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What is Pharmacology?
What is Pharmacology?
The study of the effects of drugs on the function of living systems.
What is a Pharmacist?
What is a Pharmacist?
The person that prepares, makes, and dispenses drugs as ordered by a physician/dentist.
Define Medication.
Define Medication.
Chemical compound / substance for administered for diagnosis, prevention, cure, treatment or relief of a symptom or for prevention of disease.
What is a Prescription?
What is a Prescription?
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Which of these is NOT a drug name?
Which of these is NOT a drug name?
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What is a Chemical name?
What is a Chemical name?
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What is a Generic name?
What is a Generic name?
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What is Brand/Proprietary name?
What is Brand/Proprietary name?
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What is a Therapeutic effect?
What is a Therapeutic effect?
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Which type of drug relieves symptoms of diseases but does not affect the disease itself?
Which type of drug relieves symptoms of diseases but does not affect the disease itself?
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Which type of drug cures a disease or condition?
Which type of drug cures a disease or condition?
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Which type of drug supports body function until other treatments or the body's response can take over?
Which type of drug supports body function until other treatments or the body's response can take over?
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Which type of drug replaces body fluids or substances?
Which type of drug replaces body fluids or substances?
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Which type of drug destroys malignant cells?
Which type of drug destroys malignant cells?
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Which type of drug returns the body to health?
Which type of drug returns the body to health?
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Side effects are always predictable.
Side effects are always predictable.
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An adverse drug reaction is always mild and does not require medical attention.
An adverse drug reaction is always mild and does not require medical attention.
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Secondary effects always have a negative impact on the body.
Secondary effects always have a negative impact on the body.
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What does 'augmented reactions' mean?
What does 'augmented reactions' mean?
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What does 'drug toxicity' mean?
What does 'drug toxicity' mean?
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A patient with hypersensitivity will always have a lower-than-expected blood concentration level.
A patient with hypersensitivity will always have a lower-than-expected blood concentration level.
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What is a cumulative effect?
What is a cumulative effect?
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To avoid toxic reactions, it's essential to know the patient's profile.
To avoid toxic reactions, it's essential to know the patient's profile.
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Overdosing on a medication is always intentional.
Overdosing on a medication is always intentional.
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Iatrogenic effects are always intentional.
Iatrogenic effects are always intentional.
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Drug allergy is a hypersensitivity reaction that involves the immune system.
Drug allergy is a hypersensitivity reaction that involves the immune system.
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Anaphylactic reactions to drugs are always mild and do not require immediate medical attention.
Anaphylactic reactions to drugs are always mild and do not require immediate medical attention.
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Idiosyncratic effects are predictable and expected responses to a drug.
Idiosyncratic effects are predictable and expected responses to a drug.
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Drug dependence can be psychological or physiological.
Drug dependence can be psychological or physiological.
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Drug tolerance always leads to a complete loss of drug effect.
Drug tolerance always leads to a complete loss of drug effect.
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Tachyphylaxis is a rapid decrease in drug effect that occurs over a long period of time.
Tachyphylaxis is a rapid decrease in drug effect that occurs over a long period of time.
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Drug resistance is primarily associated with antibiotics and is not a concern with other types of drugs.
Drug resistance is primarily associated with antibiotics and is not a concern with other types of drugs.
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Drug interactions can only occur between two drugs.
Drug interactions can only occur between two drugs.
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Grapefruit juice can inhibit the metabolism of certain drugs, potentially increasing the risk of side effects.
Grapefruit juice can inhibit the metabolism of certain drugs, potentially increasing the risk of side effects.
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Pharmacokinetics refers to the study of how the body affects a drug.
Pharmacokinetics refers to the study of how the body affects a drug.
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Pharmacodynamics refers to the study of how a drug affects the body.
Pharmacodynamics refers to the study of how a drug affects the body.
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The primary site for drug metabolism is the kidneys.
The primary site for drug metabolism is the kidneys.
