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PHARMACOLOGY FOR NURSESPHARMACOLOGY FOR NURSESA Pathophysiological ApproachA Pathophysiological Approach
Psychosocial, Gender, and Cultural Influences on Pharmacotherapy
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Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Holistic ApproachHolistic Approach
• Each person: integrated biological, psychosocial, cultural, communicating whole person
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Holistic ApproachHolistic Approach
• Established risk factors influence pharmacotherapeutic outcomes:– Age– Genetics– Biologic characteristics– Personal habits– Lifestyle– Environment
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Psychological and Spiritual FactorsPsychological and Spiritual Factors
• Psychosocial: one's psychological development in the context of one's social environment
• Spirituality:– Capacity to love– Convey compassion and empathy– Give and forgive– Enjoy life, and to find peace of mind and
fulfillment in living
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Strong Spiritual or Religious Beliefs Strong Spiritual or Religious Beliefs Affect Pharmacotherapy OutcomesAffect Pharmacotherapy Outcomes• Suffering• Loneliness• Despair• Death• Meaning• Value• Hope
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Better Drug ComplianceBetter Drug Compliance
• If patient believes treatment is important and beneficial, it often is more effective.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Outcomes of PharmacotherapyOutcomes of Pharmacotherapy
• Influenced by:– Past experiences with medications– Acceptability of taking medication in
social environment– Certain drugs carry social stigma– Patient's attitude toward personal health– Patient's expectations of
pharmacotherapy
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Ethnicity and CutlureEthnicity and Cutlure
• Ethnicity– Biologic and genetic similarities
• Culture– Set of beliefs, values, and norms that
provide meaning for an individual or group
• Both have influence on medication outcomes.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Cultural CompetenceCultural Competence
• Ability to provide care to people with diverse values, beliefs, and behaviors, including ability to adapt delivery of care to meet needs of these patients– Dietary considerations– Alternative therapies– Beliefs about health and disease
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Variables of Culture and Ethnicity That Variables of Culture and Ethnicity That Impact PharmacotherapyImpact Pharmacotherapy
• Diet• Alternative therapies• Beliefs of health and illness• Genetic differences
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Figure 9.1 Holistic model of pharmacotherapy: For pharmacotherapy to be successful, the nurse must consider psychosocial, cultural, environmental and biologic variables that could affect drug response.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Health CareHealth Care
• Health care is affected by:– Population growth– Complex technology advances– Evolving globalization patterns– Access to health care
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Community Factors That Affect Community Factors That Affect PharmacotherapyPharmacotherapy
• Example: women seek health care more readily than males.
• Side effects of medication can be gender-specific and affect compliance.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Local and Systemic Responses to Local and Systemic Responses to Medications Differ Between GendersMedications Differ Between Genders• Body composition • Cerebral blood flow• Rate of elimination of drug
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
FDA Requires That Drug Research FDA Requires That Drug Research Studies Include:Studies Include:
• Subjects of both genders• Analysis of clinical data by gender• Assessment of pharmacokinetic and
pharmacodynamic differences• Studies specific to women's health• Changes are result of reforms after
1993.
Pharmacology for Nursing: A Pathophysiology Approach, Fourth EditionMichael Patrick Adams | Leland N. Holland | Carol Urban
Gender Equality in Prescription Gender Equality in Prescription Drug CoverageDrug Coverage
• Some plans exclude women's contraceptive medications.