Adams CH 12013

PHARMACOLOGY
CONNECTIONS TO NURSING PRACTICE

Second Edition
Pharmacology: Connections to Nursing Practice, Second Edition
Michael Patrick Adams Carol Quam Urban
CHAPTER
Introduction to Pharmacology:
Concepts and Connections
1
Learning Outcomes
1. Identify key events in the history of
pharmacology.
2. Compare and contrast the terms drug,
pharmacology, and pharmacotherapy.
3. Explain the importance of
pharmacotherapy to clinical nursing
practice.
Learning Outcomes
4. Using specific examples, explain the
difference between the pharmacologic
and therapeutic methods of classifying
drugs.
5. Identify the advantages of using
prototype drugs to study
pharmacology.
6. Classify drugs by their chemical,
generic, and trade names.
Learning Outcomes
7. Compare the advantages and
disadvantages of a pharmaceutical
company being granted exclusivity for
the development of a new drug.
8. Analyze possible differences between
generic drugs and their brand-name
equivalents.
9. Assess the responsibilities of the nurse
in drug administration.
PharmFact
Pharmacology as Science
With science, pharmacology becomes a
discipline
Herbal remedies are first used
Word pharmacology first referenced in
1693
Modern pharmacology begins in 1800s
Chemists first isolated active agents
Early drugs are from natural plants

Pharmacology Today
Current practice is complex
Application is still the same
Focus on patient and improving quality
of life to relieve human suffering
Important part of the art and discipline
of nursing
IN NURSING THIS IS A PART OF OUR
ART AND SCIENCE THAT REQUIRES
100% TIME AND ATTENTION
1.2 Pharmacology is the study of
medicines.
Pharmacology: The Study of
Medicines
What is a Drug?
Any substance that is taken to:
Prevent
Cure
Reduce
Symptoms of a medical condition
Role of the Nurse
Drugs are a form of medical
intervention
Nursing designs interventions for
desired health goals
Pharmacotherapy is a critical
intervention
Nurse administers the drug, assesses
the effects and teaches the client about
the drug (this is a summary of the role)
Figure 1.1 Rationale for pharmacotherapy: A partnership between the patient and the health care provider.
Pharmacology:
The Study of Medicine
The word pharmacology comes from
the Greek
Pharmakon = medicine or drugs
Logos = to study
Pharmacotherapy is the application of
drugs for prevention or treatment
Pharmacology covers administration,
metabolism, and response
1.3 The perfect drug is safe and
effective.
Characteristics of an Ideal
Drug
Characteristics of Drugs
Over 11,000 brand, generic, and
combination agents
Each has its own application,
interactions, side effects, and actions
Many have multiple effects on the body
Patient factors can alter responses
Patient Factors
Age
Gender
Race
Body Mass
Health Status
Genetics this is an emerging area of
study
Drug Actions
New drugs introduced every year
New and old drugs are removed yearly
Drugs can improve quality of life
Drug reactions can also cause disability
or death
Enormous challenge to stay current and
up to date in the application of
medications
Is There a Perfect Drug?
What is the perfect drug?
It would do everything you want
No side effects
Convenient
Inexpensive
No interactions
Quickly eliminated
Drug Indications
All prescription drugs must have some
degree of effectiveness
Drugs are approved by their indications
Every drug has at least one indication
Many drugs have multiple indications
Unapproved indications are unlabelled
or off-label
Clinical Nursing Practice
Nurses need to have an understanding
of how a drug works
Drug therapy is a large part of the
nursing process
Nurses need to understand how patient
variables affect drug therapy
Nurses need to stay up to date
1.4 Drugs may be organized by their
therapeutic classification or
pharmacologic classification.
Classification of Drugs
FDA is the Food and Drug
Administration
FDA.com
Orange Book of approved drugs
Classified by therapeutic and
pharmacological properties
Pharmacologic how the drug acts
Used for both prescription and non-
prescription medications

