Pharmacology

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Anonymous
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259522
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Pharmacology
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2014-01-31 21:56:32
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pre hospital pharmacology
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  1. Concentration
    (of the medication on hand): Theamount of a medication that is present in the ampule orvial. This is usually expressed in milligrams, grams, orgrains.
  2. Desired dose
    The quantity of a medication that is to be administered to a patient. This is usually expressed in milligrams, grams, or grains.
  3. Volume
    (of the medication on hand): The amount of fluid that is present in the ampule or vial in which the medication is dissolved. This is usually expressed in milligrams, grams, or grains.
  4. Yield
    The amount of drug in 1 mL.
  5. Class
    How the medication is categorized as compared to other medications. This is usually done by grouping those medications with similar characteristics, traits, or primary components.
  6. Mechanism of action
    The way in which a medication produces the intended response.
  7. Indications
    A circumstance that points to or shows the cause, pathology, treatment, or issue of an attack of disease; that which points out; that which serves as a guide or warning.
  8. Contraindications
    Any condition, especially any condition of disease, which renders some particular line of treatment improper or undesirable.
  9. Adverse reactions/side effects
    This is an abnormal or harmful effect to an organism caused by exposure to a chemical. It is indicated by some result such as death, a change in food or water consumption, altered body and organ weights, altered enzyme levels, or visible illness. An effect may be classed as adverse if it causes functional or anatomic damage, causes irreversible change in the homeostasis of the organism, or increases the susceptibility of the organism to other chemical or biologic stress. A non adverse effect will usually be reversed when the organism is no longer being exposed to the chemical.
  10. Drug interactions
    This refers to any potential effects that a medication may have when administered in conjunction or in the presence of another medication already in the patient’s system, a medication delivery device, or fluid.
  11. How supplied
    This is how the manufacturer packages the medication for distribution and sale. Typical methods of packaging are prefilled syringes, vials, or ampules.
  12. Dosage and administration
    This is the typical or average volume of the medication that is to be administered to the patient and the route of introduction of the medication to the patient.
  13. Duration of action
    Three values are given: (1) onset: the estimated amount of time it will take for the medication to enter the body/system and begin to take effect,(2) peak effect: the estimated amount of time it will take for the medication to have its greatest effect on the patient/system, and (3) duration: the estimated amount of time that the medication will have any effect on the patient/system.
  14. Special considerations
    Additional pertinent information concerning a medication.
  15. PHARMACOLOGY
    • A BIOMEDICAL SCIENCE
    • THE STUDY OF DRUGS AND THEIR: SOURCES   NATURE PROPERTIES AND THE BODY'S REACTION TO DRUGS
  16. PHARMACY
    IS A HEALTH SERVICES PROFESSION,   IS CONCERNED WITH APPLICATION OF THE PRINCIPLES LEARNED FROM PHARMACOLOGY IN ITS CLINICAL SETTING
  17. PHARMACODYNAMICS
    STUDIES THE EFFECTS OF THE DRUGS ON BIOLOGICAL SYSTEMS
  18. PHARMACOKINETICS
    THE STUDY OF THE MOVEMENT OF DRUGS IN THE BODY, INCLUDING THE PROCESSES OF ABSORPTION                 DISTRIBUTION LOCALIZATION IN TISSUES BIOTRANSFORMATION EXCRETION (THE EFFECTS OF BIOLOGICAL SYSTEMS ON THE DRUGS)
  19. FIRST-ORDER KINETICS
    –OCCURS FOR ALL ROUTES, EXCEPT FOR IV–CONSTANT FRACTION OF MEDICATION IS ABSORBED INTO BLOODSTREAM
  20. ZERO-ORDER KINETICS
    • –ABSORPTION IS NOT DELAYED
    • –ADMINISTERED DIRECTLY INTO BLOODSTREAM
    • –100% OF MEDICATION IS AVAILABLE IN A BRIEF PERIOD
  21. ENDOCYTOSIS
    • •MINOR METHOD OF DRUG MOVEMENT
    • •CELL FORMS SAC AROUND DRUG MOLECULE WITH CELL MEMBRANE
    • •CELL MEMBRANE FOLDS INWARD, BRINGING DRUG INTO THE CELL
  22. Pharmacokinetics
    •Drug distribution
    • –Passive transport
    • •Occurs when drug molecule moves down concentration gradient–Drug moves from
    • area of high concentration to area of low concentration
    • •Factors that determine to what degree & how rapidly drug moves into passive transport:
    • –Size of drug molecule
    • –How easily drug dissolves in water or fat–Concentration of drug in body compartments
    • –Carrier-mediated facilitated diffusion
    • 1.Transportation of drug into a particular cell depends on second molecule to carry the drug molecule into the cell
    • 2.Administered drug accumulates outside cell membrane
    • 3.Drug binds with carrier macromolecule
    • 4.Carrier molecule then transports bound medication to its destination inside cell

