Bachelor of Science in Nursing 2YA

NCMA216: BASIC CONCEPTS OF PHARMA Discussed by Prof. Marivic Ilarde

BASIC CONCEPTS OF PHARMACOLOGY - Fredrich Serturner (first isolated morphine from opium,
Pharmacology injected himself and three other friends with huge doses
- Is the study of drugs and its origin, chemical structure, (100mg)
preparation, administration, action, metabolism and excretion. - Tiningnan nila kung yung morphine is makakatanggal ng
(aalamin ang tungkol sa drug, kung saan nangaling, pain
ingredients nung gamut, how they are prepared, paano - They study the effect of substances in animals
gagamitin, effect ng gamut sa tao, at paano sila e a absorb and - John Jacob Abel
ilalabas kase hindi sila pwede mag stay dahil magiging toxic; • Father of American Pharmacology
inc. level of chemical comp. in the body lead toxicity) • (Foundation of the 1st pharmacology – department in
- The study of drugs that alter functions of living organisms. University of Michigan in 1890)
Pharmacy • Hopkin’s first professor of pharmacology
- Art of preparing, compounding (we mix medication for • The early focus of his work was on isolation and
personalized medication), and dispensing drugs. It also refers characterizing the hormones of the endocrine system,
to the place where drugs are prepared and dispensed. especially adrenaline and insulin
(e.g, Mercury; sila din nag mi mix ng mga drugs-
compounding) Basic Concepts of Pharmacology
Pharmacist Drug
- A person licensed to prepare and dispense drugs to make up - Are chemicals that alter physiochemical processes in body cell.
prescriptions. - They can stimulate or inhibit normal cellular functions.
- Nurses can also dispense drugs but not allowed to mix - Used interchangeably with medicines.
medications Drug Definition
- A substance recognized by an official pharmacopoeia or
History of Pharmacology formulary
- Begun when humans used plants to relive symptoms - A substance intended for the use in the diagnosis, cure,
- Dahil hindi pa uso ang medication dati mga tapal tapal pa mga mitigation, treatment, or prevent diseases (vaccines or healthy
ginagamit noong sinauna) food).
1) Babylonians - A substance or (other than food) intended to affect the
- Earliest surviving “prescriptions” on clay tablets in 3000 structure or any function of the body
B.C. Drug Classification
- (Herbs or mga dahon) • Chemical Structure
2) Chinese - pertain to the molecular arrangement of atoms in a
- Recorded the Pen Tsao (great herbal) – a 40-volume molecule and the chemical bonds that holds the atom
compendium of plant remedies dating to 2700 B.C. together
- Herbal plants • Mechanical of Action (MOA)
- They are still using herbs until now to cure illness - refers to the specific biochemical interaction through
3) Egyptians which a drug substance produces its pharmacological
- Archives of remedies on a document known as Eber’s effect such an enzyme or receptor
(Erb’s) Papyrus in 1500 B.C. • Mode of Action (Moa)
- Sa Erb’s Papyrus nakasulat ang mga iba’t ibang medicinal - describes a functional or anatomical change resulting
plants, anatomy of the body and diseases of plants and from the exposure of a living organism to a substance
animals. Drug Information
- Ex. Aloevera - to treat burns or skin diseases. - also referred to a medication information or drug informatics
Acacia leaves – to treat internal bleeding. - range from discovery, use, and management of information in
4) Pharmacologia sen Manuductio and Materia Medicum the use of medication
- First recorded reference to the word pharmacology. - covers from drug identification, pharmacokinetics to dosage
5) Early 1800s and adverse effects.
- Chemists isolates specific substances from complex Drug Names
mixtures 1) Generic or Nonproprietary Name
- Pharmacologists then study their effects in animals - Name approved by the Medical or Pharmaceutical
Associations in the original country of manufacture and is
adopted by all countries
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- Ex. paracetamol 2) Side Effect