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The first-pass effect refers to the process where an oral drug is metabolized by the liver before entering the systemic circulation.
The first-pass effect refers to the process where an oral drug is metabolized by the liver before entering the systemic circulation.
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Intravenous administration is the safest route for all medications, as it bypasses the first-pass effect.
Intravenous administration is the safest route for all medications, as it bypasses the first-pass effect.
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The time course for ADME (Absorption, Distribution, Metabolism, Excretion) is always consistent across all individuals.
The time course for ADME (Absorption, Distribution, Metabolism, Excretion) is always consistent across all individuals.
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Drug half-life is the amount of time it takes for half of the drug to be eliminated from the body.
Drug half-life is the amount of time it takes for half of the drug to be eliminated from the body.
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A drug given as a single dose will be completely eliminated from the body after 3-4 half-lives.
A drug given as a single dose will be completely eliminated from the body after 3-4 half-lives.
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Drugs with shorter half-lives tend to have longer durations of action.
Drugs with shorter half-lives tend to have longer durations of action.
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Steady state occurs when the rate of drug administration equals the rate of drug elimination.
Steady state occurs when the rate of drug administration equals the rate of drug elimination.
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Loading doses are typically used to quickly achieve the desired therapeutic effect of a drug.
Loading doses are typically used to quickly achieve the desired therapeutic effect of a drug.
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Infusion pumps deliver medication in units of milligrams per hour (mg/hr).
Infusion pumps deliver medication in units of milligrams per hour (mg/hr).
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When converting between units, it is crucial to ensure that the units are the same.
When converting between units, it is crucial to ensure that the units are the same.
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When splitting tablets, it is not necessary to check if the tablet is scored.
When splitting tablets, it is not necessary to check if the tablet is scored.
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Rounding dosage numbers is always acceptable and does not impact patient safety.
Rounding dosage numbers is always acceptable and does not impact patient safety.
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Receptors are always located on the surface of cells.
Receptors are always located on the surface of cells.
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Agonists are drugs that enhance the activity of a receptor, while antagonists block or inhibit receptor activity.
Agonists are drugs that enhance the activity of a receptor, while antagonists block or inhibit receptor activity.
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The binding of agonists to receptors is always irreversible.
The binding of agonists to receptors is always irreversible.
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Noncompetitive antagonists bind to the same site as the natural ligand, preventing its binding.
Noncompetitive antagonists bind to the same site as the natural ligand, preventing its binding.
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Irreversible antagonists have a short duration of action because they are quickly removed from the body.
Irreversible antagonists have a short duration of action because they are quickly removed from the body.
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Drug excretion is the process by which the body removes drugs from its system.
Drug excretion is the process by which the body removes drugs from its system.
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The kidneys are the only organs involved in drug excretion.
The kidneys are the only organs involved in drug excretion.
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Drug excretion rates are always constant and do not vary based on individual factors.
Drug excretion rates are always constant and do not vary based on individual factors.
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Study Notes
Basic Concept
- Drug Names:
- Chemical names: Describe drug structures (atomic/molecular structure, functional groups). Rarely used in clinical practice.
- Generic names: Assigned by manufacturers (regulatory approval). Used globally throughout the drug's lifetime. Each drug has only one generic name.
- Brand names/Trade names/proprietary names: Usually short and easy to remember. One drug can have several brand names from different companies.
- Drug Effects:
- Therapeutic effect: Expected outcome (desired effect).
- Side effect: Unintended, typically predictable. Range from mild to severe.
- Adverse drug reactions: Harmful and undesirable responses to medications.
- Drug allergy: Abnormal immune response to a drug. Symptoms can appear within minutes to 2 weeks after administration.
- Drug Interactions:
- Effects of drugs on each other or with food/supplements.
- Can affect the action of one or both drugs (beneficial or harmful).
Overview
- Pharmacology: Study of drug effects on living systems.
- Pharmacy: Place for preparing, compounding, and dispensing drugs.
