NCM 106: Pharmacology

LECTURE
INTRODUCTION TO PHARMACOLOGY
- Rose gives ROSE WATER used as tonic
 FRUITS
PHARMACOLOGY - Senna pod gives ANTHRACINE, which is a
 STUDY OF THE BIOLOGICAL EFFECTS OF THE purgative (used in constipation)
- Calabar beans give PHYSOSTIGMINE,
CHEMICALS
which is cholinomimetic agent
 FOCUS ON HOW CHEMICALS ACT ON LIVING  SEEDS
ORGANISM - Seeds of Nux Vomica give STRYCHNINE,
which is a CNS Stimulant
- Castor oil seeds give CASTOR OIL
NURSES
 ROOTS
 DEAL WITH PHARMACEUTICS OR CLINICAL - Ipecacuanha root gives EMETINE, used to
PHARMACOLOGY TO TREAT, PREVENT, AND induce vomiting as in accidental poisoning
DIAGNOSE DISEASE - Rauwolfia serpentina gives RESERPINE, a
hypotensive agent
 TWO (2) KEY CONCERNS IN CLINICAL
 BARK
PHARMACOLOGY: - Cinchona bark gives QUININE and
- PHARMACODYNAMICS QUINIDINE, which are antimalarial drugs
- PHARMACOKINETICS - Hyoscyamus Niger gives HYOSCINE,
which is anticholinergic
 STEM
PHARMACODYNAMICS - Chondrodendron tomentosum gives
SCIENCE WHICH DEALS WITH THE INTERACTIONS BETWEEN TUBUQURARINE, which is skeletal muscle
THE CHEMICAL COMPONENTS OF LIVING SYSTEMS AND THE relaxant used in general anesthesia
FOREIGN CHEMICALS INCLUDING DRUGS THAT ENTER THOSE
2. Animal Products
o Cow and pig pancreas tissue is a
SYSTEMS
source of INSULIN, used in treatment of
Diabetes
PHARMACOKINETICS o Thyroid drugs and growth hormone
preparations from animal thyroid and
INVOLVES THE STUDY OF ABSORPTION, DISTRIBUTION, hypothalamus
METABOLISM, BIOTRANSFORMATION, AND EXCRETION OF o Cod liver is used a source of VITAMIN
DRUGS A and D
o Vaccines – suspensions of killed,
INCLUDE ONSET OF DRUG ACTION, DRUG HALF-LIFE, TIMING modified, or attenuated microorganisms
OF THE PEAK EFFECT, DURATION OF DRUG EFFECTS, 3. Inorganic Compounds
METABOLISM OR BIOTRANSFORMATION OF THE DRUGS AND
SITE OF EXCRETION ELEMENT THERAPEUTIC USE

SOURCES OF DRUGS Aluminum Antacid to decrease gastric

A. Natural Sources acidity
1. Plants Management of
o Is the oldest source of drugs hyperphosphatemia
o Most of the drugs in ancient times were Prevention of the formation
derived from plants of phosphate urinary stones
o Almost all parts (leaves, stem, fruits and
roots) are used Fluorine (as fluoride) Prevention of dental caries
 LEAVES
Gold Salts Treatment of rheumatoid
- The leaves of Digitalis Purpurea are the
arthritis
source of DIGITOXIN and DIGOXIN, which
are cardiac glycosides
Iron Treatment of iron deficiency
- Leaves of EUCALYPTUS give oil of
anemia
eucalyptus, which is important of cough
syrup
- Tobacco leaves give NICOTINE B. Synthetic Sources
- Atropa belladonna gives ATROPINE which - Chemically developed
is anticholinergic - Drugs that developed synthetically after
 FLOWERS chemical in plants, animals or the
- Poppy papaver somniferum gives environment that have been screened for
MORPHINE (OPIOID) signs of therapeutic activity
- Vinca rosea gives VINCRISTINE and - When the nucleus of the from natural source
VINBLASTINE as well as its chemical structure is altered

