MPN 2010 - Pharmacology I for CMA

Differentiate between pharmacology and drug therapy.

Select authoritative sources of drug information.

Discuss major drug laws and standards.

Describe the main categories of controlled substances in relation to therapeutic use and potential for abuse.

Identify nursing responsibilities in handling controlled substances correctly.

Discuss the role of the Food and Drug Administration.

Analyze the potential impact of drug costs on drug therapy regimens.

Describe the main pathways and mechanisms by which drugs cross biologic membranes and move through the body.

Identify and develop basic knowledge of general pharmacokinetics for each body system and/or classification of drugs.

1. Describe the principles of absorption, distribution, metabolism, and excretion of drugs in the body
2. Discuss the clinical usefulness of measuring serum drug levels
3. Describe major characteristics of the receptor theory of drug action
4. List drug-related and patient-related variables that affect drug actions

Differentiate between agonist drugs and antagonist drugs.

Discuss mechanisms and potential effects of drug-drug interactions.

Identify signs and symptoms that may occur with adverse drug effects on major body systems.

Discuss general management of drug overdose and toxicity.

1. Discuss selected drug antidotes
2. Discuss interventions to increase therapeutic effects and decrease adverse effects of drug therapy

Describe major considerations in drug therapy for children, adults, and patients with impaired renal or hepatic function or critical illness.

Discuss application of the nursing process in home care settings.

Identify and have basic knowledge of common drug classifications, drug actions, side effects, nursing considerations, client education, and precautions with administration.

Drugs Affecting the Central Nervous System (CNS).

1. Discuss signs and symptoms of CNS depression and CNS stimulation.
2. Discuss general types and characteristics of CNS depressant drugs.
3. Describe specific antidotes for overdoses of central nervous system (CNS) depressant drugs and the circumstances indicating their use
4. List characteristics of benzodiazepine antianxiety and hypnotic drugs in terms of mechanism of action, indications for use, nursing process implications, and potential for abuse and dependence.
5. Describe strategies for preventing, recognizing, or treating benzodiazepine withdrawal reactions.
6. Contrast characteristics of selected non-benzodiazepines and benzodiazepines.
7. Discuss the use of flumazenil and other treatment measures for overdose of benzodiazepine.
8. Discuss characteristics of phenothiazines and related antipsychotics.
9. Compare characteristics of “atypical” antipsychotic drugs with those of “typical” phenothiazines and related antipsychotic drugs.
10. State interventions to decrease adverse effects of antipsychotic drugs.
11. State interventions to promote compliance with outpatient use of antipsychotic drugs.
12. Discuss characteristics of antidepressants in terms of mechanism of action, indications for use, adverse effects, principles of therapy, and nursing process implications.
13. Compare and contrast the different categories of antidepressants: selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), mixed serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase (MAO) inhibitors, and other atypical antidepressants.
14. Discuss selected characteristics of atypical antidepressants.
15. Describe the use of lithium in bipolar disorder.
16. Describe the use of atypical antipsychotics in the manic phase of bipolar disorder.
17. Discuss interventions to increase safety of lithium therapy.
18. Describe the nursing role in preventing, recognizing, and treating overdoses of antidepressant drugs and lithium.
19. Analyze important factors in using antidepressant drugs and lithium inspecial populations.
20. Describe general characteristics of central nervous system (CNS) stimulants.
21. Discuss reasons for decreased use of amphetamines for therapeutic purposes.
22. Discuss the rationale for treating attention deficit-hyperactivity disorder with CNS stimulants.
23. Identify effects and sources of caffeine.
24. Identify nursing interventions to prevent, recognize, and treat stimulant overdose.

Drugs Affecting the Peripheral Nervous System (PNS)

