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T he human body functions through a complicated series of chemical reactions and processes. Drugs are chemicals that are introduced into the body to cause a biological effect. When drugs are administered, there are a sequence of processes that handle the new chemicals including the breakdown and elimination of the drugs from the body. For many reasons, understanding how drugs act on the body to cause changes and applying that knowledge in the clinical setting are important aspects of nursing practice. For example, patients often follow complicated drug regimens and receive potentially toxic drugs. In addition, some drugs interact with other drugs and some foodstuffs. Many patients also manage their own care at home. Therefore, the nurse is in a unique position regarding drug therapy because nursing responsibilities include the following: • Administering drugs • Assessing drug effects • Intervening to make the drug regimen more tolerable • Providing patient teaching about drugs and the drug regimen • Monitoring the overall patient care plan to prevent medication errors. Understanding the mechanism of action of drugs makes these tasks easier to handle, thus enhancing drug therapy and ultimately patient concordance . This text is designed to provide the pharmacological basis for understanding drug therapy. The physiology of a body system and the related actions of many drugs on that system are presented in a way that allows clear understanding of how drugs work and what to anticipate when giving a particular type of drug. Thousands of drugs are available for use, and it is impossible to memorize all of the individual differences among drugs in a class. However, it is important to know and understand the most common drugs prescribed and administered on a daily basis. When using unfamiliar drugs, the nurse should fi rst seek out the relevant information [e.g. from the British National Formulary (BNF)] prior to drug administration. The Management and Administration of Drugs by Nurses For many years, nurses in clinical settings have administered drugs in accordance with instructions given by the hospital pharmacist. The Nursing and Midwifery Council set standards for safe practice in the management and administration of drugs. The council’s up-to-date guidelines are included in Standards for Medicines Management (2008) . As a registrant (nurse or midwife), in exercising your professional accountability in the best interests of your patients, you must: • Be certain of the identity of the patient to whom the medicine is to be administered. • Check that the patient is not allergic to the medicine before administering it. • Know the therapeutic uses of the medicine to be administered, its normal dosage, side-effects, precautions and contraindications. • Be aware of the patient’s plan of care (care plan/pathway). • Check that the prescription or the label on the medicine dispensed is clearly written and unambiguous. • Check the expiry date (where it exists) of the medicine to be administered. • Have considered the dosage, weight where appropriate, method of administration, route and timing. • Administer or withhold in the context of the patient’s condition (e.g. digoxin not usually to be given if the pulse is below 60 beats per minute) and coexisting therapies (e.g. physiotherapy). • Contact the prescriber or another authorized prescriber without delay where contraindications to the prescribed medicine are discovered, where the patient develops a reaction to the medicine, or where assessment of the patient indicates that the medicine is no longer suitable. •
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