Pharmacokinetics, pharmacodynamics, pharmacogenomics, and
pharmacotherapeutics are fundamental to working with patients.
Understanding these concepts
... [Show More] enables the nurse to utilize the nursing
process to better assess, diagnose, plan, intervene, and evaluate for
pharmacology related problems.
NURSING ASSESSMENT:
Noticing key factors about a patient including their allergies and
medications enables the nurse to look for clues that may generate
question needing more information. This is the nursing assessment
process. In pharmacology, an initial grasp of the medications, the context
of how they relate to the age, diagnosis, and situation, will help the nurse
to identify patterns they may require further clinical decision-making.
Consider the following information you’ve learned so far about
pharmacodynamics, pharmacogenomics, pharmacokinetics, and
pharmacotherapeutics.
IV:
Advantages
Complete absorption
100% bioavailability
Precise control of dosing
Quick dilution of irritating drugs
Disadvantages
Irreversible administration
Drug concentration, formulation, and rate of injection sensitivity
Risks of overloading body fluid volume, infection, and embolism
IM
Advantages
The use of poorly water-soluble drugs
The use for depot drug formulation (e.g., Penicillin G)
Disadvantages
Discomfort and inconvenience
Local tissue injury caused by chronic administration
Risk of nerve damage because of improper injection
Moderate to low bioavailability
TRANSDERMAL:
Advantages
Good control of drug release (e.g., nitroglycerin and contraceptive
hormones)
Convenient to use (e.g., patch and ointment)
Disadvantages
Inconvenient administration for liquid formulation of drug
SUBLINGUAL:
Advantages
The use of poorly water-soluble drugs
The use for depot drug formulation
Disadvantages
Discomfort and inconvenience
Local tissue injury caused by chronic administration
Risk of nerve damage because of improper injection
Moderate to low bioavailability
ORAL:
Advantages
Convenient and inexpensive
Higher safety of administration
Disadvantages
Variability of drug absorption and difficulty of drug concentration
control
Inactivation of certain drugs because of acidic environment of the
stomach (e.g., Penicillin G) and/or the liver “first-pass” effect
(nitroglycerin)
Patients consciousness requirement
Local irritation of the GI tract to cause vomiting and nausea
IMPLEMENTATION AND EVALUATION:
Once planning is completed, it is time for the nurse to take action and
evaluate how those actions work. This is the implementation and
evaluation part of the nursing process. This can include administering,
holding, or changing medication. It also includes working collaboratively
with other healthcare personnel to reflect and identify further outcomes
and goals.
ADVERSE EFFECTS:
As a health care provider, you gain knowledge by assessing a particular
medication (i.e. drug) prior to safe drug administration.
Take the time to review pharmacodynamics, as it refers to the drug’s
response from the drug action. Safety in medication administration
includes understanding the drug’s response (i.e. drug effect). Remember
that a drug can modify cell function or the rate of function, but it can’t
make the cell do something new. Drugs can produce multiple effects, not
just the desired effect. Sometimes these effects can be adverse. An
adverse effect is a general term for undesirable effects that are a direct
response to one or more drugs (Lilley et. al, 2020).
As a health care provider, recognizing potential hazards, unfavorable
effects, and potential life-threating effects of medications is essential. You,
as the health care provider, will use assessment skills, think critically, and
use clinical judgement to identify and prioritize the adverse effects of a
drug’s response. A patient’s response to a drug can greatly differ,
depending on factors such as the following:
Age
Cardiovascular function
Diet
Exercise
Gender
GI function
Hepatic function
Infection
Renal function
Other drugs (individuals may be taking more than one drug at a time
= drug-drug interaction)
In your drug guide, recognize and highlight adverse drug effects that are
“high alert” therefore potentially life-threatening!
CONTRAINDICATIONS:
As a health care provider, you gain knowledge by assessing a particular
medication (i.e. drug) prior to safe drug administration.
Safety in medication administration includes understanding
contraindications. Contraindication is a general term for any condition
(related to a disease state or patient characteristic), which renders a
particular form of treatment improper or undesirable (Lilly et al, 2020). In
other words, a contraindication is any condition or factor that serves as a
reason to withhold a certain medication due to harm it would cause.
Contraindication is the opposite of indication for use. Indication for use is
the reason to use a certain medication.
Health care providers use knowledge of the drug(s) with information
about the patients’ medical and social history to indicate if any
contraindications exist. Common contraindications for use include the
following:
Drugs currently used (prescription, OTC, herbal, illicit or street
drugs)
Pregnancy status
Breastfeeding
Concurrent illness(es)
Age-appropriate considerations
Pay careful attention to these assessment indicators to ensure an optimal
therapeutic plan.
Safety = Understand Contraindications
DRUG INCOMPATIBILITIES:
As a health care provider, you gain knowledge by assessing a particular
medication (i.e. drug) prior to safe drug administration.
Safety in medication administration includes understanding drug
incompatibilities. Drug incompatibility is an undesirable reaction that
occurs between a drug and a solution, container, or another drug. The
result is a chemical deterioration of one or both of the drugs and can
formulate a physical precipitate, haziness, or color change in the solution.
It is a term most commonly used to describe parenteral drugs. Before
medication administration, inspect the medication vial or IV solution for
precipitate and/or color changes. As a resource, contact the pharmacist if
you have any questions or concerns regarding the physical characteristics
of a medication, to include a solution.
Often in the clinical environment, you may see a drug compatibility chart
located in the medication dispensing room for quick reference. Always use
your learning resources to check drug compatibility prior to medication
administration.
TEST
1. ondansetron and lorazepam NO
2. furosemide and ondansetron NO
3. morphine and furosemide NO
4. phenytoin and morphine sulfate NO
5. linezolid and magnesium sulfate YES [Show Less]