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 - EXAMPLE: Emetine Bismuth Iodide –
treatment of amoebic dysentery

DRUG EVALUATION
 FDA – CAREFULLY MONITORS NEW DRUG
DEVELOPMENT
 FOR SAFETY AND RELIABILITY OF ANY DRUG
APPROVED
 DRUGS SHOULD PASS SEVERAL STAGES OF
DEVELOPMENT BEFORE MARKETED
 REGULATES THE DEVELOPMENT AND SALE OF
DRUGS
 MONITOR POTENTIALLY ADDICTIVE DRUGS

PHASES OF NEW DRUG DEVELOPMENT

1. PRE-CLINICAL TRIALS – TEST ON LABORATORY

ANIMALS
A. TO DETERMINE WHETHER THEY HAVE THE
PRESUMED EFFECTS IN LIVING TISSUE
B. TO EVALUATE ANY ADVERSE EFFECTS
O AT THE END OF THE PRECLINICAL TRIALS, SOME
CHEMICALS ARE DISCARDED FOR THE FOLLOWING
REASONS:
A) THE CHEMICALS LACK THERAPEUTIC
ACTIVITY WHEN USED WITH LIVING
ANIMALS
B) THE CHEMICAL IS TOO TOXIC TO LIVING
ANIMALS TO BE WORTH THE RISK OF
DEVELOPING INTO A DRUG
C) THE CHEMICAL IS HIGHLY TERATOGENIC
D) THE SAFETY MARGINS ARE SO SMALL THAT
THE CHEMICAL WOULD NOT BE USEFUL IN
THE CLINICAL SETTING
2. PHASE I – TEST ON HEALTH HUMAN VOLUNTEERS
3. PHASE II – TRIALS WITH PEOPLE WHO HAVE THE PREGNANCY CATEGORIES
DISEASE WHICH DRUG IS THOUGHT TO BE
 THE FOOD AND DRUG ADMINISTRATION (FDA) HAS
EFFECTIVE
ESTABLISHED FIVE CATEGORIES TO INDICATE THE
4. PHASE III – USE DRUG IN VAST CLINICAL MARKET
POTENTIAL FOR A SYSTEMATICALLY ABSORBED
FOR SURVEILLANCE OF DRUG’S THERAPEUTIC
DRUG TO CAUSE BIRTH EFFECTS
EFFECTS
5. PHASE IV – FDA CONTINUALLY EVALUATES DRUGS
 THE KEY DIFFERENTIATION AMONG THE
CATEGORIES RESTS ON THE DEGREE (RELIABILITY)
IN THE MARKET
OF DOCUMENTATION AND THE RISK-BENEFIT RATIO

O AFTER PASSING PHASE III…

- EVALUATION OF DRUGS BY FDA, WITH ITS CATEGORY DESCRIPTION
COMMITTEES OF EXPERTS FAMILIAR WITH
THE SPECIALTY AREA IN WHICH THE
Category A Adequate studies in pregnant
women have not
DRUGS WILL BE USED
demonstrated a risk to the
- ONLY THOSE DRUGS THAT RECEIVE FDA fetus in the first trimester of
COMMITTEE pregnancy, and there is no
evidence of risk in later
WHAT’S IN A NAME? trimesters.
 Brand Name
- also called trade or proprietary name Levothyroxine, folic acid,
- given by the pharmaceutical company that magnesium sulfate
developed it
 Generic Name Category B Animal studies have not
- Original designation that the drug company demonstrated a risk to the
applied for the approval process fetus but there are no
 Chemical Names adequate studies in pregnant
- Reflect the chemical structure of a drug women, or animal studies
have shown an adverse
effects, but adequate studies

