Basic Pharmacology For Nurses 01

Basic Pharmacology
Welcome to NUR 106 Basic Pharmacology For Nurses
Instructor: M Kroning, RN MSN
Basic Pharmacology For Nurses

Welcome to NUR 106 Instructor: Maureen Kroning, RN MSN Office: Ext: 4707 Office location: Academic II Rm: 2305 Office hours: Wed 1-6pm
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .
Slide 2
Basic Pharmacology For Nurses

Text book: Authors : Clayton, Stock and
Harroun 14th Edition
Chapters:
1,2,3,7,8,9,10,11,12,14,16,20,23,25,27,29,30, 33,34,35, 36, 42,46,48
Slide 3
NUR 106: Course Schedule

1/24: 1/31: 2/7: 2/14: 2/21: 2/28: 3/7: 3/14: Ch: 1,2 Ch: 3,7,8 Ch: 9, 10 Exam 1 Ch: 11,12, 14 Ch: 16,20,23 Ch: 25,29 Exam 2
Slide 4
NUR 106: Course Schedule Contd

3/21: 3/28: 4/4: 4/11: 4/18: 4/25: 5/2: 5/9:
Ch: 30,33 Ch: 34,35 No Classes 27,36 Exam 3 Ch: 42, 46 Ch: 48 Last Day of Class- Exam 4
Slide 5
Chapter 1
Definitions, Names, Standards, and Informational Sources Foundations of Pharmacology
Slide 6
Types of Drug Names:

Chemical Generic Official Trademark (brand) Proprietary
Slide 7
CHEMICAL NAME
Slide 8
Sources of Drug Information

American Drug Index American Hospital Formulary Service Drug Interaction Facts Drug Facts and Comparisons Handbook on Injectable Drugs Handbook of Nonprescription Drugs MartindaleThe Complete Drug Reference Package inserts Natural Medicines Comprehensive Database Physicians Desk Reference (PDR) Nursing journals
Slide 9
Sources of Patient Information
United States Pharmacopeia Dispensing

Information (USPDI)
Therapeutic Choices
Slide 10
U.S. Drug Legislation
Federal Food, Drug, and Cosmetic Act (1938,

1952, 1962)
Controlled Substances Act (1970)
Slide 11
Foundations of Pharmacology
Drug review process
Slide 12
Chapter 2
Principles of Drug Action and Drug Interactions
Mosby items and derived items 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 1
Basic principles
A strong understanding of the human bodys processes are important to grasp drug actions and drug interactions in the body
Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.
Slide 14
Examples:
Antagonistbeta blockers
Agonistepinephrine
Partial agonistpentazocine
Slide 15
Drug Stages After Administration

Absorption Distribution Metabolism Excretion
Slide 16
Categories of Drug Administration

Enteral route: PO, Rectal, NG Parenteral route: subQ, IM, IV Percutaneous route: inhalation, sublingual,
topical
HalfHalf-life of Drugs
Factors modifying the

quantity of drug reaching a site of action after a single oral dose
Slide 18
Terms used in relationship to medications

Desired action Side effects/ Adverse effects Allergic reactions: i.e. hives, urticaria Idiosyncratic reactions Carcinogenicity Teratogen
Slide 19
Principles of Drug Action and Drug Interactions

Desired effect: when a drug enters a patient,
is absorbed and distributed, and produces the expected response
Adverse effect: Any noxious, unintended and

undesired effect of a drug, which occurs at d i d ff t f d hi h t doses used in humans for prophylaxis, diagnosis or therapy (World Health Organization)
Slide 20
Principles of Drug Action and Drug Interactions (contd)

Drug interaction
Drug interactions represent 3% to 6% of preventable in-hospital adverse drug reaction cases Drug interactions are a major component of the number of hospital emergency department visits and admissions
Slide 21
Factors Influencing Drug Action

Age Body weight Metabolic rate Illness Psycological aspects Tolerance Drug dependence Cumulative effect
Chapter 3
Drug Action Across the Life Span
Slide 23

Age and gender affect drug therapy Gender-specific medicine
A developing science th t studies th d l i i that t di the differences in the normal function of men and women and how people of each sex perceive and experience disease
Slide 24
Across The Life Span

Age <38 weeks 0-1 month 1-24 months 1-5 years 6-12 years 13-18 years 19-54 years 55-64 years 65-74 years 75-84 years 85+ years
Title of Stage Premature Newborn, neonate Infant, baby Young child Older child Adolescent Adult Older adult Elderly The aged The very old

