study of drugs and interaction w/living systems

study of drugs to diagnose, prevent, treat, disease & pregnancy

The big 3: Effectiveness, Safety, Selectivity

Additional Properties: Reversibility, Predictability, Ease of Admin, Minimal Drug Interactions, Low Cost, Chemical Stability

Effectiveness 

Safety 

   Selectivity 

  Reversibility 

(we'd like cancer drug to have a small window of this)

– if stop drug, all side effects will subside

Predictability 

Therapeutic objective of drug therapy

Factors that determine intensity of drug response (factors influencing drug response)

a.     Right Drug

b.    Right Patient

c.     Right Dose

d.    Right Route

e.     Right time

f.      Right documentation

 Components of preadministration assessment and ways to access information

             i.     Collect Baseline assessment data;

                                            ii.     Identify High Risk patients

                                          iii.     Assess self-care capacity

  Methods for collecting baseline assessment data to determine effect of drug

• Interviewing
• Observation (color, breathing)
• Physical Examination
• Labratory Tests
• Patient Medical History (background, comorbidity)
• Drug History (street drugs? herbals?)

Types of High Risk Patients

(if you identify - watch them like a hawk)

• Liver dysfunction
  
• Kidney Dysfunction – cant excrete it
• Genetic Factors
• Drug Allergies
• Pregnancy – few drugs safe to administer
• Elderly
• Infants – may encounter development issues

Capacity for Self Care Factors

• Visual Acuity – can they see the labels
• Manual Dexterity – can pt get the bottle open
• Intellectual Ability –understand why they’re taking it
• Memory – understand when to take it (pill box, medipac may be used)
• Finances – can they afford medication, cheaper alternative
• Cultural Attitudes – some cultures will permit only certain procesdures

• Prescription Drugs
• OTC drugs
• Herbal remedies
• Caffeine
• Nicotine
• Alcohol use
• Illicit drug use
• Drug Allergies
• Adverse drug Reactions

• READ medication order
• VERIFY identity of patient
• READ medication label
• VERIFY dosage calculations
• IMPLEMENT special handling
• QUESTION if unsure

Essential information to be included in patient education about drug therapy

• Drug name/therapeutic category (be ready with more resources)
• Dosage size
• Dosage schedule
• Route of transmission
• Technique of Administration
• Non-pharmacologic measures (alternatives or complimentary actions)
• Expected response
• Duration of treatment
• Method of storage
• Major adverse side effects
• Drug-drug interactions
• Drug food interactions
• Contact person (for questions) 

 Information to know to prepare for evaluation of drug therapy

• Reason for treatment (understand condition)
• Nature and time course of intended response
• Nature and time course of adverse effects

Ways to determine success of drug therapy 

a.    Therapeutic response – did we accomplish what we aimed for

b.    Do we have minimal drug reactions/interactions

c.     Do we have patient adherence/compliant to drug therapy

d.    Is pt satisfied with the drug regime

1Ways to enhance medication adherence 

• Decrease frequency of or # to administer
• Optimal Route of transmission (oral if possible)
• If cognitive problems – write down, or use pill box, medipac

General knowledge about pharmacology and the nursing process

a.     Assessment

b.    Analysis

c.     Plan

d.    Implement

e.     Evaluation

                                              i.     Judge the appropriateness of therapy

                                            ii.     Identify potential health problems

                                          iii.     Analyze patient self care ability