LORENZO WALKER INSTITUTE OF TECHNOLOGY
PRACTICAL NURSING PROGRAM
COURSE: Pharmacology
PLACEMENT: Semester 2
TIME ALLOTMENT: 50 Hours
PURPOSE: The purpose of this course is to provide the student with the necessary background, knowledge and skills to safely and accurately administer medication. (32.0)
COURSE DESCRIPTION: This course will include an overview of pharmacology, calculation of dosages, systems of measurement, administration of medication, use of medication references/resources as well as identification of medications used in the treatment of diseases/disorders of body systems. (34.03)
SUMMARY OF UNITS:
Unit I - Introduction to Pharmacology including Systems of Measurement and
Calculation of Dosages
Unit II - Administration of Medications
Unit III - Drug Classifications
METHODS OF EVALUATION: Evaluation will be based upon written objective tests and quizzes as well as instructor assigned projects/assignments, class participation and preparedness. The Calculation of Dosage test will be given at various times during the course of instruction and the student will have three opportunities to accomplish a grade of 100%.
COURSE REQUIREMENTS: For successful completion of this course, the student must have an average grade of 80% based on the three unit exams/quizzes and other unit assignments. Additionally, the student must maintain an average score of 80% from all methods of evaluation.
The student must also receive 100% on a 10-question dosage calculation test – each student will have three opportunities to achieve 100%. This 100% grade is a requirement to continue in Pharmacology and is not averaged into the final grade.
METHODS OF INSTRUCTION:
Required readings Written Assignments Multimedia presentations
Lecture/Discussion Guest lecturers Laboratory experiences
Cooperative learning
REFERENCES:
Castaldi, PA Study Guide for Christensen and Kockrow Foundations of Nursing, St. Louis: Mosby/Elsevier, 2006.
Christensen, BL and Kockrow, EO, Foundations of Nursing, 5th edition, St. Louis: Mosby/Elsevier, 2006.
Deglin, J and Vallerand, A., Davis’s Drug Guide for Nurses, 10th ed., Philadelphia: FA Davis Company, 2007.
FA Davis, Taber’s Cyclopedia Medical Dictionary, Philadelphia: FA Davis Company, 20th ed., 2005.
Linton, AD, Introduction to Medical Surgical Nursing, Philadelphia: Saunders/Elsevier, 2007.
Maebius, NK, Study Guide for Linton Introduction to Medical-Surgical Nursing, Philadelphia: Saunders/Elsevier, 2007.
Myers, E and Hopkins, T., LPN Notes, 2nd ed., Philadelphia: FA Davis Company, 20th ed., 2007.
Ogden, S, Calculation of Drug Dosages, 8th ed., St. Louis: Mosby/Elsevier, 2007.
Pagano, KD and Pagano, TJ, Mosby’s Diagnostic and Laboratory Test Reference, 8th ed. 2008.
Scanlon, Valerie and Sanders, Tina, Essentials of Anatomy and Physiology, 5th ed. Philadelphia: F.A. Davis Company, 2007.
Scanlon, Valerie and Sanders, Tina, Student Workbook for Essentials of Anatomy and Physiology, 5th ed. Philadelphia: F.A. Davis Company, 2007.
Silvestri, LA, Saunders Comprehensive Review for NCLEX-PN, 3rd ed., Philadelphia:WB Saunders Co., 2007.
Sparks, Sheila and Taylor, Cynthia, Nursing Diagnosis Reference Manual, 7th ed. Pennsylvania: Lippincott, Williams and Wilkins, 2008.
Virtual Clinical Excursions – Skilled Nursing; for Christensen and Kockrow Foundation of Nursing 5th ed., 2007
Virtual Clinical Excursions – Medical Surgical; for Linton Introduction to Medical Surgical Nursing, 4th ed., 2007.
Instructor selected handouts/multimedia
Unit I - Introduction to Pharmacology including Systems of Measurement and
Calculation of Dosage
OBJECTIVES:
At the completion of this unit, the student will be able to:
1. Set up proportions and solve for unknown quantities. By end of course be able to calculate ten (10) problems in drug and solutions with 100% accuracy.