In nearly every body system, men and women function differently Men and women perceive and experience disease differently Fundamental questions remain about how humans function and the effect of disease on function Pharmacogenetics Polymorphisms
Slide 26
Drug Absorption: Age Considerations

Special considerations for pediatric and older
adult patients
Differences in muscle mass, blood flow, and inactivity affect medicines given intramuscularly Topical and transdermal administration differs in the very young and the very old
Slide 27

Topical administration in infants is effective
because:
Outer layer of skin (stratum corneum) not fully developed de eloped Skin more fully hydrated; plastic diaper increases skin hydration Inflammation (diaper rash) increases absorption
Slide 28

Difficult to predict in geriatric patients
Dermal thickness decreases with age and may enhance absorption Drying, wrinkling, and decreased hair follicles decrease absorption Decreased cardiac output and diminishing tissue perfusion also affect absorption
Slide 29

Gastrointestinal absorption influenced by:
Gastric pH Gastric emptying time Enzymatic activity Blood flow of mucous lining and intestines
Slide 30
10
Drug Absorption: Gender Considerations

Increased potential for toxicity and slower
absorption times in women
Empty solids more slowly Have greater gastric acidity Have lower gastric levels of alcohol dehydrogenase needed to metabolize alcohols
Slide 31
Drug Distribution
Depends on pH, body water concentrations,
presence and quantity of fat tissue, protein binding, cardiac output, and regional blood flow
I f t have larger volume of water content Infants h l l f t t t

and require higher dose
With age, total body water decreases and fat

increases
Slide 32
Drug Distribution
Highly fat-soluble drugs take longer to act
and accumulate in fat tissues, increasing potential for toxicity
P Protein bi di i binding
Drugs that are relatively insoluble are transported in circulation by binding to plasma proteins
Slide 33
11
Drug Distribution
Age considerations Some drugs have lower protein binding in
neonates and require larger loading dose
Albumin levels decrease with age

Gender considerations Some differences between men and
women in globulin proteins
Slide 34
Drug Metabolism
Drug metabolism
Process by which the body inactivates medicine Affected by genes, diet, age & maturity of enzyme systems Liver weight and hepatic blood flow decrease with age
Slide 35
Routes of Medication Excretion

Primary Routes
Renal tubules: into the urine GI tract: through feces

Minor Routes
Evaporation: through skin Exhalation: from the lungs Secretion: in saliva & breast milk
Slide 36
12
Drug Excretion
Metabolites of drugs (and sometimes the
drug itself) eventually excreted
Preterm infant has 15% of adult renal

capacity; fully functional by 9 to 12 months
Slide 37
Drug Excretion (contd)

Decreased renal function with age No prediction of renal function can be based
y g solely on age because of wide individual variation in changes
Slide 38
Percentages of Body Water
Slide 39
13
Therapeutic Drug Monitoring

Entails measurement of a drugs
concentration in biologic fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response
Timing of drugs administration and collection

of specimen are crucial to accurate interpretation
Slide 40
Use of Monitoring Parameters

Before administering medicine, assess
expected therapeutic actions, side effects, reportable adverse effects, probable drug interactions
Monitoring parameters related to patients

age
Slide 41
Monitoring Parameters: Pediatric Patients

Infants and young children more susceptible
to dehydration
Weight variation affects dosage g g Aspirin never to be administered to children Allergic reactions occur rapidly in children,
most commonly to antibiotics
Slide 42
14
Monitoring Parameters: Older Adult Patients
Factors that place older patient at risk:

Reduced renal and hepatic function Chronic illness Polypharmacymultiple-drug therapy required by chronic illness A greater likelihood of malnourishment due to polypharmacy
Slide 43
Monitoring Parameters: Older Adult Patients
Drug therapy
Take thorough drug history and nutritional assessment Determine whether new symptoms have y p been induced by existing medicines Gradually taper dosage when discontinuing drug Start at one third to one half normal dosage when initiating therapy; gradually increase Review regimen periodically
Slide 44
Potentially Inappropriate Medications for Older Adult Patients
Slide 45
15
Use of Monitoring Parameters: Pregnant Women

Avoid drugs if at all possible When taking womans history, be alert to
possibility of pregnancy
I Instruct patient to avoid d i id drugs, alcohol, l h l

tobacco
Try nonpharmacologic treatments before

using medicines
Avoid herbal medicines

Slide 46
Drugs Known to Be Teratogenic
Slide 47
Use of Monitoring Parameters: BreastBreast-Feeding Patients

