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.