    • –Carrier-mediated facilitated diffusion
    • •Once inside cell, the bound drug disassociates from  carrier molecule
    • •Drug molecules go to their target site to produce desired effect
    • •Is saturable process–External concentrations do not increase rate of influx

    • –Active transport
    • •Requires macromolecule
    • to assist in transport
    • •Capable of reaching point of saturation
    • •Molecules that transport drugs require energy
  23. Pharmacodynamics
    •Drug/enzyme interactions
    • –Enzymes
    • •Chemicals or compounds that control various chemical changes & reactions within the body–Drugs interact with enzymes & increase/decrease enzyme’s mediated chemical reaction
    • –Drugs are capable of binding/interacting with various enzymes
    • •Either accelerate or arrest their actions


    • –Enzyme works by binding to starting compound (substrate)
    • –Some drugs that act on enzyme systems work by:
    • •Mimicking substrate molecule- MOCKING BIRD
    • •Binding with enzyme system- HAND CUFFS
    • •Clogging chemical reaction regulated by that particular enzyme- CLOGGED DRAIN–Other drugs can bind enzymes & accelerate a chemical reaction
  24. COMPETITIVE/NONCOMPETITIVE
    • •COMPETITIVE ENZYME INTERACTIONS- ARE REVERSABLE- THERE IS A KEY TO UNLOCK THE DOOR–ACE INHIBITORS, ETOH
    • •NONCOMPETITIVE ENZYME INTERACTIONS- ARE NOT REVERSABLE- HAS BEEN SUPER GLUED SHUT–ASA, PROTON PUMP INHIBITORS
  25. GENERIC
    • •ABBREVIATED VERSION OF DRUG’S CHEMICAL NAME
    • •IS REGISTERED WITH FOOD AND DRUG ADMINISTRATION (FDA)
    • •LISTED IN UNITED STATES PHARMACOPEIA-NATIONAL FORMULARY (USP-NF)
    • •ARE WRITTEN IN LOWER CASE
  26. TRADE (BRAND)
    • CREATED BY PHARMACEUTICAL COMPANIES WHEN A PHARMACEUTICAL COMPANY DISCOVERS A NEW DRUG,
    • SCIENTISTS ASSIGN IT A CHEMICAL NAME MANUFACTURER PROPOSES A GENERIC NAME TO FDA FOR APPROVAL COMPANY
    • THEN CREATES A MEMORABLE & DESCRIPTIVE TRADE NAME
    • ALWAYS BEGIN WITH A CAPITAL LETTER
  27. STAGES OF DRUGS IN THE BODY
    • –ABSORPTION
    • –DISTRIBUTION
    • –BIOTRANSFORMATION
    • –ELIMINATION
  28. Drug Sources
    • •PLANTS
    • •ANIMALS AND HUMANS
    • •MINERALS
    • •SYNTHETIC OR CHEMICALS
  29. SOLIDS
    • –Capsule
    • –Pulvule
    • –Pill
    • –Powder
    • –Suppository
    • –Tablet
    • –Lozenge
    • –Medication patch
  30. LIQUIDS
    • –Solution
    • –Elixir
    • –Emulsion
    • –Suspension
    • –Syrup
    • –Tincture
    • –Topical cream
    • •Gas forms of drugs
  31. ABSORPTION
    MOVEMENT OF MEDICATION FROM POINT OF ADMINISTRATION INTO BLOODSTREAM FOR MOVEMENT THROUGHOUT BODY
  32. DOSE
    AMOUNT OF MEDICATION ADMINISTERED
  33. DOSAGE
    SIZE, FREQUENCY, & NUMBER OF DOSES TO BE ADMINISTERED
  34. BIOAVAILABILITY
    • PERCENTAGE OF ADMINISTERED DRUG AVAILABLE IN BLOODSTREAM TO ACT AT TARGET TISSUE DOSE ADMINISTERED MINUS AMOUNT NOT ABSORBED BY  INTESTINE & AMOUNT NOT METABOLIZED BY THE LIVER
    • •Factors that alter bioavailability:
    • –How rapidly medication breaks down & is absorbed  in intestinal tract
    • –Dietary habits of patient
    • –Size of tablet
    • –Formulation of medication
  35. 1st pass Metabolism
    WHEN DRUG IS ABSORBED BY GI TRACT, MUST 1ST GO TO LIVER & ACTED ON BY LIVER ENZYMES
  36. SITES OF DRUG METABOLISM
    • •LIVER
    • •KIDNEYS
    • •LUNGS
  37. DRUG METABOLISM
    • –OFTEN CHANGES CHEMICAL NATURE OF MEDICATION, MAKING IT INACTIVE
    • –CAN CHANGE EFFECTIVENESS OF MEDICATION
    • –PATIENTS WHOSE DRUG METABOLISM IS INCREASED OFTEN REQUIRE
    • INCREASED DOSING
    • –SLOWED METABOLIC RATE RESULTS IN A DECREASE IN THE BREAKDOWN
  38. FACTORS THAT ALTER DRUG METABOLISM
    • •PATIENT AGE
    • •ROUTE OF ADMINISTRATION
    • •DOSAGE
    • •GENETIC PREDISPOSITION OF PATIENT
    • •DIET OR STARVATION
    • •PREEXISTING DISEASE