Some drugs are known to enter breast milk
and harm nursing infant
Discuss all medications with physician Take medicine immediately after breastfeeding or just before infants longest sleeping period
Slide 48
16
Chapter 7
Principles of Medication Administration
Slide 49
Legal and Ethical Considerations

Standards of care: developed by the states
nurse practice act, state and federal law, JCAHO, professional organizations Before administering medication, nurse must have:
Current license t practice C t li to ti Clear policy statement authorizing the act Signed medication order Understanding of rationale for drug use Understanding of drug action, dosing, dilution, route and rate of administration, side effects, adverse effects to report, contraindications
Slide 50
Contents of Patient Charts

Summary sheet Consent forms Physicians order form History and physical exam form Progress notes P t Critical pathways Nurses notes Laboratory tests record
Slide 51
17

Graphic record Flow sheets Consultation reports Other diagnostic reports Medication administration record (MAR) or medication profile PRN or unscheduled medication record Case management Patient education record
Slide 52
Legal and Ethical Considerations

Standards of care: developed by the states
nurse practice act, state and federal law, JCAHO, professional organizations Before administering medication, nurse must have:
Current license t practice C t li to ti Clear policy statement authorizing the act Signed medication order Understanding of rationale for drug use Understanding of drug action, dosing, dilution, route and rate of administration, side effects, adverse effects to report, contraindications
Slide 53

Summary sheet Consent forms Physicians order form History and physical exam form Progress notes Critical pathways Nurses notes Laboratory tests record
Slide 54
18
Contents of Patient Charts (contd)

Graphic record Flow sheets Consultation reports Other diagnostic reports Medication administration record (MAR) or medication profile PRN or unscheduled medication record Case management Patient education record
Slide 55
The Kardex
Slide 56
Drug Distribution Systems

Floor or ward stock system Individual prescription order system C Computer-controlled di t t ll d dispensing system i t Unit dose system Long-term care unit dose system
Slide 57
19
Narcotic Control Systems
Slide 58
The Drug Order Stat order

Standing order Renewal order PRN order Verbal orders Electronic transmission of patient orders
Slide 59
Medication Errors
Prescribing errors Transcription errors Dispensing errors Administration errors Monitoring errors
Slide 60
20
Nurse Responsibilities
Verification
Nurse makes professional judgment regarding acceptability and safety of the drug order, including type of drug, dose and dose preparation, therapeutic intent, route, potential allergic reactions, or contraindications
Transcription
Nurse is responsible for verification of orders transcribed by others
Slide 61
The Six Rights

1. Right drug
Compare exact spelling and concentration of drug with medication card and drug container; drug label should be read three times
2. Right time g
Standard abbreviations Standardized administration times Maintenance of consistent blood levels Maximum drug absorption Diagnostic testing PRN medications
Slide 62
The Six Rights (contd)

3. Right dose
Abnormal hepatic or renal function Nausea and vomiting Accurate dose forms Accurate calculations Correct measuring devices
4. Right patient
Bracelet checking Pediatric and older adult patients
Slide 63
21
The Six Rights 5. Right route

IV route Intramuscular route Intravenous route Subcutaneous route Oral route
6. Right documentation
Safety/ethical considerations Legal considerations Always include date/time, drug name, dose, route, site of administration
Slide 64
Special Documentation Circumstances

Patient refuses medication
Thoroughly record incident and reason for refusal in nurses notes Notify physician
Medication error occurs

Notify physician Complete incident report
Slide 65
Chapter 8
Percutaneous Administration
Slide 66
22
Percutaneous Administration Application of medications to the skin or

mucous membranes for absorption
Includes:
Topical application of ointments, creams, lotions, lotions or powders to the skin Inhalation of aerosolized liquids or gases Installation of solutions into the mucous membranes of the mouth, eye, ear, nose, or vagina
Always follow the six rights of drug

administration
Slide 67
Premedication assessment and explanation Patient teaching
Hygiene requirements Proper application techniques and timing Cautions particular to drug or drug administration Side effects When to contact physician
Slide 68
Documentation
Date, time, drug, dosage, route Record ongoing assessment data, including signs of adverse drug effects
Slide 69
23
Creams, Lotions, Ointments Wash hands, put on gloves, position patient