2. Recognize and define metric terms of measurement.
3. Differentiate and perform calculations between the metric, apothecary, and household systems of measurement.
4. Define pharmacology, drug, pharmacist, generic, trade, official and chemical name.
5. Discuss drug legislation and know specifics of Controlled Substance Act including 5 classes of habit forming drugs.
6. Identify the drug reference designated by the FDA.
7. Describe the procedure the nurse is to follow in accounting for narcotics and controlled drugs.
8. Name four (4) drug references, and demonstrate how to use drug reference books.
9. Discuss Pharmacokinetics and differentiate between absorption, distribution, biotransformation and excretion.
10. Describe how drugs are prepared. Identify the forms.
11. Describe factors to be considered in drug dosage.
12. Describe methods of drug administration.
13. Differentiate between minimal, therapeutic, maximal, initial, toxic and lethal dose.
14. Differentiate between local and systemic sites of action.
15. Discuss drug effects such as synergism, antagonism, adverse reaction, side effect, idiosyncratic effect, and anaphylaxis.
16. List the 7 parts of a prescription. Know who is allowed to write a prescription.
17. Explain what is meant by a written order, a verbal order, a standing order, a stat order and transcribing physician orders.
18. Apply the nursing process to medication administration.
STUDENT ACTIVITIES:
Complete the Worksheets in this scope on Systems of Measurements and Dosage Calculation
Students are expected to complete workbook activities that correspond with chapter readings to enhance learning and facilitate successful completion of this course.
Instructors may assign workbook activities to be submitted for review/grading.
It is also recommended that students complete corresponding sections in NCLEX-PN Comprehensive Review Text.
THE METRIC SYSTEM
It is not necessary for you to know the entire metric system to administer medications safely, but you must understand its basic structure. In order to do that, you will have to MEMORIZE a few basic concepts and rules.
MEMORIZE
Basic Units
Length = meter (M)
Volume = Liter (L)
Weight = Gram (Gm. or g)
Prefixes are used with the names of the basic units to identify larger and smaller units of measure. Prefixes also change the value of each of the basic units by the same amount.
MEMORIZE
kilo – largest prefix – multiplies basic unit by 1000
centi – divides basic unit by 100
milli – divides basic unit by 1000
micro – divides basic unit by 1,000,000
Only two types of metric measures are used in drug dosages-
WEIGHT and VOLUME
MEMORIZE
Weight Volume
kg = kilogram L = liter
g or Gm = gram ml = milliliter
mg = milligram
mcg = microgram
A cubic centimeter (cc) is the amount of space occupied by 1 ml. Therefore, 1 ml = 1 cc and these two units are used interchangeably (MEMORIZE THIS FOREVER AND EVER, AMEN!)
The metric system is also a decimal system and conversion between the units is simply a matter of moving the decimal point.
MEMORIZE
Each of the units differs from the next (those above) by 1000.
There are three zeros in 1000, so move the decimal point three places.
If going down the scale, move the decimal point to the right. Downright Easy!!
If going up the scale, move the decimal point to the left. Uplifting News!!
THE APOTHECARY SYSTEM
The apothecaries system is the oldest system of weights and measures. It is also obsolete and outdated; however, you will see it still in use to some extent and you must, therefore, be able to recognize its symbols, abbreviations, and notation rules.
There are only four units of measure to MEMORIZE
For Weight - gr. = grain
For Volume - m = minim
= dram
= ounce (more bounce to the ounce)
Notation Rules:
Rule I -- Apothecary abbreviations are printed in small letters
Rule II -- The quantity is written in Roman numerals. For safety, always draw a line over the
digits and dot the numeral 1 (one) each time as a safeguard against errors.
Rule III -- The symbol is placed in front of the quantity.
Rule IV -- Fractions are expressed as common fractions in Arabic numbers.
