Instructional Material

NCM 106 (Pharmacology)

Judith P. Valenzuela, RN, MAN

Faculty Member

Mariano Marcos State University

College of Health Sciences
Department of Nursing
City of Batac, Ilocos Norte
 To my past, present, and future
students in pharmacology

and

To my mentors, my family,
and my friends,

I dedicate this humble piece of work.

 EDITORIAL BOARD

Judith P. Valenzuela
Author

Gileen I. Lagadon
Marvin R. Lutrania
Roel M. Beljamin
Reviewers

Editors

DISCLAIMER:

The faculty members in charge of this course DO NOT own copyrights to the e-
books/software and other online materials or images included herein. Further, the faculty
members DO NOT intend to damage or infringe copyright policies. The sources (links,
images, etc.) are available and free from various websites, and these are shared with the
students for educational purposes. Students are encouraged to purchase original/licensed
educational learning materials.
The author, reviewers, and editor have exerted every effort to ensure the accuracy of
the information presented and described in this material. However, in view of ongoing
research, changes in government laws and policies, and the constant flow of information
relating to pharmacology and drug therapy, the learner is urged to check the package inserts
for each drug for any changes or updates in information.
 ACKNOWLEDGMENTS

Completing this humble accomplishment can never become a reality without

the love and support of family, friends, and loved ones. They will always be my
source of inspiration. To them, I offer my most sincere expression of gratitude.

I also extend my recognition and thanks to all my colleagues and contributors

for their generosity of knowledge and expert advice. Their kind assistance in
reviewing and editing the content of the lessons is instrumental in ensuring the
accuracy and relevance of the information written herein.

To all the wonderful people who have touched my life profoundly, I thank
them sincerely for helping me get through life’s up and down journey.
 ABOUT THE AUTHOR

The author, Prof. Judith P. Valenzuela, is a faculty member of the College of

Health Sciences, Department of Nursing of the Mariano Marcos State University. She
graduated with her Bachelor’s degree (BSN) and master’s degree (MAN) from the
same University. Before her present teaching career, she worked as a clinical
practice nurse in a tertiary-level medical center, where she attended to the needs of
a variety of patients for four (4) years. She began to handle the Pharmacology course
in nursing when she joined the teaching workforce of MMSU in 2003. She has
attended various seminars and training to continuously update her knowledge and
skills in her area of interest and expertise.
 INTRODUCTION

Pharmacology is an essential and prerequisite course in almost all nursing

fields. However, many students find this course very challenging. Students are
sometimes overwhelmed with the vast information they need to learn to administer
medications while safely providing comprehensive care to their patients.

This instructional material has been designed to help you understand the basic
principles of pharmacology. It integrates essential concepts, including applying
critical thinking, ethico-moral, and legal principles to promote safe drug
administration. It also highlights important information that you can include in your
patient education. As a pharmacology nurse, your responsibility is to provide health
education (Figure 1) so that your clients can understand their pharmacologic
regimen and participate actively in achieving the therapeutic goal.

The various concepts in this material are organized into three units and 17
lessons to expand your knowledge and skills along the pharmacologic aspects of
care. Unit I is composed of four lessons. The first lesson introduces you to the
definition, various names, and classifications of drugs. Lesson 2 discusses the process
and procedures to keep medicines in check. It also presents available drug sources
which you can utilize in studying different drugs. The third lesson acquaints you with
the many factors that affect drug absorption, distribution, metabolism, and
excretion. Lesson 4 presents the relevant laws on drug use and therapy.

Unit II covers three lessons. Lesson 5 highlights the nursing process as an

indispensable tool for the nurse in drug therapy. It also integrates a review of the
fundamental rights in drug administration. Lesson 6 focuses on the principles of
recording and reporting and how these principles relate to pharmacology. Also, it
discusses the common drug effects and interactions that patients may experience
during drug therapy. Lesson 7 discusses the specific roles and core values of the
pharmacology nurse.

Unit III includes ten lessons that discuss the various pharmacologic agents
affecting the different organ systems. Nursing responsibilities based on the nursing
process are emphasized to guide you in providing effective, efficient, and holistic
patient care during drug therapy. Lesson 8 presents the antimicrobial agents used to
treat infection and emerging diseases. It also includes a discussion of antineoplastic
agents used in cancer management. Lesson 9 discusses drugs that are used in the
management of male and female reproductive system disorders. Lessons 10, 11, and
12 cover pharmacologic agents affecting the cardiovascular, respiratory, and
gastrointestinal systems. Lesson 13 highlights the pharmacologic agents used to
manage endocrine disorders, while Lesson 14 introduces the drugs that affect the
nervous system. The nervous system and the endocrine system are two interrelated
systems that participate in regulating different bodily processes. Thus, the sequence
of these lessons enables you to understand the link between the two systems and
compare and contrast drugs’ effects on the neuroendocrine system. Lesson 15
provides information on the various drugs affecting the respiratory system. Lesson
16 briefly discusses the miscellaneous agents used in conditions such as eye and ear
problems, disorders of the Immune system, and alternative therapies. Lastly, Lesson
17 focuses on the current trends and issues in nursing pharmacology. The
appendices also offer valuable information and resources for your reference.