    –FIRST-PASS METABOLISM FOR DRUG GIVEN ORALLY REQUIRES SIGNIFICANTLY HIGHER DOSE THAN IF GIVEN BY PARENTERAL ROUTE
  39. DRUG EXCRETION
    • –REMOVAL OF DRUG OR METABOLITE FROM BODY
    • –KIDNEY IS TYPICALLY THE ORGAN RESPONSIBLE FOR REMOVAL
    • –LIVER DOES SO LESS FREQUENTLY
  40. LOADING DOSE
    • •RAPID THERAPEUTIC CONCENTRATION OF DRUGS IN LIFE-THREATENING EMERGENCY
    • •FACTORS THAT DETERMINE DOSE: –DESIRED SERUM CONCENTRATION–VOLUME OF DISTRIBUTION
    • •ADMINISTERED VIA IV TO ACHIEVE RAPID 100% BIOAVAILABILITY
  41. MAINTENANCE DOSE
    • •MAINTAINS AN AVERAGE CONCENTRATION OF DRUG AT SERUM-STEADY STATES
    • •IN ABSENCE OF LOADING DOSE, 5 HALF-LIVES MUST PASS TO ACHIEVE STEADY STATE OF DRUG CONCENTRATION
  42. HALF-LIFE
    •TIME REQUIRED FOR CONCENTRATION OF MEDICATION IN  BLOODSTREAM TO DECREASE HALF ITS ORIGINAL LEVEL
  43. Potency
    • •Term used to compare different doses of 2 medications in producing
    • same effect
    • •Is independent of that medication’s efficacy–SUCH AS MORPHINE AND ASA
  44. Summation
    •Occurs when 2 medications with same effect given together produce effect in equal magnitude to effects of 2 drugs given independently–SUCH AS LORAZAPAM AND VALUME
  45. Synergism
    • •Observed effect of 2 medications when given concurrently is greater than effects of medications when given individually
    • •Combined effect greater than effect of drug A + effect of drug BSUCH AS MORPHINE AND PROMETHAZINE
  46. Potentiation
    • •Final enhancement of drug’s effect
    • •Occurs when drug lacking effect of its own increases effect of 2nd drug–SUCH AS EPI AND DIAPHENHYDROMINE
  47. Idiosyncratic response
    –Rare & unpredicted response to medication
  48. Anaphylactic reaction
    • –Allergic reaction with life-threatening manifestations–Signs/symptoms:
    • •Swelling of airway
    • •Inability to breath
    • •Hypotension
    • •Shock
  49. Drug interaction
    • –Occurs when effects of 1 drug are modified by or interfere with effects of 2nd drug administered concurrently
    • –Result is the effect of 1 drug is increased by the 2nd–Two types occur:
    • •Those that alter plasma levels of particular medication
    • •Those that alter effects of medication
  50. INHALED MEDICATIONS
    • •USED TO DELIVER MEDICATION FOR ASTHMA
    • •ARE RAPIDLY ACTIVE, EASY TO ADMINISTER, CONVENIENT
    • •IMMEDIATELY ACT ON LUNGS & ABSORBED INTO BLOODSTREAM
    • •CAN BE GIVEN IN LIQUID FORM
  51. ORAL
    • •APPROPRIATE FOR STABLE, CHRONIC CONDITIONS
    • •MUST BE SWALLOWED
    • •TRAVEL TO THE STOMACH
    • •BROKEN DOWN
    • •ABSORBED IN INTESTINE
    • •PASSED THROUGH BLOODSTREAM
    • •DELIVERED TO SITE OF ACTION
  52. Enteral
    • •ARE ABSORBED THROUGH GI TRACT
    • •GIVEN ORALLY OR RECTALLY
    • •MUST 1ST PASS THROUGH LIVER BEFORE BEING DISTRIBUTED THROUGHOUT BODY
    • •FIRST PASS METABOLISM–DRUG IS PARTIALLY METABOLIZED–REDUCES AMOUNT OF MEDICATION AVAILABLE