1. State names and general characteristics of drugs affecting the autonomic nervous system.
2. Identify effects produced by stimulation of alpha- and beta-adrenergic receptors.
3. List characteristics of adrenergic drugs in terms of effects on body tissues, indications for use, adverse effects, nursing process implications, principles of therapy, and observation of patient responses.
4. Discuss use of epinephrine to treat anaphylactic shock, acute bronchospasm, and cardiac arrest.
5. Identify patients at risk for the adverse effects associated with adrenergic drugs.
6. List commonly used over-the-counter preparations and herbal preparations that contain adrenergic drugs.
7. Discuss principles of therapy and nursing process for using adrenergic drugs in special populations.Describe signs and symptoms of toxicity due to noncatecholamine adrenergic drugs.
8. Discuss treatment of overdose with noncatecholamine adrenergic drugs.
9. List characteristics of antiadrenergic drugs in terms of effects on body tissues, indications for use, nursing process implications, principles of therapy, and observation of patient response.
10. Discuss alpha1-adrenergic blocking drugs and alpha2-adrenergic agonists in terms of indications for use, adverse effects, and other selected characteristics.
11. Compare and contrast beta-adrenergic blocking drugs in terms of cardioselectivity, indications for use, adverse effects, and other selected characteristics.
12. Discuss principles of therapy and nursing process for using antiadrenergic drugs in special populations.
13. Describe effects and indications for use of selected cholinergic drugs.
14. Discuss drug therapy for myasthenia gravis.
15. Discuss the use of cholinergic drug therapy for paralytic ileus and urinary retention.
16. Discuss drug therapy for Alzheimer’s disease.
17. Describe major nursing care needs of patients receiving cholinergic drugs.
18. Describe signs, symptoms, and treatment of overdose with cholinergic drugs.
19. Discuss atropine and pralidoxime as antidotes for cholinergic drugs.
20. Discuss principles of therapy for using cholinergic drugs in special populations.
21. List characteristics of anticholinergic drugs in terms of effects on body tissues, indications for use, nursing process implications, observation of patient response, and teaching patients.
22. Discuss atropine as the prototype of anticholinergic drugs.
23. Discuss clinical disorders or symptoms for which anticholinergic drugs are used.Describe the mechanism by which atropine relieves bradycardia.
24. Review anticholinergic effects of antipsychotics, tricyclic antidepressants, and antihistamines.
25. Discuss principles of therapy and nursing process for using anticholinergic drugs in special populations.
26. Describe the signs and symptoms of atropine or anticholinergic drug overdose and its treatment.

Drugs used to fight infection

1. Outline common and potentially serious adverse effects of antimicrobial drugs.
2. Identify patients at increased risk for adverse drug reactions to antimicrobial drugs.
3. Discuss ways to increase benefits and decrease hazards of antimicrobial drug therapy.
4. Discuss ways to minimize emergence of drug-resistant microorganisms.
5. State appropriate nursing implications for a patient receiving an antimicrobial drug.
6. Discuss important elements of using antimicrobial drugs in children, older adults, patients with renal or hepatic impairment, and patients with critical illness.
7. Describe general characteristics of beta-lactam antibiotics.
8. Discuss penicillins in relation to effectiveness, safety, spectrum of antibacterial activity, mechanism of action, indications for use, administration, observation of patient response, and teaching of patients.
9. Differentiate among extended-spectrum penicillins.
10. Describe characteristics of beta-lactamase inhibitor drugs.
11. Discuss similarities and differences between cephalosporins and penicillins.
12. Differentiate cephalosporins in relation to antibacterial spectrum, indications for use, and adverse effects.
13. Describe major characteristics of carbapenem and monobactam drugs.
14. Identify characteristics of aminoglycosides and fluoroquinolones in relation to effectiveness, safety, spectrum of antimicrobial activity, indications for use, administration, and observation of patient responses.
15. Recognize factors influencing selection and dosage of aminoglycosides and fluoroquinolones.
16. Discuss the importance of measuring serum drug levels during aminoglycoside therapy.
17. Describe measures to decrease nephrotoxicity and ototoxicity with aminoglycosides
18. Describe characteristics, uses, adverse effects, and nursing process implications of fluoroquinolones.
19. Discuss major characteristics and clinical uses of tetracyclines.
20. Recognize doxycycline as the tetracycline of choice in renal failure.
21. Discuss characteristics, clinical uses, adverse effects, and nursing implications of selected sulfonamides.
22. Recognize trimethoprim-sulfamethoxazole as a combination drug that is commonly used for urinary tract and systemic infections.
23. Describe the use of urinary antiseptics in the treatment of urinary tract infections.
24. Identify characteristics and specific uses of macrolide and ketolide antibacterials.
25. Compare and contrast macrolides and ketolides with other commonly used antibacterial drugs.
26. Discuss characteristics and clinical indications for using chloramphenicol, clindamycin, daptomycin, linezolid, metronidazole, quinupristin- dalfopristin, rifaximin, spectinomycin, and vancomycin.
27. Discuss the roles of metronidazole and oral vancomycin in the treatment of pseudomembranous colitis.
28. List characteristics, uses, effects, and nursing implications of using primary antitubercular drugs.
29. Describe the rationale for multiple-drug therapy in treatment of tuberculosis.
30. Discuss ways to increase adherence to antitubercular drug therapy regimens.
31. Describe factors affecting drug therapy in multidrug-resistant (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB).
32. Discuss difficulties in developing and using antiviral drugs.
33. Differentiate types of antiviral drugs used for various viral infections.
34. Describe selected antiviral drugs in terms of indications for use, adverse effects, and nursing process implications.
35. Discuss the rationale for using combinations of drugs in treating human immunodeficiency virus (HIV) infection.
36. Describe commonly used antifungal drugs in terms of indications for use, adverse effects, and nursing process implications.
37. Differentiate between adverse effects associated with systemic and topical antifungal drugs.