Specials icons are used in this learning material to represent the following:

All lessons follow a uniform format for your convenient learning. Each lesson
starts with an introduction and a list of learning outcomes to help you frame the
fundamental points for each lesson. A warm-up activity is included to get you into
the right mindset and focus your attention on the task. The terms central activities
and learning inputs guide you in discussing concepts. Aside from the must-know
information, some lessons include web links that you can click for additional
learning; these links are found in the additional learning boxes. The lessons also
provide learner activity boxes that allow you to apply your knowledge. Moreover,
board exam-type questions are posted in the practice for PNLE boxes to test your
critical thinking skills and prepare you for the Philippine Nurse Licensure
Examination. You are encouraged to discuss your answers with your professor. A
summary of the concepts is found in the last part of the lesson to give you a concise
breakdown of the key points to help you comprehend the information. A wrap-up
activity is also provided to help you reflect on the material you have learned. Bible
verses and quotes on life, learning, and success are added to inspire and motivate
you in your learning.

What is your learning outcome for

this instructional material? What
preparations do you need to help
you understand the lessons?

Sound knowledge of Pharmacology is

your firm foundation in caring for patients
before, during, and after drug therapy.
Hence, after working on this instructional
material, you should be able to gain knowledge of the different principles of
medication administration, the properties of drugs and their effects on bodily
processes, and the nursing responsibilities relevant to the safe and effective
administration of medications. Specific learning outcomes at the beginning of each
lesson will help you identify key concepts and guide you through your study.

This instructional material is devised in its most simplified form to help you
understand the principles of drug administration, apply critical thinking when
administering drugs, and assist patients and families in coping with their drug
therapy. A good comprehension of the pharmacokinetics and pharmacodynamics of
drugs is grounded upon basic concepts and principles. With this, you should have a
good knowledge of Anatomy and Physiology, Microbiology and Parasitology, Basic
Mathematics, General Chemistry, and Biochemistry. It is further recommended that
you review your lectures in NCM 101a (Health Assessment-lecture) and NCM 103a
(Fundamentals of Nursing Practice-lecture) and the procedures you learned in NCM
101b (Health Assessment-RLE) and NCM 103b (Fundamentals of Nursing Practice-
RLE) particularly on medication administration before you proceed in your study
with this material. Integrating all these preparatory courses into your study will make
learning pharmacology easy, fun, and exciting. Good luck in your learning journey!
 TABLE OF CONTENTS

Cover Page iii

Dedication
Editorial Board …………………………………………………………………………………………………..
Acknowledgments ……………………………………………………………………………………………… iv
About the Author ….…………………………………………………………………………………………… v
Introduction ………………………………………………………………………………………………………. vi
Table of Contents ……………………………………………………………………………………………… ix

UNIT I: FUNDAMENTAL CONCEPTS OF PHARMACOLOGY ………………………………….

Lesson 1 Drug Definition, Drug Names, and Drug Classifications …………………..
Lesson 2 Drug Standards and Drug Information ………..………………………………….
Lesson 3 Pharmacodynamics and Pharmacokinetics …………………………………….
Lesson 4 Laws Regulating Drug Use ………………………………………………………………

UNIT II: THE NURSE AND THE NURSING PROCESS IN PHARMACOLOGY ……………..
Lesson 5 The Nursing Process in Pharmacology ………………………………….…………
Lesson 6 Recording and Reporting, Types of Drug Effects, and Drug
Interactions …………………………………………………………………………………….
Lesson 7 Roles and Core Values of the Nurse as Applied in Pharmacology ……

UNIT III: DRUGS AFFECTING THE BODY SYSTEMS …………………………………………………

Lesson 8 Chemotherapeutic Agents ………………………………………………………………
Lesson 9 Pharmacologic Agents Acting on the Reproductive System …………….
Lesson 10 Pharmacologic Agents Acting on the Cardiovascular System ………….
Lesson 11 Pharmacologic Agents Acting on the Respiratory System ……………….
Lesson 12 Pharmacologic Agents Acting on the Gastrointestinal System ………..
Lesson 13 Pharmacologic Agents Acting on the Endocrine System …………………
Lesson 14 Pharmacologic Agents Acting on the Nervous System ……………………
Lesson 15 Pharmacologic Agents Acting on the Renal System ………………………..
Lesson 16 Miscellaneous Agents ………………………………………………………..…………..
Lesson 17 Trends and Clinical Alerts in Nursing Pharmacology ……………………….