    • •HAS VARIABLE RATE OF ABSORPTION
    • •POTENTIAL IRRITATION OF MUCOUS LINING OF THE STOMACH OR INTESTINE
    • •POSSIBLE PATIENT NONCOMPLIANCE
    • •MOST COMMON & SAFEST ROUTE
    • •SLOW ABSORPTION PREVENTS RAPID & HIGH BLOOD LEVELS THAT LEAD TO ADVERSE EFFECTS
    • •CONVENIENT, WITHOUT NEED FOR STERILE TECHNIQUE
  53. PARENTERAL
    • •DRUGS THAT BYPASS GI TRACT
    • •INJECTABLE MEDICATIONS – DIRECTLY INTO MUSCLE, VEIN, OR SUBCUTANEOUS TISSUE
    • •RAPIDLY AVAILABLE & CIRCULATE THROUGHOUT BODY IN MINUTES
    • •REQUIRES SPECIAL TRAINING AND/OR SPECIAL EQUIPMENT
    • •IV IS PREFERRED ROUTE FOR CARDIAC MEDICATIONS IN ALS SITUATIONS
  54. BUCAL ADMINISTRATION
    • •ADMINISTERED BETWEEN CHEEKS & GUMS
    • •RAPIDLY ABSORBED
    • •MOST COMMON: GLUCOSE GEL
  55. SUBLINGUAL ADMINISTRATION
    • •PLACED UNDER PATIENT’S TONGUE
    • •RAPIDLY ABSORBED THROUGH ORAL MUCOUS MEMBRANES
    • •MOST COMMON: NITROGLYCERIN
  56. TRANSDERMAL ADMINISTRATION
    •ACROSS THE SKIN
  57. GAS
    • •INHALED
    • •MOST COMMON – O2
    • •NITROUS OXIDE
  58. DRUG DISTRIBUTION
    • –Transportation of drug through bloodstream to various tissues & target site
    • –Factors that determine how rapidly & to what magnitude medication can accumulate in tissue:
    • •Organs that have rich blood supplies receive drug rapidly
    • •Lipid or fat-soluble drugs easily cross membranes that separate body compartments
    • •Lipid insoluble drugs take longer to cross body compartments
  59. VOLUME OF DISTRIBUTION
    • •SPACE THAT DRUG WOULD OCCUPY
    • •DRUG WITH A HIGH VOLUME OF DISTRIBUTION:
    • –IS FAT SOLUBLE
    • –CAN EASILY PASS THROUGH MEMBRANES INTO BODY COMPARTMENTS
  60. THERAPEUTICINDEX (TI)
    • –Measurement of the relative safety of drug–Factors used to determine:
    • •Effective dose 50 (ED50)
    • •Lethal dose 50 (LD50)
    • •Calculated as follows:–TI = LD50/ED50
  61. DRUG/RECEPTOR INTERACTIONS
    • –Drugs have complex shapes
    • –Drugs bind to a receptor
    • –Combined drug/receptor interaction then allows drug to act on target tissue
    • - LIKE 2 POLAR MAGNETS
    • –Reversible binding
    • •Occurs when drug is able to separate from cell’s receptor
    • •When drug is removed from receptor, effect of drug stops–Irreversible binding
    • •Some medications are unable to separate from receptor once they bind to receptor
  62. Agonist
    •Drug that produces desired physiologic effect upon binding with receptor- Turn things on
  63. Antagonist
    • •Drug that diminishes or eradicates physiologic effect of agonist- Turn things off
    • •Competitive antagonists–Can bind to the receptor in a reversible fashion
    • •Noncompetitive antagonist–Irreversibly binds to the receptor

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