PHARMACOLOGY AGONIST- drugs that interact with a receptor

- Came from the Greek word to produce a particular response.

“pharmakon” meaning drugs and ANTAGONIST- drugs that attach to the
“logos” meaning study. receptor but do not stimulate a response.
- Deals with the study of drugs and other PARTIAL AGONISTS- drugs that interact with
actions on living things a receptor but inhibit other responses.
THERAPEUTIC METHOD - Commonly given to those patient who
- Therapeutic approaches done to treat hallucinate.
diseases and illness.
a. DRUG THERAPY- treatment using THREE CATEGORIES OF DRUG
Drugs. ADMINISTRATION:
b. DIET THERAPY- treatment using Diet 1. ENTERAL- administered directly into
c. PHYSIOTHERAPY- treatment with GI Tract by oral, rectal, or nasogastric
natural physical forces such as water, router.
ligh, and heat. - Iniinom, sinusuot, pinapasok
d. PSYCHOLOGICAL THERAPY- 2. PARENTERAL- bypass the GI Tract
identification of stressors and methods through subcutaneous, intramuscular,
to reduce or eliminate stress and/or the or intravenous injection.
use of drugs. - tinuturok
DRUGS- chemical substances with a 3. PERCUTANEOUS- done through
substantive effect on living orgaism. inhalation, sublingual(under the tongue)
MEDICINES- drugs that are therapeutic. or topical administration
DRUG NAME: - Pinapahid (cream and ointments)
● CHEMICAL NAME- it is the chemical
constitution of drug, such as its exact atomic WHAT HAPPENS TO THE DRUG AFTER
placement and molecular groupings. ADMINISTRATION?
● GENERIC NAME- (nonproprietary names) it is A. ABSORPTION- process by which the
the common or general name of a particular drug is transferred from the site of entry
drug to the circulating fluids (blood and
● OFFICIAL NAME- name under which the drug lymphatic system) of the body.
is listed in the US FDA FACTORS THAT AFFECT THE
● TRADEMARK- (Brand Name) followed by the DISTRIBUTION:
symbol ● Blood flow through the tissue where the
- Indicates that the name is registered drug is administered.
and that its use is restricted to the drug ● Drug solubility
owner/manufacturer. B. DISTRIBUTION- ways in which drugs
HOW DO DRUGS ACT ON THE BODY: are transported by circulating body
➔ They do not create new responses, but alter fluids to the sites of actions,
existing physiologic activity. metabolism, and excretion.
➔ It interacts with the body by forming chemical C. METABOLISM- also called as
bonds with specific sites called RECEPTORS. “Biotransformation”
➔ Intensity of the drug responses is also related - Process by which the body inactivates
to the number of receptor sites occupied. the drugs
➢ LIVER- primary organ
 D. EXCRETION- elimination of the BODY WEIGHT- basis for dosage of
metabolites of drugs. drugs.
➢ KIDNEY- primary organ METABOLIC RATE- if metabolism is
slow, effect of drugs are also slow and
OTHER RELATED TERMS: vice versa
● HALF LIFE- amount of time required ILLNESS- taking of other medicine can
for 50% of the drug to be eliminated contradict other medications due to
from the body illness.
● CARCINOGENICITY- ability of the drug
PSYCHOLOGICAL ASPECT
to induce living cells to mutate and
TOLERANCE
become cancerous.
● PLACEBO- a drug dosage form such DEPENDENCE
as capsule or tablet that has no
pharmacologic activity because the DRUG EVALUATION:
dosage form has no active ingredients. ● Pre-clinical Trials- chemicals tested
- Ex: empty capsule on laboratory animals
● TOLERANCE- occurs when a person ● Phase I Studies- chemicals tested on
begins to require higher doses to human volunteers.
produce the same effects that lower ● Phase II Studies- drug tried on
doses once provided. informed patients with the disease.
● Phase III Studies- Drug used in vast
DRUG ACTIONS: clinical market
● DESIRED ACTION- drugs expected ● Phase IV Studies- Continual
response evaluation of the drug
● SIDE EFFECTS/ ADVERSE DRUG INTERACTION:
EFFECTS- affects more than one body - Said to occur when the action of one
system simultaneously drug is altered by the action of another
- undesired. drug.
● IDIOSYNCRATIC REACTION- occurs - Elicited in two ways:
when something unusual or abnormal 1. Agents that when combined
happens when a drug is first increase the actions of one or both
administered drugs.
- due to patients inability to metabolize 2. Agents that when combined
drugs. decrease the effectiveness of one
● ALLERGIC REACTION- or both drugs.
