Hi, 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
and 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 patient to have
enhanced their physical or their mental well being.
So it's not just limited to things
that healthcare providers prescribe.
They 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
We want it to be selective, like with antibiotics,
we want them to kill the bugs in 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.
And I'm sure you've heard
a lot about the opiate crisis.
We have a drug called Narcan or Naloxone,
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.
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 to reach the 'no adverse effects level',
When you take two medications, you
have the potential to have interaction.
And when drugs 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 with pharmacology?
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 about pharmacology.
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 thing, about the route of medication.
I give a much smaller dose if I give them
medication IV, intravenous or straight into the vein.
If I give them 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 a route like IV, or sublingual,
versus if I give a medication that's
swallowed and goes down into the stomach.
The timing between doses matters.
If I want less drug to get to the site, I just
increased the amount of time in between doses.
So if I have a patient that's
showing us signs of toxicity,
that they've got too much of the drug on
board, instead of giving it every four 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 was predictable.
If we gave this drug to patient A and this drug
to patient B, they would act exactly the same.
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 experienced 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,
distribution, 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 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 pharmacology
type concepts that we'll explore more in other videos.