1.1 Pharmacology, Interdisciplinary Teams, and Nursing Practice

Pharmacology is crucial for nurses, involving the study of drugs and their effects on the body. It enables nurses to make informed decisions about medication administration, recognize issues, and collaborate with other healthcare professionals.

Nurses play a vital role in medication management, adhering to the "five rights" of administration. They assess patients, document responses, educate about medications, and work with interdisciplinary teams to optimize treatment plans and ensure patient safety.

Introduction to Pharmacology and Nursing Practice

Definition and relevance of pharmacology

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• Pharmacology involves studying drugs and their effects on living organisms
  • Encompasses drug composition, properties, therapeutic uses, and adverse effects
• Nurses play a vital role in medication management and patient safety
  • Administer medications (oral, injectable, topical)
  • Monitor patients for therapeutic effects and adverse reactions (changes in vital signs, allergic reactions)
  • Educate patients about their medications (proper use, potential side effects)
• Knowledge of pharmacology enables nurses to:
  • Make informed decisions about medication administration (dosing, timing, route)
  • Recognize and respond to medication-related issues (adverse reactions, interactions)
  • Collaborate effectively with other healthcare professionals (physicians, pharmacists)

Milestones in pharmacology's development

• Ancient civilizations used natural remedies and plant-derived substances for healing (herbs, poultices)
• 19th century marked the isolation and purification of active ingredients from plants
  • Morphine from opium poppy (1804) used for pain relief
  • Quinine from cinchona bark (1820) treated malaria
  • Aspirin from willow bark (1899) reduced pain and inflammation
• 20th century saw the synthesis of new drugs and development of modern pharmacology
  • Sulfonamide antibiotics (1930s) combated bacterial infections
  • Penicillin (1940s) revolutionized treatment of infectious diseases
  • Psychotropic medications (1950s) managed mental health conditions (depression, anxiety)
• 21st century focuses on personalized medicine and targeted therapies
  • Pharmacogenomics studies genetic influences on drug response (tailoring treatments to individual genetic profiles)
  • Biologic agents are drugs derived from living organisms or their products (monoclonal antibodies, vaccines)

Interdisciplinary Collaboration and Nursing Practice

Interdisciplinary collaboration for medication management

• Interdisciplinary teams include healthcare professionals from various disciplines
  • Physicians, nurses, pharmacists, therapists, and social workers
• Collaboration ensures comprehensive and coordinated patient care
  • Shared decision-making and problem-solving (treatment planning, discharge coordination)
  • Improved communication and information sharing (electronic health records, team meetings)
• Medication management is a key area of collaboration
  • Physicians prescribe medications (selecting appropriate drugs, dosing)
  • Pharmacists review orders, dispense medications, and provide drug information (checking for interactions, monitoring therapy)
  • Nurses administer medications and monitor patient response (assessing effectiveness, identifying adverse reactions)
• Collaboration promotes patient safety and optimal outcomes
  • Identification and prevention of medication errors (double-checking orders, using barcode scanning)
  • Monitoring for adverse drug reactions and interactions (reporting to physicians, adjusting therapy)
  • Development of individualized treatment plans (considering patient preferences, comorbidities)
  • Medication reconciliation to ensure accurate and up-to-date medication lists across care transitions

Nurse's role in medication administration

• Nurses are responsible for the "five rights" of medication administration
  1. Right patient (verifying identity with two identifiers)
  2. Right drug (checking medication label against order)
  3. Right dose (calculating and measuring accurately)
  4. Right route (ensuring appropriate route of administration)
  5. Right time (administering at prescribed time intervals)
• Nurses must have knowledge of drug actions, indications, and contraindications (mechanism of action, therapeutic uses, precautions)
• Patient assessment before, during, and after medication administration
  • Vital signs, pain levels, and other relevant parameters (blood pressure, respiratory rate, blood glucose)
  • Recognition of adverse reactions or therapeutic ineffectiveness (rash, difficulty breathing, uncontrolled symptoms)
• Documentation of medication administration and patient response (electronic medication administration record, progress notes)
• Patient education about medications
  • Indications, proper use, potential side effects, and precautions (taking with food, avoiding alcohol, recognizing allergic reactions)
  • Strategies for adherence and self-management (pill organizers, reminder apps)
• Collaboration with interdisciplinary team members to optimize medication regimens
  • Reporting concerns or observations to physicians or pharmacists (ineffective therapy, adverse reactions)
  • Participating in medication reconciliation and discharge planning (ensuring accurate medication lists, providing education)

Pharmacological Considerations in Nursing Practice

• Understanding the therapeutic index to balance drug efficacy and safety
• Monitoring for drug-drug interactions, especially in patients with complex medication regimens
• Addressing polypharmacy challenges in elderly or chronically ill patients
• Promoting patient adherence through education and support
• Participating in pharmacovigilance efforts to identify and report adverse drug reactions