Drugs used to manage pain

1. List characteristics of opioid analgesics in terms of mechanism of action, indications for use, and major adverse effects.
2. Describe morphine as the prototype of opioid analgesics.
3. Explain why higher doses of opioid analgesics are needed when the drugs are given orally.
4. Contrast the use of opioid analgesics in opioid-naive and opioid-tolerant patients.
5. Describe characteristics and treatment of opioid toxicity.
6. Discuss principles of therapy for using opioid analgesics in special populations.
7. Discuss non-opioid drugs used in pain management.
8. Discuss aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) in terms of mechanism of action, indications for use, contraindications to use, nursing process, and principles of therapy.
9. Compare and contrast aspirin, other NSAIDs, and acetaminophen in terms of indications for use and adverse effects.
10. Differentiate among antiplatelet, analgesic, and anti-inflammatory doses of aspirin.
11. Differentiate between nonselective NSAIDs and the cyclooxygenase-2 inhibitor, celecoxib.
12. Identify factors influencing the use of aspirin, NSAIDs, and acetaminophen in special populations.
13. Discuss recognition and management of acetaminophen toxicity.
14. Discuss the use of NSAIDs and antigout drugs.
15. Discuss the use of NSAIDs, triptans, and ergot antimigraine drugs.
16. Drugs Affecting the Neuromuscular System.
17. Discuss major factors that influence choice of an antiseizure drug for a patient with a seizure disorder.
18. Recognize characteristics and effects of commonly used antiseizure drugs.
19. Differentiate between older and more recent antiseizure drugs.
20. Compare advantages and disadvantages between monotherapy and combination drug therapy for seizure disorders.
21. Apply the nursing process with patients receiving antiseizure drugs.
22. Discuss the use of antiseizure drugs in special populations.
23. Differentiate the types of commonly used antiparkinson drugs.
24. Discuss therapeutic and adverse effects of dopaminergic and anticholinergic drugs.
25. Discuss the use of antiparkinson drugs in selected populations.
26. Discuss common symptoms and disorders for which skeletal muscle relaxants are used.
27. Differentiate uses and effects of selected skeletal muscle relaxants.

Drugs Affecting the Respiratory System

1. Identify general categories of drugs used to treat respiratory disorders.
2. Discuss the uses and effects of bronchodilating drugs, including adrenergics, anticholinergics, and xanthines.
3. Differentiate between short-acting and long-acting inhaled beta2- adrenergic agonists in terms of uses and nursing process implications.
4. Discuss the uses of anti-inflammatory drugs, including corticosteroids, leukotriene modifiers, and mast cell stabilizers.
5. Discuss reasons for using inhaled drugs when possible.
6. Differentiate between “quick relief” and long-term control of asthma symptoms.
7. Discuss the use of antiasthmatic drugs in special populations.
8. Delineate effects of histamine on selected body tissues.
9. Discuss allergic rhinitis, allergic contact dermatitis, and drug allergies as conditions for which antihistamines are commonly used.
10. Identify the effects of histamine that are blocked by histamine1 (H1) receptor antagonist drugs.
11. Differentiate first- and second-generation antihistamines.
12. Describe antihistamines in terms of indications for use, adverse effects, and nursing process implications.
13. Discuss the use of antihistamines in special populations.
14. Review decongestant and adverse effects of adrenergic drugs.
15. Describe general characteristics and effects of antitussive agents.
16. Discuss the advantages and disadvantages of using combination products to treat the common cold.
17. Evaluate over-the-counter allergy, cold, cough, and sinus remedies for personal or patients’ use..