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 in pregnant women have not
demonstrated a risk to the DEA SCHEDULES OF CONTROLLED SUBSTANCES
fetus during the first trimester  Schedule I (C-I) – high abuse potential and no
of pregnancy and there is no accepted medical use [heroin, marijuana, lysergic
evidence of risk in later acid diethylamide (LSD), ecstasy]
trimesters  Schedule II (C-II) – high abuse potential with severe
dependence liability [narcotics, amphetamines, and
Metformin, barbiturates]
hydrochlorothiazide,  Schedule III (C-III) – less abuse potential than
cyclobenzaprine, amoxicillin schedule II drugs and moderate dependence liability
[nonbarbiturate sedatives, nonamphetamine
Category C Animal studies have shown stimulants, limited amounts of certain narcotics]
an adverse effect on the fetus
but there are no adequate  Schedule IV 9C-IV) – less abuse potential than
studies in humans; the schedule III and limited dependence liability [some
benefits from the use of the sedatives, antianxiety agents, and non-narcotic
drug in pregnant women may analgesics]
be acceptable despite its  Schedule V (C-V) – limited abuse potential; primarily
potential risks, or there are no small amounts of narcotics (codeine) used as
animal reproduction studies antitussives or antidiarrheals
and no adequate studies in
humans. TYPES OF DRUGS
1. Orphan Drugs – have been discovered but not
Tramadol, gabapentin, financially viable because of limited market or narrow
amlodipine, prednisone margin of safety
2. Over-the-Counter Drugs – available without
Category D There is evidence of human prescription
fetal risk, but the potential - are deemed safe when used as directed
benefits from the use of the - for self-treatment of various complaints
drug in pregnant women may
be acceptable despite its
SOURCES OF DRUG INFORMATION
potential risks.
1. PACKAGE INSERTS (DRUG LITERATURE)
Lisinopril, alprazolam, 2. REFERENCE BOOK
losartan, clonazepam 3. PHYSICIAN’S DRUG REFERENCE
4. NURSING DRUG GUIDE
Category X Studies in animals or humans
demonstrate fetal 5. JOURNALS (AJN)
abnormalities or adverse 6. INTERNET INFORMATION
reaction; reports indicate
evidence of fetal risk. The risk PHARMACODYNAMICS
of use in a pregnant woman
clearly outweighs any  STUDY OF DRUG MECHANISMS THAT PRODUCE
possible benefit. BIOCHEMICAL OR PHYSIOLOGIC CHANGES IN THE
BODY
Atorvastatin, simvastatin,  DRUG ACTION – INTERACTION AT THE CELLULAR
warfarin, methotrexate LEVEL BETWEEN A DRUG AND CELLULAR
COMPONENTS
NOTE: REGARDLESS OF THE DESIGNATED PREGNANCY  DRUG EFFECTS – RESPONSE RESULTING FROM THIS
CATEGORY OR PRESUMED SAFETY, NO DRUG SHOULD
BE ADMINISTERED DRUING PREGNANCY UNLESS IT IS
CLEARLY NEEDED.

DRUG ACTION
1. To replace or act as substitutes for missing chemicals
2. To increase or stimulate certain cellular activities
3. To depress or slow cellular activities
4. To interfere with the functioning of foreign cells
CONTROLLED SUBSTANCES (microorganism or neoplasm)
 CONTROLLED SUBSTANCES ACT OF 1970 RECEPTOR SITES
ESTABLISHED CATEGORIES FOR RANKING OF THE
 Specific areas on cell membranes that react with
ABUSE OF POTENTIAL OF VARIOUS DRUGS
certain chemicals to cause an effect within the cell
 GAVE CONTROL OVER CODING OF DRUGS a) Reacts with certain chemicals to cause an
 PRESCRIPTION, DISTRIBUTION, STORAGE AND USE effect within the cell (agonist)
OF THESE DRUGS ARE CLOSELY MONITORED o (+) affinity to receptor and
 THE DRUG ENFORCEMENT AGENY (DEA) IS stimulates it
RESPONSIBLE FOR THE ENFORCEMENT OF THESE o EXAMPLE: Insulin reacts with
REGULATIONS insulin receptor sites to change cell

