PHARMACOLOGY

What is Pharmacology?

Pharmacology is the scientific study of the

origin, nature, chemistry, effects, and uses

of drugs. This knowledge is essential to

providing safe and accurate medication

administration to your patients.

PHARMACOKINETICS PHASES

Absorbtion

how does the drug enter

the body? Distribution

how does the drug get

where it needs to go?

how does the drug leave

the body?

Three basic

concepts of

pharmacology:

the absorption,

distribution, metabolism,

and excretion of drugs

by the body.

Pharmacokinetics
Pharmacodynamics

the biochemical and

physical effects of drugs

and the mechanisms of

drug actions.

Pharmacotherapeutics

the use of drugs to

prevent and treat

diseases.

Metabolization

how does the drug is

broken down?

Excretion

ABBREV AT ONS

ROUTES OF ADMINISTRATION

PO

IM

PR

SubQ

SL

ID

GT

IV

IVP
IVPB

NG

by mouth

intramuscularly

per rectum

subcutaneously

sublingual

intradermal

gastrostomy tube

intravenous

intravenous push

intravenous piggyback

nasogastric tube

TIMES OF MEDICATIONS

ac

pc

daily

bid

tid

qid
qh

ad lib

stat

q2h

q4h

q6h

prn

hs

before meals

after meals

every day

2x a day

3x a day

4x a day

every hour

as desired

immediately

every 2 hours

every 4 hours

every 6 hours

as needed

at bedtime

ABBREV AT ONS

DRUG PREPARATION

tab, tabs
caps

gtt

EC

CR

susp

el, elix

sup, supp

SR

tablet

capsule

drop

enteric coated

controlled release

suspension

elixir

suppository

sustained release
DOSAGE

CALCULATION

Basic Dosage Calculation

D desired dose

amount on hand /

available dosage

of the medication

Vvolume

________

IV Flow Rates

__

of

ol
_

ut

io

x = dose

total no. of hours

= mL/hr

IV Flow Rates

________

sample:

mL of solution

total no. of minutes

xdrop factor =

gtt/min

Administer digoxin 0.5 mg IV

daily. The drug concentration

available from the pharmacy is

ML will you need to administer a

0.5 mg dose?

1.

D / H x V = Dose

0.5 / 0.25 x 1 = 2mL

2. Nurse A will infuse 1 1/2 L of NS in

over 7 hours; drop factor is 15

gtt/mL. What flow rate (mL/hr) will

the nurse set on the IV infusion

pump?

mL of solution / total hours = mL/hr

1,500mL / 7hrs = 214.3 mL/hr

3. A patient is receiving 250 mL

normal saline IV over 4 hours, using

tubing with a drip factor of 10

drops/mL. How many drops per

minute should be delivered?

mL of solution / total minutes x

drop factor = gtt/min

250 mL x 10gtts per mL / 240 mins =

10.42 gtts/min

Dosage Calculation Conversions

1 kg 1,000 grams 2.2 pounds

1 pound 0.45 kg 16 ounces

1 mg 1,000 mcg

1 grain 60 mg

1 liter 1,000 mL 1 quart 2 pints 4 cups

1 teaspoon 5 mL 60 drops

32 ounces

1 tablespoon 3 teaspoons 15 mL

1 ounce 2 tablespoons 30 mL

1 cup 1/2 pint 8 ounces 240-250 mL

1 pint 2 cups 16 ounces 480 mL

1 quart 2 pints 4 cups 32 ounces 1 liter 1,000 mL

1 gallon 4 quarts 8 pints 16 cups 128 ounces 3, 785 mL

DRUG ADMINISTRATION

Drugs that are available as gases can be administered into

the respiratory system through inhalation.

These drugs are rapidly absorbed. In addition, some of

these drugs can be self-administered by devices such as

the metered-dose inhaler.

The respiratory route is also used in emergencies—for

example, to administer some injectable drugs directly into

the lungs via an endotracheal tube.

Specialized infusions

epidural—injected into the epidural space

intrapleural—injected into the pleural cavity

intraperitoneal—injected into the peritoneal cavity

long bone

intra-articular—injected into a joint

intrathecal—injected into the spinal canal.

The gastric route allows direct administration of a drug into

the GI system.

This route is used when patients can’t ingest the drug

orally. This route is accessed through a tube placed directly

into the GI system, such as a “G-tube.”

Suppositories, ointments, creams, or gels may be instilled

into the rectum or vagina to treat local irritation or

infection.

Some drugs applied to the mucosa of the rectum or vagina

can also be absorbed systemically.

Buccal (in the pouch between the cheek and teeth),

Sublingual (under the tongue), or Translingual (on the

tongue)

This is to prevent their destruction or transformation in the

stomach or small intestine.

Oral administration is usually the safest, most convenient,

and least expensive route.