Clean area Wear gloves Shake lotion bottle; use tongue blade to
remove desired amount of ointment or cream from container
Use dressings according to orders

Slide 70
Patch Testing Method to identify sensitivity to contact

materials (soaps, pollen, dyes)
Allergens on patch placed in contact with

back, arms, or thighs
Patch left in place for 48 hours Site aired for 15 minutes, then read Emergency equipment must be available in
case of anaphylactic response
Slide 71
Patch Testing
Wash hands, put on gloves,position patient Clean the area Wear gloves g Apply dose-measuring applicator paper Do not rub in ointment Cover area with plastic wrap
Slide 72
24
Transdermal Drug Delivery Disk or patch providing controlled release of

medication
Wash hands,put on gloves,position patient Apply topical disk or patch Application frequency depends on drug Wash hands after application Label disk with time, date, nurse initials
Slide 73
Topical Powders
Particles of medication in a talc base Wash hands, put on gloves Position the patient Wash and thoroughly dry area Apply powder, smooth over area for even
coverage
Slide 74
Sublingual and Buccal Tablets

Sublingual tablets: placed under the tongue Buccal tablets: held in the buccal cavity Advantage: rapid absorption and onset of
action
Action is usually systemic, rather than

localized to the mouth
Slide 75
25
Eye Drops, Ointments, and Disks

OD (right eye), OS (left eye), OU (both eyes) Wash hands, put on gloves,position patient Inspect affected eye Expose lower conjunctival sac Approach eye from below Never touch eye with dropper, tube
Slide 76
Ear Drops Ensure ear is clear of wax

Warm medication to room temperature Younger than age 3: pull earlobe downward
and back
Older than age 3 and adults: pull earlobe

upward and back
Patient should remain on side for a few

minutes
Slide 77
Nose Drops, Nasal Spray

Patient should blow nose gently Nose drops
Position patient lying down with head hanging back
Nose spray
Patient is upright Block one nostril Shake bottle and insert tip into nostril Spray while patient inhales
Slide 78
26
Nebulizers and Inhalers

Nebulizers
Prepare medication and fill nebulizer Patient exhales Put nebulizer in mouth; do not seal completely Patient inhales
Metered-dose inhalers
Follow instructions on inhaler
Dry powder inhalers

Follow instructions on inhaler
Slide 79
Vaginal Medications
Wash hands, put on gloves Fill applicator Place patient in lithotomy position, elevate
hips with pillow
Spread labia and insert applicator or p pp

suppository
Slide 80
Chapter 9
Enteral Administration
Slide 81
27
Administration of Oral Medications

Enteral is direct administration to the GI tract Most drugs are available in oral dose forms:
Capsulessmall, cylindrical gelatin containers used to administer unpleasant tasting medications; timed-release capsules (provides a gradual and continuous release of the drug); lozenges or trochesflat disks in a flavored base Tablets (powdered drugs that have been compressed) Elixirsdrugs dissolved in water and alcohol Emulsions of water-in-oil or oil-in-water Liquid suspensions and syrups
Slide 82
Administration of Oral Medications

Common methods used to administer oral
medications
Unit dose packaging providing a single dose Souffl cups Medicine cups Medicine droppers Teaspoons Oral syringes: plastic syringes calibrated and used to measure liquid medications Nipples with additional holes, used for infants
Slide 83
Administration of Solid-Form SolidOral Medications

Two techniques for administering medications:
the medication card and unit dose distribution
Perform premedication assessment in all cases All techniques follow FIVE RIGHTS procedure:
RIGHT patient RIGHT drug RIGHT route of administration RIGHT dose RIGHT time of administration
ALWAYS check or recheck the FIVE RIGHTS

Slide 84
28

General principles apply to all distribution systems
Give the most important medications first Do not touch the medication with your hands Encourage liquid intake to ensure swallowing Remain with patient while medication is taken; DO NOT leave the medication at bedside unless an order to do so exists Discard the medication container
Provide complete documentation of administration

and responses to therapy
Slide 85

Documentation of medication administration and
responses to drug therapy is called the Sixth Right
General principles apply to all medication

administration
Chart date, time, drug name, dosage, and route of administration d i i t ti Regularly record patient assessments to evaluate therapeutic effectiveness Chart and report any sign of adverse drug effects
Perform and validate essential education about drug

therapy and other aspects of intervention for the individual
Slide 86
Administration of Liquid-Form LiquidOral Medications