- Pharmacist: Person who prepares, makes, and dispenses drugs as ordered by a physician/dentist.
- Medication: Chemical compound/substance used for diagnosis, prevention, cure, treatment, or symptom relief/prevention of disease.
- Prescription: Written instructions for drug preparation and administration (by a professional).
Drug Effects- Therapeutic
- Palliative: Relieves symptoms without affecting the disease itself.
- Curative: Cures a disease or condition.
- Supportive: Supports body function until other treatments take over.
- Substitutive: Replaces body fluids or substances.
- Chemotherapeutic: Destroys malignant cells.
- Restorative: Returns the body to health.
Drug Effects - Side Effects & Adverse Reactions
- Side effect: Unintended, usually predictable, ranging from mild to severe.
- Adverse drug reactions: Harmful and undesirable responses.
- Secondary effects: Additional effects (can be beneficial or harmful).
More Terms
- Augmented reactions (drug toxicity): Patient with altered pharmacokinetics (absorption, metabolism, and excretion) may have higher-than-expected drug concentration levels.
- Increased receptor sensitivity: Increased patient's response to therapeutic or adverse effects or impaired metabolism/excretion.
- Cumulative effect: Increased response to repeated doses of a drug when the rate of administration exceeds the metabolism/excretion.
- Overdose: Excessive dose, intentionally or accidentally.
- Iatrogenic effects/disease: Unintended effects from medical treatment or drug therapy (e.g., aspirin-induced GI irritation or bleeding).
- Drug Allergy: Abnormal immune response to a drug resulting in various symptoms, ranging from mild to severe.
Drug Allergy
- Hypersensitivity: Abnormal response from an immunologic reaction to a drug.
- Symptoms: Can appear in minutes to a few weeks, often identifiable by allergic history and related symptoms.
- Severe reactions: Life-threatening, possibly fatal reactions such as wheezing, dyspnea, swelling of respiratory tissue, acute hypotension, and tachycardia.
- Mild reactions: Skin rash/urticaria, itching, angioedema, diarrhea, vomiting.
What Nurses MUST DO?
- Check patient's allergy status.
- Properly monitor the drug's effect on the patient.
- Evaluate drug effects and side effects.
- Identify potential drug allergies.
- Provide pertinent patient education on their medication profile.
Drug Effects - Adverse Reactions
- Idiosyncratic effect: Unexpected, unexplained, abnormal response to a drug, sometimes due to genetics.
- Examples: Stevens-Johnson syndrome (SJS).
- Dependence:
- Physiological dependence (biochemical changes): Body tissues become dependent on the drug for normal functioning and require the substance. Drug cessation leads to withdrawal symptoms.
- Psychological dependence (emotional reliance): emotional reliance to maintain well-being, accompanied by needs or cravings for the drug.
- Loss of drug effect
- Drug tolerance: Gradual decrease in responsiveness to a drug with time; increased dosage needed for similar response.
- Tachyphylaxis: Rapid decrease in responsiveness to a drug with repeated doses.
- Drug resistance: Loss of drug effect due to repeated use over time; usually observed with antibiotics.
Drug Interactions
- Interactions between drugs, food, or other supplements.
- Possible effects: Decrease or increase drug action, cause adverse effects.
Drugs-Food Interactions Example
- Milk interferes with the absorption of tetracycline antibiotics.
Drug Interactions - Grapefruit Juice
- Grapefruit juice contains furanocoumarins.
- Inhibits the cytochrome CYP3A4 enzyme in the liver.
- Decreases metabolism of some drugs.
- Increases the risk of developing side effects.
How to Prevent Drug Interactions
- Use appropriate monitoring.
- Identify potential drug interactions and allergies early.
- Provide patient education
Pharmaco-kinetics vs. Pharmacodynamics
- Pharmaco-kinetics: What the body does to the drug (movement).
- Absorption
- Distribution
- Metabolism
- Excretion (ADME)
- Pharmaco-dynamics: What the drug does to the body (effects).
