I don't know how whippersnapperRN's keep abreast of the constant barrage of drugs. Just listening to all those direct to consumer ads on TV is headspinning. The pharmaceutical industry truly has some remarkable offerings, but this progress has come with problems I could have never imagined.
We had a very limited number of drug classifications and they really did work for their application. Drugs like: penicillin, digoxin, gelfoam, and Lasix did not need drug reps to sell them-they sold themselves.
Gelfoam was one of the most extensively used pharmacologic products. This animal gelatin hemostatic substance came in a powder, sheets (about 4X5 in), and even in zig-zag strips for packing. It was a conditioned response-anywhere there was bleeding, think gelfoam. We even tried to force a slurry of the powder down NG tubes for GI bleeding. It was a remarkable hemostatic agent and I vividly recall that comforting rectangular Upjohn logo on the container.
The only limitation was that Gelfoam did not work well with arterial bleeding. It was like attempting to patch a firehose with chewing gum. The pressure would dislodge the gelfoam.
For pain control, Demerol was used for 3-4 days post-op. The patient was usually kept in the hospital until pain free. Upon discharge, they went home with some APC's (aspirin, phenactin, and caffeine) tabs We used to call them All, Purpose Cures. There was no drug seeking issues with this analgesia regimen and nobody ever claimed to misplace or lose APCs.
Antibiotic wise there was penicillin for gram+ infections and sulfa or gentamycin for gram- infections. When there was a question as to sensitivity, Keflin always seemed to work. The microbiology course I took made no mention whatsoever of viral illness. The concept of drug resistance was unknown and the limited number of antibiotics available did seem to be effective.
Digoxin was used extensively for compromised cardiac issues as well as nitroglycerine SL for angina. We also used a nitroglycerine paste that was applied to the chest wall. There were no beta blockers or calcium channel blockers. As a pressor agent, ephedrine capsules were used. Maybe it was a blessing that we lacked IV pressor agents. There would be no way to accurately dose without IV pumps or controllers.
Diabetics had the choice of beef or pork insulin. When antibodies to beef were developed, switch to pork. This came in two confusing strengths U40 and U80.
Huge categories of drugs we take for granted today were lacking. Things like statins, SSRIs, atypical antipsychotics, beta blockers, anti-neoplastic drugs, and oral hypoglycemics all missing
No unit dose. All drugs were dispensed from stock on the ward. This led to some whacky drug dosage calculation test questions such as you have a stock bottle of a 1:50 solution. How would you dilute this to a 1:250 with only 10 cc of diluent
Patients today have much greater expectations and I think the pharmaceutical companies promote this by overhyping their products. Nurses today have it so much more difficult today than I ever did. I never had to face anyone demanding more opiates because they lost their prescription