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Introduction to Pharmacology


The science of drugs, their properties, use and effects. Medicinal ... The study of chemicals ... anabolic steroids & paregoric (Tylenol with codeine) ... – PowerPoint PPT presentation

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Title: Introduction to Pharmacology

Introduction to Pharmacology
  • Presented by
  • Cynthia Bartlau, RN, PHN, MSN

Introduction to Pharmacology
  • The science of drugs, their properties, use and
  • Medicinal drugs do not include
  • Non-prescription
  • Nicotine
  • Alcohol
  • Illegal Drugs

Pharmacology Definition
  • Study of the effect of chemical substances on
    living tissue
  • The study of medicinal drugs
  • The study of chemicals and toxic properties
  • The study of the use of chemicals for
    psychotropic or social purposes

History of Drugs
  • Primitive
  • Herbal Remedies
  • Arrow Poisons
  • Mood altering foods
  • Opium
  • Cocoa

History of Drugs (cont.)
  • Ancient
  • Preservation substances (Egyptian Mummification)
  • 100 A.D. 600 substances listed in the Roman
    Materia Medica

History of Drugs (cont.)
  • Medieval
  • Plants and herbs are classified
  • Relationship of dose to toxicity is recognized
  • Use of poisons for homicide prevalent

History of Drugs (cont.)
  • 17th and 18th Century
  • Increased knowledge of drugs and shared with
    world as increase in world travel continued
  • Widely accepted by physicians and lay persons

History of Drugs (cont.)
  • 19th Century
  • The beginning of the modern science of
  • Problems Recognized
  • Dose effect relationship
  • Processes involved in absorption/excretion
  • Localization of the site of action of a drug
  • Specific mechanisms of drug action
  • Relation between chemical makeup biologic
    activity of substances

History of Drugs (cont.)
  • Developed
  • Anesthetics
  • Injection technique
  • Antipyretics (Aspirin)

History of Drugs (cont.)
  • Modern Medicine
  • Complex science Big business
  • Virtually every body function can be enhanced,
    suppressed, or manipulated by chemical means
  • Problem with drug abuse worldwide
  • Chemical technology
  • Herbicide
  • Insecticide
  • Fuel/solvents
  • Poison affecting our health and environment
  • We need to use this new technology wisely
    without poisoning ourselves and environment

Drug Laws
  • Drug Standards
  • Drugs of the same name must have the same
    strength, quality, and purity
  • Federally approved requirements for safety of
  • Three major acts that provide consumer safety

Drug Laws (cont.)
  • 1906 Pure Food Drug Act
  • Empowered federal government to enforce standards
    set by US Pharmacopoeia and National Formulary
  • Drugs must meet standards of strength purity
  • Type amount of narcotics must be listed on
    label of opiate mixture
  • 1912 Sherley Amendment to FFDCA prohibits
    fraudulent therapeutic claims

Drug Laws (cont.)
  • 1914 Harrison Narcotic Act
  • Legally defines the term narcotic
  • Regulates manufacture, import, sale, and use of
    cocaine and opiates
  • Revision to Harrison Act regulates the use of
    marijuana and synthetic opiates

Drug Laws (cont.)
  • 1938 Food, Drug and Cosmetic Act
  • Requires drugs products be tested for harmful
  • Drug labels and literature must be complete
    accurate, setting dose, manufacturers name
    address, names amounts of potentially harmful
    ingredients, a warning if habit forming,
    direction for use, and contraindications
  • Medical devices must be safe effective and
    cosmetics must be safe

Drug Laws (cont.)
  • 1952 Durham-Humphrey Amendment
  • Distinguishes between prescription and over the
    counter medication
  • A prescription for narcotics, hypnotic,
    habit-forming drugs, and potentially harmful
    drugs can be refilled only with a new
    prescription, and requires that the label state
    this fact

Drug Laws (cont.)
  • 1962 Kefauver-Harris Act
  • Allows FDA to evaluate the testing methods of
    drug manufacturers
  • Requires manufacturers to prove that a drug is
    effective, not just nontoxic

