pharm ch 2: Application of Pharmacology in Nursing Practice

Seven aspects of drug therapy
1) pre-administration assessment
2) dosage and administration
3) evaluating and promoting therapeutic effects
4) minimizing adverse effects
5) minimizing adverse interactions
6) making PRN decisions
7) managing toxicity

Three goals of ASSESSMENT
1) collecting baseline data
2) identifying high-risk patients
3) assessing the pts capacity for self-care.

low doses of Aspirin
relieve pain

high doses of Aspirin
relieve inflammation

Morphine doses
Oral = higher doses
injected = lower doses

to make an evaluation you must know:
-the rationale for treatment
-nature and time course of intended response

-given for HTN and ANGINA PECTORIS
-used for two cardiovascular disorders

extent to which a pts behavior coincides with medical advice

anti-seizure drug

PRN most common for:
hypnotics (sleeping pills)

drug for TB – creates a harmless red-orange color to urine, sweat, saliva and tears

antidepressant – can cause dangerous elevations in BP if taken with certain drugs (amphetamines) or certain foods (figs, avocados, most cheeses)

nursing process
1) assessment
2) analysis
3) planning
4) implementation
5) evaluation

4 goals of preadmnistration assessment
1) collection of baseline data needed to evaluate therapeutic responses
2) collection of baseline data needed to evaluate adverse effects
3) identification of high risk patients
4) assessment of the pts capacity for self care

drug hx should include:
-rx drugs
-OTC drugs
-herbal remedies
-drugs taken for non-med purposes (alcohol, nicotine, caffeine, illicit drugs)

idiosyncratic reactions
reactions unique to the individual

preexisting condition that precludes use of a particular drug under all but the most desperate circumstances
(allergic reaction to penicillin = contraindication to penicillin unless pt has a life threatening infection that can’t be controlled by another antibiotic)

preexisting condition that significantly increases the risk of an adverse reaction to a particular drug but not to a degree that is life threatening.

4 groups of nursing interventions
1) drug administration
2) interventions to enhance therapeutic effects
3) interventions to minimize adverse effects and interactions
4) pt education (encompasses info in first 3 groups)

pt education should include:
-pts capacity to learn
-technique of admin
-dosage size
-duration of treatment
-method of drug storage
-measures to promote therapeutic effects
-measures to minimize adverse effects

4 major components of implementation
1) drug admin
2) pt education
3) interventions to promote therapeutic effects
4) interventions to minimize adverse reactions

evaluate for:
1) therapeutic response
2) adverse drug reactions/interactions
3) adherence to prescribed regimen
4) satisfaction w/ treatment

adverse effect (AE) = CNS stimulation

AE – gastric erosion

AE – urinary retention

AE – stimulation of GI smooth muscle

AE – impotence

AE – reduction in WBC count

AE – dysrhythmias

AE – excessive urine production

AE – damage to 8th CN

AE – thinning of skin

AE – involuntary movements

AE – hypotension

AE – bradycardia

AE – spontaneous bleeding

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