Drugs Affecting the Cardiovascular System

1. Discuss atherosclerosis as the basic disorder causing many cardiovascular disorders for which drug therapy is required.
2. Differentiate the types of drugs used to treat heart failure (HF).
3. Identify the role of digoxin in the management of heart failure (HF) and atrial fibrillation.
4. List characteristics of digoxin in terms of effects on myocardial contractility and cardiac conduction, indications for use, principles of therapy, and nursing process implications.
5. Differentiate digitalizing and maintenance doses of digoxin.
6. Explain the roles of potassium chloride, lidocaine, atropine, and digoxin immune fab in the management of digoxin toxicity.
7. Discuss the roles of sodium channel, beta-adrenergic, potassium channel, and calcium channel blockers along with two unclassified drugs in the management of dysrhythmias.
8. Describe the nursing process implications and actions related to caring for patients using selected antidysrhythmic drugs.
9. Describe principles of therapy to include nonpharmacologic and pharmacologic measures to manage tachydysrhythmias.
10. Describe general characteristics and types of antianginal drugs.
11. Discuss nitrate antianginals in terms of indications for use, routes of administration, adverse effects, nursing process implications, and drug tolerance.
12. Differentiate between short-acting and long-acting dosage forms of nitrate antianginal drugs.
13. Use the nursing process in the care of individuals on antianginal and adjunctive therapy for treatment of myocardial ischemia.
14. Describe therapeutic and adverse effects of vasopressor drugs used in the management of hypotension and shock.
15. Review the effects of alpha-adrenergic blockers, beta-adrenergic blockers, calcium channel blockers, and diuretics in hypertension.
16. Discuss angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in terms of mechanisms of action, indications for use, adverse effects, and nursing process implications.
17. Describe the rationale for using combination drugs in the management of hypertension.
18. Discuss interventions to increase therapeutic effects and minimize adverse effects of antihypertensive drugs.
19. Discuss the use of antihypertensive drugs in special populations.
20. List characteristics of diuretics in terms of mechanism of action, indications for use, principles of therapy, and nursing process implications.
21. Discuss major adverse effects of thiazide, loop, and potassium-sparing diuretics.
22. Identify patients at risk for developing adverse reactions to diuretic administration.
23. Recognize commonly used potassium-losing and potassium-sparing diuretics.
24. Discuss the rationale for using combination products containing a potassium-losing and a potassium-sparing diuretic.
25. Discuss the rationale for concomitant use of a loop diuretic and a thiazide or related diuretic.
26. Discuss important elements of diuretic therapy in special populations.
27. Compare and contrast heparin and warfarin in terms of indications for use, onset and duration of action, route of administration, blood tests used to monitor effects, and nursing process implications.
28. Discuss antiplatelet agents in terms of indications for use and effects on blood coagulation.
29. Describe thrombolytic agents in terms of indications and contraindications for use, routes of administration, and major adverse effects.
30. Describe systemic hemostatic agents for treating overdoses of anticoagulant and thrombolytic drugs.
31. Use the nursing process in the care of patients on anticoagulant, antiplatelet, and thrombolytic agents.
32. Describe dyslipidemic drugs in terms of mechanism of action, indications for use, major adverse effects, and nursing process implications.

Drugs Affecting the Endocrine System

1. Compare steroid and protein hormones in relation to site of action and pharmacokinetics.
2. Differentiate between physiologic and pharmacologic doses of hormonal drugs.
3. Identify clinical uses of selected hormones.
4. Recognize the limitations of hypothalamic and pituitary hormones as therapeutic agents.
5. Identify major nursing considerations in the care of patients receiving specific hypothalamic and pituitary hormones.
6. Review physiologic effects of endogenous corticosteroids.
7. Discuss clinical indications for use of exogenous corticosteroids.
8. Differentiate between physiologic and pharmacologic doses of corticosteroids.
9. Differentiate between short-term and long-term corticosteroid therapy.
10. Recognize at least 10 adverse effects of long-term corticosteroid therapy.
11. Examine the potential benefits for administering corticosteroids topically when possible rather than systemically.
12. Analyze the use other drugs and interventions to decrease the need for corticosteroids.
13. Discuss the use of corticosteroids in selected populations and conditions.
14. Apply the nursing process with a patient receiving long-term systemic corticosteroid therapy, including teaching needs.
15. Describe characteristics, uses, and effects of thyroid drugs.
16. Identify characteristics, uses, and effects of antithyroid drugs.
17. Evaluate the influence of thyroid and antithyroid drugs on the metabolism of other drugs.
18. Evaluate the use of calcium and vitamin D supplements, calcitonin, and bisphosphonate drugs in the treatment of osteoporosis.
19. Describe major effects of endogenous insulin on body tissues.
20. Discuss characteristics and uses of the various types of insulins and insulin analogs.
21. Differentiate types of oral agents used to manage diabetes mellitus in terms of mechanisms of action, indications for use, adverse effects, and nursing process implications.
22. State reasons for combinations of insulin and oral agents or different types of oral agents.
23. List the three common types of insulins, stating their onset, peak, and duration of action; and the four common groups of oral anti-diabetic agents, identifying examples of each group.
24. Outline the benefits and risks of postmenopausal hormone replacement therapy.
25. Recognize adverse effects associated with estrogens, progestins, and hormonal contraceptives.
26. Apply nursing process with patients taking estrogens, progestins, and hormonal contraceptives.
27. Discuss uses and effects of exogenous androgens and anabolic steroids.
28. Identify potential consequences of abusing androgens and anabolic steroids.