General procedures are the same as with
solid-form oral medications
Perform premedication assessment in all

cases
All techniques follow the FIVE RIGHTS

procedure
Slide 87
29
Administration of Liquid-Form LiquidOral Medications (contd)

General principles for infants, children, and
adults
Give adults and children the most important medications first NEVER dilute medications without specific orders. DO NOT leave a medication at the bedside without an order to do so Check an infants ID and be certain the infant is alert
Provide complete documentation of

administration and responses to therapy
Slide 88
Administration of Liquid-Form LiquidOral Medications

Measuring techniques vary according to
receptacle used
With a measuring cup:

Cover label to prevent smearing; place fingernail at exact level on measuring cup; read the volume at the level of meniscussee Figure 9-13. Recheck FIVE RIGHTS.
With an oral syringe:

Select syringe of appropriate size. Draw up prescribed volume of medication from bottle or medicine cup
Slide 89
Administration of Medications by Nasogastric Tube

Drugs are administered via NG tube for
specific patients, using a liquid form whenever possible. Remember:
Always flush the tube before and after administration Perform premedication assessment p Assemble equipment before administration
Slide 90
30
Administration of Medications by Nasogastric Tube (contd)

Prepare doses as for administration of solidform or liquid-liquid form oral medications
Three methods for checking NG tube location Follow procedure for administering
medication di i
DO NOT attach suction for 30+ minutes Provide complete documentation of

Slide 91
Administration of Enteral Feedings via Gastrostomy of Jejunostomy Tube

Enteral formulas are in several mixtures to
meet individual needs
Assemble equipment beforehand Prescribed enteral formula should be

checked
Slide 92
Administration of Enteral Feedings Via Gastrostomy or Jejunostomy Tube (contd)
Formula should be fully labeled Discard unused formula every 24 hours Follow the guidelines specific for patients
receiving general nutrition via intermittent or continuous feedings Follow FIVE RIGHTS
RIGHT patient, RIGHT drug (formula), RIGHT route of administration, RIGHT dose (amount, dilution, strength), RIGHT time
Slide 93
31
Administration of Enteral Feedings via Gastrostomy or Jejunostomy Tube (contd)
Verify tube placement and initiate feeding Flush, then clamp tube Proceed with tube feeding technique
Intermittent: use Toomey syringe y y g Continuous: use disposable feeding container and enough formula for a 4-hour period

Slide 94
Administration of Rectal Suppositories

Suppositories are solid medication designed
to dissolve inside a body orifice
Equipment is simple:
Finger cot or disposable glove Water-soluble lubricant Prescribed suppository P ib d it
Perform standard premedication assessment
Slide 95
Administration of Rectal Suppositories (contd)

Technique begins with FIVE RIGHTS
Explain procedure and check pertinent parameters Patient bends uppermost leg Apply lubricant t ti of suppository. Pl A l l bi t to tip f it Place suppository about 1 inch beyond orifice, past internal sphincter

Slide 96
32
Administration of a Disposable Enema

The dose form will be a prepackaged,
disposable-type enema solution
Equipment is simple Perform standard premedication assessment
Slide 97
Administration of a Disposable Enema (contd)

Technique begins with FIVE RIGHTS
Explain procedure and check pertinent parameters Time of last defecation Patient b d P ti t bends uppermost leg tl Apply lubricant to rectal tube Insert lubricated tube and insert solution

Slide 98
Parenteral Administration
Parenteral means drug administration by any
route other than the gastrointestinal tract
Parenteral route
Intradermal Subcutaneous Intramuscular (IM) Intravenous (IV)
Slide 99
33
Chapter 10
Parenteral Administration: Safe Preparation of Parenteral Medications
Slide 100
Equipment Used in Parenteral Administration

The syringe has three parts: barrel, plunger,
and tip
Syringes are calibrated in minims, milliliters,

or cubic centimeters
Tuberculin syringes are used to measure

small volumes of medication accurately ll l f di ti t l
Slide 101
Equipment Used in Parenteral Administration (contd)

The insulin syringe has a special scale for
measuring insulin
In the United States, insulin is manufactured

in U-100 concentration
The U-100 syringe holds 100 units of insulin per milliliter Low-dose insulin syringes are used for patients receiving 50 units or less of U-100 insulin
Slide 102
34

Prefilled syringes are disposable and have a
premeasured amount of medication
Advantages: time saved in preparation, less chance of contamination h f t i ti Disadvantages: additional expense, different holders for different cartridges, volume of second medication limited
Slide 103