Therapeutic what is being treated by
the drug

Therapeutic Classifications
Therapeutics is the usefulness in
treating a specific disease
A drug may lower blood pressure, but
also relieve chest pain
A drug may lower blood glucose and
also lower cholesterol
Classification is what condition is being
treated by the particular drug
Table 1.1 Organizing Drug Information by Therapeutic Classification
Pharmacologic Classification
Pharmacologic is the mechanism of the
drug or how the drug produces its
effects in the body
Three different drugs can lower blood
pressure, but each differs in its
mechanism of action
May use drugs chemical name
Table 1.2 Organizing Drug Information by Pharmacologic Classification
Classifications
Drugs can have multiple classifications
Dependent on the clinical use of the
drug
Important to understand and know the
different classifications for each drug
You will be learning drugs by
classification. I will focus on these
rather than individual drugs*
1.5 A prototype drug is the agent to
which all other drugs in a class are
compared.
Drug Prototypes
Prototype
Single drug from each class
May compare all other medications in
the class to the prototype
Usually first drug in its class
Can be combination of traditional and
new drugs
Helps with learning pharmacology
1.6 Drugs have chemical, generic, and
trade names.
Naming Drugs
Chemical Names
Each drug has only one chemical name
Clear, concise meaning of the nature of
the drug
Often difficult to remember and
pronounce
As nurses we are not concerned about
the chemical name

Generic Name
Assigned by United States Adopted Name
Council
Less complicated than chemical names
Many organizations use generic names to
describe and identify
Easy for students to memorize one name
Focus on the generic name
For testing purposes I will give both
generic and trade

Brand Name
Name given by the pharmaceutical
company marketing the drug
Tries to be short and easy to remember
Proprietary
Each drug receives period of exclusivity
for marketing
Trade Names
Products with the same drug
May contain one or more active
ingredient
Combination drugs have more than one
active generic ingredient
Generic Drugs
Usually less expensive than trade name
drugs
Drug formulations may be different
Inert and/or active ingredients may be
same or different
This can change the bioavailability
Table 1.3 Examples of Generic Drugs Contained in Brand-Name Products
1.7 Generic drugs are less expensive
than brand-name drugs, but they may
differ in bioavailability.
Naming Drugs
Generic Substitution
Laws vary by state
Pharmacists may substitute generic for
brand
Pharmacists may have to obtain approval
from provider before substituting generic
Can be cost saving for patients
Many pharmacies offer generic lists
PCP may write DAW (dispense as written)
of NO GENERIC SUBSTITUTIONS
Exclusivity of New Drugs
Pharmaceutical companies market their
brand-name drugs
Claim significant difference between
brand and generic
Consumer advocates argue generic
should be available
Cost difference between generic and
brand can be significant
Bioavailability
Defined as the rate and extent to which
the active ingredients are absorbed
from a drug product and then available
at the site of action
May be different between trade and
generic
Internet Sales
Drug laws vary by country
Some drugs may be available without a
prescription
Quality control standards may differ
Sources may be unreliable
Nurses must help patients understand
the differences and dangers
1.8 Pharmacology is intimately
connected to nursing practice and is a
key intervention in relieving and
preventing human suffering.
Connecting Pharmacology to
Clinical Nursing Practice
Nursing Practice
Understanding of pharmacology is
critical to nursing practice
One of the key interventions in nursing
care
The nurse must understand the
pharmacotherapeutic principles for all
medications
Key to elimination of medication errors
Nurses Responsibilities
Name of drug
Intended use (sometimes used for
unlabeled use or side effects)
Dose range
Effects on body
Contraindications and precautions
Special considerations of administration
Nurses Responsibilities
Why it is prescribed
How to administer the drug
Nursing process considerations related
to drug
Application of all 5 steps of the nursing
process

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PHARMACOLOGY

CONNECTIONS TO NURSING PRACTICE

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