APPENDICES ……………………………………………………………………………………………………….
Appendix A Basic Solid and Liquid Conversion Table
Appendix B Drug Computation Formulas
Appendix C Compatibility Chart

“Continuous effort - not strength or

intelligence - is the key to unlocking
our potential.”
― Winston S. Churchill

www.uniqueteachingresources.com
Instructional Material in NCM 106 (Pharmacology) |1

UNIT I
FUNDAMENTAL CONCEPTS
OF PHARMACOLOGY

One of your most important roles as a nurse is ensuring safe medication

administration. Each day, it is common for you to make clinical judgments regarding
the safety, appropriateness, and effectiveness of the medications administered to
your clients. Examples of decisions that you might make during client care include

Is my client allergic to the antibiotic that I am going to give?

Does my client have any condition that would affect drug absorption?
Is the prescribed dose appropriate for my client?
Is this pain medication effective in managing my client’s discomfort?

To make safe medication administration decisions, you must have a solid

understanding of pharmacology. Disease management, symptom control, physical
recovery, and individual well-being can be intensely associated with using
pharmacologic agents in a client’s treatment plan. Hence, it is crucial that you know
how medications work within the body and how the body reacts to them before you
review a medication order, check a medication administration record, or administer
a drug.

Studying pharmacology requires applying your previous knowledge of the

physical, social, natural, and health sciences. With the vast information you need to
understand about drugs, your background knowledge should ease your learning of
the core concepts in pharmacology.

The core concepts in pharmacology included in this unit are the following:

Lesson 1 - Drug Definition, Drug Names, and Drug Classifications;

Lesson 2 - Drug Standards and Drug Information Sources
Lesson 3 - Pharmacodynamics and Pharmacokinetics
Lesson 4 - Laws Regulating Drug Use

These lessons are discussed in the next sections of this unit.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |2

LESSON 1: DRUG DEFINITION, DRUG NAMES, AND DRUG CLASSIFICATIONS

A cheerful heart is good medicine, but a crushed spirit dries up the bones.
- Proverbs 17:22

Drug administration is a nursing function that is both challenging and

rewarding. The nurse must know the basic pharmacologic principles to deliver safe
and effective nursing care to patients and families receiving drug therapy.

INTRODUCTION OF THE LESSON

AND PRESENTATION OF OUTCOMES

This lesson presents a brief history of pharmacology, the definition of drugs

and other related terms, how drugs are named, and how drugs are classified based
on specific categories.

At the end of this lesson, you must have:

• integrated your knowledge of physical, social, natural and
health sciences and humanities in nursing pharmacology;
• defined drug, pharmacology, and therapeutics;
• discussed the different drug names;
• identified the various ways in which drugs are classified;
• explicated the purposes of drug administration; and
• discussed the implications of prescription and over-the-
counter medications.

WARM-UP ACTIVITY. Drug Search.

Do you use drugs? Check your medicine kit at home

and see if there are drugs stored in it. Get one (1) drug and
study the label. Bring the drug to class.

1. What is the name of the drug?

2. What is it for?
3. How do you classify this drug?

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |3

CENTRAL ACTIVITIES

This lesson covers two learning inputs that will introduce you to the intricate
nature of pharmacology. Two activities are included in this lesson to assess your
understanding and to apply your knowledge of the concepts.

LEARNING INPUT 1.1.

Drug and Pharmacology

Drug discovery is as old as the history of humankind. However, practices in the

treatment of diseases by prehistoric humans were mainly based on observations of
their environment and personal experiences after consuming some plant extracts
and herbs as remedies. Primitive societies discovered the medicinal value of plants
and the curable properties of other available natural compounds by accident since
they did not understand how the different body systems work. The earliest known
documentation of medical substances is the prehistoric Sushruta Samhita, an Indian
Ayurvedic treatise from the 6th century BC. Additional examples of ancient
pharmacological records are the various papyri from ancient Egypt that date back to
the 16th century BC (Carrington College, 2022).

In ancient times, the diseases were viewed with great superstition. The
ancients considered disease a consequence of sin, a punishment from the gods, or
something inflicted by evil forces (Encyclopedia of Bioethics, n.d.). Hence, treating
illness was commonly accompanied by religious rituals and according to the position
of the moon, stars, and other elements in the universe. As humankind continuously
searched for more concrete explanations of how diseases develop and became more
fascinated with finding cures for these ailments, the science of pharmacology began.

Pharmacology is a science focused on studying the history, sources, physical

and chemical properties, and metabolism of drugs and how they affect the
functioning of living organisms. Therapeutics is concerned with the treatment of
diseases through the use of remedial agents. Pharmacotherapy is the branch of
science that deals with the use of drugs in treating diseases, other conditions, and
symptoms.