“hypersensitivity” TERMS DESCRIBING DRUG INTERACTIONS:
- Occur in patients who have previously ● ADDITIVE EFFECT- 2 drugs with similar
been exposed to a drug and have actions are taken for a doubled effect.
developed antibodies. ● SYNERGISTIC EFFECT- interaction
between two or more drugs that causes the
FACTORS AFFECTING DRUG ACTION: total effect of the drugs to be greater than
the sum of the individual effects of each
AGE- the younger you are, the more
drug.
difficult it is to absorb drugs.
- Effective na yung isang drug pero mas
effective kapag sabay tinake.
 ● ANTAGONISTIC EFFECT- one drug was the drug prescribed? What
interferes with the action of the other. symptoms should be relieved?)
● DISPLACEMENT- displacement of drug by ● Identification of side-effects to expect
the 2nd drug increases the activity of the ● Identification of the recommended
1st drug. dosage and route of administration
● INTERFERENCE- one drug inhibits the ● Scheduling of drug administration
metabolism/activity of the 2nd drug, based on doctor’s orders
causing increased activity of the second ● Teaching the patient to keep a record of
drug. responses to the prescribed
- Kapag tinake yung isa pang drug ay mas medications
effective yung isa. D. FOR IMPLEMENTATION/NURSING
● INCOMPATIBILITY- one drug is chemically INTERVENTIONS: Dependent and
incompatible with another drug, causing Independent Nursing Actions
deterioration when the 2 drugs are mixed in ● FOR DEPENDENT NURSING
the same syringe or solution. ACTIONS: actions done by nurses
which can’t be performed without the
RELATING THE NURSING PROCESS TO guidance of an attending physician.
PHARMACOLOGY: ○ Nurse prepares and administers
A. FOR ASSESSMENT: TAKING THE drug based on physician’s
DRUG HISTORY. Important because: orders
● It evaluates the patient’s need/s for ○ Nurse stops drug administration
medications for any untoward symptoms as
● It obtains the patient’s current and past ordered by doctor
use of OTC, prescription, herbal
products and street drugs ● IN INDEPENDENT NURSING
● It identifies problems related to drug ACTIONS: actions where the nurse
therapy can do without supervision of the
● It elicits subjective and objective data, attending physicians.
including information from secondary ○ Nurse visits the patient and
and tertiary sources obtain nursing/medication hx
B. FOR PROBLEM IDENTIFICATION: ○ Nurse verifies drug order and
NURSING DIAGNOSIS. This is assumes responsibility for
valuable because: correct transcription
● It allows the nurse to recognize ○ Nurse makes professional
etiologic and contributing factors – judgments concerning all drug
which refer to clinical and personal aspects
situations that can cause the problem E. FOR EVALUATION:
or influence its development. ● Assesses response to the medications
C. FOR PLANNING: With reference to the prescribed, such as observation of
prescribed medications, it must include signs and symptoms of recurrent
the ff steps: illnesses or development of side-effects
● Identification of the therapeutic client ● It also includes the determination of the
for each prescribed medication (Why patient’s ability to receive patient
 education and perform REMINDERS PRIOR TO DRUG
self-administration of drugs ADMINISTRATION:
● This should also encompass the 1. CHECK:
patient’s potential for compliance - the label of the container for
drug name, concentration, and
PRINCIPLES OF MEDICATION route of appropriate
ADMINISTRATION: administration
6 RIGHTS OF DRUG ADMINISTRATION: - the patient’s chart
1. RIGHT DRUG- are you administering - the medications to be mixed in
the right drug? Are you sure that you one syringe
are properly giving what was indicated - the patient’s identity ALL THE
exactly on the doctor’s chart? TIME
2. RIGHT TIME- are you giving it too
early or too late?
3. RIGHT DOSE- are you sure that your 2. DO:
calculations are correct? Are you sure - Approach the patient in a kind but firm
that you have performed the necessary manner
computations before actually preparing - Adjust the patient to the most
the dose and administering them? appropriate position for the route of
4. RIGHT PATIENT- make sure you are Administration
giving the care and treatment to the - Remain with the patient to ensure that
right patient. Ask the patient their name all medications have been swallowed
and they should be the one to answer it - Health education
not the other people unless the - NOT administer a drug which is not
circumstances ask to. properly labeled or from a container
5. RIGHT ROUTE where the label is not legible.
6. RIGHT DOCUMENTATION
- documenting what you’ve done TYPES OF MEDICATION ORDERS:
completely and accurately. ● START ORDER
- Chart the date, time, drug name, dose - It means that the drug should be
and route of administration. administered ASAP but only once.