- Efficacy
- Toxicity
Pharmaco-kinetics
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Absorption: Process of drugs entering the bloodstream.
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Distribution: Movement of drugs throughout the body.
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Metabolism: Biotransformation of drugs in the body.
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Excretion: Removal of drugs and metabolites from the body.
Why Absorption, Distribution, Metabolism, and Excretion Important?
- Understand time required for these processes.
- Drug type, individual health, and other factors can affect these processes.
ADME- Absorption
- Process by which a drug enters the bloodstream
- Requires crossing semipermeable cell membranes
- Types of drug absorption: Passive diffusion, Facilitated diffusion, Active transport, Endocytosis.
ADME- Distribution
- Transportation of a drug from its absorption site to its site of action
- Determined by factors like:
- Blood flow: Organs (brain, liver, kidneys) with high blood flow receive large amounts of drug quickly. Low blood flow organs receive drug later.
- Solubility: Drugs that are lipid soluble accumulate in fatty tissue. Drugs that are water-soluble bind to plasma proteins.
ADME- Metabolism
- Liver, primarily via CYP450 enzymes, chemically alters drugs.
- Convert pro-drugs to active form or inactive forms.
- Metabolites may require further metabolism.
- Metabolites are eventually excreted from the body.
ADME - Excretion
- Removal of drugs and metabolites from the body.
- Most important route is renal excretion.
- Other ways: sweat, breast milk, and lungs.
Drug Administration Routes
- Oral (PO)
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Buccal
- Sublingual (SL)
- Rectal (PR)
- Inhalation
- Topical
- Transdermal (TD).
Drug Absorption (oral-limitations)
- Rate of absorption varies.
- Food can delay dissolution and absorption.
- Acid medium in the stomach varies.
- Some drugs don't dissolve well in GI fluids.
Drug Absorption (oral, intravenous, intramuscular, subcutaneous, rectal)
- Advantages and disadvantages for each route.
- IV is rapid, 100% bioavailability.
- IM is faster than oral and gives larger amounts.
- Oral has a lot of variability in drug absorbtion and is frequently used.
What Nurses Do - Bioavailability
- Alert for suitable routes
- Monitor liver function tests (important regarding metabolism)
- Monitor renal function tests (important for excretion).
Drug Half-life
- Time required for drug concentration to decrease by 50%.
- Factors affecting half-life: Rate of absorption, metabolism, and excretion rates.
- Determine dosage frequency.
Steady State
- Rate of drug availability equals rate of drug elimination from the body.
- Takes four to five regular doses to reach steady state.
- Crucial, consistent drug concentration for effective symptom management.
Loading Dose and Maintenance Dose
- Loading dose: Higher initial dose to quickly reach the therapeutic threshold.
- Maintenance dose: Subsequent doses to maintain therapeutic plasma concentration of the drug.
Basic Concepts Of Pharmacodynamics
- Receptor and non-receptor mechanisms
- Agonists: Drugs that activate receptors (similar to "natural ligand").
- Complete agonists
- Partial agonists
- Inverse agonists
- Antagonists: Drugs that block receptors.
- Competitive antagonists
- Non-competitive antagonist
- Competitive antagonists
Receptor and Non-receptor Mechanisms
- Receptor: Drug's specific target ("lock and key").
- Binding is reversible
- Drug action terminates once the drug leaves the receptor.
- Types of receptors: Ion channel, G protein-coupled, Enzyme-linked.
Dosage Calculation (Examples)
- Converting units (pounds to kilograms, grams to milligrams, etc.).
- Universal Formula: Dose = (Desired amount) x (Quantity) / (Amount on hand)
- Ratio and proportion (calculate amounts based on ratios)
- Incorporating body weight in dosage calculation.
- Infusion pump settings (mcg/kg/min).
SMART Nursing Tips
- Capsule cannot be divided.
- Some drugs cannot be chewed/cut.
- Proper drug dispensing tools and techniques.
- Correct rounding of dosage numbers.
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