pharmacology

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lingcla
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232103
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pharmacology
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2013-09-15 19:24:53
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  1. what is pharmacology
    study of drugs. drug is any substance or chemical that affects processes of an organism.
  2. names of drugs
    generic: short, simple

    trade: registered, patent

    chemical: molecular structure and chemistry
  3. PRILS
    ACE inhibitors
  4. sartans
    ARBS
  5. triptans
    serotonin agonists
  6. prazoles
    proton pump inhibitors for GERD
  7. olols, alols, ilols
    Beta blockers
  8. dipines
    calcium channel blockers
  9. tidines
    H2 blockers (histamine 2)
  10. zepams or zolams
    benzodiazepines
  11. statins
    lower LDL cholesterol
  12. Drug forms
    • -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
  13. Drug Routes
    • -Enternal
    • -paternal: IV SQ IM ID
    • - intrathecal
    • - transdermal
    • - inhalation
    • -topical: eye skin, ears, nose, vaginal
  14. Five rights plus Five
    -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
  15. Passive diffusion (drug movement)
    moving from area of higher concentration to area of lower concentration- no energy required
  16. facilitated diffusion (drug movement)
    same as passive diffusion however the drug is carried by an enzyme of protein
  17. Active transport ( drug movement)
    moving from area of lower concentration to area of higher concentration (against the concentration gradient) and REQUIRES ENERGY
  18. Drug Movements
    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
  19. Pharmacokinetics
    what the body does to a drug
  20. Four Phases of Pharmacokinetics
    • Absorption
    • Distribution
    • Metabolism/biotransformation
    • Excretion/elimination
  21. Absorption
    movement of drug particles from the time it enters the body until it is in the bloodstream
  22. absorption depends on:
    • -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)
  23. what affects absorption
    blood flow, pain, stress, hunger, fasting, food, disease, pH of stomach acid, poor circulation, route of administration
  24. Bioavailability
    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
  25. Factors which alter Bioavailability
    • -Drug form & route
    • -GI mucosa & motility
    • -Food & other drugs
    • -changes in liver metabolism
  26. First Pass Effect
    • -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)
  27. Distribution
    • -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
  28. Distribution influenced by:
    • -blood flow
    • -water soluble vs. fat soluble (slower)
    • -blood-brain barrier
    • -protein-binding protein
  29. Distribution: PROTEIN BINDING:
    • -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
  30. Metabolism/Biotransformation
    • -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
  31. Biotransformation influenced by:
    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
  32. factors that decrease metabolism
    enzyme inhibitor, liver function, cardiovascular dysfunction, renal dysfunction, starvation. erythromycin or ketoconazole drug therapy
  33. factors that increase metabolism
    enzyme inducer, barbiturate therapy, rifampin therapy
  34. Delayed drug metabolism results in:
    • -accumulation of drugs
    • -prolonged action of the drugs
  35. stimulating drug metabolism causes:
    -Diminished pharmacologic effects
  36. Excretion
    Elimination of drug and metabolites from body
  37. Elimination routes:
    • GI tracts
    • Kidneys
    • skin
    • breathing
    • saliva
    • half life
  38. 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 
  39. Pharmacodynamics
    drug effects, what the drug does to the body
  40. therapeutic action
    drug doing what is expected
  41. onset of action
    time drug takes to get to point to start working
  42. MEC (minimum effective concentration)
    when drug starts working
  43. Peak of action
    highest level of drug
  44. duration of action
    level sufficient to elicit a therapeutic response
  45. drug effects
    • -peak and trough levels
    • -therapeutic index
  46. bolus vs. loading dose
    bolus: drug administered by rapid injection

    loading: drug dose given to achieve rapid MEC
  47. Receptor Sites
    Drug binds with receptor on cell

    Receptors are proteins on cell surfaces
  48. agonist
    enhances
  49. antagonist
    blocks
  50. nonselective drugs
    work on different areas
  51. nonspecific drugs
    different areas regards to receptor sites
  52. side effects
    • -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
  53. adverse drug events (ADE)
    -any undesirable/nonpredicted event involving meds
  54. Drug Interactions
    • Drug-food
    • drug-lab
    • drug induced photosensitivity
    • OTC
    • additive effect
    • synergistric effector potentiation
    • antagonistic effect- blocks effect
    • incompatability
  55. OTC DRUGs
    • Categories:
    • -category I- safe & effective
    • -category II- unsafe & ineffective
    • -category III- insufficient date to judge
  56. Pregnancy considerations
    changes in physiology d/t hormonal influences, growth of fetus, mothers physical adaption to changes
  57. tetratogenicity
    • 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
  58. FDA (Food, Drug & Cosmetic ACT)
    monitor and regulate the manufacture and marketing of drugs
  59. controlled substance act
    designed to remedy the problem of drug abuse with several provision
  60. schedule I
    • -high potential for drug abuse no accepted medical use
    • -ex. heroin, hallucinogens 
  61. schedule II
    • -high potential for drug abuse. accepted medical use. can lead to physical/psychological dependency
    • -ex. demerol, morphine, hydrocodone, codeine, oxycodone
  62. schedule III
    • -medically excepted drugs. may cause dependence. less likely for abuse
    • -ex. codeine preparations, non narcotic drugs
  63. schedule IV
    • -medically accepted drugs, may cause dependence
    • -ex phenobarbital, benzodiazepines (diazepam, lorazepam)
  64. schedule V
    • -medically accepted drugs. very limited potential for dependence
    • -opioid-controlled substances for diarrhea and cough
  65. nurse practice act
    each state has own, which contain laws regarding drug administration by nurses
  66. transcultural nursing
    traditional (tea, herb), complimentary health, alternative health, mainstream health practices
  67. basic ethical principles
    informed consent, communication, space, social organization, time, environmental control, biological variations
  68. human clinical experiment
    • -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
  69. pharmacogenetics
    effect of a drug that varies from the predicted response due to genetic factors

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