A drug is defined as any substance, singly or in a mixture, that modifies cellular

functions and causes an effect on body cells. Because this definition is broad, it is
essential that you can identify drugs from other substances such as foods, cosmetics,
cleaning solutions, and other household agents that may also cause some effects on
the body. When drugs are used for therapy, either for the prevention or treatment
of diseases, they are often called medicines. In this learning material, the terms drug
and medicine are used interchangeably.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Nursing responsibilities in Drug therapy Succinylcholine: skeletal muscle relexant used in general
* Administering drug anesthesia
* assessing drug effects
* providing patient teaching about drugs and the drug regimen • Metabolized by the enzyme pseudocholine esterase
• Lack of this is recessively inherited
* Monitoring the overall patient care plan to prevent medication errors
• Leads to respiratory paralysis
* Intervening to make the drug regimen more tolerable
Fr: fast relief

Drug Classification
• Natural
Pharmacogenomics • Synthetic
* the broader application or genomic technologies to new drug discovery and further characterization of older drugs
* the recombinant DNA technology involves the artificial joining of DNA of specie to another.

Pharmacoeconomics
* deals with the cost of drugs
*cost of one drug is compared with another for same use

Pharamacoepidemiology
* deals with the use and effects of drugs on large population
* application of the epidemiologic knowledge; methods, and reasoning to the study of the effects and use of drugs in human population

Chronopharmacology
*Deals with the study of interaction of biologic rhythm’s with medication
*Deals with the optimization of drug effects and the minimization of adverse effects by timing medication in relation to the biolgical rhytm

Comparative Pharmacology
*deals with the comparison of one drug to another belonging to the sane or another group
Animal Pharmacology
* deals with the different properties of drugs in animals.
*a vast variety of animals are utilized including rabbits, mice guinea pigs
Pharmacognosy
*Deals with the drug in grade or unprepared form
Pharmacy
*blends health science with chemical science and effective use of drug
Toxicology
*deals with symptoms mechanism, treatments and detection of poisoning caused by different chemical substances
Posology
*deals with the dose of the drug
Pharmacogenetics
*deals with the genetic variations that cause difference in drug response among individuals
Drug classification
According to the body system
• CNS Drugs : medicines that include sedatives, tranquilizers, and hypnotics. These drugs can slow brain activity,
making them useful for treating Anxiety, Panic, Acute stress reactions, and Sleep disorders
• Cardiac Drugs : agent that affects the function of the heart and blood vessels.
• Gastrointestinal Drugs: for care and treatment of digestive organs including liver, biliary tract and pancreas.
• Respiratory Drugs: used to relieve, treat, or prevent respiratory diseases such as asthma, chronic bronchitis, chronic
obstructive pulmonary disease (COPD), or pneumonia.
• Renal Drugs
• Endocrine Drugs : agents directed to a malfunctioning endocrine path. Several agents are secreted in or target the
nervous system, and are thus more prone to cause neurologic adverse events (AEs).
• Reproductive Drugs

According to Therapeutic Use/ Clinical Use

• Antihypertensives : are medicines that bring your blood pressure down in various ways. Example: Losartan,
Candesartan, Talmesartan, Amlodipine
• Antiemetics: medications used to treat nausea and vomiting.
• Antacids : that relieves heartburn and indigestion by reducing the amount of acid in your stomach. Antacids neutralize
the acid in your stomach by stopping an enzyme that creates acid to break down food for digestion (pepsin).
• Antibiotics : to treat or prevent some types of bacterial infection. They kill bacteria or prevent them from reproducing
and spreading.
• Antianemics : that increases the number of red blood cells or the amount of hemoglobin (an oxygen-carrying protein) in
the blood, deficiencies of which characterize the disorder known as anemia.
• Anticholinergics : treat a range of conditions, including COPD, an overactive bladder, gastrointestinal disorders, and
symptoms of Parkinson's disease. Anticholinergics are only available via prescription
• Anticoagulants : medicines that help prevent blood clots. They're given to people at a high risk of getting clots, to
reduce their chances of developing serious conditions such as strokes and heart attacks
• Anticonvulsants : to treat seizures and many other medical conditions unrelated to seizure disorders.

