Jul 8, 2021
In this episode, I provide an explanation about why Nursing Pharmacology is so darn hard and why it's not your fault. Here is the link to my book Memorizing Pharmacology Mnemonics which you can find here: https://geni.us/iA22iZ
and subscribe to TonyPharmD YouTube Channel here: https://www.youtube.com/c/tonypharmd
Here is the Link to my Pharmacy Residency Courses: residency.teachable.com
Auto Generated Transcript:
Hey, welcome to episode three of the Memorizing Pharmacology Podcast. The next topic I wanted to cover is how to study for next semester's pharmacology class, whether it's in nursing, pharmacology technician, pharmacist, medicine, or whatever. But with nursing, it's especially difficult because not all nursing schools require the same prerequisites. Some nursing schools require chemistry, some don't require any chemistry, and some require up to organic chemistry, especially if you're going to become a nurse practitioner.
So, what I wanted to do was make sure that I clarify why pharmacology is so hard and what you can do about it if you are a nursing student. Let's get on with the show on how to study nursing pharmacology. I wanted to make a video because I've seen a couple of videos with this title, but no one ever explained why it was hard in this way. They'll talk about memorization, they'll talk about time management, but there are some things that you need to know about nursing pharmacology and why it's specifically harder than other pharmacologies.
So first, I'll talk about why nursing pharmacology is hard. In the nursing curriculum, you have anatomy and physiology, usually eight credits of lab, very comparable to a pharmacist or physician's curriculum. Then you have chemistry, maybe zero to three credits usually, and then pathophysiology, followed by pharmacology, and all of this happens very quickly. Whereas pharmacists and physicians take anatomy and physiology just like nurses or nursing students, but then inorganic chemistry, eight credits, organic chemistry, eight to 10 credits, and biochemistry, three credits. Then that's all happening in undergrad. After that, they go to professional school where they take pathophysiology and then pharmacology, maybe in their M1, M2 year or P1, P2 year. So, not only are these nursing student rock stars trying to take pharmacology way earlier, which is impressive, but they're also taking it with up to 18 credits less of chemistry. Let me make it clear, I'm not saying we need to add organic chemistry to the nursing curriculum. I'm saying there's a workaround and a solution to this. If you talk to pharmacy students and medical students and you ask them what they remember from organic chemistry, they'd be hard-pressed to tell you a lot. And if you ask them what they remember from biochem, they might say they remember Krebs cycle and glycolysis, but they might not be able to draw it. What they did learn was the language of pharmacology, and that makes all the difference. Because now, when they're looking at a textbook, it's much easier for them to understand the words that are in there.
What's the curse of knowledge? Well, instructors, pharmacology instructors, are usually nurses, physicians, pharmacists, or maybe Ph.D.s. They might have a Ph.D. in pharmacology and be research scientists or even physician assistants. The curse of knowledge says that as you teach for a long time, your brain will change and make it much more efficient. As I showed in the videos, I did everything from memory. I know the top 200 drugs from memory, not because I'm a great memorizer, but because I created a way to use serial memory, as well as some mnemonics, to help me remember them. Another thing is that I was experienced clinically. I've seen hundreds of thousands, maybe millions of prescriptions. So, I have lots of examples to pull from, and that makes it easier. As a nurse, you'll also have this curse of knowledge, and that'll be when you talk to a patient, you'll explain something, and what you think is really clear, the patient will look at you, and they'll say, 'I have no idea what you're talking about.' That's because you'll have many, many patients that you've helped, and they've seen what's happened with them, and they don't have that confidence that you know the last hundred times everything just worked out fine.
The curse of knowledge is the first thing. The second thing is that you may be getting an instructor that has a physical science background, someone who has a lot of chemistry and is very comfortable with pharmacology. So, the inorganic and the organic, that I talked about, that's a very different thing to study than anatomy and physiology. So, the two things that might get in the way are the curse of knowledge, that they've internalized it and it's just so easy for them because of their experience in teaching, and that they may come from a different background that is, you know, they're not from around here.
So, what are the solutions? The first solution might be books. Additional books can provide what I would call a translation, but you have to learn the textbook and the translation. You may not have time for a print book. With my 'Memorizing Pharmacology' book, many follow along with the videos, but most actually follow along with the audiobook. The audiobook has this great Scottish narrator, and he's just got a much better voice than I do, but also, he puts so much emotion into it. It's really pleasant to listen to over and over again, which in some ways you may have to for some parts of pharmacology, depending on your background.
The other one was a little bit of a surprise because I just wanted something to better explain how to pronounce drug names. What I was finding was that some nurses were using it with their patients, and a patient would come in and say, 'You know, I really don't understand the medicines,' and they would start sitting down with them, talking one-on-one with them, and making it part of patient education. You can see some other videos, but I translate the medication names into regular English words. So, acetaminophen becomes 'the A' from 'coma,' 'the C' from 'ceiling,' 'the TA' from 'data,' 'the MIN' from 'mint,' 'the NUH' from 'cannon,' and then 'the FIN' from 'hyphen.' Those are all English words that you can use to help them understand the medication name, how to pronounce it, and how to spell it. That's really important because if you have the patient on board with their self-care, then they might catch something, maybe a medication error or something like that, that maybe wouldn't have been caught otherwise.