Drug Laws (cont.)
  • 1970 Controlled Substance Act
  • Controls substances (narcotics, tranquilizers,
    barbiturates, amphetamines) into 5 categories
    (schedules) based on drugs potential for abuse
    medical effectiveness
  • Limits the number of RX refills for controlled
    substances each 6 months
  • Lists drugs that can be called into pharmacy
    (prescriber must register with DEA)
  • Symbol for schedule C

Drug Laws (cont.)
  • 1984 Drug Price Competition and Patent Term
    Restoration Act
  • Makes it possible for generic drugs of
    bioequivalent equals to be marketed without
    duplicating clinical trials
  • Gives longer patent protection to companies
    introducing new drugs

Drug Laws (cont.)
  • 1992 Prescription Drug User Fee Act
  • Allowed FDA to collect user fees from pharm
    companies (with new drug apps) to shorten review
  • Specified a review time of 12 months for standard
    drugs/6 mos for priority drugs

Drug Laws (cont.)
  • 1997 FDA Modernization Act
  • Updated regulation of biologic products
  • Increased client access to experimental drugs and
    medical devices
  • Accelerated review of important new drugs
  • Allowed drug companies to disseminate info about
    off-label (non-FDA approved) uses and costs of
  • Extended user fees

Drug Laws (cont.)
  • FDA (Federal Drug Administration)
  • General safety standards
  • Approval removal of products on market
  • DEA (Drug Enforcement Administration)
  • Controlled substances
  • Only enforces laws against illegal drug use
  • Monitors need for changing schedules of abused

Controlled Substances
  • Groups of medications that have potential for
    abuse or physical psychological dependence
  • Proper handling of controlled substances is
  • Violations may result in suspension of your
    nursing license
  • 5 Schedules

Controlled Substances (cont.)
  • Schedule I - CI
  • Highest risk for abuse
  • Not acceptable for prescription use
  • May be available for investigational use
  • Includes
  • Cannabinols (marijuana)
  • Hallucinogens (LSD, heroin, mescaline)

Controlled Substances (cont.)
  • Schedule II - CII
  • Medically useful, but carry high potential for
    abuse and may lead to physical psychological
  • Includes certain barbiturates, narcotics
    (opiates), and stimulants (MS, codeine,
  • Prescriptions may not be refilled
  • Medically useful drugs with high abuse potential
  • Includes pure preparations of narcotics (opiates)
  • Includes stimulants (uppers)
  • Includes stimulants (uppers) used for treatment
    of hyperactive children

Controlled Substances (cont.)
  • Schedule III - CIII
  • Lesser abuse potential that schedule I or II
  • Includes nonbarbiturate sedatives, narcotics in
    combination with other drugs, stimulants,
    anabolic steroids paregoric (Tylenol with

Controlled Substances (cont.)
  • Schedule IV - CIV
  • Low potential for abuse, with psychological
    dependence more common that physical dependence
  • Includes benzodiazepines, propoxyphene (Darvon),
    and chlordiazepoxide (Librium)

Controlled Substances (cont.)
  • Schedule V - CV
  • Least abuse potential
  • Have a small amount of narcotic combined with an
    antitussive or antidiarrheal

Controlled Substances (cont.)
  • Scheduled Drugs in Hospital Nrsg. Home
  • II, III, and IV
  • Nurses
  • All are signed for with patients name, date,
    time, reason, nurses signature.
  • While student, controlled substances must have a
    second signature of licensed nurse.
  • All are counted at change of work shift, with two
    nurses leaving and arriving
  • Records and signatures may be written or on
  • Locked with two different keys, either actual
    or virtual

Controlled Substances (cont.)
  • Scheduled Drugs in Hospital Nrsg Home
  • II, III, and IV
  • Doctors and nurses
  • Schedule II drug prescriptions/orders in effect
    only 72 hours
  • Schedule III drug prescriptions/orders in effect
    for up to one month
  • Nurses must not give drug if order is out of date
  • Nurses remind doctors with regular visit
  • Rules change

