Pharmacology Test 1

Study of drugs and their actions on living organisms

concerned with the movement of drugs within the body

the branch of pharmacology concerned with the effects of drugs and the mechanism of their action.

a drug attaches to a receptor site and STIMULATES the cell to perform an action

drug attaches to a receptor site and PREVENTS a response from occuring

• High abuse potential, no accepted medical use.
• Ex: Heroin, Marijuana, LSD, Mescaline (peyote), Cocaine

• Narcotics: Written Prescription. No telephone refills. High abuse potential. Accepted medical use.
• EX: Opium, morphine, codeine, methadone, meperidine, secobarbital, amphetamine)

• Moderate Abuse. Non narcotic derivatives. Prescriptions can be rewritten after 6 months or 5 refills. Less abuse potential. low physical but high psycho dependance. Accepted medical use.
• EX: Androgens and anabolic steroids

• Less abuse potential. mild dependence. limited physical or psych dependence. Limit to 5 refills. written or oral prescription.
• Ex: Valium, phenobarbital, chloral hydrate, benzodiazepine, meprobamate

Preps containing limited opioids. Cough Syrups, antidiarrheals. Limited potential for abuse. prescription may be required, depends on state laws.

Oral or SL

IM, SQ, Interdermal, IV

Dopamine, imipramine, isoproterenol, lidocaine, morphine, nitroglycerin, propranolol, reserpine, warfarin

33-44 hours

0.5-3 days

6-7 days

20-50 hours

22 hours

• Dilantin
• Theophylline
• Lithium
• Coumadin (warfarin)
• Digitoxin
• Digoxin
• Aminoglycocides
• Insulin

Fight or flight

Rest and digest

act on the parasympathetic nervous system

overstimulation at the neuromuscular junction due to an excess of Acetylcholine

S/S: Respiratory failure, flaccid paralysis, excessive salivation and perspiration

• Anticholinergics
• parasympatholytics
• cholinergic antagonists

Cholinergic Antagonist

Use: Emergency use, bradycardia, pulseless electrical activity, asystole, cpr, decrease resp. secrestions, induction of mydriasis

Contraind: hypersensitivity, myasthenia gravis, acute MI, glaucoma

SE: Blurred vision, dry mouth, constipation, urinary retention (CRUCIAL TO MONITOR)

mad as a hatter (CNS PSYCHOSIS) dry as a bone (SALIVARY) red as a beet (VASODILATION) blind as a bat (MYDRIASIS)

eyes, blood vessels, bladder, male sex organs

Pre synaptic nerve terminals

primarily the HEART, but also kidneys

arterioles of the heart, LUNGS, and skeletal muscles, bronchi, uterus, liver

to EPI, NE, Dopamine

to EPI , NE

EPI

• Adrenergics
• SympathoMIMEtics
• Adrenergic Agonist

Use: wide variety, asthma, shock, etc

Admin: parentally, topically or by inhalation

• Metabolized: liver
• Pregnancy CAT C

Absorption: tissues

Excreted: Kidneys

Duration: 1-4 hours

Stimulates ALL adrenergic receptors

Contraind: hypersensitivity, sulfite sensitivity, close angled glaucoma, labor

AE: HTN Crisis, angina, cerebral hemorrhage, cardiac arrythmias

Drug Interaction: tricyclic antidepressants, oxytocics, halogenated anesthetics and beta blockers

• Sympatholytics,
• adrenergic blockers,
• adrenergic antagonists

Beta blocker

USE: HTN, Angina, MI, Migraine, essential tremor, situation anxiety, substance withdrawal

• b1: decreases heart rate
• b2: bronchospasm

given orally or IV

Contraind: bradycardia, heart block, airway disease, raynaud syndrome, antidepressant use

SE: Myocardial ischemia if stopped suddenly, infarction, htn, angina, depression, diarrhea

Use: treatment of CHF, AFIB, Tachycardia

Admin: Oral, IV

Excreted: Kidneys

Contraind: heart block, vfib, hypersensitivity

AE: Dysrhythmias, anorexia, n/v/d, HA, wkns, apathy, drowsiness, visual disturbances, confusion, restlessness, disorient, seizures, delirium, hallucinations, neuralgia, psychosis

Drug Interactions: Multiple drugs

Check intake of K+, Ca, Mg.

25 to 35

Under 100mg/dl

5 to 10

0.84 to 1.21

7 to 20

0.5 to 2.0

3.6 to 5.2

• T3 free 0.2-0.5 ng/dl
• T3 total 75-195 ng/dl

5.0 to 12.0 mcg ug/dl

10 to 20 ug/ml

0.4 to 4.0 mu/L

1mg

1gm

15gr

1 TBSP

1 TSP

1 kg

1 oz

60mg

1L

5ML

33.8oz

15.4gr

ipophilic or have a transport system

• Drugs enter capillaries surrounding Bowman’s capsule
• Most drugs move easily through capillary walls and into the proximal tubule (urine)
• Proteins cannot pass
• If drug molecules are still bound to protein, they will not pass and can lead to toxicity.