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 membrane permeability thus - GASTROINTESTINAL TRACT: ORALLY AND
promoting the movement of glucose RECTALLY
into the cell - MUCOUS MEMBRANES
b) Prevent breakdown of natural chemicals that - SKIN
are stimulating the receptor site
o EXAMPLE: Monoamine oxidase
- LUNGS
(MAO) inhibitors block the - MUSCLE AND SUBCUTANEOUS
breakdown of norepinephrine by the
enzyme MAO HOW ARE DRUGS ABSORBED?
c) Reacts with receptor sites but block normal  At cellular level: active transport or passive diffusion
stimulation producing no effect (competitive 1) Passive diffusion
antagonist) o Requires no cellular energy
o EXAMPLE: Curare (a drug used on o Moves from higher to lower
the tips of spears by inhabitants of concentration
the Amazon basin to paralyze prey o Oral drugs (from GIT – blood
and cause death) occupies receptor stream)
sites for acetylcholine, which is 2) Active transport
necessary for muscle contraction o Requires cellular energy to move
and movement thus preventing drugs from lower to higher
muscle stimulation, causing concentration
paralysis o Used to absorb electrolytes such as
d) Reacts with specific receptor sites on a call Na & K
and, by reacting there, prevent the reaction o Transport fat soluble vitamins
of another chemical with a different receptor
(ADEK)
site on that cell (noncompetitive
 Fast acting
antagonist)
- If only a few cells separate the active drug
from systemic circulation, absorption occurs
SELECTIVE TOXICITY rapidly, and drug quickly reaches therapeutic
level
 ABILITY OF THE DRUG TO ATTACK ONLY THOSE - Sublingual, IV, inhalation
SYSTEMS FOUND IN FOREIGN CELLS (PATHOGEN OR  Not so fast
NEOPLASTIC) WITHOUT AFFECTING HEALTHY - Oral, IM, SQ – slower rate of absorption
HUMAN CELLS - Due to complex membrane systems of GI
 EXAMPLE: PENICILLIN – CAUSES CELL DEATH mucosal layer, muscle, and skin – delay drug
WITHOUT DISRUPTING NORMAL HUMAN CELL passage
 More blood, more absorption
FUNCTIONING
- Increase blood flow to an absorption site
improves drug absorption
PHARMACOKINETICS - More rapid absorption leads to quicker onset
of drug action
 KINETICS = MOVEMENT - Pain and stress decrease absorption due to:
 DEALS WITH DRUG’S ACTIONS AS IT MOVES a. Change in blood flow
THROUGH THE BODY b. Reduced movement through GI
- High fat and solid foods – slow rate at which
HOW DO DRUGS MOVE THROUGH THE BODY contents leave stomach and enter in
1. Absorbed – taken into the body intestine
2. Distributed – moved into various tissues - Drug combination or with food – cause
3. Metabolized – change into a form that can be interactions that may increase or decrease
excreted absorption
4. Excreted – removed from the body
DISTRIBUTION
CRITICAL CONCENTRATION
 REFERS TO MOVEMENT OF A DRUG FROM THE
- Amount of drug that is needed to cause a
SYSTEMIC CIRCULATION INTO TISSUES
therapeutic effect
- Basis of the recommended dosage  DEPENDS ON SEVERAL FACTORS
LOADING DOSE - BLOOD FLOW OR PERFUSION
- Amount of drug to immediately provide a
- LIPID SOLUBILITY
therapeutic effect or reach critical - PROTEIN BINDING
concentration
HOW ARE DRUGS DISTRIBUTED?

