depends on the concentration of the drug
→ immunologic reaction to a drug
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→ (Ex. Vitamins)
→ occurs when the body cannot metabolize a
drug, causing the drug to accumulate in the TYPES OF MEDICATION ORDERS
blood
→ indicates that the medication is to be given
immediately and only once
→ is a highly unpredictable response that maybe
manifested by overresponding, under
response, or an atypical response → or one time order is for medication to be given
o Ex. If 40,000 clients will develop aplastic anemia once at a specified time
after receiving chloramphenicol (antibiotic)
→ maybe carried out indefinitely, may or may not
→ two drugs with the same effect when given have a termination date
together produce SAME EFFECT/s if drug is
given individually → or as needed order, when necessary
o 1+1=2
DRUG PREPARATIONS (Dosage Forms)
ORAL SOLIDS
→ result of 2 drugs whose combined effects is
greater than the sum of each drug alone.
→ compressed or molded substances formed into
→ two drugs with the same effect when given
a hard disc to be swallowed
together produce GREATER EFFECT if the drug
is given individually
o 1+1>2 → chewed before swallowing

→ is the effect that occurs when one drug → in between the cheek
increases the effect of a second drug
o 1+1=0
→ under the tongue
THERAPEUTIC ACTIONS OF DRUG
→ coated tablets that dissolve in the intestine
→ relieves the symptoms of a disease but does
not affect the disease itself
→ (Ex. Aspirin for pain) → substance encased in either hard or a soft
soluble container or gelatin shell that dissolves in
→ cures/treat a disease or condition the stomach
→ (Ex. Penicillin for infection)
→ encased substances that are further enclosed in
→ support body function until other treatments or smaller casings that deliver a drug dose over an
body's response can take over extended period of time
→ (Ex. Aspirin for fever)
→ compounded substances designed to release
→ replaces body fluids or substances a drug slowly to maintain a steady blood
→ (Ex. Insulin for Diabetes Mellitus) medication level

→ destroys malignant(cancer) cells → finely ground substances

→ (Ex. Busulfan for leukemia)
→ similar preparations of drugs designed to
→ returns the body to health dissolve in the mouth
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→ substances dissolved in sugar liquid

→ applied to skin

→ aqueous solution to treat nasopharyngeal

→ substances mixed with an alcohol, oil, or soapy
(tonsilitis, pharyngitis)
emollient that are applied to the skin

→ aqueous solutions for cleansing oral cavity

→ semi-solid substances for topical use

→ aqueous solutions in the form of drops or sprays

→ semi-solid substances thicker than an ointment
that is instilled into the nose
absorbed slowly thru the skin

→ aqueous solution as drops into the ear

→ contain medication that is absorbed thru the
skin over an extended period of time
→ aqueous solution instilled as drops into the eye

→ gelatin substance designed to dissolve when RIGHTS OF DRUG ADMINISTRATION

inserted into an opening. 1. Right Drug
o - (rectum ) 2. Right Patient
o - (urethra) 3. Right Dose
o - (vagina) 4. Right Time
5. Right Route of Administration

→ drugs or dilution of drugs administered by the

nasal or oral respiratory route for a local or → Compare the name of drug prescribed
systemic effect (physician's order sheet, prescription,
medication record, medicine card) with the
label on the package, bottle, or unit dose
→ contain one or more chemical substances packet
dissolved in water o GN (BN)
o Expiry date
→ aqueous solution for rectal instillation o Preparation
o Storage

→ aqueous solution used as cleansing or 3 Checks ( Right Drug)

antiseptic agent for dissolving in a specific 1. Check the label when removing drug from the
quantity of warm water drawer/cabinet
2. Check the drug when removing it from
container
→ powder substances that must be dissolved in a
3. Check the drug before returning it to the client's
liquid (shaken vigorously) before administration
medication drawer

→ non-aqueous solutions that contain water Abbreviations commonly seen in tablet preparation
varying alcohol content, and glycerin or other Controlled Release
sweeteners Controlled Release Tablet
Long Acting
Sustained Release
→ a two-phase system in which one liquid is Time Release
dispersed in the form of small droplets Time Delay
throughout another liquid used as base in some Sustained Action
medication Extended Release
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V.A.B. CAMATO