Rule V -- The symbol ss may be used to denote 1/2.
HOUSEHOLD MEASURES
Three household measures are still in common use for drug dosage:
T or tbsp. = Tablespoon
t or tsp. = teaspoon MEMORIZE these if you are not familiar with these terms.
gtt. = drop (In French, the word for drop is goutte)
UNITS - U
An expression of biological action rather than actual weight.
Insulin and some antibiotics as well as some anticoagulants are commonly measured in units. Hundred of thousand or even millions of units are common for antibiotics, Insulin will be measured in less than 100 U.
CONVERSION FACTS TO MEMORIZE
METRIC APOTHECARY HOUSEHOLD
Liquid Measure
1 liter = 1000 ml. = 1 quart = 2 pints = 4 cups
30 ml. = 30 cc. = 1 ounce = 2 tbsp.
5 ml. = 5 cc. = 1 dram = 1 tsp.
1 ml. = 1 cc. = 15 minim = 15 gtts.
Dry Measure
60 mg. = 1 gr. = (too small)
1000 mg. = 1 g. = 15 gr. = ¼ tsp.
1 kg. = none = 2.2 lbs.
Also know that:
1 mg. = 1000 mcg.
3 tsp = 1 tbsp. = 15 ml.
Please note that gram can be written as g. or Gm.
With these facts memorized you will be able to compute any medication dosage problem.
SYSTEMS OF MEASUREMENT PRACTICE
1 dram = ______cc.
1 Gram = ______grains
1 cc = ______minims
1 tsp. = ______drams
1 Quart = ______cc.
1 L = ______quarts
1 cc. = ______ml.
2 Grams = ______grains
180 cc. = ______ounces
75 grains = ______Grams
30 cc. = ______ounce
1 grain = ______mg.
0.5 Gram = ______grains
1 Kg. = ______lbs.
DOSAGE CALCULATION PRACTICE
Aspirin gr. X is ordered. Aspirin is supplied in 300 mg. / tablet. How much would you give?
Digoxin 0.125 mg. is ordered. Digoxin is supplied in 0.25 mg./tablet. How may tablets would you give?
PRACTICE, PRACTICE, PRACTICE
FOR
SYSTEMS OF MEASUREMENT
1000 ml. = ______L
1000 mg. = ______g. or Gm.
1000 cc. = ______L = ______ml. = ______quart
30 cc. = ______oz. = ______t. or tsp.
5 ml. = ______drams = ______t. or tsp.
1 cc. = ______minims
60 mg. = ______grains
gr. XV = ______g. or Gm.
1 quart = ______pints = ______cups
1 Kg. = ______g. = ______lbs.
OH YES, YOU WILL GET IT!!!!!!
0.5 g. = ______mg. = ______gr.
gr. X = ______mg. = ______g.
30 mg. = ______gr. = ______g.
IDENTIFY THE SYMBOLS:
______
Systems of Measurement
Solve the following systems equivalents.
1. 0.125 mg. = ______mcg.
2. 45 lbs. = ______kg.
3. 0.71 g. = ______mg.
4. 36 cc. = ______ml.
5. 240 ml = ______
6. 1 tsp. = ______ml.
7. 2 ½ c. = ______ml.
8. iii = ______ml.
9. minim iv = ______ml.
10. gr. xv = ______g.
11. gtt. i = minim ______
12. 1 qt. = ______pt. = ______cc.
13. 30 ml. = ______= ______Tbsp.
14. gr. i = ______g
15. gr. 1/5 = ______mg.
