Welcome to the introductory
video to pharmacology.
Now I don't know what you've
heard about pharmacology,
but I want you to be assured
that you are going to have
fun learning this content.
In this video, we're going to talk about
the nurse's role in safe and effective
administration of drugs.
So let's start at the beginning.
What do you think pharmacology is?
Okay, good job answering the question.
Now, let's take a look at the formal
definition of pharmacology.
It's the science dealing
with the preparation,
uses, and especially, the
effects of drugs, okay?
So, probably pretty close, and
hopefully, you got that answer.
Now, let's look at what a
drug is. Now, it can be
any chemical substance.
A lot of times, people think drugs are just
things that have to have prescriptions.
It must come from a health care
provider, but they're really not.
A drug can encompass anything:
any substance that we use in treatment,
cure, prevention, or diagnosis of a disease.
Anything that helps our patients
enhance their physical
or their mental well-being.
So, it's not just limited to things that
health care providers prescribe.
It can also be anything from
a health food store,
a chemical, a vitamin, a supplement.
So remember, when you're
taking care of clients,
you want to make sure that you ask about
all the substances that they take.
We need complete information in
order to keep them safe.
So, what do you think the ideal drug is?
Well, there's three things that we look for.
We'd like the drug to be safe.
We like it to be selective,
and we want it to be effective.
Okay, so when we say "safe,"
nobody wants to take a drug that gives
them more problems than benefits.
We want it to be selective,
like with antibiotics.
We want them to kill the bugs
and the bacteria,
but we don't want them to
kill the human cells.
And we want it to be effective.
If we take a drug to treat someone's
high blood pressure,
we want it to lower their blood pressure.
So when you're just dipping your toes
into the pool of pharmacology,
what you want to think about is,
is this drug safe?
Is it going to be selective?
And is it going to be effective
for my patient?
Now, if you gave me a wish list
of lots of other things
that we could have for the drugs,
these are great things to have.
First of all, is reversibility.
Now, I'm sure you've heard a
lot about the opiate crisis.
We have a drug called Narcan or Naloxalone,
that if someone has an opioid overdose,
if you give Narcan, it will bump
those opioids off the receptors
and bring that patient, essentially,
back to life.
So the ability for the drug
to be reversible
is really important when
it comes to safety.
Not all drugs are.
Now, predictable. I want to know
when I give this drug to patient A
or to patient B, I'm going to have
relatively the same effect.
The next one is no adverse effects.
Well, that would be wonderful, but
that really doesn't exist.
All drugs have some negative effects.
And so, you want to minimize those,
but we're never going to get…
reach the "no adverse effects" level.
No interactions. When you
take two medications,
you have the potential to
have that interaction.
And when drug start working together,
they can either impact and significantly
increase the action of the drug,
or they could diminish the
action of the drug.
And finally, we want it to be
cheap and simple.
Now, if you think this drug exists,
that's all three of those things, safe,
selective and predictable,
plus reversible, no adverse
effects, no interaction,
and cheap and simple, it simply doesn't exist.
We try for those things,
it's a wish list and we get
as close as we can,
but many drugs can't meet
all of these criteria.
So, overall, what is our goal
We've already talked about all the things
that we wish a drug could do,
and that there is no true ideal drug.
So what is our target?
Well, we're looking for maximum
benefit for the patient
with minimum harm to the patient.
And really, that's the exciting part
It's not just memorizing drugs, and names,
and side effects, and adverse effects.
That would be completely boring.
What we're looking for is
how do I help my patient get
the most from this drug
and the minimum harm?
And that's where nurses play a pivotal role.
So, here's another question for you.
What determines the strength
of a drug response?
Okay. Now that you've selected your answer,
let's look at some of our ideas.
Okay. So, let's look at the factors
of how much of the drug
we can get to the site,
and what are the things that impact it?
First of all, the dosage of the medication,
and when we say that, we mean
the amount of the medication.
So, if I give a larger dose,
more drug will make it to the site
where we want it to work.
If I give a smaller dose, less will make it.
Next, think about the route of medication.
I give a much smaller dose if I
give the medication IV:
intravenous or straight into the vein.
If I give the medication orally,
it goes through a first pass
effect in the GI tract,
which we'll talk about more in another video,
but just know that for now, the route
I give the medication matters.
More of the drug will reach a site if I
give it in route like IV or sublingual,
versus if I give a medication
and goes down into the stomach.
The timing between doses matters.
If I want less drug to get to the site,
I just increase the amount of
time in between doses.
So if I have a patient that's
showing us signs of toxicity,
or that they've got too much
of the drug on board,
instead of giving it every 4 hours,
I'll give it every 6 hours,
or maybe even every 8 hours.
So changing the timing in
between doses will affect
how much of the drug gets to the site.
Now then, every patient is different.
I would love to tell you that everything
If we gave this drug to patient A
and this drug to patient B,
they would act exactly the same.
It never happens that way in my practice.
So, listen to your patients.
When they tell you when they
take this medication,
they have this weird side effect,
believe them, because everyone's
body is different.
Now, diphenhydramine is a common
medication like Benadryl.
Most people, when they take
it, get really sleepy.
Some people when they take it get really
wired up, particularly with children.
So just keep in mind, we know what
the medication usually does,
but always listen to your patients
when they tell you
what they experience taking that medication.
Now, pharmacokinetics starts
to sound super fancy,
but it's really just how the drug
moves through the body.
You'll see the words there on the slide, "ADME."
That just stands for absorption,
metabolism, and excretion.
We'll talk more about those
later in another video.
But how each one of those processes,
ADME, is affected,
manages how much of the drug
gets to the actual site of action.
The last one is pharmacodynamics
and that's the effects of the
drug on the body.
So these are two very important
Pharmacokinetics, that talks about movement,
and that's just movement of the
drug through the body.
Pharmacodynamics is the effects
of the drug on the body.
So those are two really important
that we'll explore more in other videos.