Intro to Pharmacology Slides

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Characteristics of an Ideal Drug
1. Effective
2. Selective
3. Reversible
4. Predictable
5. No harmful side effects
6. No drug/food interactions
7. Inexpensive
8. Easy to administer
9. Chemically Stable
10. Simple Name
(Currently there are not ideal drugs)

Objective of Drug Treatment
Maximum benefit with minimum harm

Pharmacotherapeutics: The use of drugs to…
1. Diagnose
2. Prevent Disease
3. Treat Disease
4. Prevent Pregnancy

Application of pharmacology in nursing includes…
1. Assessment
2. Knowledge of Patient’s disorders
3. Dosage, administration
4. Evaluation
5. PRN decisions
6. Toxicity

Questions a nurse might ask when dealing with patients and their medications
Vital Signs?
Lab Values?
Other meds?
Allergies?
Why is this prescribed?
Why am I giving this?
How will this med help my patient?
Onset? Peak? Duration? Interactions?
Does the order sound right? Reasonable?
Have I ensured safety?

Questions a nurse might ask during evaluation of a patient after having been given a medication
1. Effectiveness
2. Side Effects
3. Vitals?
4. Lab?
5. Patient’s account

Six Rights of Medication Administration
(P3DRT)
1. Right Patient
2. Right Drug
3. Right Dosage
4. Right Documentation
5. Right Route
6. Right Time

Education of Patient & Family
1. Medication name
2. Expected response (& time); possible side effects
3. Dosage and administration schedule
4. Route of administration
5. Duration of drug use
6. Drug storage
7. anything else of importance.

Four Phases of Pharmacokinetics:
How drugs KIN move
1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Absorption of drug includes…
1. From site of administration (route) into bloodstream
2. Speed of absorption varies with route, blood supply and drug form
3. Route effects onset (oral is the slowest, IV is the fastest)

Distribution of drugs includes…
1. Transported through body in circulatory system
2. Drug diffuses out of blood to site of action

Metabolism
unbound drug molecules are broken down in liver, small amount might be broken down in kidney
(Liver and kidney labs are important to determine functioning and prevent toxicity)

Excretion
Excreted by kidneys and eliminated in urine (also glands, feces, pores, breast milk, breath)

Passage of Drug across cell membranes
1. through channels or pores
2. passage with aid of transport system
3. direct penetration of membrane

Absorption
1. Rate determines how soon effects occur
2. Amount determines intensity of effects
3. bioavailability – extent of drug absorption
4. How it is dissolved
5. surface area of absorption
6. Blood flow

Bioavailability
Extent of drug absorption
What % of drug reaches circulation
IV drugs are more bioavailable than PO drugs

First pass
not active until it meets liver

Factors Affecting Drug Absorption
Rate of dissolution
Surface area
Blood flow
Lipid solubility
Food or fluids taken along with the drug
Some drugs attach to fat, some are stored in fat
Irritante on not black & white every time

Routes of administration
Enteral
-Absorbed through oral or gastric mucosa, small intestine or rectum
-Topical
-IV, IM, SQ

Distribution
1. Movement of drug throughout body
2. Determined by:
-Blood flow to tissues
-Ability of drug to exit vascular system
-Ability of drug to enter cells

Blood-Brain Barrier
1. Tight junctions between cells of capillary walls in CNS
2. What are the benefits? Prevents toxic drugs, bacteria, etc. from hurting the brain
3. What are the disadvantages? Cancer or infection of the brain is difficult to reach because of the BBB.

Protein Binding
1. Type of drug storage system
2. Drugs form reversible bonds with protein
3. Drugs not bound are in a free state
4. As free drug acts on cells, there is a decrease in plasma drug levels

What is the significance of protein binding?
Elderly lack proteins, so there are more free drug particles. Can be toxic.
Also if a patient is taking 2 drugs and one takes of most of the protein, then the other drug has a lot of free proteins.
OR, one of the drugs might have more/less affinity for protein binding and therefore there is more/less of the drug free. they compete.

Metabolism is also known as this
Biotransformation

also most of of this happens in the liver
metabolism of medicine

Hepatic microsomal enzyme system is also known as
P450 system

What is the Hepatic Mircosomal Enzyme System?
The enzyme (P450) pathway that helps liver metabolize

Consequences of metabolism
some drugs are deactivated or are not activated until they go through the process of metabolism. This is called the 1st pass.