According to Physiologic/ Chemical Actions

• H2 - blockers : reducing the amount of stomach acid secreted by glands in the lining of your stomach.
• Sympathomimetics : mimic the stimulation of the sympathetic nervous system. They are classified as directly acting
(act directly on α or β receptors), indirectly acting (act by providing more norepinephrine to act on α or β receptors), or
mixed acting (act by both mechanisms).
• Calcium Channel Blockers : used to lower blood pressure. They stop calcium from entering the cells of the heart and
arteries. Calcium causes the heart and arteries to squeeze more strongly. By blocking calcium, calcium channel
blockers allow blood vessels to relax and open.
• Anticholinergics : block and inhibit the activity of the neurotransmitter acetylcholine (ACh) at both central and peripheral
nervous system synapses.
Instructional Material in NCM 106 (Pharmacology) |4

Drug Names

Drugs are assigned several names, which may confuse both the members of
the health team and the consumers. Know the different drug names to identify
whether two or more names refer to the same medication or different drugs. For
example, Amoxil (brand name) is the same as amoxicillin (generic name). The drug
names and their descriptions are as follows:

Generic Name
– the name is given to identify a drug during its useful clinical lifetime
– it is the same in all countries
– generic names are not capitalized when written. Example: amoxicillin

Brand Name
– also known as the trade name
– the name is given by a drug company for commercial purposes
– the name is often followed by a superscript which means that the name
is registered to a specific drug maker or owner.
– easy to spell and remember, so prescribers are likelier to use it.
– first letter (and sometimes other letters) of the name is capitalized.
Example: Amoxil

Official Name
– this is the name given by agencies (such as the Food and Drug
Administration [FDA]) authorized to enlist the drug in official publications
such as the US Pharmacopeia, Philippine Index for Medical Preparations, or
the Philippine National Drug Formulary.
– this name is sometimes similar to either the generic or brand name.

Chemical Name
– this name describes the atomic or molecular composition of the drug
– usually long; hence, the name is difficult to remember and is too complex
for general use.
Example: (2S,5R,6R)-6-[[(2R)-2-amino-2-
(4-hydroxyphenyl)acetyl]amino]-3,3-dimethyl
-7-oxo-4-thia-1-azabicyclo[3.2.0]heptane-2-
carboxylic acid (amoxicillin)

PRACTICE FOR PNLE. Answer the following question:

Which among the following statements is TRUE about drug names?

A. The brand name of drugs is similar in all countries
B. The generic name is usually the same as the brand name.
C. The chemical name specifies the molecular composition of drugs.
D. The official name of drugs always starts with a capital letter.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |5

Drug Labels

You may have seen various medications with different labels. Drug labels are
printed text on the containers and packaging of medications. These labels include
much helpful information for the consumer. As a nurse, you teach your client how to
interpret the labels before they purchase and use a drug. It is important to note that
local and international drug authorities may have different standards and formats
but generally contain the same information. In the Philippines, the local labels for
drugs and medicine are presented in Figure 1.

Figure 1.1. Medication label, erythromycin. Source: www.opilizeb.blogspot.com

Product Name. The product name is usually the first thing that stands out on
the label and packaging. In the interest of marketing, the brand name is usually
recognizable at first glance. The generic name of the preparation should also be easy
to read. In the Philippines, the generic name is usually printed within an outlined
box. While the brand names and logos are easier to spot on the shelf, instruct your
client to always check for the active ingredients and strengths. Some brand names
are used for several preparations, and they might accidentally get the wrong one
(Nera, 2020). The product names of the drug in Figure 1 are erythromycin (generic
name) and Ery-Tab (brand name).

Dosage Form and Strength. If there is a prescription, look for the medicine in
the same strength and dosage form. Typical dosage forms are tablets, capsules,
syrups, lotions, ointments, and creams. On the other hand, strengths are written as
numbers with units such as milligrams (mg), grams (g), ounces (oz.), milliliters (mL),
and liters (L). In Figure 1, erythromycin is in tablet form with a strength of 333 mg
per tablet.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |6

Total Volume/Amount. The total volume or amount of the medication in a

container is indicated in addition to the dosage supply. The volume of the container
in the case of oral solid dosage forms like tablets and capsules is simply the total
number of units in the container (In our example, the total volume is 100 tablets).
The volume of liquid medication is the indicated liquid volume, typically measured in
milliliters. The total volume of topical medications like ointments, creams, and many
inhalation products is indicated by weight and measured in grams.

Indication, Warnings, and Storage Conditions. The indication (intended drug

use) is usually printed on the drug label and packaging. Examples of indications
include pain relief, cough, and fever. Contraindications (when the drug should not be
used), precautions, and warning labels are required. Warnings include statements
such as, “Keep out of reach of children” or “For external use only.” Instruct your
client to read the drug label carefully before taking the medication. In addition, the
storage conditions of the preparation should be printed on the label. This includes
special instructions such as refrigeration, protection from light, and specific
temperatures to maintain drug potency. Can you read the drug label's indications,
warnings, and storage conditions in Figure 1?

National drug code (NDC). The NDC comprises numbers assigned to every
drug product, legend (prescription), and OTC (over-the-counter). This code is a
specific sequence of numbers grouped into three sets to identify every drug product
(Basicmedicalkey.com, 2016). The first set of numbers identifies the manufacturer;
every drug manufactured by a particular company has the first group of numbers.
The second set of numbers identifies the drug itself. For example, in our sample
drug, all Searle Cytotec® products have the same numbers for the first two groups:
the first for the manufacturer, Searle, and the second for Cytotec®. The last set
indicates the package size the product was dispensed from or the package size
purchased by the patient in the case of OTC products.