ABSORPTION  Blood Flow

- Drug is quickly distributed to organs with
 A DRUG’S MOVEMENT FROM ITS ADMINISTRATION large blood supply like heart, liver, kidneys
SITE INTO SYSTEMIC CIRCULATION - Slower distribution rate (internal organs,
 CAN VARY DEPENDING ON FACTORS SUCH AS skin, fats and muscle)
- ADMINISTRATION ROUTE  Lipid Solubility
- PATIENT’S AGE AND CONDITION - Ability to cross cell membrane – depends
whether it is water or lipid soluble
- DRUG’S SOLUBILITY, INTERACTIONS
 DRUGS CAN BE ABSORBED:

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 - Membrane crossing: lipid soluble easily  Length of time the drug produces its therapeutic effect
cross through cell membrane
- Water soluble can’t easily cross FACTORS INFLUENCING DRUG EFFECTS
 Protein Binding 1. Weight
- Drugs can remain free or bind to protein o Heavier – more dosage because of increased
- INACTIVE – portion of drug that bind to tissue to perfuse & increased receptor sites
protein with NO therapeutic effect o Lighter – lesser dosage
- ACTIVE – free or unbound portion
2. Age
 Blood-Brain Barrier
o Children – immature system for handling drugs,
- The blood brain barrier is a protective
pediatric dosage
system of cellular activity that keeps many
o Older adult – aging process (their bodies respond
things away from the CNS
- Drugs that are highly lipid soluble are more very differently)
likely to pass through the blood brain barrier 3. Gender
and reach the CNS o Physiological difference
- Almost all antibiotics are not lipid soluble and  Men – more vascular muscle, so
cannot pass through the blood brain barrier the effects will be seen sooner in
- Effective antibiotic treatment can occur only mean than in women
when the infection is bad enough to alter the  Women – more fat cells so drugs
blood brain barrier and allow antibiotics to that deposit in fat may be slowly
enter released and cause effects for a
prolonged period
4. Physiological Factors
METABOLISM o Diurnal rhythm – nervous and endocrine; acid-
 ALSO CALLED BIOTRANSFORMATION
base balance and hydration & electrolyte balance
5. Pathological Factors
 PROCESS BY WHICH BODY CHANGE A DRUG FROM
o Diseases – hepatic, renal, gastrointestinal,
ITS DOSAGE FORM TO A MORE WATER-SOLUBLE
vascular and low blood pressure
FORM THAT CAN BE EXCRETED 6. Genetic Factors
 FIRST PASS EFFECT: o Some people lack/over enzymes necessary for
- A MECHANISM WHEREIN LIVER metabolizing a drug or cause drugs to be broken
METABOLIZED MUCH OF THE DRUG BEFORE down more quickly
IT ENTERS CIRCULATION o Differing metabolism that alter their chemical
- LOWERS THE AMOUNT OF ACTIVE DRUG reactions and the effects of a given drug
RELEASE INTO SYSTEMIC CIRCULATION 7. Immunological Factors
o Develop allergy due to exposure to drug
o Develop antibodies to drug
EXCRETION

 ELIMINATION OF DRUGS FROM CIRCULATION 8. Psychological Factors

 KIDNEYS THROUGH URINE-MAJOR SITE o Attitude – placebo effect
 OTHER EXIT POINTS OF DRUGS ARE THE LIVER, o Personality
LUNGS, INTO BREAST, THROUGH SALIVA, TEARS &
o Patient’s attitude about a drug has shown to
have real effect on how that drug works
SWEAT
o Personality also influences compliance with
the drug regimen
HALF-LIFE
9. Environmental Factors
 Time it takes for the plasma concentration of a drug to o Environments can also help in the success
fall to half of its original value of a drug therapy
 Time it takes for one half of the drug to be eliminated o Quiet, cool, non-stimulating promote drug
by the body effects
 20 mg – half life 2 hours. 10 mg of the drug will o Sedatives
remain after 2 hours from administration o Temperature
 Factors that affect a drug’s half-life include its rate of o Anti-HPN (cool)
absorption, metabolism, excretion 10. Tolerance
 Knowing how long a drug remains in the body helps o Taken for a long time results to increased
determine how frequently a drug should be tolerance to its effects
administered o Drugs that are tolerated no longer cause the
same reaction and they need to be taken in
ONSET OF ACTION larger doses to have a therapeutic effect
 Time from administration until therapeutic effect o Morphine – opiate for pain relief
begins 11. Cumulation
 Rate of onset varies depending on the route of o Successive doses at shorter intervals –
administration and other pharmacokinetic properties drugs accumulate in the body leading to
toxic levels and adverse effects
PEAK CONCENTRATION 12. Drug-Drug or Drug-Alternative Therapy Interactions
 Maximum blood concentration level achieved through 13. Drug-Food Interactions
absorption 14. Drug-Laboratory Test Interactions