- Perform and record for regular patient - Giving it once and for all
assessments to evaluate therapeutic - Commonly given during emergency
effectiveness situations although can be given also at
- Chart any signs and symptoms of non-emergency cases.
adverse drug effects. ● STANDING ORDER
- Perform and validate essential patient - The drug is administered continuously
education about the drug therapy. until discontinued at a later date.
- If a patient is on NGT, chart the - Doctors will give medicine orders and
verification of NG tube placement, nurses do not stop giving it unless the
including all fluids administered . doctor told them to do so.
● PRN ORDER
- Means “administer if needed”
 - PRN means Pro Re Nata which means 2. If looking for hours to consume:
“a circumstances require” Volume of fluid x drop factor = no. of hours
● VERBAL ORDERS gtts/min x 60
- Oftenly done during emergency
situations because doctors can’t always EX: PNSS 1L x 30gtts/min
go back and forth at the ward to write 1L= 1000mL
the doctor's order. 1000mL x 20
- It is valid but the nurse should make 30gtts/min x 60
sure that the doctor will write his orders = 20 000
at the doctor’s sheet within 24 hours. 1800
● ELECTRONIC TRANSMISSION OF = 11.11 hours
PATIENT’S ORDER
- Can be done through email if the doctor 3. If looking for drops or nggts/min:
can’t report to the hospital or can be Volume of fluid x drop factor = gtts/min or
done using the official data base of the No. of hours x 60 ngtts/min
hospital. Note: adults drop factor ar either 15 or 20 but
NURSES RESPONSIBILITY: pediatric drop factor is 60
Verification
Transcription EX: PNSS 1L x 12 hours (adults)
1L= 1000mL
DOSAGE CALCULATIONS: 1000mL x 15
● gtts/min 12 hrs x 60
- Drops per minute = 15 000
- Microdrops per minute 720
- Commonly used to adults = 20.8 or 20-21 gtts/min
patients/ microset IV lines EX: PNSS 1L x 12 hours (pediatric)
1L= 1000mL
● nggts/min 1000 mL x 60
- Microdrops per minute 12 hrs x 60
- Commonly given to pediatric = 60 000
patients/ Macroset IV lines 720
= 83.33 ngtts/min
DRUG FORMULAS:
● FOR IC FLOW IV FLOW RATE: When there is additional fluid:
1. If looking for cc(ml) per hour: Ex: PNSS 1L + 80 meqs of KCl x 15 hrs
Volume of fluid = no. of cc/hr First, convert the additional fluid to mL by
No. of hours finding the stock of preparation.
EX: PNSS 1L x 10 hours = cc/hr ? Volume of fluid x drop factor = gtts/min or
1L= 1000mL No. of hours x 60 ngtts/min
1000mL
10 hours KCl= 2.0 meqs/mL
= 100 cc/hr or 100mL/hr So, 80 meqs
2.0 mews/mL
= 40mL
 ➔ The slow absorption rate makes the PO
1L= 1000mL (by mouth) route relatively safe.
1000mL+ 40mL x 15 hrs ➔ Some PO medications are irritating to
1040mL x 20 the patient’s GI tract, and larger tablets
15hrs x 60 may be difficult for some patients to
= 20 800 swallow.
900 DOSAGE FORMS- ENTERAL:
= 23. 11 or 23gtts/min 1. CAPSULES
- Small, cylindrical gelatin
EX: PNSS 1L + 60 meqs of NaCl x 15 hrs containers that hold dry
NaCl= 2.5 meqs/ml powder or liquid
So, 60 meqs medicinal agents
2.5 meqs/mL - They do not require
= 24mL coatings or additives to improve taste
❖ TIME-RELEASE OR SUSTAINED
1L= 1000mL RELEASE CAPSULES – provide a
1000mL+ 24mL = 1024mL gradual but continuous release of a
1024mL x 20 drug because the granules within the
15hrs x 60 capsule dissolve at
= 20 480 different rates
900 2. LOZENGES
= 22.7 or 22-23gtts/min - flat disks containing a
medicinal agent in a
FOR IV INJECTIONS: suitably flavored
FORMULA: base.
𝐷
𝑥𝑄 3. PILLS
𝑆
- refer to both tablets
D= dosage or doctors order
and capsules
S= stock of preparation
Q= quantity 4. TABLETS
- dried that
Ex: Doctor ordered 1g of ceftriaxone, but the have been
stock available is 500mg of ceftriaxone only to compressed into
be diluted 10cc. small disks. It can
1g= 1000mg be enteric-coated
1000𝑚𝑔 or not.