Lot Numbers and Expiration Dates. The law requires that all medication
packages be identified with a lot number or control number. Lot numbers track
products for mandatory or voluntary withdrawal by the Food and Drug
Administration (FDA) or the manufacturer. These lot numbers or control numbers
have been used to recall OTC products, vaccines, and various prescription drug
products.

Expiration dates appear on all manufactured medication packages to notify the

pharmacy, distributor, and patient when the product is too old to be used. Some
products lose potency; others degenerate into toxic substances. Other products,
such as oral suspensions and injectable and intravenous products, must be marked
with an expiration date when prepared for patient use. Part of your client teaching is
informing your client to note the storage and expiration dates provided on the
medication label, noting the time and date the product must be discarded.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |7

Manufacturer. The manufacturer is the pharmaceutical company that

produces the brand-name drug.

LEARNER ACTIVITY 1.1. Applying your Knowledge. Given the

following drug labels below, supply the generic name, brand
name, and the chemical name of each drug in the table. Include
your drug sample in the last number.

1.

Op and
oXYMORPHOne
HYDROCHLORIDe

2.

Nitrostat

3.

artpassenger.weebly.com
PARACCTAMOL

4. (Your drug sample) Medi Flexin

Heal Quick
Dexametaproxil
hydrochorizide

Next, identify the information presented in the given drug labels. You
can also do this to your drug sample. Be ready to share your output in class.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) |8

LEARNING INPUT 1.2.

Classifications of Drugs

Aside from having several names, drugs are also classified in different ways.
More commonly, drugs are categorized based on the source of the substance, the
body system in which the drugs exert their effect, their therapeutic use or clinical
indication, their physiologic or chemical action, and the purpose of administration.

Drugs are derived from various sources that include the following:

❖ Plants
– most parts of the plant can be used as a source of drugs.
– Examples: Digitalis is a cardiac glycoside derived from the leaf of Digitalis
purpurea (Figure 1.2a). Quinine, an antimalarial drug, is derived from the bark
of the Cinchona tree (Figure 1.2b). Main component of the growing alternative therapy movement

Figure 1.2. Plants as drug sources: 1.2a. Digitalis purpurea, and 1.2b. Cinchona
tree (Sources: (www.pflanzenbestimmung.info & www.nephicode.blogspot.com)

❖ Animals
– some enzymes are extracted from the organs and tissues of animals and are
used as sources of drugs.
– Example: The hormone insulin can be extracted from the pancreas of pigs and
cows to be used by diabetic human patients.
– some references use the term biologics to refer to agents that are produced
naturally in animal cells, microorganisms, or the body itself. Examples of these
are monoclonal antibodies, interferons, and vaccines.
Used to replace human chemicals that are not produced because of disease or genetic problems
❖ Inorganic compounds
– various environmental elements such as aluminum, fluoride, and iron are used
to treat certain conditions.
– Examples: Iron is used to treat iron-deficiency anemia; aluminum hydroxide
and sodium bicarbonate are used as antacids.
Therapeutic effects on the body

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

 Instructional Material in NCM 106 (Pharmacology) |9

❖ Synthetically produced drugs

– through genetic engineering, chemicals from various sources are structurally
altered to produce more effective drugs.
– Examples: Genetically engineered Hepatitis B vaccine and recombinant DNA-
engineered insulin.
– When drugs are produced synthetically, their potency, effectiveness, and other
parameters are improved.
Genetic engineering: process that involved altering the DNA to produce large scale, better drug products
Drugs are also classified based on the organ or body system in which they
exert their effects. In this manner, drugs that affect the activities of the heart are
called cardiac drugs. On the other hand, drugs that affect the respiratory system are
known as respiratory drugs (Figure 1.3). Based on this classification, what would you
Durqs can be classified thru : call the drugs that influence the activities of the liver and the kidneys?
⑪ organ/body system

② therapeutic I clinical indication

③ physiologic/chemical action in the
body

RChaL DRVG

Figure 1.3. Drug classification based on organ system.

Another way in which drugs can be classified is through their therapeutic use
or clinical indication. For example, drugs used to manage asthma symptoms are
called anti-asthma drugs, and those pharmacologic agents that help boost the
immune system are called immune modulators. Additionally, drugs used to lower
blood cholesterol are called antihyperlipidemics, and those that promote urination
are called diuretics. Using this classification as your basis, what do you call the drugs
that manage high blood pressure and diabetes? Antihypertensives ,

Drugs may also be classified according to their physiologic or chemical action in

Sympathomimetics
the body. For example, drugs categorized as H2-blockers inhibit the action of the *

* Calcium channel blockers

enzyme histamine at the receptor sites. Adrenergic agonists, on the other hand, Anticholinergies
*

facilitate the activation of the adrenergic receptors. Now, refer to a drug information
source and check why the HMG CoA reductase inhibitors, a class of cholesterol
medications, are called such.

