Pharmacology I Review

Lauren Busse                                        Pharmacology 1 Final Review

Schedule for Controlled Substances

Schedule 1

        •        High abuse potential

        •        Not legally approved

Schedule 2

        •        As above with accepted use

Schedule 3

        •        Lower abuse potential

Schedule IV

        •        Still lower abuse

Schedule V

        •        Contain only small amount of narcotic

        •        Minimal risk for abuse

* If wasting part of the narcotic, another nurse must witness the disposal of the medication. You dispose of a narcotic in the trashcan*

6 rights of Drug Administration

        •        Right client

        •        Right medication

        •        Right dose

        •        Right time

        •        Right route

        •        Right documentation

* Always assess for allergies before administering a medication*

* Always administer a medication and then document!!*

Pharmacokinetics: what the body does to the drug

4 major processes

        •        Absorption: how it gets in the body; the rate at which a drug leaves its site of administration and becomes bioavailable

        •        Distribution: how it gets around the body; process by which drug is carried from its site of absorption to its site of action

        •        Metabolism: how it’s broken down in the body (LIVER); process by which the body changes a drug from its original form to a form that is pharmacologically inactive and can be readily eliminated or excreted. A.K.A biotransformation

        •        First-pass effect: metabolism of a drug & its passage from liver into systemic circulation

        •        Drugs given parenterally bypass the first pass-effect  

        •        Excretion: how you get rid of the drug (kidneys, lungs, sweat, breath); process where all drugs and/or their metabolites are eliminated from the body

Pharmacodynamics: what the drug does to the body

Half-life: time required to reduce by ½ the amount of drug concentration in the body; a measure of the rate at which the drug is eliminated

Antineoplastic Agents

Cell cycle non-specific- cytotoxic in any phase

        •        Alkylating agents

        •        Cytotoxic antibiotics

Cell cycle specific- cytotoxic in any phase

        •        Antimetabolites

        •        Natural products

        •        Hormonal agents

Chemotherapy: harmful to all rapidly growing cells

        •        Affects cancer cells plus normal human cells: hair follicles, GI cells, bone marrow cells

        •        Absorbed through skin or mucous membranes by: injection, ingestion, and inhalation

        •        Dose-limiting side effects due to high risk for toxicity

        •        Wear gown, gloves, & mask/eyewear

Extravasation: leaking of an antineoplastic drug into surrounding tissues during IV administration. Continuous monitoring of IV site is essential.

        •        If suspected, STOP IV SITE

        •        Aspirate remaining drug of blood from the tube

        •        DO NOT REMOVE IV LINE- may need to give antidote through existing IV tube. Some antidotes not given through IV catheter

        •        Cover are with sterile, occlusive dressing

        •        Apply warm or cold compresses

        •        Elevate the limb

        •        Follow extravasation instructions per facility protocol

Nursing Implications

        •        Assess baseline blood counts before giving any antineoplastic agents