Drugs Affecting the Gastrointestinal System

1. Identify general categories of drugs used to treat gastrointestinal disorders.
2. Discuss the effects of non-gastrointestinal drugs on gastrointestinal functioning.
3. Describe adverse effects associated with overdoses of vitamins.
4. Discuss the rationale for administering vitamin K to newborns.
5. Describe treatment of sodium, potassium, magnesium, and chloride imbalances.
6. Describe treatment of iron deficiency anemia.
7. Discuss the chelating agents used to remove excessive copper, iron, and lead from body tissues.
8. Assist patients with effective use of approved weight-loss drugs, when indicated.
9. Differentiate the types of drugs used to treat peptic ulcers and acid reflux disorders.
10. Discuss the advantages and disadvantages of proton pump inhibitors.
11. Differentiate between prescription and over-the-counter uses of histamine2 receptor blocking agents.
12. Discuss significant drug-drug interactions with cimetidine.
13. Describe characteristics, uses, and effects of selected antacids.
14. Discuss the rationale for using combination antacid products.
15. Differentiate the major types of laxatives according to effects on the gastrointestinal tract.
16. Differentiate the consequences of occasional laxative use from those of chronic laxative use.
17. Discuss rational choices of laxatives for selected patient populations or purposes.
18. Discuss possible reasons for and hazards of overuse and abuse of laxatives.
19. Describe types of diarrhea in which antidiarrheal drug therapy may be indicated.
20. Differentiate the major types of antidiarrheal drugs.
21. Discuss characteristics, effects, and nursing process implications of commonly used antidiarrheal agents.
22. Differentiate the major types of antiemetic drugs.
23. Discuss characteristics, effects, and nursing process implications of selected antiemetic drugs.

Drugs Affecting the Hematopoietic and Immune Systems

1. Discuss common characteristics of immunizations.
2. Discuss the importance of immunizations in promoting health and preventing disease.
3. Identify authoritative sources for immunization information.
4. Discuss ways to promote immunization of all age groups.
5. Discuss the use of hematopoietic agents in the treatment of anemia.
6. Discuss the use of filgrastim and sargramostim in neutropenia and bone marrow transplantation.
7. Describe the adverse effects and nursing process implications of administering filgrastim and sargramostim.
8. Discuss interferons in terms of clinical uses, adverse effects, and nursing process implications.
9. Discuss characteristics and uses of major immunosuppressant drugs in autoimmune disorders and organ transplantation.
10. Identify adverse effects of immunosuppressant drugs.
11. Discuss nursing interventions to decrease adverse effects of immunosuppressant drugs.
12. Describe major types of antineoplastic drugs in terms of mechanism of action, indications for use, administration, and nursing process implications.
13. Discuss the rationales for using antineoplastic drugs in combination with each other, with surgical treatment, and with radiation therapy.
14. Drugs Used in Ophthalmic Conditions.
15. Discuss selected drugs in relation to their use in ocular disorders.
16. Use correct techniques to administer ophthalmic medications.
17. Assess for ocular effects of systemic drugs and systemic effects of ophthalmic drugs.

Drugs Used in Dermatologic Conditions

1. Review characteristics of skin structures that influence drug therapy of dermatologic disorders.
2. Discuss antimicrobial, anti-inflammatory, and selected miscellaneous drugs in relation to their use in dermatologic disorders.
3. Use correct techniques to administer dermatologic medications.