- (kung saan nanggagaling yung drugs or na manufactured - also referred as the secondary effect (unintended effect)
yung drugs) - ex. Side effect of anti-biotic is diarrhea, nausea, and
2) Brand Name or Trade Name vomiting.
- Name given by the manufacturer of the drug (ex. adol or - adverse effect (severe side effect) kaya dpt i-reevaluate pt.
panadol or biogesic pareho lang ang effects, same lang - not all pare pareho ang effect kaya need talagang e
ang effect) evaluate ang pt lagi para if may mga effects ma heads up
3) Chemical Name agad ang Doctor
- Name that describes the atomic or chemical structure. 3) Drug Toxicity
- Ingredients like N-acetyl-p-aminophenol - deleterious effects of a drug resulting from over dosage,
Examples of Generic, chemical, and brand names: ingestion of external use drug, and accumulation on the
Brand blood stream
Generic name Chemical name
name - pwedeng ma overdose ang pt kapag mali ang computation
N-methyl-3phenyl- (halimbawa ang ibibigay sa baby is .5 kaso ang nabigay is
Fluoxetine HCI Prozac
propylamine 5mL so nagkulang ng point you can overdose the pt)
Acetaminophen 4-hydroxyacetanilide Tylenol - Nagkakaroon ng auto toxicity dahil kapag may mga sakit
2-p-isobutylphenyl-propionic kunwari sinisipon lang inom agad ng gamot, nagkaubo
Ibuprofen Motrin lang inom agad gamot, masama pakiramdam umiinom
acid
agad ng gamut tapos lahat nung ininom mong gamut
merong paracetamol so it will cause problem
Generic Name - Signs of drug toxicity:
Route of - Hepatotoxic- liver damage; necrotoxic- kidney damage;
Brand Name medication high blood and etc.
- like in pregnant woman who have hypertension tapos
Dosage/ content Action
of vial bingyan ng magnesium sulfate malalaman kung nag ka
drug toxicity sya kung bumaba bp, pulse, respiration at
absent na ung patellar reflex so dpt mabigyan siya ng
calcium gluconate sa bed side ng pt. usually nakalagay
lang sa chart is observe for drug toxicity.
4) Drug Allergy
- immunologic reaction to drug or hypersensitivity
- should have skin test for IV drugs
- should ask patient for allergy in oral drugs
- if the pt. have many food allergy then ask the doc.
5) Drug Tolerance
- exists in person with unusually low physiologic response
to a drug
- may mga taong mababa tolerance sa mga substances at
ung iba nmn dhil usual silang uminom ng pain reliever
tumataas pain tolerance nila

Drug Regulation & Mandates

Food and Drug Administration of the Philippines or FDA
- created under the Department of Health or DOH to license,
monitor, and regulate the flow of food, drugs, cosmetics,
medical devices, and household hazardous waste in the
Philippines
Drug Action - FDA’s main goal is to ensure the health and safety of the food
1) Therapeutic Effect and drugs made available to the public
- Also referred as the desired effect (primary effect - (sila ang nagbibigay ng lisensya sa mga drugs. Tinitingnan
intended) nila kung may mga ibang substances pa sa drugs. Kapag
- Binibigyan ang anti-biotic to slow down growth of bact. meron tine terminate nila yung drugs kase magkakaroon ng
to kill the bacteria bad effect yun sa katawan ng tao)
- Govt. doctors- write generic name not the brand name

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• Republic Act No.3720 • Correct Identification of the Patient:

- known as the Food Drug, and Cosmetic Act. - ID band or ID bracelet (Kozier)
- An act to ensure the safety and purity of foods, drugs, - Ask the patient’s name.
and cosmetics being made available to the public by - Avoid: calling the client in Name because they may
creating the food and drug administration which shall answer “Yes” to the wrong Name.
administer and enforce the laws. • Observe the Ten Rights:
• Republic Act No. 8203 1) Right medication
- Otherwise known as the special law on counterfeit - Means that the client receives the drug that was
drugs. prescribed
- “Unregistered and imported drug product” as - Medication orders may be prescribed by:
distinguished from counterfeit drug defined under o Physician
Section 3 of RA…shall refer to unregistered o Dentist
counterpart brand in the Philippines o Podiatrist- treat infection in foot and lowerlimb
- (Ito yung nagche check if totoo or peke yung product) o License health care provider such as advance
• Republic Act No.7394 practice registered nurse
- Consumer Act of the Philippines o With authority from the state to order medication
- Protects the interest of the consumer, promotes - Components of Medication Prescription:
general welfare and to establish standards of conduct o Component of drug order
for business and industry o Date and time the order is written
- Protection against deceptive, unfair, and o Drug name: BN and GN
unconscionable sales acts and practices. o Drug dosage: 500mg
• Republic Act No.9165 o Route of administration
- Comprehensive Dangerous Drugs Act of 2002 the o Frequency and duration of administration
Philippine Drug Enforcement Agency (PDEA) o Any special instructions for withholding or
- Created for the efficient and effective law adjusting dosage based on nursing assessment,
enforcement of all the provisions on dangerous drugs drug effectiveness, or laboratory result
and or precursor and essential chemicals as provided o Physician or other health care provider signature
in R.A or name if TO or VO
- Two of the most used and valuable illegal drugs in o Signature of license practitioner taking TO or
the country are “methamphetamine hydrochloride VO
known as shabu and marijuana” - Categories of Drug Order:
o Standing- maintenance medications or taken for
Principle of Drug Administration several days like anti biotics. Give cephalexin
• Are substances administered for the diagnosis, cure, treatment, 5mg 1 cup 3x a day for 7 days
or relief of symptom or prevention of disease. o One time- diphenhydramine 50mg IV prior to
• Practice Guidelines: blood transfusion.
- RNs are responsible for own actions, illegible order o PRN / when necessary- some doc. Don’t indicate
should be questioned or clarified. prn. Paracetamol 500mg 1 tab every 4 hours for
- RNs should be knowledgeable about the medication. temp. 38.5 and above. So ang basehan dito ay
- If the RN is uncertain about the calculation, ask another temp. kase walang prn. Ibibigay kada 4hrs
nurse to double check. tuwing may lagnat na ang temp ay 38.5 pataas.
- What you prepare, you administer. 8am-12pm walang lagnat wag ibigay, 2pm may
- Do not leave medications at bedside. lagnat ibigay ang gamot.
- If the client vomits, report to charge nurse, MD, or both. o STAT/immediately/now- demerols IM stat, so
o Charge nurse- does the charting and carry out doc. ibigay na agad kahit may ginagawa ka pa iwan
Order mo ginagawa mo balikan mo na lang
o Medication nurse- focus on pt. get direct care to pt. 2) Right dose
and give medications and check pt. chart to check - Right dosage of the medicine that will be given to the
bago umuwi client
- When error is made, assess the patient first and report to 3) Right route
MD immediately. - Is necessary for adequate or appropriate absorption
(there is no room for error because it is cause life of - Common routes are the following:
patient so you should focus on what you are doing) o Oral

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o Sublingual 8) Right to refuse

o Buccal - Client can and do refuse to take medication
o Inhalation - It is the nurses’ responsibilities to determine when
o Topical possible, the reason for refusal and to take reasonable
o Inhalation measure to facilitate the client taking the medication
o Instillation- ex. eyedrops - Should have waiver signed by the pt.
o Suppository, etc. 9) Right assessment
4) Right time - Requires the appropriate data be collected before
- the time at which the prescribed dose should be administration of drugs.
administer. 10) Right evaluation
- Daily drug dosages are given at specified time during - Requires that the effectiveness of the medication be
a day such as: determined by the client response to medication
o Twice a day b.i.d - (you must observe the first 5 rights)
o Three time a day t.i.d
o Four times a day q.i.d.
o Every 6hrs q6h
o HS: hour of sleep
5) Right client
- Can be measured by checking the client identification
bracelet by having and by having the client state her
or his name.
- Tanungin ang name but do not call the name of the
client let the client speak her/his name Date prescription was
Prescriber’s Info.
written
- Some client answers to any name or unable to
respond, so client identification should verify each Patient’s Info. Inscription:
time of medication administered. Medication Prescribed
Superscription:
- In the event of missing identification bracelet, the “Recipe”
Quantity of
nurse must verify the client identity before any drug
Medication
administration. Sigma: Directions
6) Right client education for Patient
Instruction to the
- Requires that the client received accurate and pharmacy
thorough information about the medication an d how Physician’s License
and PTR Number Physician’s signature
it relates to his or her situation
- Client teaching also includes therapeutic purpose, - Rx- from latin word recipe means to take. Called
possible side effect of the drugs, any dietary superscription
restriction or requirements skills administration, and - Inscription- medication prescribe
laboratory monitoring - Sigma- direction for pt. on how to take the medication
7) Right documentation - PTR-yearly kumukuha sa munisipyo
- Requires that the nurses immediately record the - S2 no.- used for prescribing drugs that cause addiction like
appropriate information about drug administered Demerol
include the ff:
• Name of the drug Oral Medications
• Dose - Most common route
• Route - Contradictions:
• Time and date • Client is vomiting
• Nurse initial or signature • Client with intestinal or gastric suction
• Unconscious client
• Inability to swallow
- Unsafe actions
• Do not crush enteric coated or gel coated tablets (to
prevent form gastric juice)
• Do not crush long-acting tablets (slowly inaabsorb
gamot)

