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Nursing Management of Drug Therapy
Chapter 1
Pharmacotherapeutics Pharmacokinetics Pharmacodynamics Contraindications / Precautions Adverse effects Drug Interactions “ Prototype”
Core Drug Knowledge: Facts Relevant to Every Drug
Must know about the patient that will receive the drug
Factors that may interact or affect drug therapy for that particular person
Core Patient Variables:Facts Relevant to Every Patient
Health Status Life span Gender Lifestyle, diet , habits Environment Culture ( Inherited traits)
Core Patient Variables
Awareness of all drugs the patient is taking …Prescription and OTC ( over the counter) as well as herbal preparations
Utilization of current drug references to gain knowledge of the medication prior to administration or teaching of a patient
Assessment of Core Drug Knowledge
Patient Interview Patient History Patient Physical Exam Use of the Medical Record
Assessment of Core Patient Variables
Nursing Diagnoses / Outcome Identification
Terms given to the identified interactions between the core drug knowledge and core patient variables
Nursing Management of Drug Therapy:
Core Pt. Variables + Core Drug Knowledge =
( Knowledge of unique Pt. variables)
Utilization of the Nursing Process: ( RN determines what significant interactions
may occur) Planning Intervention Evaluation
Nursing Management of Drug Therapy:
Common protocols used for certain drugs Standard of care for all patients receiving
a particular therapy Uses an interdisciplinary approach Utilized in conjunction with continued
nursing assessment : not instead of Not an automatic recipe ! Inclusion of: Core patient variables + Core drug
knowledge always
CLINICAL PATHWAY
How does the nurse assess core patient variables ?
Why does the RN need to assess the core drug knowledge of each drug a pt. receives?
How does learning core drug knowledge about “prototype” drugs help the RN?
How do the core pt. variables affect the pt. education that will be provided ?
REVIEW
Pharmaceuticals: Development
Safeguards
Delivery
Chapter 2
Where do drugs come from ?
Plants – alkaloids, glycosides, gums, oils, resins Animals Synthetic Chemicals Genetically Engineered Chemicals- pharmacogenomics
pharmacogenetics
Sources of Drugs
Chemical name ( p-isobutylhydratropic acid)
Generic name (Official name) -ibuprofen
Trade name ( Advil, Motrin, Motrin IB, Nuprin)
Drug Nomenclature
Classifying by similar characteristics:
Chemical
Physiologic
Therapeutic
A drug may belong to more than one class of drugs depending on the classification system used
Drug Classifications
Official Pharmacopeia
U.S. Pharmacopeia ( USP) National Formulary (NF) British Pharmacopeia (BP) The International Pharmacopeia
Sources of Drug Information
Unofficial Compendia: American Hospital Formulary Service British National Formulary FDA Bulletin USP Dispensing Information Pharmaceutical Package Inserts Physician’s Desk Reference ( PDR) Electronic databases PDA’s
Other Sources of: Drug Information
Pure Food and Drug Act of 1906 ( Shirley Amendment -1912 )
Federal Food Drug and Cosmetic Act ( FFDCA) 1938 (Kefauver-Harris Amendment 1962)
Legislation for Drug Safety and Efficacy
Clinical Trials Pre-clinical ( conducted on animals)
Clinical ( conducted on humans) Occurs in 4 phases Takes about 5 – 9 yrs for completion Med Watch program –
www.fda.gov/medwatch
Drug Development and Approval
Harrison Narcotic Law 1914
Controlled Substance Act 1970
Legislation: Controlled Substances
Important nursing responsibility
Health care facility must use automated system or “double lock system”
Violation of the Controlled substance act can result in:
fine, imprisonment, or both.. loss of nursing license
Nursing Management of Controlled Substances
Durham- Humphrey Amendment – 1952 ( to the Federal Food Drug and Cosmetic Act -
FFDCA) Separated drugs into two classifications: legend – prescription drugs- must have
inscription: Caution Federal Law prohibits dispensing without a prescription
non- prescription drugs
Ryan Haight Internet Pharmacy Consumer Protection Act of 2005
Bill introduced into Congress – to amend the FFDCA with respect to the purchase of sales on internet
Legislation : Drug Distribution
Canadian Food and Drug Act
Canadian Narcotics Control Act
Similar Legislation to the U.S.
Familiar with : Institutional policy Laws Professional regulations ( nurse practice
act) Cannot administer medication without an
order Patient education important safety
concern
Nursing Management of Drug Therapy
1. What is the purpose of the USP and NF ? 2. What is the purpose of the omics
technologies? 3. Explain how drugs are named ? 4. How are drugs classified? Why is this
done? 5.Discuss the purpose and intent of the
Food, Drug, Cosmetic Act and Durham – Humphrey amendment .
Review
6. Explain the purpose of clinical trials. Discuss advantages and disadvantages
7. What are controlled substances ?Nursing responsibilities/ special precautions
when administering these? 8. Safe drug use to be taught to patients?
Review