Oral drugs are administered to patients who are conscious

and able to swallow. Topical

The topical route is used to deliver a drug via the skin or a

mucous membrane.
This route is used for most dermatologic, ophthalmic, otic,

and nasal preparations.

Buccal, sublingual, and translingual

Gastric

Oral

Rectal and vaginal

Respiratory

·The IM route allows drugs to be injected directly into

various muscle groups at varying tissue depths.

This form of administration provides rapid systemic action

and allows for absorption of relatively large doses (up to 3

mL).

Aqueous suspensions and solutions in oil as well as drugs

that aren’t available in oral forms are given IM.

Needle size: 18-27 gauge

Uses Z-track method

·small amounts of a drug are injected beneath the dermis

and into the subcutaneous tissue, usually in the patient’s

upper arm, thigh, or abdomen.

This allows the drug to move into the bloodstream more

rapidly than if given by mouth.

Drugs given by the subcutaneous route include

nonirritating aqueous solutions and suspensions contained

Needle size: 25-18 gauge

Note: Do not inject more than 15mL of solution

Parenteral Administration

Intramuscular

Subcutaneous

Intravenous

Intradermal

Intramuscular Subcutaneous

The IV route allows injection of drugs and other substances

directly into the bloodstream through a vein.

Appropriate substances to administer IV include drugs,

fluids, blood or blood products, and diagnostic contrast

agents.

Administration can range from a single dose to an ongoing

infusion that’s delivered with great precision.

Needle size: 16 gauge- patients who have trauma

18 gauge- surgery and blood administration

22 to 24 gauge- children. older adults and

clients who have medical issues or are stable

post-op
Drugs are injected into the skin.

A needle is inserted at a 10- to 15-degree angle so that it

punctures only the skin’s surface.

Used mainly for diagnostic purposes, such as testing for

allergies or tuberculosis.

Should form a "BLEB"

Needle size: 26-27 gauge

Parenteral Administration

Intravenous

Intradermal

Subcutaneous

Intramuscular

Intravenous Intradermal

Intravenous Therapy

TYPES OF SOLUTIONS

Hypertonic Solution

D5N5

5% Dextrose in 0.45% Saline

5% Dextrose in LR

Low levels of sodium or chloride; metabolic alkalosis

Replaces fluids

Used for burns, bleeding, dehydration

Isotonic Solution

0.9% saline (NS)

Ringer

'

s Solution

5% Dextrose in Water

Sodium or chloride replacement

Used with blood products

Replaces fluids

Used for burns, bleeding, dehydration

Replaces deficits of total body water

Not used alone: dilution of electrolytes can occur

Hypotonic Solution

0.45% NS

2.5% Dextrose

0.33% NS

Helps kidneys excrete

excess fluids

Treats intracellular

dehydration (DKA)
Never give to patients

with burns or liver Causes cell to shr disease ink

No effect w/ same

concentration

Causes cell to swell

Intravenous Therapy

COMPLICATIONS

Air Embolism

Symptoms Treatment

air enters the vein

through the IV

tubing

Infiltration

Tachycardia

Chest pain

Hypotension

Decreased LOC

Cyanosis

Clamp the tubing

Turn the patient on their left

position

Notify the HCP

IV fluid leaks into

the surrounding

tissues

Pain

Swelling

Coolness

Numbness in the site

No blood return

Remove the IV

Elevate the extremity

Apply warm or cool compress

Do not rub the area

Infection

entry of microorganism

into the body via IV

Tachycardia

Redness

Swelling

Chills & fever

Malaise

Nausea & Vomiting

Obtain cultures

Possible antibiotics

administration

Intravenous Therapy

COMPLICATIONS

Circulatory Overload

administration of

fluids too rapidly

(FLUID VOLUME

OVERLOAD)

Increase blood

pressure

Distended neck veins

Dyspnea

Wet cough and

crackles

Decrease flow rate (keep

vein-open rate)

Elevate head of the bed

Keep the patient warm

Notify the physician

inflammation of the

veins that can lead

to thrombophlebitis

Heat

Redness

Tenderness at the site

Decrease flow of IV

Remove the IV

Notify the physician

Restart the IV on the

opposite side

Hematoma

collection of blood

in the tissues

Ecchymosis

Blood

Hard painful lump at

the site

Elevate the extremity

Apply pressure and ice

Symptoms Treatment
6 RIGHTS OF MEDICATION

ADMINISTRATION

RIGHT PATIENT

RIGHT TIME

RIGHT DOSE

RIGHT MEDICATION

RIGHT ROUTE

RIGHT DOCUMENTATION

DRUGS

ANTIBIOTICS/ANTIBACTERIALS

BROAD SPECTRUM ANTIBIOTICS

TETRACYCLINES

SULFONAMIDES

CEPHALOSPORINS

PENICILLINS

AMINOGLYCOSIDES

& MACROLIDES
FLUOROQUINOLONES

–oxacin

-cycline

sulf-

–cef

ceph-

-cillin

-mycin

–floxacin

ANTIVIRALS

Antiviral (disrupts viral mutation)