DURATION OF ACTION TOXIC EFFECTS OF DRUGS

 Adverse Effects

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 - Unwanted or potentially harmful drug effects
(all drugs have one or more adverse
reactions in addition to producing a desired
effect)
 Reasons Adverse Effects of Drugs Occur:
o Other effect on the body besides
therapeutic effect
o Sensitive to drug given
o Drug’s action causes undesirable
responses
o Too much or too little dose
 STOMATITIS
TYPES OF DRUG EFFECTS - INFLAMMATION OF THE MUCOUS
 Primary Actions
- Overdosage, extension of the desired effect MEMBRANE: MOUTH SORES
 Secondary Actions - INTERVENTION: MOUTH CARE WITH NON-
- Undesired effects produced in addition to the
pharmacologic effect IRRITATING SOLUTION
 Hypersensitivity reactions
- EXAMPLE: ADRUCIL – ANTINEOPLASTIC
- Excessive response to a primary or
secondary effect of drugs AGENT

DRUG ALLERGY

 OCCURS WHEN THE BODY FORMS ANTIBODIES TO A

PARTICULAR DRUG, CAUSING AN IMMUNE
RESPONSE WHEN THE PERSON IS RE-EXPOSED TO
THE DRUG

CLASSIFICATION OF DRUG ALLERGIES

i. Anaphylactic Reactions
- A sudden, potentially life-threatening allergic
reaction that involves the whole body
- An emergency condition  SUPERINFECTIONS

o Signs and Symptoms of Anaphylactic Reactions - NORMAL FLORA PROTECT THE BODY FROM
 Difficulty Breathing INVASION BY OTHER BACTERIA, VIRUSES,
 Wheezing
 Increased BP, HR FUNGI AND SO ON. SEVERAL KINDS OF
 Skin redness, hives and itching
DRUGS LIKE ANTIBIOTICS DESTROY THE
 Panic feeling
ii. Cytotoxic Reactions NORMAL FLORA, LEADING TO
- Causing cell death
- Not immediate but may be seen over a few SUPERINFECTIONS OR INFECTIONS CAUSE
days
BY USUALLY CONTROLLED ORGANISMS
iii. Serum Sickness
- Occurs a week or more after exposure to a
medication
iv. Delayed Reactions
- Occurs after several hours of exposure

DRUG-INDUCED TISSUE AND ORGAN DAMAGE

 DERMATOLOGICAL REACTIONS
- INVOLVES THE SKIN
- RANGES FROM SIMPLE RASH – DERMATITIS
- INTERVENTIONS: ANTIHISTAMINES;  BLOOD DYSCRASIA
TOPICAL CORTICOSTEROIDS
- BONE MARROW SUPPRESSION CAUSED BY
- EXAMPLE: PROCAINAMIDE – TREAT
DRUG EFFECTS
CARDIAC ARRHYTHMIAS
- OCCURS WHEN DRUGS THAT CAN CAUSE

CELL DEATH ARE USED

TYPES OF DRUG TOXICITY

 Liver Injury
- Due to irritating or toxic metabolites
o Symptoms of Liver Injury Due to Drugs

