Module 1: Principles of Pharmacology
(Reading assignment: chap. 1,2,4,5)
Introduction
A. Basic terms
Nurses use pharmaco-therapeutics daily
o Understand pharmacology
o Substance use- causes cellular changes and t
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Module 1: Principles of Pharmacology
(Reading assignment: chap. 1,2,4,5)
Introduction
A. Basic terms
Nurses use pharmaco-therapeutics daily
o Understand pharmacology
o Substance use- causes cellular changes and then cause a
o Reaction-(hope) be a positive reaction
Pharmacokinetics: what the body does to the drug
Pharmacodynamics: what drug does to the body
Understand side effects/adverse reactions
And drug chemistries such as: half-lives/therapeutic index
B. Drug properties
Efficacy: maximal response drug can produce
Potency: index of how much to give for desired response
Drug (Characteristics): (3)
o Effectiveness- Drug does what it is intended to do
Most important properties
U.S. Laws require to be proven effective before released for use
o Safety Does no harm, even if given at high doses for a long time (there is no drug safe at that level)
Proper dosing and selection should reduce the adverse effects
o Selectivity only produces the outcomes intended. There are no side effects
Know how to administer and signs to watch for
“There is not thing as a safe and selective drug”
There is laws and rules to protect the patient
C. Therapeutic objective
GOAL FOR DRUG USE: Provide maximum benefit with minimum harm
Other factors for drug selection:
o Administration ease
o Stability
o Cost
D. Drug intensity (factors):
Administration dosage size, route and timing are critical (medication errors, patient adherence)
Pharmacokinetics the impact of the body on drugs (absorption, distribution, metabolism, excretion)
Pharmacodynamics Determines the responses a drug elicits (drug receptor interaction, patient’s functional state,
placebo effects all determine drug elicited responses)
Characteristics specific to each patient gender, age, weight, mayor organ function & potency of drug administered
II. Pharmacology applied in nursing practice
A. Nursing responsibility (roles of the nurse)
The 6 rights of medication administration
Goal for drug use: Promote benefits and minimize harm
You just don’t give the medication with the 6 rights
Must anticipate patient reactions
Recognize when they occur and respond to them efficiently and appropriately
Must know drug for the patient
Contraindications for a positive therapeuti
Module 2: Pharmacological Effects on the Autonomic Nervous System
(Reading assignment: chap. 18-21)
Introduction: Module 2 will focus on medications that affect Peripheral Nervous System (PNS)
o With the main focus on the Autonomic Nervous System (ANS)
o Module 3 will address medications that affect the Central Nervous System (CNS)
Medication class study- Very important to understand:
o How they work
o Potential frequent side effects
o Therapeutic responses (how we know the medication is working)
o Nursing concerns (such as assessments before and after and other interventions for example take
medication with food or give at bedtime etc.)
I Review anatomy and function of the ANS and Classification of the ANS drugs
B. Basic mechanism- ANS affects everything!!!
Principles Functions of the ANS
o Regulation of the heart
The autonomic nervous system regulates the heartbeat
When a person is stressed, the sympathetic nervous system activates and the heartbeat will
increase
When the person is relaxed the heartrate will decrease
The role of the nurse is to recognize an increase or decrease in the heart rate. This will help us
understand when we need to intervene and change the rate. With experience we will learn when
high is too high and low is too low
o Regulation of secretory glands
Increase or decrease secretions
o Regulation of smooth muscle
How will your patient present with each function listed?
o Bronchi: constriction or dilation
o Blood vessels constriction or dilation (Increase or decrease BP)
o GU: contraction or relaxation of the bladder
o GI: Increase or decrease of GI motility
o Eye: pupil constriction or dilation
IX. Receptors
A. Increase receptor activation/increase transmitter synthesis
B. Decrease receptor activation/decrease transmitter synthesis
Module 3: Pharmacological Effects on the Central Nervous System (CNS)
(Reading assignment: chap. 10, 12, 14)
Analgesics
o Medications that relieve pain without causing loss of consciousness.
o Patients ask for “Painkillers” in the right does
o Opioid analgesics- high potency
o Adjuvant analgesic drugs- lower potency
Non opioid- provides pain relief through other pathways.
Familiar medications, OTC.
o Opioid is the new term for narcotics.
o Narcotics are used for illegal street drugs.
o What is pain?
Pain results from stimulation of sensory nerve fibers called nociceptors.
These receptors transmit pain signals from various body regions to the spinal cord and brain for
processing.
Pain is whatever the patient says it is whenever the patient says it is.
In past, nurses were encouraged to help the patient endure and learn to tolerate the pain to prevent
addiction. Research supports medicating for acute pain so the patient can heal faster and move
around more. It prevents many complications from immobility and long hospital stays.
Adjuvant Drugs
o Work with and add to the opioid regiment of pain relief.
Such as ibuprofen, Advil, Tylenol, Morten, acetaminophen.
Primary drugs in relieving pain- ex. Ibuprofen
o NSAIDs (non-steroidal anti-inflammatory drug)-blocks the production of prostaglandins (prostaglandins
are tissue irritants and promote nerve irritation and contractions of smooth muscles)
Mild-mod. pain
NSIADS work well for menstrual cramps, muscle and tissue injuries.
OTC dose of ibuprofen is 200-400mg every 6-8 hours (1-2 TABS)
Common to give 800mg every 8 hours in the hospital to women who gave birth. It is very
effective especially when alternated or combined with an opioid.
o Opioids-block pain receptors from receiving pain signals
Mod-severe pain
Dosage is generally higher for severe pain like immediate post-surgery or heart attack.
We must monitor closely for respiratory depression.
Always be aware of respiratory depression
o Anticonvulsants-effective with nerve pain
Pain that arises from nerve sources.
Diabetic or cancer neuropathy may cause severely shooting/ tinkling pain. Adding an
anticonvulsant to the treatment regimen allows
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