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• Do not try to open sealed capsules (wag itry buksan if Subcutaneous

mahigpit) Site Angle Gauge Length Max cc
• Do not crush contents of spansule with beads or - Outer aspect 45-degrees 25, 26, 27 3/8”, 5/8”, 1-3 mL
pellets of the upper (1 inch of ½”
• Do not give sublingual formulations orally arms tissue can
- Anterior be grasped)
• Do not crush sublingual formulations
thighs
• Do not give oral medications sublingually - Abdomen 90-degrees
- Safe actions - Upper back (2 inches of
• Scored tablets may be split (no scoring wag hatiin) - Ventroglutea tissue can
• Chewable medications can be crushed safely l be grasped)
• If a capsule opens easily, powder from the capsules can be - Dorsogluteal
mixed with food or liquid
• Liquid filled capsule contents can be (a) squeezed out, or
(b) aspirated then mixed with food or liquid
• A sublingual formulation can still be given ever if client is
NPO
• Beads from readily opened capsules can be sprinkled over
soft food, but should not be chewed.
- Tablets or Capsule:
• Difficulty in swallowing
• Crush and mix with small amount of water
- Avoid Crushing: Intramuscular
• Sustained-action • Site:
• Enteric coated - Ventrogluteal
• Buccal and sublingual tablets  1y/o and adult
- Liquid Medication:  No large nerve or
• Mix before pouring blood vessels
• Place medication cup on flat  Sealed off by bone
surface at eye level  Contains less fat
• Fill the cup with the desired level than buttock
using the bottom of the meniscus. - Vastus lateralis
 Site of choice for 1 y/o
Parenteral Medications and younger
Intradermal  Infants with poorly
Site Angle Gauge Length Max cc developed gluteal
- Inner lower Almost 25, 26, 27 3/8”, 5/8”, ½” 0.1 to 0.2 muscles
arm parallel to mL - Dorsogluteal
- Upper the skin  For adults and children
chest 10-15 O with well-developed
- Anterior gluteal muscles
chest  Contradicted: For
- Upper back
adults and children
beneath the
with well-developed
scapula
gluteal muscles
- Perfect wheel should have right angle and hawak sa syringe, if
 Increased risk of
no wheel means malalim ang pag inject
striking the sciatic nerve
- Deltoid
 Small muscle, very
close to the radial
nerve and artery
 Rapid absorption
for adults
 Cannot administer
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more than 1 mL 3) Otic medications

 Recommended site for Hepa B vaccine • Preparations:
administration - Clean the pinna and the
- Rectus femoris meatus of the ear canal
 Can be used for self- - Warm the medication: In
administration between hands
 Disadvantage: causes - Place in warm water
discomfort • Straighten the auditory canal:
• Angle: - Adult (>3 years old): Pull the pinna upward and
 90-degrees backward
• Gauge: - Child (<3 years old): pull the pinna downward and
 24,23,22,21,20 backward
• Length: • Instill the medication:
 1”, 1 1/2”, 2” - Along the side of the canal
• Max cc: • Actions after:
 2-5 mL - Gently press the tragus
Intravenous/ Intravascular - Insert small piece of cotton fluff loosely
• Gauge: 24,23,22,21,20 • Instruction after:
• Length: 1”, 1 1/2”, 2” - Remain in side-lying for 5 minutes
• Max cc:
- Push: 10 mL
- Infusion: 4L in 24 hours
ID/ SC IM/ IV
Gauge 25 24
length <1 inch 1 inch and 

Topical Medication
1) Transdermal patch
• Site:
- Trunk or lower abdomen
- Hairless
- (+) hair (CLIP, do not shave)
- Not subject to excessive movements or wrinkling
• Avoid:
- cuts, burns, abrasions, distal extremity
2) Ophthalmic medications
• Preparation:
- Clean the eyelid and lashes
from inner to outer canthus
• Instruction before administration:
- Look up
• Where and how much to apply:
- Liquid: instill correct number
of drops
- Outer third of the lower
- Ointment: discard the first
bead
- Squeeze 2cm on the lower conjunctival sac
• Instruction after installation:
- Do punctual occlusion for 30 seconds
- Close but not squeeze the eyelid

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