JOPHELLE JUCOM 6
  Fever, malaise, nausea,  Consult with the prescriber to decrease drug dose or
vomiting discontinue the drug
 Jaundice
 Change in color of urine or PATIENT TEACHING AND INTERVENTIONS TO PREVENT
stools TERATOGENICITY
 Abdominal pain
 Elevated liver enzymes  Advise the pregnant woman of the possible effects on
 Changes in clotting factors the baby before administering a drug
 Renal Injury  Weight the actual benefits against the potential risks
- Larger drug molecules causes inflammation  Advise pregnant women not to self-medicate during
and renal problems pregnancy
 Poisoning
- Overdose of a drug damages multiple body
systems

ALTERATIONS IN GLUCOSE METABOLISM

 Hypoglycemia
- Low serum blood glucose concentrations
 Hyperglycemia
- High serum glucose levels

ELECTROLYTE IMBALANCE
 Hypokalemia
- Low serum potassium levels
 Hyperkalemia
- Increase in serum potassium levels

SENSORY EFFECTS OF DRUG TOXICITY

 Ocular Toxicity
- Some drugs are deposited into tiny arteries NURSING PROCESS IN DRUG ADMINISTRATION
in the eyes causing inflammation and tissue  NURSING MANAGEMENT
damage
o HOLISTIC APPROACH
 Auditory Toxicity
- Certain drugs can easily irritate and damage  CONSIDER HOW PERSON
tiny vessels and nerves in the eight cranial RESPONDS TO TREATMENT,
nerve DISEASE AND CHANGES
 ENSURE COMPLIANCE TO
NEUROLOGICAL EFFECTS OF DRUG TOXICITY DRUG THERAPY
 General Central Nervous System (CNS) effects o USE OF NURSING PROCESS
- Although the brain is protected by the blood
brain barrier. Some drugs do affect the
neurological functioning, either by directly or
altering electrolyte or glucose levels
- Beta blockers can cause anxiety, insomnia
and nightmare
 Atropine-like (anticholinergic) effects
- Blocks the effects of the parasympathetic
nervous system by block cholinergic
receptors
 Parkinson-like syndrome
- Affects dopamine levels in the brain causing
a syndrome that resembles Parkinson’s
disease
- Loss of normal muscular tonicity and
responsiveness, rigidity, involuntary
movements most of the time felt as restless
legs, spasm and involuntary repetitive
movements of the facial muscle
 Neuroleptic malignant syndrome
- Caused by general anesthetics and other ASSESSMENT
drugs that have direct central nervous
system effect  DETERMINE FOOD OR DRUG ALLERGIES
 OBTAIN A DRUG HISTORY
INTERVENTIONS FOR A PATIENT WITH CNS EFFECTS  OBTAIN A MEDICAL HISTORY
 Provide safety measures to prevent injury  PERFORM A PHYSICAL EXAMINATION
 Caution the patient to avoid dangerous situations
such as driving a car or operating dangerous
machinery NURSING DIAGNOSIS
 Orient the patient and provide support

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  COMMON LISTED NURSING DIAGNOSIS RELATED TO
DRUG ADMINISTRATION INCLUDE:
- DEFICIENT KNOWLEDGE
- RISK FOR INJURY
- INEFFECTIVE THERAPEUTIC REGIMEN
- NONCOMPLIANCE

PLANNING

 USE THESE GOALS AS OUTCOME CRITERIA FOR

EVALUATION

IMPLEMENTATION

 PUT THE CARE PLAN INTO ACTION

 INCLUDE ALL RELEVANT NURSING INTERVENTIONS,
INCLUDING DRUG THERAPY, TO MEET THE
PATIENT’S HEALTH CARE NEEDS

EVALUATION

 EVALUATE WHETHER INTERVENTIONS ENABLED THE

PATIENT TO ACHIEVE THE DESIRED OUTCOMES
 MODIFY OUTCOMES & INTERVENTIONS AS NEEDED

VIDEO

SUBTOPIC 2

SUBSUBSUB

PARAMETERS DESCRIPTION

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