• Inamrinone (Inocor)
• Milrinone (Primacor)

short term management of heart failure, long term management of pt's awaiting heart transplant

given IV, only used when other meds are not working

reduce K+

ace inhib:

use: antiHTN

Contraind: hypersensitivity

SE: Dry non productive cough, HA, Fatigue, Increased k+

Edu: 1h ac, rise slowly, photosensitivity, do not take k+ supps

reduce myocardial o2 demands by increasing o2 to heart or both

• ex: nitrates
• beta blockers
• ccb's

• Propranolol (inderal)
• Atenolol (Tenormin)
• Metoprolol (Lopressor)

• Verapamil (Calan)
• Diltiazem (Cardizem)

drug tested on healthy volunteers to make sure the drug can be given safely to people. 20-80 volunteers.

100-300 volunteers who have the disease for which the drug is thought to be effective.

Large number of patients, 1000-3000 in medical research centers receive the drug. Provides info about infrequent or rare side effects. Double blind study.

Voluntary. Post market surveillance of the drugs therapeutic effects.

• lacrimination
• excitation of nicotinic receptors
• salivaiton
• sweating
• diarrhea
• urination
• micturition
• bronchoconstriction

• Isoproterernol
• Dopamine
• Epiniphrine
• Atropine

• Beta blockers
• CCB

• coughing
• hematotisis
• orthopnea
• pneumonia

• splenomegaly/hepatomegaly
• edema
• ascites
• distended neck veins

Nipride

Furosemide (lasix)

Adrenergic

Beta 1, Beta 2, Alpha 1, Alpha 2

• Cholinergic
• Parasympathomimetics
• Cholinergic agonists
• Cholinergic stimulants

Bethanechol (Urecholine)

•Use: postoperative urine retention and retention caused by neurogenic atony of bladder

•Contraindications: inflammatory lesions on GI tract, bronchial asthma, CAD, hypertension,

•Side effects: overstimulation of the PNS what does that look like?

•No not give IM or IV because of risk for cholinergic crisis

• Nicotine
• Muscarinic

Norepinephrine

directly stimulate adrenergic receptors

stimulate the release of norepinephrine from nerve endings into the synapse

stimulates both adrenergic receptor and release of norepinephrine

Alpha 1 Agonist

Use: vascular failure in shock, drug induced hypotension. SVT, Nasal congestion, mydriasis (dilation)

•Contraindication: drug hypersensitivity, severe hypertension, VT, glaucoma

•Side Effects: HA, restlessness, excitability, reflex bradycardia

Alpha 2 Agonist

•Use: management of hypertension

•Contraindication: hypersensitivity

•Side effects: agitation, dizziness, drowsiness, fatigue, HA, CP, hypotension, decreased libido

•Education: Rise slowly, position changes

Beta Agonist

Use: Beta 1 Bradycardia (positive inotropic and chronotropic effects) Beta 2 treat bronchospasm in asthma and prevent bronchospasm in COPD

•Contraindication: angina, hypersensitivity

Alpha Blocker

•Use: management of refractory chronic heart failure, Raynaud vasospasm, prostatic outflow obstruction, hypertension

•Contraindication: hypersensitivy, angina pectoris (severe hypotension)

•Side Effects: light headedness, dizziness, HA, weakness

•Given orally

patients are asymptomatic and have no limitation of thier activities

patients are short of breath or fatigure with moderate activity such as climbing two flights of stairs, slight limitation

patients are short of breath or fatigued with very mild exertion activity such as climbing one half flight of stairs and are only comfortable at rest, limited activity

patients are exhausted short of breath or fatigued at rest

Can be given PO or IV, absorption rate 70%, low protein binding, excretion 70% in urine 30% by liver, Peak 6-8 hours, PO onset 30min to 5 hours, IV 10 to 30 min, Peak 1 to 5 hours

• catopril
• lisinopril
• DO NOT GIVE PRILS TO PREGNANT WOMEN

Treats Heart failure and HTN.

May take 2-3 mo for heart to get to optimal functioning---

Increased survival for pts if they get a dose within 24 hrs after an acute MI

Combine hydrochlorazide ( diuretic) with Lisinopril.

Unlabelled use - migraines

• all beta blockers ending with olol
• propanolol
• atenolol
• metropolol

Used to prevent angina that does not respond to other drugs. Can also be used as antiarrhythmics and antihypertensives

For long term use only

Prevent the passage of calcium ions across the myocardial cell membrane and vascular smooth muscle cells

Causes dilation of the coronary and peripheral arteries

Decreases the force of the hearts contraction and reduces workload

• Verapamil (Calan)
• Dilitiazem (Cardizem)
• Amlodipine (Norvasc)
• Bepridil (Vascor)
• Nifedipine (Procardia)

Adverse Reactions: headache, fatigue, cough, angioedema, increased serum potassium

Check BP, Pulse prior to giving

Monitor fluid/electrolyte status

Monitor for hypotension, or positional blood pressure changes (safety)

Use: antihypertensive

Acts similar to nitrates EXCEPT hydralazine is selective for arteries

Contraindications: angina, MI, tachycardia. Lupus.

Take with food

Monitor BP and pulse regularly, Tolerance can develop.

Discontinue immediately if Pt has lupus-like symptoms (arthralgia (joint pain), fever, myalgia, pharyngitis, splenomegaly)

lower BP, can be given if pulse is below 60

• Chronotropic-lower rate
• inotropic-less force
• dromotropic-less beats

• worklord
• resistance
• cardiac output

• depine
• zem
• amil

patients with CHF

• pril
• sartan