𝑥 10𝑐𝑐
500𝑚𝑔 - It contains one or more of the ff
= 2 x 10 ingredients:
= 20cc a. Binders – adhesive substances
that allow the tablet to stick
together
ENTERAL ADMINISTRATION OF DRUGS: b. Disintegrators – encourages
➔ These preparations enter the GI tract dissolution in body fluids
and are absorbed more slowly into the c. Lubricants – needed for
bloodstream than via any other route. efficient manufacturing
 d. Fillers – makes the tablet size - All suspensions should be shaken well
convenient before administration to ensure
thorough mixing of particles.
5. EMULSIONS
- Dispersions of small droplets of MEDICAL EQUIPMENT:
water-in oil or oil-in water. 1. SOUFFLE CUPS
- Dispersion is - small paper or plastic
maintained by cups that may be used
emulsifying agents to transport solid
such as:(1) sodium medications (such as
lauryl sulfate, (2) capsule or tablet) to
gelatin, or (3) acacia. prevent contamination
- It masks bitter tastes by handling.
and provide better 2. MEDICINE CUPS
solubility to certain drugs. - glass or plastic
6. ELIXIRS container with 3 scales:
- Clear liquids made up of apothecary, household,
drugs dissolved in alcohol and metric used for the
and water. measurement of liquid
- Used primarily when the medications
drug will not dissolve in - It is not reliable when measuring doses
water alone. of less than a teaspoon but reasonably
- After the drug is dissolved accurate for larger volumes
in the elixir, flavoring agents are added
to improve taste MEDICINAL EQUIPMENTS (CONT)
1. ORAL SYRINGE
7. SYRUPS - Used in measuring liquid
- Medicinal agents medications accurately
dissolved in a - Various sizes are
concentrated available to measure
solution of sugar, volumes from 0.1 to 15
usually sucrose. ml.
- Commonly used 2. NIPPLE
for pediatric patients, because of its - An infant feeding nipple
effectiveness in masking the bitter taste with additional holes
of drugs. used in administering
8. SUSPENSIONS oral medications to
- liquid dose forms infants
that contain solid, 3. MEDICINE
insoluble particles DROPPER
dispersed in a - Used in administering
liquid base. eye drops, ear drops,
and occasionally,
pediatric medications
 4. TEASPOON Give the patient liquid to swallow
- Commonly used for administering liquid medication. Encourage keeping the
medications per orem. head forward while swallowing.
Drink a full glass of liquid to ensure that
medication reaches the stomach to
COMMONLY- USED MEASUREMENT dilute the drug and decrease potential
EQUIVALENTS: for irritation
Always remain with the patient while
HOUSEHOLD APOTHECARY METRIC the medication is taken. DO NOT leave
MEASUREMENTS MEASUREMENTS MEASUREMENTS
the medication on the bedside unless
2 tbsp 1 oz 30 mL an order exists to do so (e.g.,
Nitroglycerin)
1 tbsp ½ oz 15 mL Discard the medication container.
2 tsp ⅓ oz 10 mL Give the most important medication
first
1 tsp ⅙ oz 5 mL Never dilute a liquid medication unless
specifically ordered to do so.
5. SUPPOSITORIES Always remain with the patient while
- Cone-shaped, the medication is taken. DO NOT leave
egg-shaped, or the medication on the bedside unless
spindle-shaped an order exists to do so
medication made for
insertion into the TUBAL MEDICATIONS:
rectum or vagina ● Nasogastric (NG) tubes are used to
- Dissolves at body temperature and administer liquid medications to
absorbed directly into the bloodstream unconscious patients, dysphagic
- Useful for infants, patients who cannot patients, and those who are too ill to
take oral preparations, and patients eat.
with nausea and vomiting ● Many medications come in liquid form;
- Stored in cool place so they do not melt if they do not, solid tablets may be
pulverized in a mortar and pestle, and
GENERAL FORMS OF SOLID-FORM capsules can be opened.
MEDICATION ADMINISTRATION: ● Not all tablets are safe to use when
Give the most important medication crushed, and not all capsules are safe
first to use when opened.
Allow the patient to drink a small SYRINGES:
amount of water to moisten the mouth A. PARTS:
and make swallowing of the medication a. Barrel- place of calibration
easier b. Plunger- used for ejection and
Have the patient place the medication drawing up of solutions
well on the back of the tongue. c. Needle- used to penetrate the
medication container
 d. Prefilled syringes –
with a premeasured
amount of medication in
a disposable
cartridge-needle unit;
called by Brand
Names.