The needle has three parts:
Hub Shaft Beveled tip
The needle gauge is the diameter of the hole

through the needle
Needle selection depends on age of patient,

and site (subcutaneous, IM, or IV)see Table 10-1
Slide 104

Major safety development: needleless
systems
Provide an alternative to needles for routine procedures, reducing the risk of needlesticks with contaminated sharps
Slide 105
35

Other safety devices have been developed
BD Safety-Lok Syringe BD SafetyGlide Shielding Hypodermic Needle BD SafetyGlide Syringe Tiny Needle Technology BD Integra Syringe
Slide 106
Parenteral Dose Forms

Ampules
Glass containers usually containing a single dose
Vials
Glass containers that contain one or more doses
Mix-O-Vials
Glass containers with one dose, two compartments
Slide 107
Preparation of Parenteral Medication

Equipment needed for preparation of
parenteral medications
Drug in sterile, sealed container Syringe of the correct volume Needles of the correct gauge and length Needleless access device Antiseptic swab MAR or medication profile
Slide 108
36
Preparation of Parenteral Medication

Techniques for preparing all parenteral
medications
Use the five RIGHTS: Right Patient, Right Drug, Ri ht R t of Ad i i t ti D Right Route f Administration, Ri ht Right Dose (Amount and Concentration), Right Time of Administration Check the drug dose form ordered against the source you are holding
Slide 109
Preparing a Medication from an Ampule

Move solution to the bottom of the ampule Cover the ampule neck with a sterile gauze
pledget or antiseptic swab while breaking off top
Using an aspiration needle, withdraw

medication from ampule
Slide 110
Preparing a Medication from an Ampule

Remove the needle from the ampule and
point the needle vertically
Pull back the plunger. Replace the aspiration

needle with a new sterile needle
Push plunger until medication is at tip of

needle
Slide 111
37
Preparing a Medication from a Vial

Cleanse the top of the vial of diluent Pull plunger of syringe to fill with an amount
of air equal to the volume of the solution to be withdrawn
Insert the needle or needleless access device

through the diaphragm, inject air
Withdraw the measured volume of diluent

required to reconstitute the powdered drug
Slide 112
Preparing a Medication from a Vial

Tap the vial of powdered drug to break up
caked powder; cleanse the rubber diaphragm with swab
Insert the needle or needleless access device

in the diaphragm and i j t th dil i th di h d inject the diluent i th t in the powder
Mix thoroughly to dissolve powder Change needle to correct gauge and length
to administer the medication to the patient
Slide 113
Preparing a Medication from a MixMix-O-Vial

Tap the container a few times to break up the
caked powder
Remove the plastic lid protector Push firmly on the diaphragm-plunger Mix thoroughly Cleanse the rubber diaphragm and remove
drug using syringe to administer to patient
Slide 114
38
Special Preparations
Occasionally two medications may be drawn
into the same syringe for a single injection
M di ti Medications need t b prepared f use i d to be d for in

the sterile field during a surgical procedure
Slide 115
39

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Basic Pharmacology

Welcome to NUR 106 Basic Pharmacology For Nurses

Instructor: M Kroning, RN MSN

Basic Pharmacology For Nurses

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Basic Pharmacology For Nurses

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

NUR 106: Course Schedule

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

NUR 106: Course Schedule Contd

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Types of Drug Names:

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Sources of Drug Information

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Sources of Patient Information

United States Pharmacopeia Dispensing

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

U.S. Drug Legislation

Federal Food, Drug, and Cosmetic Act (1938,

Controlled Substances Act (1970)

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc .

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Drug Stages After Administration

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Categories of Drug Administration

Factors modifying the

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Terms used in relationship to medications

Principles of Drug Action and Drug Interactions

Adverse effect: Any noxious, unintended and

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Principles of Drug Action and Drug Interactions (contd)

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Factors Influencing Drug Action

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Drug Action Across the Life Span

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Across The Life Span

Drug Action Across the Life Span

Drug Absorption: Age Considerations

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Drug Absorption: Age Considerations

Drug Absorption: Age Considerations

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Drug Absorption: Age Considerations

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Drug Absorption: Gender Considerations

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

I f t have larger volume of water content Infants h l l f t t t

With age, total body water decreases and fat

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Albumin levels decrease with age

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Copyright 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc.

Routes of Medication Excretion

Renal tubules: into the urine GI tract: through feces