Pharmacology Dosage Calculation Practice
Like Measurements
Please solve for the correct dosage:
1. Order: Vitamin B12 500 mcg IM 2X weekly
Supply: Vitamin B12 1000 mcg / ml
Give: ______
2. Order: Vistaril 75 mg IM STAT
Supply: Vistaril 100 mg / 2 ml
Give: ______
3. Order: Cimetidine HCL 100 mg IM qid
Supply: Cimetidine HCL 300 mg / 2 ml
Give: ______
4. Order: Dilantin 100 mg PO qd
Supply: Dilantin 250 mg / 2 ml
Give: ______
5. Order: Potassium chloride 30 mEq PO qd
Supply: Potassium choride 20 mEq / 15 ml
Give: ______
6. Order: Decadron 0.5 mg PO tid
Supply: Decadron 0.25 mg tablets
Give: ______
7. Order: Mandelamine 1 g PO q12h
Supply: Mandelamine 0.5 g tablets
Give: ______
8. Order: Glyburide 2.5 mg PO qd
Supply: Glyburide 1.25 mg tablets
Give: ______
9. Order: Decadron 3 mg IM STAT
Supply: Decadron 4 mg / ml
Give: ______
10. Order: Mandol 750 mg IM q8h
Supply: Mandol 1000 mg / 3.5 ml
Give: ______
Pharmacology Worksheet
Unlike Measurements
1. Order: Depakene 0.75 Gm.
Supply: Depakene Syrup 250 mg. / 5 ml.
Give: ______
2. Order: Tylenol 480 mg.
Supply: Tylenol elixer 160 mg. / 1 teaspoon
How many ml. would you administer?
Give: ______
3. Order: Nembutal gr. iss
Supply: Nembutal 50 mg. capsules
Give: ______
4. Order: Apresoline 25 mg. PO BID.
Supply: Apresoline tablets gr. 1/6
Give: ______
5. Order: Tylenol gr. X
Supply: Tylenol 325 mg. tablets
Give: ______
6. Order: Erythromycin 0.4 Gm
Supply: Erythromycin 500 mg / 10 ml
Give: ______
7. Order: ASA gr. XV now
Supply: ASA 0.3 Gm. tablets
Give: ______
8. Order: Tylenol with codeine gr 1/8 PO qid
Supply: Tylenol with codeine 7.5 mg tablets
Give: ______
9. Order: Thorazine 50 mg. IM STAT.
Supply: Thorazine 0.1 Gm. / 2 ml.
Give: ______
10. Order: Prostophlin 1000 mg PO qid
Supply: Prostophlin 0.25 Gm capsules
Give: ______
Dosage Calculations
Sample 100% Test
Solve the following dosage calculation problems:
1. Order: Librium 25 mg. IM.
Supply: Librium 100 mg. / 2 ml.
Give: ______
2. Order: Penicillin G potassium 350,000 U IM BID.
Supply: Penicillin G potassium 500,000 U / 2 ml.
Give: ______
3. Order: Phenobarbital 45 mg. PO QID.
Supply: Phenobarbital 30 mg. tablets
Give: ______
4. Order: Apresoline 25 mg. PO BID.
Supply: Apresoline tablets gr. 1/6
Give: ______
5. Order: Coumadin 10 mg. PO at 1800
Supply: Coumadin 2.5 mg. tablets.
Give: ______
6. Order: Lasix 6 mg. PO BID
Supply: Lasix 10 mg. per ml.
Give: ______
7. Order: Celcor oral suspension 250 mg.
Supply: Ceclor oral suspension 125 mg. / 5ml.
How many tsp. will you give?
Give: ______
8. Order: Robaxin 0.3 Gm. IM
Supply: Robaxin 100 mg. / ml.
Give: ______
9. Order: Solumedrol 125 mg. IM
Supply: Solumedrol 0.5 Gm. / 8 ml.
Give: ______
10. Order: Codeine gr. ss IM q4h.
Supply: Codeine 0.03 Gm. / ml.
Give: ______
Unit II – Administration of Medications
OBJECTIVES:
At the completion of this unit, the student will be able to:
1. Differentiate between local and systemic effects of drugs.
2. List six routes by which medications can be given; state the relative rates of absorption, effectiveness, and safety of each.
3. State the six rights of administering medications.
4. Demonstrate the correct way to measure tablets, capsules, and liquid medications.
5. Demonstrate the correct method of administration of a subcutaneous and an intradermal injection.