Antiviral (undefined group)

Antiviral (neuraminidase inhibitors)

HIV Protease Inhibitors

HIV/AIDS

–virimat

vir- -vir- -vir

-navir

–vudine

Antifungal

ANTIHYPERTENSIVES

ANTIFUNGAL

–azole

ACE Inhibitors

Beta Blockers

Angiotensin II receptor antagonists

Calcium channel blockers

Vasopressin receptor antagonist

Alpha-1 blockers

Loop diuretics

Thiazide diuretics

Potassium sparing diuretics

-pril

-olol

–sartan
–pine -amill

-vaptan

-osin

–ide -semide

-thiazide

–actone

ANTIHYPERLIPIDEMICS

HMG-CoA reductase inhibitors –statin

OTHERS

Anticoagulants (Factor Xa inhibitors)

Anticoagulants (Dicumarol type)

Anticoagulants (Hirudin type)

Low-molecular-weight heparin (LMWH)

Thrombolytics (clot-buster)

Antiarrhythmics

–xaban

–arol

–irudin

–parin
–teplase –ase

–arone

UPPER RESPIRATORY

LOWER RESPIRATORY

Second-gen antihistamines (H1-antagonist)

Nasal decongestants

–adine; -trizine; -ticine

–ephrine –zoline

Beta2-agonists (Bronchodilator)

Xanthine derivatives

Cholinergic blockers

Immunomodulators & leukotriene modifiers

histamines (H1-antagonist)

–terol

–phylline

–tropium; -clindidiun

–zumab; –lukast

ANESTHETICS

Local Anesthetics –caine

ANTIANXIETY

Barbiturates (CNS depressant)

Barbiturates (used for anxiety/sedation)

–barbital

–zolam; -zepam

Serotonin Reuptake Inhibitors (SSRIs)

Serotonin- Norepinephrine Reuptake

Inhibitors (SNRI/DNRI)

Tricyclic antidepressants (TCAs )

–oxetine; -talopram; -zodone

–faxine; -zodone; -nacipram

–triptyline; -pramine

ANALGESICS/OPIODS

Opiods

NSAIDs

Salicylates

Nonsalicylates
–done; -one

–olac; -profen

Aspirin (ASA)

Acetaminophen

GASTROINTESTINAL

Histamine H2 Antagonist (H2-Blockers)

Proton Pump Inhibitors (PPIs)

Laxative

–tidine; dine

-prazole

-lax

ANTIDIABETIC

Oral hypoglycemic

Inhibitor of the DPP-4 enzyme

Thiazolidinedione

–ide –tide –linide

–gliptin

–glitazone
OTHERS

Corticosteroids

Triptans (anti-migraine)

Ergotamines (anti-migraine)

Antiseptics

Antituberculars (TB)

Bisphosphonates

–asone; -olone; -inide

–triptan

–ergot-

–chloro

rifa-

–dronate

OTHERS

Atypical antipsychotics

Neuromuscular blockers

Retinoids (anti-acne)

Phosphodiesterase 5 inhibitors

Carbonic anhydrase inhibitors

–nuim

tretin-

–afil

–lamide

–trel

-ridone

Common Meds &

their drug

classification

ANTIBIOTICS

Penicillin

Ampicillin

Oxacillin

Cefuroxime Sodium

Cefotaxime Sodium

Co-amoxiclav

Piperacillin + Tazobactam

Ciprofloxacin

Clindamycin
Erythromycin

ANTIVIRAL

DRUGS

Acyclovir

Zidovudine

Oseltamivir

Ribavirin

Ganciclovir

Indinavir

Amantadine

Zanamivir

Trifluridine

Penciclovir

ANTIFUNGAL

AGENTS

Fluconazole

Ketoconazole

Itraconazole

Amphotericin-B

Flucytosine

Cystatin

Griseofulvin

ANTIPROTOZOAL

AGENTS

Metronidazole

Pentamidine

Tinidazole

Nitazoxanide
Atovaquone

ANTINEOPLASTIC

Cisplatin

Cyclophosphamide

Carboplatin

Dacarbazine

Chlorambucil

ANTI-

HELMINTIC

Albendazole

Ivermectin

Mebendazole

Praziquantel

Pyrantel

ANTIDOTES

Opiods/narcotics

Warfarin

Heparin

Digoxin

Anticholinergics

Benzodiazepines

Cholinergic crisis

Acetaminophen (Tylenol)