When a drug is prescribed to your patient, it is essential that you know the
reason why the drug is being ordered. This leads us to another drug classification
based on the drug administration's purpose or intent. Based on this category, drugs
are prescribed for the following purposes:
 Prophylactic/preventive – drugs are given to decrease the possibility of
experiencing the disease. Examples: vaccines are given to clients to
prevent viral or bacterial infection; terramycin eye ointment is given to a
newborn as a prophylactic antibiotic against maternal gonorrhea.

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 Instructional Material in NCM 106 (Pharmacology) | 10

 Diagnostic – drugs are administered to help diagnose a medical problem.

Example: diatrizoates is a radiopaque dye that is administered during x-ray
procedures. The drug contains high-level iodine, which absorbs X-rays to
obtain a clearer picture of the body area. Ex: barium sulphate
 Therapeutic – drugs are administered for therapeutic purposes; that is,
they are given to the patient for the following reasons: provide treatment to certain condition

Supportive Dextran to manage hypovolemia 

*
palliative/supportive – a drug used to relieve the distressing signs and
*
Chemotherapeutic anti cancer agents symptoms of a disease but does not affect the disease itself. Example:
Destroy malignant cells paracetamol is used to relieve fever in dengue
 curative – a drug used to treat the disease. Example: penicillin is given
to patients with infection Antibiotics to treat infection
Antineoplastic agents to kill cancer cells

 substitutive – a drug is administered to replace fluids/substances in the

body. Example: synthetic insulin is given to a diabetic patient as a
replacement for deficient insulin in the body
 restorative – a drug used to help the body to return to its normal
healing state. Example: prostaglandin E2 has been found to stimulate
tissue repair and promote healing faster

Based on dispensing, drugs may also be classified as legend (prescription) or

over-the-counter (OTC) drugs, legal or illegal, investigational or orphaned.
Prescription drugs bear on their labels the prescription legend (Rx). The legend
“Caution: Federal law prohibits dispensing without prescription” is also indicated on
their labels, which is why prescription drugs are sometimes called legend drugs. The
statement serves as a reminder that the drug should only be accessible through a
written prescription from a physician or authorized practitioner. This is one way to
control drug dispensing and administration, especially for habit-forming medications
that may cause adverse effects when given indiscriminately. Examples of
prescription drugs are hypnotic drugs, sedatives, and other drugs that may cause
severe adverse effects when misused or overused.

A prescription is a written
order for the preparation and
administration of medication/ PATentS INFO

therapy by the physician or

BIRTHDAY
authorized practitioner. You must
consult the prescribing physician
for any concerns regarding the DO SAGL
prescribed drug. Can you still
remember the essential
information that must be included
in the order? Identify at least five
PHYSICIANS
from the sample prescription in
Figure 1.4. How do you interpret SIGNATURE
the order?

Figure 1.4. Physician’s written prescription.

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) | 11

Patients may also take drugs that their physicians do not prescribe. Usually,
your patient may experience mild symptoms and choose to self-medicate before
they seek medical help. Drugs that can be legally purchased at a drug store without a
prescription are called non-prescription or over-the-counter (OTC) drugs. Over-the-
counter drugs are safe when taken as directed for self-treatment of various health
complaints. Nonetheless, you should consider the following issues related to the use
of OTC drugs:

1. OTC drugs may contain chemicals or substances that can result in adverse
drug interaction when taken with other drugs;
2. OTC drugs may conceal manifestations of a severe underlying illness, thus
delaying the diagnosis and making the treatment difficult; and
3. OTC drugs are often available in low dosages; however, more frequent
intake may result in abuse or overdosage.

PRACTICE FOR PNLE. Answer the following question:

A drug that is legally acquired over the counter

A. does not cause overdosage
B. does not interact with prescription drugs
C. is a controlled substance by Food and Drug
Administration.
D. can be purchased for self-treatment of discomforts

In some cases, illicit or illegal drugs are produced and consumed by some
people. These drugs are not subjected to quality or price control and are not
approved by the FDA (and other drug regulating agencies). Illicit drugs include street
or illegal drugs, prescription drugs not used for medical purposes, or other misused
substances, such as inhaling paint thinner. Illegal drugs contain harmful chemicals of
unknown strength, and using them could lead to severe and dangerous
consequences. Examples of illegal drugs are methamphetamine and cocaine. As a
nursing student and a health advocate, you must stay healthy and safe. One way to
do so is to avoid these drugs.