SAFE ADMINISTRATION OF PARENTERAL
MEDICATIONS:
It is essential that nurses preparing
medications focus on:
1. The basic knowledge needed
regarding the individual drugs being
ordered, prepared, and administered.
2. Symptoms for which the medication is
prescribed, and collection of baseline
e. Outside of the barrel is data to be used for evaluation of
calibrated in milliliters, minims, therapeutic outcomes
insulin units, and heparin units. 3. Nursing assessments needed to detect,
B. Types prevent, or ameliorate adverse effects
a. Tuberculin syringe 4. Exercising clinical judgments about
a. Insulin syringe scheduling of new drug orders, missed
b. Three-milliliter syringe doses, modified drug orders or
c. Safety-Lok syringes substitution of therapeutically-
d. Disposable injection units equivalent medicines by the pharmacy

NEEDLES:
A. Common IV needle colors and gauges
● Gauge 18 –Green
● Gauge 20 – Pink
● Gauge 22 – Blue
● Gauge 24 –Yellow
● Gauge 26 -Violet
B. Parts of the Needle
● Bevel/Beveled Tip (sharp, pointed tip)
● Shaft (tubular body of the needle)
● Hub (base of the needle)

DOSAGE FORM- PARENTERAL:

1. Ampules
- glass containers
that usually
contain a single
 dose of medication. It has a darkened substance such as a serum, vaccine, or
ring around the neck, - a marker at skin test agent
which the ampule is broken open - Not aspirated
2. Vials – glass - Small volumes (0.1 ml) injected to form
containers with a small bubble like wheal just under the
one or more skin
doses of sterile - Used for allergy sensitivity tests, TB
medication. screening, and local anesthetics
- A tuberculin syringe used with a
25-gauge, 3/8- to 5/8-inch needle
3. Mix-O Vials –
glass containers with 2 C. Subcutaneous
compartments; lower Injections
chamber contains the - Injections made
drug (solute), and the into the loose
upper chamber contains connective tissue
the sterile diluent. between the
dermis and the
muscle layer
A. Intramuscular Injections - Drug absorption slower than with IM
- Involves injections
inserting a - Given at a 45-degree angle if the
needle into the patient is thin or at a 90-degree angle if
muscle tissue to the patient has ample subcutaneous
administer tissue
medication - Usual needle length is 1/2 to 5/8 inch
- Site Selection and 25 gauge
- Gluteal - Used to administer insulin and heparin
sites
- Vastus lateralis muscle PERCUTANEOUS ADMINISTRATION OF
- Rectus femoris muscle MEDICATIONS:
- Deltoid muscle ● With these routes, medications are
absorbed through the skin or the
- Z-track Method mucous membranes.
- Used to inject medications that ● Most produce a local action, but some
are irritating to the tissues produce a systemic action.
● Drugs include topical applications,
B. Intradermal instillations, and inhalations and
Injections ointments, creams, powders, lotions,
- Introduction of a and transdermal patches.
hypodermic needle ● Absorption is rapid but of short
into the dermis for duration.
the purpose of
instilling a
 ● Nosedrops
- Nosedrops are for individual use only.
● Nasal Sprays
- Sprays are absorbed quickly; less
medication is used and wasted when
administered in this manner.
● Inhalation
- Drugs may be absorbed through the
mucous membranes of the respiratory
tract.
- Inhalation produces a relatively limited
DRUGS ADMINISTERED effect or a systemic effect.
PERCUTANEOUSLY: - This method is actively used by
respiratory therapy and
● Ointments anesthesiologists.
- An oil-based semisolid medication; may ● Sublingual Administration
be applied to the skin or a mucous - Drug is administered by placing it
membrane beneath the tongue until it dissolves.
● Creams - Drug may be a tablet or liquid
- Semisolid, non-greasy emulsions that squeezed out of a capsule.
contain medication for external - It is rapidly absorbed into the
application bloodstream.
● Lotions
- Aqueous preparations that are used as ● BuccalAdministration
soothing agents that relieve pruritus, - A tablet is placed between the cheek
protect the skin, cleanse the skin, or act and teeth, or between the cheek and
as astringents the gums.
● Transdermal Patches (Topical Disk) - Absorption into the capillaries of the
Adhesive mucous membranes of the cheek gives
- backed medicated patches applied to rapid onset of the drug’s active
the skin provide sustained, continuous ingredient.
release of medication over several
hours or days.
● Eye Drops and Eye Ointments
- Care should be taken to keep all
ophthalmic preparations sterile by not
touching the dropper or the tube to the
eye.
● Eardrops
- Containers of solutions to be used as
ear drops will be labeled “otic.”
- They must be at room temperature
when applied.