Controlled Substances (cont.)
  • Five pregnancy categories established by FDA

Controlled Substances (cont.)
  • Cat A
  • No demonstrated risk to fetus in first trimester
    of pregnancy
  • No evidence of risk in second and third trimester

Controlled Substances (cont.)
  • Cat B
  • Animal studies have not demonstrated risk to
    fetus or have demonstrated adverse effect, but
    adequate studies on pregnant women have not
    demonstrated a risk to fetus during 1st, 2nd, or
    3rd trimesters

Controlled Substances (cont.)
  • Cat C
  • Animal studies have shown adverse effects on
    fetus, but there are no adequate studies on humans

Controlled Substances (cont.)
  • Cat D
  • Evidence indicates a risk to the human fetus
  • Potential benefit from use of drug may outweigh
    the risk to the fetus

Controlled Substances (cont.)
  • Cat X
  • Studies in animals and humans demonstrated fetal
    abnormalities or reports indicate evidence of
    fetal risk

Nursing Process in Medication Administration
  • The nurse is the primary member of the health
    care team responsible for the timely, safe, and
    accurate administration of drugs
  • Using the nursing process can minimize drug
    errors or omissions

Nursing Process (cont.)
  • Assessment (collection of data about patient)
  • Allergies?
  • Current medications?
  • Why is the patient taking RX or OTC drugs?
  • Condition of the patient skin?
  • Current level of use of tobacco, alcohol, etc.
  • Amount of coffee, tea, cola use?
  • Known problems with drug metabolization?
  • Physical or mental problem affecting ability to
    take med?
  • Learning need, language, literacy level?
  • Nursing history?

Nursing Process (cont.)
  • Diagnosis
  • Consists of 3 elements
  • Problem
  • Its etiology
  • Signs and symptoms
  • Address problems that post immediate threats
  • Knowledge deficit
  • Risk for injury
  • Ineffective management of therapeutic regimen
  • Noncompliance

Nursing Process (cont.)
  • Planning
  • Establishing short long term goals objectives
    for care
  • Take into consideration patients physical,
    psychological, and sociocultural life-style needs
  • Following three teaching sessions, patient will
    identify the reasons for delaying the eating and
    drinking of milk products for at least 2 hours
    after taking tetracycline.

Nursing Process (cont.)
  • Implementation
  • Follow the 5 rights of drug administration
  • Administer meds as prescribed
  • Monitor for therapeutic effect
  • Evaluate for adverse reaction
  • Provide patient teaching
  • Consider legal aspect associated with drug
  • Complete med order, question any handwriting
    difficult to read, unclear dosages, or if drug is

Nursing Process (cont.)
  • Evaluation
  • The nurse to determine whether the goals have
    been met

Nursing Process (cont.)
  • Patient Teaching and Medication Therapy
  • Name of medication
  • Purpose of medication
  • How and when to take medication
  • How to monitor med effectiveness
  • Drugs that may interact with prescribed meds
  • Any required dietary changes
  • Possible adverse effects
  • Signs symptoms to bring to MD attention
  • Required follow-up procedures

Nursing Process (cont.)
  • Documentation
  • Serves as a way to communicate with other members
    of health care team

Nursing Process (cont.)
  • Legal responsibilities regulated by SNPA
  • To administer medication safely and accurately
  • Must be familiar with the pharmacologic profile
    of the drug to eliminate or decrease errors
  • Common Errors dose amount, dosing interval,
    inappropriate route
  • Accurate recording of all drugs given
  • Nurse might be found liable for not
  • recognizing and reporting adverse reaction

Read, Study, Take Notes
  • Strategies for studying pharmacology
  • CD math practice and NCLEX review questions
  • Complete chapter exercises
  • Lecture notes
  • Math help Tech Center at PCC and Nursing and
    Health Technology Learning Center at LAC
  • Study techniques

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