ADDITIONAL LEARNING.
Do you know what drug
addiction can do to your
health? Check the negative health
effects of illicit drugs by clicking the
link below:

https://www.youtube.com/watch?v=W11ergeD09o&t=124s

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications

Instructional Material in NCM 106 (Pharmacology) | 12

Investigational drugs are under experimentation in the clinical laboratory to

determine their safety and effectiveness. These drugs may have received FDA
approval for human testing but not for marketing or consumption by the public.
Under exceptional circumstances, the drug development process of investigational
drugs is accelerated significantly if some parameters indicate possible beneficial
effects or cures to a specific disease with unknown treatment. For example, in 2020,
the development of vaccines and other treatments to combat Covid-19 was
accelerated to slow the pandemic and minimize the disease’s damaging effects.
Pfizer®, a global drug company, developed the vaccine BNT162b2 against Covid-19,
which moved forward in clinical trials and tested on approximately 30 000 patients
(statnews.com, August 2020).

On the other hand, some drugs have been discovered but are commercially
underdeveloped. These are called orphan drugs. These pharmacologic agents are
often discovered as treatments for rare diseases. Unfortunately, no pharmaceutical
company has adopted the drugs because of their low capital investment recovery. In
some cases, drugs may not be developed because they are derived from a research
process that cannot be patented. The FDA approved isavuconazonium sulfate (Brand
name: Cresemba) as an orphan drug for treating Aspergillosis.

LEARNER ACTIVITY 1.2. Applying your Knowledge. Based on

what you have learned so far on drug names and
classifications, supply the required information in the concept
map below using the drug sample that you presented in
Activity 1.1. Be ready to present your output in class.

Organ/ System
Affected

Drug Source
Clinical Indication

DRUG SAMPLE Drug Chemical Action

Generic Name Class
Purpose of
Administration

Brand Name
Based on
Dispensing

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Instructional Material in NCM 106 (Pharmacology) | 13

Lesson Summary

Pharmacology is a science focused on studying drugs and how they

affect the functioning of living organisms.
Pharmacotherapy is the branch of science that deals with the use of
drugs in managing various diseases and symptoms.
A drug is any substance that modifies cellular functions and causes an
effect on body cells.
Drug labels consist of important information that help health care
providers and consumers understand the drug.
A prescription is a written order for medication/therapy made by a
physician or authorized practitioner.
consult the prescribing physician for any concern regarding the
prescribed drug.
A drug may be classified based on its source, the organ or body system
it affects, its therapeutic use or clinical indication, physiologic or
chemical action, or purpose of administration. It can also be
categorized as legend or prescribed, OTC, illegal or legal,
investigational or orphaned. Understanding these basic concepts
about drugs is an important step towards delivering safe and effective
drug therapy to your patient.

WRAP-UP ACTIVITY. Reflect on this.

Looking back on the concepts you have learned in this lesson,

what information do you find easiest to learn, somewhat confusing, or
difficult to comprehend? Write them in the boxes below.

easy confusing difficult

So what can you do to enhance your learning of the concepts?

This ends lesson 1. Review the topics and prepare for a 20-item post-test to
be announced by your lecturer. Good luck!

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Instructional Material in NCM 106 (Pharmacology) | 14

REFERENCES:

Brown, M.J., Sharma, P., Mir, F. A. & Bennett, P. N. (2019). Clinical Pharmacology
(12th ed.). Elsevier Limited.
BasicMedical Key (2016). Understanding drug labels. BasicMedical Key.com.
https://basicmedicalkey.com/understanding-drug-labels/
Carrington College. (2015 January 22). A historical overview of pharmacology [blog].
Carrington College. https://carrington.edu/blog/historical-overview-of-
pharmacology/
Encyclopedia of Bioethics. (n.d.). Health and disease: History of the concepts.
Encyclopedia.com. https://www.encyclopedia.com/science/encyclopedias-
almanacs-transcripts-and-maps/health-and-disease-i-history-concepts
Karch, A. M. (2017). Focus on Nursing Pharmacology (7th ed.) Wolters Kluwer
Health, Incorporated.
Nera, S. (2020). How to read drug labels the right way.
https://hellodoctor.com.ph/drugs-supplements/how-to-read-drug-labels/
Nercum, Z. T. (2013). Pharmacology. C&E Publishing, Incorporated.
Standring, S. (ed.). (2016). Gray’s anatomy: The anatomical basics of clinical practice
(41st ed.). Elsevier.
Woodrow, R. & Colbert, B. (2019). Essentials of pharmacology for health professions
(8th ed.). Cencage Learning.

“Nursing is an art; and if it is to be

made an art, it requires an exclusive
devotion as hard a preparation as any
painter’s or sculptor’s work.”
― Florence Nightingale

www.uniqueteachingresources.com

UNIT I Lesson 1 Drug Definition, Drug Names, Drug Classifications