INSTRUCTIONS ( RIGHT DRUG) METRIC SYSTEM

✓ Question orders for handwriting, misspelling,
inappropriateness, allergies, drug interactions
✓ Never give medication that someone else has
prepared ⁰
✓ Never leave medications at the bedside ⁻
✓ Return the medication (unopened packet) to ⁻
⁻
the cart, drawer or medicine µ ⁻⁶ µ µ
✓ room if patient is unable to take 10⁻⁹
✓ Never open the unit-dose packet until the ⁻
patient is prepared to take the medicine APOTHECARY MEASUREMENT
→ one of the oldest drug measurement systems
RIGHT CLIENT ( PATIENT) → infrequently used but sill seen on drug labels
Ask client to state their full name and prescriptions
Check identification bands and replace if → important to administer medications safely
blurred or are missing after properly checked → uses fractions
prior to placement of new band → unit measure comes before numerical quantity
Never identify a patient solely by calling the o grain (gr)
person's name because some clients maybe o minim (m, min, )
confused and will answer to any name o dram or drachm (dr)
RIGHT DOSE o ounce (oz)
Careful and correct calculation (double
checked) - ex. Insulin
Correct and appropriate measurement devices
FORMULA (DRUG COMPUTATION)
(cups, syringes, droppers)
Scored or crushed medications 𝐷 𝐷
- evenly broken to prevent overdosage or 𝑆
𝑜𝑟
𝐻
underdosage
- use of mortar and pestle thoroughly cleansed 𝐷 𝐷
𝑜𝑟 𝑥 𝑞
to prevent mixing of drugs and receive 𝑆 𝐻
minute amounts causing serious side effects Where:
o – Desired / Drug Ordered
HOUSEHOLD MEASUREMENT
→ aka: U.S. Customary Measurement o – Stoc; – Drug on Hand
→ used in cookbooks and recipes o – quantity

1 gallon (gal)
1 quart (qt) 𝑉𝑜𝑙𝑢𝑚𝑒
1 pint 𝑇𝑖𝑚𝑒
1 measuring cup
1 fluid ounces (fl. oz) 9℃ = 5℉ − 160
1 tablespoon (tbsp)
5
1 fluid dram (fl. Dr) ℃= (℉ − 32) 𝑜𝑟 ℃ = 1.8℉ − 32
9
1 minim (m)
1 drop (gtt) 9
℉ = ℃ + 32 𝑜𝑟 ℉ = 1.8℃ + 32
5

RIGHT TIME
→ On a scheduled dose in a timely manner for
proper therapeutic effect ac- before meals pc-
after meals
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- once a day Il. PARENTERAL

- twice a day → thru injection
- thrice a day – intradermal
- four times a day – intramuscular
- at bedtime
– intravenous
- pro re nata/ as needed, when
necessary – subcutaneous
- round the clock Intraarterial
⁰ - every 6 hrs. Intracardiac
Intrapleural
Military Standard Military Standard Intraosseous
Time Time Time Time Intrathecal/Intraspinal
0100 1:00 AM 1300 1:00 PM
III. TOPICAL
0230 2:30 AM 1430 2:30 PM → into the skin
0300 3:00 AM 1500 3:00 PM
0405 4:05 AM 1605 4:05 PM
0900 9:00 AM 2100 9:00 PM o Lotions
1000 10:00 AM 2200 10:00 PM o Liniments Ointments
1100 11:00 AM 2300 11:00 PM o Pastes
1200 12:00 NN 2401 12:01 AM o Powders
RIGHT ROUTE OF ADMINISTRATION o Transdermal patch
→ Written order. If not identified or differs ---consult
prescriber IV. OPTHALMIC
→ into the eyes (Lower conjunctival sac)
→ Properly labeled by manufacturers "For
Parenteral Use Only " Instructions:
I. ALIMENTARY 1. Don't let solution run from one eye to another
→ Pass thru the GIT 2. Close gently so as not to squeeze out the
Oral solution
3. Press gently on the inner canthus after
→ thru the mouth
administration for faster absorption
4. Wait at least 5 mins for another instillation of eye
→ chewed before swallowing medication
5. Instill eyedrops first... (5 mins) → ointment
→ in between the cheek Sublingual- under the V. OTIC
tongue → into the ears