The second thing are the videos. These videos are really people translating the language of pharmacology from physical science to plain English or to something that's understandable with mnemonics and things like that. But you have to be really careful here, kind of buyer beware because you don't know them really. So, watch the comments. If you see in as a shortcut or lamb or pam. So, 'in' is they're saying it's an ending, and all things that end with 'een' are antihistamines, and that's just not true. Loratadine, which is generic for Claritin, and cetirizine both end with 'en,' which is generic for Zyrtec, and they're
both antihistamines. But they didn't go on to think, 'Wait a minute, fluoxetine is Prozac. That's not an antihistamine. That's an antidepressant. Morphine, that's not an antihistamine either. That's for pain.' So, that shortcut doesn't work. There are shortcuts that do work, and I'll go over them in the next slide. But let me tell you right now, there is a list, and it's not on. It's a list on the United States Adopted Names Council list. It's on the American Medical Association website. The list and then the World Health Organization also has a list, but these lists are very long. I've shortened it in the book. I want to say it's about 800 or 900 endings.
Misspelled drugs. If you see misspelled drugs, that means they're not paying attention to detail, and you want to be really, really careful. I'm going to give you the Skittle story, and I don't know if this is true or not, but I heard that certain rock bands would put a clause in their contract that says, 'We want this many Skittles, and we want no green ones,' or something like that. The reason they're doing it is not to be jerks, but to make sure that the person's reading the contract so that their stage doesn't collapse, so that their sound is going to be good, and all these things. If you see misspelled drugs, that's someone who's not paying attention to the very important details.
Now, why do so many people put, like, 500,000 views or a million views on something like that, where it might even be wrong? Well, students give ethos to pathos rather than attending to logos, and I'll translate that. So, students believe an instructor is credible, that is, they have ethos, because they are smiling and excited, that's pathos, even if a person says they're a beginner. Studies have shown that if you've got an expert and you've got someone who's not an expert, but the expert is boring, and the other person is really excited and smiling, you'll believe the other person, and that's what's happening. So always be careful, buyer beware. Watch for incorrect shortcuts like 'lamb' or 'pam,' or not the endings for benzodiazepines. It's 'azepam' and 'azolam.' It's not 'en.' For loratadine, it's 'adidene,' and then I go over those in my video, so I won't belabor those here. But you may not have time to watch videos; you may have time to listen to it. But the video might be made for someone who's watching it, and that might not be the best solution either.
My thought for the best solution is audiobooks, and I have to confess, I'm totally addicted to audiobooks. I've almost listened to 200 since, I want to say, 2014, just on Audible. Nursing students are busy. My sister-in-law is a nurse; my mother-in-law's a nurse; my grandmother was a nurse. They're busy with families, their jobs, and school, and audiobooks, I think, are the best way to fit learning the language of pharmacology into these small windows of time. Because you're doing something on top of the textbook that's supposed to make the class easier. I always recommend listening to it on the semester or even a couple of weeks before you take the pharmacology class. In my book, I say it explicitly, to learn pharmacology, you have to have taken pharmacology. This is a very approachable pharmacology because as soon as someone talks about proton pump inhibitors, which are in GI, and that might be the first module, they also have to talk about drug interactions, and one drug interaction is clopidogrel, which is in cardiology. But you haven't taken cardiology, so what is clopidogrel? You've never heard that before. And that's what makes it so hard. So to succeed in pharmacology, you almost have to have already taken pharmacology.
So, the first book teaches classifications, which is a real struggle a lot of times, through stems, prefixes, infixes, and suffixes. I assure you, these are right. These are the ones that come from the United States Adopted Names Council and the World Health Organization, things like 'alol' for beta-blockers and 'cillin' for penicillin. But also, some ones that maybe you don't know as well, which is like 'omalizumab,' which has two infixes and then the monoclonal antibody suffix. But that's all in the videos; I'm not going to go into that. And then the other book, I was a little surprised because people picked it up to help patients with their self-care. I had made it so that I had difficulty explaining to students how to pronounce something without just saying, 'Well, here's how I say it, you say it back.' And so, I talk about something called 'back building,' which is where you say the last syllable, like with acetaminophen, it would be 'phen,' 'nothing,' 'menifen,' 'tamina,' 'fin,' 'cetominophin,' 'acetaminophen.'
And the audiobook's coming out in a week or two at most, and that'll be out soon, which will do that for 400 drugs. So, I'm so excited to help health practitioners avoid embarrassment and help patients with their self-care. So, why is nursing pharmacology hard? Because, in many ways, there's just not a lot of chemistry, but there's a way around that curse of knowledge. They've internalized it; it's tough to talk to someone that doesn't know or is a novice. And then, solutions: books, videos, and audiobooks.
Like to learn more?
Find my book here: https://geni.us/iA22iZ
and subscribe to my YouTube Channel TonyPharmD here: https://www.youtube.com/c/tonypharmd
Here is the Link to my Pharmacy Residency Courses: residency.teachable.com