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Pharmacology

For us, nurse students, pharmacology is about understanding drugs and medications we handle while in placement, we need to understand the intended effect the drug will have, we need to be able to explain it to a patient in simple terms, we need to know the prescribed dosage, the potential side effects, the routes, and sometimes is necessary that we are able to learn more about the drug in a busy environment.

Learning about pharmacology can be hard, there is to much to learn, however, the best thing we can do when we start learning is to just know what the drugs do, and then consult the The British National Formulary (BNF) for more information.

The following are my thoughts about the minimal knowledge we should have as students:

Medication Classes

The absolute minimal we should know as nurse students is to been able to recognise to which category the drug belongs.

Note that depending on where you are working you might need to know different type of medications.

For example in a very specialised unit located outside a hospital ground, such as dialysis centre, you might only need to know about fluids and heparins. However, in a General Meds ward you might need to know all the above:

  • Antibiotics: Medications used to lower cholesterol levels.
    • Popular Examples: Atorvastatin, Simvastatin.
  • Antibiotics: Medications used to treat bacterial infections.
    • Popular Examples: Amoxicillin, Metronidazole, Ciprofloxacin, Flucloxacillin, Doxycycline, Clindamycin, Nitrofurantoin, Trimethoprim.
  • NSAIDs (Nonsteroidal Anti-Inflammatory Drugs): Drugs for pain relief, inflammation reduction, and lowering fever.
    • Popular Examples: Ibuprofen, Naproxen, Diclofenac, Naproxen, Meloxicam, Piroxicam, Etoricoxib, Benzydamine.
  • Antidepressants: Medications to treat depression and mood disorders, there are so many types of these, however Selective Serotonin Reuptake Inhibitors (SSRIs) seem to be the most popular type on the wards I worked, these focus on serotonin regulation.
    • Popular Examples of SSRIs): Fluoxetine (Prozac), Sertraline (Zoloft)
    • Popular Examples of non-SSRIs: Mirtazapine, Amitriptyline (also used for nerve pain), Trazodone and Venlafaxine.
  • Anti-hypertensives: These are drugs to lower blood pressure. There are so many different types of anti-hypertensives used in the NHS, these are the ones I came across on the wards:
    • Popular Examples: Enalapril, Lisinopril, Perindopril, Ramipril, Candesartan, Irbesartan, Losartan, Valsartan, Olmesartan.
  • Anti-diabetic Medications: Medications for managing diabetes.
    • Popular Examples: Metformin, Pramlintide, Glipizide, Glyburide, Acarbose, Miglitol, Pioglitazone, Sitagliptin, Saxagliptin, Vildagliptin, Exenatide, Liraglutide.
  • Anti-psychotics: Medications to treat psychotic disorders.
    • Popular Examples: Amisulpride, Aripiprazole, Clozapine, Lurasidone, Olanzapine, Paliperidone, Quetiapine, Risperidone, Chlorpromazine, Flupentixol.
  • Opioids: Drugs for pain management.
    • Popular Examples: Morphine, Oxycodone, Fentanyl, Buprenorphine, Codeine, Dihydrocodeine, Tramadol, Hydromorphone, Methadone, Tapentadol.
  • Anticoagulants: Medications to prevent blood clot formation.
    • Popular Examples: Dalteparin, Warfarin, Dabigatran, Rivaroxaban, Apixaban, Edoxaban.
  • Antivirals: Medications to treat viral infections, the ending "vir" usually gives them away.
    • Popular Examples: Nirmatrelvir, Ritonavir, Sotrovimab, Remdesivir, Molnupiravir.
  • Barrier Creams: Creams used to protect the skin from irritation and moisture.
    • Popular Examples: Sudocrem (Antiseptic), Cavilon, Conotrane, Medi Derma, Honey cream (do not use this last one on diabetic patients)

There is so much more to learn about medication, there are sub-types, different types of delivery and different brand names for each drug, however, knowing the list above would be a great start, feel free to consul the British National Formulary (BNF) as well at: bnf.nice.org.uk

Five Rights of Medication Administration

The main skills we should have when dealing with medication is to know how to apply the 5 rights of medication administration.

  • Right Patient: Confirm the patient's identity to ensure the medication is administered to the correct individual.
  • Right Medication: Verify that we are administering the correct medication as prescribed, and that it has not expired.
  • Right Dose: Ensure that the correct dosage of the medication is being administered.
  • Right Route: Administer the medication through the correct route as specified in the prescription.
  • Right Time: Give medications at the prescribed times to maintain their effectiveness.

Getting any of the 5 rights wrong could be catastrophic.

Nursing Numeracy

The thing with mathematics is that there are many ways of solving an equation, I use logic, thus that is what I will show on this web-page.
However, it is possible you could learn everything by using predetermine formulas, you must use the approach your school or ward asked you to use.

Simple Rule of Three:

All of the maths I have done so far is about using simple rule of three. Simple rule of three is about finding 1 missing value when you have 3 related values.

For example if we have a vial of Paracetamol injectable solution. The vial label indicates it contains 1,000 mg of Paracetamol in 100 mL of solution. A doctor has ordered us to administer 750 mg of Paracetamol to a patient with severe pain. How many mL of the solution should you give?

So we know the 3 values:

We have 1,000 mg of Paracetamol which is ------------- 100 mL

We need 700 mg of paracetamol which is ------------- ?


We multiply 700 by 100 and divide the result by 1000 and we get 75 mL


Everything is like that when it comes to calculating dosages, sometimes it might become more complex because you have to apply simple rule of 3 more than once, but basically that is all the maths you need to know. However, 1 thing that is absolutely essential is that you know equivalences in the metric system:

Liters
Unit Equivalence
1 Liter (L) 1,000 Milliliters (mL)
1 Milliliter (mL) 1,000 Microliters (µL)
1 Milliliter (mL) 1,000,000 Nanoliters (nL)
1 Microliter (µL) 1,000 Nanoliters (nL)
Grams
Unit Equivalence
1 Gram (g) 1,000 Milligrams (mg)
1 Milligram (mg) 1,000 Micrograms (µg)
1 Gram (g) 1,000,000,000 Nanograms (ng)
1 Milligram (mg) 1,000,000 Nanograms (ng)
1 Microgram (µg) 1,000 Nanograms (ng)
Kilograms
Unit Equivalence
1 Kilogram (kg) 1,000 Grams (g)

The beauty of knowing the table is that you can use the simple rule of three to convert values from 1 unit to another.
For example if you need to convert the 75 mL we had before to Microliters (µL), we know that:

         1 mL is ----------------- 1,000 µL
and 75 mL is ----------------- ? µL

We multiply 75 by 1,000 and divide the result by 1 and we get 75,000 µL

And so far that is all the basic maths we need to know.