pharmacology

study of drugs. drug is any substance or chemical that affects processes of an organism.

generic: short, simple

trade: registered, patent

chemical: molecular structure and chemistry

ACE inhibitors

ARBS

serotonin agonists

proton pump inhibitors for GERD

Beta blockers

calcium channel blockers

H2 blockers (histamine 2)

benzodiazepines

lower LDL cholesterol

• -tablets: timed, enteric coated, sustained release:
• -capsules
• -troches/lozenges
• -solutions/suspensions: more rapid oral
• -suppositories
• -emulsions
• -topical: dermatological or patches: delayed act
• -implants
• -IV: full effect asap
• Inhalants : fast act

• -Enternal
• -paternal: IV SQ IM ID
• - intrathecal
• - transdermal
• - inhalation
• -topical: eye skin, ears, nose, vaginal

-Right patient, drug, dose, time, route

• -Right documentation
• -Right assessment: each med has something that MUST be assessed before med given
• -Right education: why giving
• -Right evaluation
• Right to refuse

moving from area of higher concentration to area of lower concentration- no energy required

same as passive diffusion however the drug is carried by an enzyme of protein

moving from area of lower concentration to area of higher concentration (against the concentration gradient) and REQUIRES ENERGY

LIPID soluble drugs cross the cell membrane better than water

LIPID soluble drugs cross cell membranes by dissolving in lipid layer

WATER soluble cross thru via pores and channels

what the body does to a drug

• Absorption
• Distribution
• Metabolism/biotransformation
• Excretion/elimination

movement of drug particles from the time it enters the body until it is in the bloodstream

• -Dosage form/route
• -GI: function, pH, presence of food (usually empty stomach improves absorption)
• -Drug soluble and ionization (drugs that are lipid soluble and nonionized are absorbed faster)

blood flow, pain, stress, hunger, fasting, food, disease, pH of stomach acid, poor circulation, route of administration

percentage of an administered drug that is available in the body to produce an effect

• Oral: bioavailability ALWAYS <100%
• IV: bioavailability is 100%
• IM/SC: high availability

• -Drug form & route
• -GI mucosa & motility
• -Food & other drugs
• -changes in liver metabolism

• -Rapid inactivation (by rapid metabolism) of some oral drugs by the liver before reaching the systemic circulation
• -reduce amount of available drug
• -avoid by using different route
• Must consider when changes route (iv to po, po to iv)

• -process by which a drug is moved from the circulation to its site of action
• -areas of rapid distribution: heart, liver, kidneys, brain
• -areas of slow distribution: muscle, skin, fat

• -blood flow
• -water soluble vs. fat soluble (slower)
• -blood-brain barrier
• -protein-binding protein

• -Drug attaches to blood proteins
• -unattached drug is free to act
• -allows storage & release of drug as needed- >longer duration of action
• -reduces risk of toxicity
• -source of drug interactions: competition for binding sites

• -process by which body inactivates drugs
• -increased or decreased toxicity
• -primary site is the liver
• -drugs inactivated by liver enzymes to: inactive metabolites, water-soluble substances, active metabolites

age, body weight, genetics, metabolic rate, illness, tolerance, dependence, enzyme induction, nutrition status, drug competition, first pass effect, half life, concurrent use of other drugs

enzyme inhibitor, liver function, cardiovascular dysfunction, renal dysfunction, starvation. erythromycin or ketoconazole drug therapy

enzyme inducer, barbiturate therapy, rifampin therapy

• -accumulation of drugs
• -prolonged action of the drugs

-Diminished pharmacologic effects

Elimination of drug and metabolites from body

• GI tracts
• Kidneys
• skin
• breathing
• saliva
• half life

• -the time it takes for one half of the original amount of a drug in the body to be removed
• -a measure of the rate at which drugs are removed from the body which is determined by the rate of metabolism & excretion
• -most drugs effectively removed after about five half lives
• -determines dose amt & frequency 

drug effects, what the drug does to the body

drug doing what is expected

time drug takes to get to point to start working

when drug starts working

highest level of drug

level sufficient to elicit a therapeutic response

• -peak and trough levels
• -therapeutic index

bolus: drug administered by rapid injection

loading: drug dose given to achieve rapid MEC

Drug binds with receptor on cell

Receptors are proteins on cell surfaces

enhances

blocks

work on different areas

different areas regards to receptor sites

• -Predictable, well known reactions that result in little or n change in patient management
• -predictable frequency
• -occurrences are related to the size of the dose
• -usually resolve when the drug is discontinued

-any undesirable/nonpredicted event involving meds

• Drug-food
• drug-lab
• drug induced photosensitivity
• OTC
• additive effect
• synergistric effector potentiation
• antagonistic effect- blocks effect
• incompatability

• Categories:
• -category I- safe & effective
• -category II- unsafe & ineffective
• -category III- insufficient date to judge

changes in physiology d/t hormonal influences, growth of fetus, mothers physical adaption to changes

• ability of a substance to interfere with fetal development
• drugs categorized as A, B, C,D, and X
• D and especially X are not to be given... effects fetus

monitor and regulate the manufacture and marketing of drugs

designed to remedy the problem of drug abuse with several provision

• -high potential for drug abuse no accepted medical use
• -ex. heroin, hallucinogens 

• -high potential for drug abuse. accepted medical use. can lead to physical/psychological dependency
• -ex. demerol, morphine, hydrocodone, codeine, oxycodone

• -medically excepted drugs. may cause dependence. less likely for abuse
• -ex. codeine preparations, non narcotic drugs

• -medically accepted drugs, may cause dependence
• -ex phenobarbital, benzodiazepines (diazepam, lorazepam)

• -medically accepted drugs. very limited potential for dependence
• -opioid-controlled substances for diarrhea and cough

each state has own, which contain laws regarding drug administration by nurses

traditional (tea, herb), complimentary health, alternative health, mainstream health practices

informed consent, communication, space, social organization, time, environmental control, biological variations

• -phase one: to determine human dosage range based on healthy subjects and identity, pharmacokinetics
• -phase two: to demonstrate safety and efficiency of drugs in subjects with disease to be treated
• -phases three and four: to demonstrate safety and efficiency of drug for well client population to include long term data if a chronic regimen

effect of a drug that varies from the predicted response due to genetic factors