P450
Enzymes from liver which aid in metabolism of many drugs
Drug to drug interactions involving P450
-Inhibitor works against enzymes
-Inducer makes more enzymes available

Factors influencing rate of metabolism
1. Age (young- not fully developed liver; old-slower)
2. Nutritional status (generally protein)
3. Liver disease (liver needs to work)
4. Induction of drug-metabolizing enzymes (P450)
5. First pass effect (not active until hits liver or becomes inactive…may want IV to bypass liver)

Excretion
1. Elimination of drugs from body
2. Primarily through kidneys
– Glomerular filtration
– Passive tubular reabsorption
– Active tubular secretion
3. Other routes

Glomerular filtration & drugs
1.blood with drugs is filtered at bowman’s capsule
2. protein bound drugs are not filtered
3. Passive reabsorption moves lipid soluble drugs into blood
4. polar and ionized drugs remain in the urine
5. Active transport via tubular pumps for organic acids and bases move drugs from the blood to urine
6. Excretion.

Drug Half-Life
1. Time for amount of drug to decrease 50%
2. Most drugs eliminated over 4 half-lives

Drug Actions
1. Cellular processes involved in drug and cell interaction
2. Onset
3. Peak effect
4. Duration

Drug Actions: Onset
time it takes for drug to elicit therapeutic response

Drug Actions: Peak effect
time it takes for drug to reach maximum therapeutic response

Drug Actions: Duration
time that drug concentration is sufficient to elicit therapeutic response

Which drug is it important to know peaks and durations for?
Insulin

Pharmacodynamics
1. What drugs do to the body and how they do it
2. It’s dynamite what drugs do to the body!

Drug Mechanisms of Action: 3 Basic ways that drugs can act to produce therapeutic effects
1. Receptor interaction
2. Enzyme interaction
3. Nonspecific interations

Types of receptor interaction
A. Tissue Receptor (empty)
B. Poor receptor fit, no response likely
C. Some drug-receptor fit. Some response likely.
D. Excellent receptor fit. Good response likely.

Types of Receptor Interaction
1. Agonist
2. Antagonist
3. Agonist-Antagonist

Agonist
Mimic actions of endogenous regulatory molecules (produces a response that’s already in body. ex. epinephrine)

Antagonist
Prevents or inhibits action of agonist

Agonist-Antagonist
Exerts some agonist and some antagonist action (Benadryl)

Enzyme Interaction
1. Drugs can inhibit action of a specific enzyme
2. Enzyme binds to drug instead of normal target cell

Nonspecific Interactions
Sites of action include cell membranes and metabolism

Drug Process and Resources
FDA
Controlled Substances (mostly narcotics – counted)
Drug names (Generic and Brand)
Drug Resources (cell phone, drug book)

Cultural Considerations
1. Heritage
2. Communication
3. Family Organization
4. Nutrition
5. Spirituality
6. Herbs

Herbal Therapies
1. Define Herbs
2. Commonly used herbs:
1. Aloe Vera
2. Chamomile
3. Dong Quai
4. Echinacea
5. Garlic (anticoagulant)
6. Ginkgo
7. St. john’s Work (depression, acts like a real drug, anticoagulant)

Drug Research
Informed consent
Experimental Drugs
Awareness of protocols
Communication of data when client receiving study drug

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Drug chemical that interacts with an organism to alter its function, show biolgoical processes and provide methods of diagnosis, …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Pharmacokinetics Describes the absorption, distribution, metabolism, excretion, of drugs. Absorption Movement of the drug from site of administration to …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Drug any substance, other than food, which alters physiologic function, regardless of whether the effect is beneficial or harmful …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy What is pharmacokinetics? study of drug movement through the body What are the 4 elements of Pharmacokinetics? absorption, distribution, …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy Absorption refers to the movement of drug into the bloodstream, with the rate dependent on the physical characteristics of …

We use cookies to give you the best experience possible. By continuing we’ll assume you’re on board with our cookie policy how do over the counter drugs compare/contrast to prescribed drugs -don’t require doc supervision -can still cause drug toxicity …

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