VI. INHALATION
Hold the tablet in place with mouth closed until → Nasal or respiratory route for local or systemic
medication is absorbed effect
Do not swallow the medication VII. Others--- SUPPOSITORIES
Do not drink or take food until medication is
completely absorbed → into the vagina
ENTERAL
→ Intestine → into urethral orifice
→ (Nasogastric Tube)
→ (Percutaneous Endoscopic Gastrostomy) → into the rectum/anus
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V.A.B. CAMATO

GENERAL PRINCIPLES FOR DRUG ADMINISTRATION 17. Document properly

1. Know the 5 Rights of Drug Administration  Drug administration
Right Patient  Unnecessary assessments (unusual findings)
Right Drug  Evaluation of drug's effectiveness
Right Time  Degree of side effects
Right Dose/Dosage
LEGAL & ETHICAL CONSIDERATIONS IN DRUG
Right Route of Administration
ADMINISTRATION
2. Always check for client's allergies
1. Nurses must know the 3 conditions for the legal
3. Check all medications 3x as follows
administration of drugs
✓ when locating in the cart or on shelf (cabinet)
a. valid medication order
✓ When pouring or preparing medications
b. licensed physician/ prescriber/nurse
✓ Before returning to cart or shelf (cabinet)
c. Knowledgeable about drugs for safe &
4. Check all medications listed on the Medication
accurate administration
Administration Record (MAR) against chart
• MOA (Mechanism of Action)
orders at least once per shift
• Purpose, Side effects,
5. Never administer medication prepared by
2. Nurses must know the limitations of their own
another staff member
skills, expertise, knowledge, experience
6. Sign only for controlled substance waste that
according to the Board of Nursing Regulation of
you have witnessed
the state in which the nurse practice
7. Give medications within 60 mins before or after
3. Nurses must practice under the code of Ethics
the time scheduled, if unable to give at
when considering ethical issues about drug
scheduled time
administration
8. Identify clients by checking their identification
4. Nurses should question orders that are
band, and if possible, ask them to speak their
incomplete, incorrect, inappropriate, invalid
names. ( Ask parents to state children's names)
5. Nurses should never give a medication that is
9. Always double check medications questioned
unfamiliar to them
by clients (They are often right! )
6. Nurses maybe involved in research projects
10. Wash your hands before medication
concerning drug therapy. Informed consent is
administration and between clients
required of the clients.
11. Use gloves to protect self from contamination
7. (nurses do not hold the responsibility of
and to avoid absorbing medications to the skin
explaining a research project r the drugs
12. Asses the client according to the medication
included in the project)
administered
8. Nurses may administer placebo therapy, but
they have an ethical responsibility to consider all
Check BP in lying, standing or sitting position aspects of the client's care and must have a
direct order for the placebo therapy
check breath sounds 9. Nurses must know the special/legal
considerations/actions/laws in the
administration of narcotic drugs
check/assess pain type, location and intensity o yellow prescription
13. Never give unfamiliar medications o S2 license of doctors
be sure to question unusual route, dosage or o 3 copies (doctor, patient, pharmacist)
combination of medications o DDB (Dangerous Drug Board) proper storage/
14. Sign out all controlled substances refill/ recording
15. Discard needles, gloves, alcohol swabs in
containers clearly marked " hazardous
wastes"
16. Check expiry dates of medicines & IV Fluids
prior to administration
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COMMON DRUG CATEGORIES/ CLASSIFICATION

→ drug to prevent pregnancy
→ drug to relieve pain
→ drug to promote urination
→ drug to lower down body temperature
→ drug to induce/promote vomiting
→ drug to relieve inflammation
→ drug to expel mucous secretion after
→ drug to prevent infection/microbes liquefaction

→ drug that liquify phlegm

→ drug to prevent bacterial infection
→ drug to promote pupil constriction
→ drug to prevent viral infection
→ drug to dilate the pupils
→ drug to prevent fungal infection
→ drug to promote/induce uterine contraction
→ drug to prevent parasites/worm infestation
→ drug to prevent uterine contraction
→ drug to prevent amoeba
→ drug that constricts the vessels
→ drug to prevent vomiting
→ drug that dilates the vessel Vitamin- drug to
→ drug to prevent convulsion/seizure increase body resistance

→ drug to lower down blood pressure

→ drug to prevent allergy

→ drug to prevent/relieve itchiness

→ drug to prevent clot formation

→ drug to prevent hyperacidity

→ drug to counteract the effect of poison

→ drug to prevent spasm

→ drug used for Cancer ( Ca)

→ drug that dilates the airway passage to relieve

dyspnea