Magnesium sulfate

Iron
Lead

Alcohol withdrawal

Beta blockers

Calcium channel blockers

Aspirin

Insulin

Pyridoxine

Tricyclic antidepressants

Cyanide

Naloxone (Narcan)

Vitamin K

Protamine sulfate

Digibind

Physostigmine

Flumazenil (Romazicon)

Atropine (Atropen)

Acetylcysteine

Calcium gluconate

Deferoxamine

Chelation agents; Dimercaprol &disodium

chlordiazepoxide

Glucagon

Glucagon, insulin, calcium

Sodium bicarbonate

Glucose

Deferoxamine

Sodium bicarbonate

Hydroxocobalamin
Emergency drugs

A -Atropine Sulfate

Used to decrease

respiratory secretions;

treats sinus bradycardia;

reverses effects of

anticholinesterase

medication

N -Narcan Used for Opioid-induced toxicity; opioid-induced

respiratory depression; used in neonates to

counteract or treat effects from narcotics given to

mother during labor

"LEAN"

L -Lidocaine

Used for Ventricular arrhythmias,

topical/local anesthetic

E -Epinephrine

Used for Bronchodilation;

anaphylaxis; hypersensitivity

reaction; Acute asthma attack;

also an antipyretic

should not exceed 4g within 24 hours

no anti-inflammatory properties or GI

irritation

antipyretic, anti-inflammatory,

anti-platelet

Non-Opiate Analgesics

Monitor liver function,

assess for jaundice and

increase LFT

Educate the patient to

avoid alcohol while taking

acetaminophen

Tylenol

acetaminophen

Hepatotoxicity

Nausea/vomiting and

gastric irritation

Aspirin

Acetylsalicylic acid
GI irritation is expected

NOTE: if GI bleeding develops,

report immediately

Decreased platelets

count and has higher

risk of bleeding

Watch for signs of

salicylism (aspirin

overdose) which includes:

-Tinnitus

Impaired hearing and vision

-Fever

_Dizziness

-Confusion

-Nausea and

vomiting

-Sweating

side effects

nursing considerations

Educate patient to report for

any rashes, itching and vision

changes as this could be

Stevens-Johnsons Syndrome.
Take note that NSAIDs can also

impair kidney function.

Non-Opiate Analgesics

NSAIDs should be avoided

in those patients with IBS or

ulcer disease because of

possible GI bleeding

Dizziness, drowsiness and

possible risk of stroke is

associated with the use of

NSAIDs

NSAIDs

COX-1 inhibitors ibuprofen

COX-2 inhibitors vioxx

celebrex

Opiate Analgesics

Morphine

Fentanyl (Duragesic) Methadone (Dolophine) Codeine Sulfate

Oxycodone (Oxycontin) Hydromorphone (Dilaudid) Ultram (Tramadol) Meperidine (Demerol)

Use for relieving pain w/o

producing loss of consciousness or

reflex activity.
Opiates act on opioid receptor by

altering perception of, and

reducing severe pain. Constipation

Ensure that patient is well-hydrated.

Encourage mobility

Administer stool softeners or stimulant

laxatives to avoid constipation

Monitor VS and have naloxone available.

Avoid administering w/other CNS

depressants.

Respiratory Depression

Urinary Retention

Encourage patient to void at least 4 hours.

Monitor I&O, and obtain an order to

bladder scan if needed. CNS

depression &

sedation

Advise patient to avoid hazardous activities

like driving.

Frequently assess pain level and

document its effectiveness.

Take VS before administering the

breaths per min.

Administer IV opioids SLOWLY.

Educate patient on long-term use of high

dosage of opioids to wean off slowly.

nursing considerations

side effects

Morphine Side Effects

"MORPHINE"

M -Myosis

O -Out of it (sedation)

R -Respiratory depression

P -Pneumonia (aspiration)

H -Hypotension

I -Infrequency (constipation, urinary retention)

N -Nausea

E -Emesis

I can do all things through Christ

who strengthens me.

Good luck future RN!

PHILIPPIANS 4:13
References

Chelsea (2020). Complete Nursing School Bundle. CeceStudyGuides.

Koharchik, L.S. & Hardy, E.C. (2013). As easy 1,2,3! Dosage calculations. Nursing Made Incredibly

Easy!, 11(1), 25-29. https://www.doi.org/10/.1097/01.NME.0000424170.34092.7a

Tuttle, K. (2020). The Complete Nursing School Bundle. NurseInTheMaking LLC.

Vera, M. (2019). Pharmacology Nursing Mnemonics & Tips. Nurses Labs. Retrieved from

https://nurseslabs.com/pharmacology-nursing-mnemonics-tips/

Wilson, K.M. (2013). The nurse's quick guide to I.V. drug calculations. Nursing Made Incredibly

Easy! 11(2), 1-2. https://www.doi.org/10.1097/01.NME.0000426306.10980.65

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