Pharmacology Basics: Pharm, Cardio & Monitoring

Basic Pharm

• Pharmacokinetics involves four processes: absorption, distribution, metabolism, and excretion.
• Bioavailability is the proportion of a drug that enters the bloodstream and has an active effect.
• The first-pass effect is the metabolism of a drug in the liver after it's taken, reducing its bioavailability.
• Highly protein-bound drugs can become toxic if protein levels are low, as they remain in the body longer.
• Drug metabolism involves chemically altering drugs in the liver so they can be excreted.

Cardio

• Symptoms of right-sided heart failure include swelling, shortness of breath, and weight gain.
• Side effects of ACE inhibitors include dry cough, low blood pressure, and high potassium levels.
• Cardiac glycosides work by inhibiting sodium-potassium pumps in heart muscle cells, treating heart failure and atrial fibrillation. Monitoring is crucial for toxicity, which can manifest in various ways.

Lab Monitoring & Antidotes

• Coumadin is monitored by PT and INR and Vitamin K is the antidote.
• Heparin is monitored by aPTT and protamine sulfate is the antidote.

Gastro

• Nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided or used cautiously due to potential gastric ulcers.
• Antacids should be separated by 1-2 hours from other medications.
• Histamine H2 blockers' effectiveness can be reduced by smoking, increasing acid production.

Respiratory

• First-generation antihistamines can cause drowsiness and reduced coordination.
• Fluticasone (Flovent) should be used regularly, even without symptoms, and users should report any skin rashes.
• Medications can target smooth muscle, submucosa, fibroblasts, and the mucosa basement membrane.
• Systemic corticosteroids have short-term and long-term side effects including increased medication use, withdrawal syndrome, insomnia, elevated blood pressure, and infections.

CNS

• Narcan (Naloxone) is used to treat opioid overdoses.
• NSAIDs are used for pain relief, fever reduction, and inflammation (including reducing the risk of stroke and blood clots). Aspirin has additional blood clotting benefits.
• Acetaminophen (Tylenol) is an analgesic, with a limit of 3000 mg daily. Liver damage is a major concern at higher doses.
• Antiepileptic drugs can cause drowsiness, mood changes, and gum swelling

Autonomic NS

• Beta-1 receptors are in the heart, and beta-2 receptors are in the lungs. Blocking these receptors affects heart rate, blood pressure, and lung function .
• The sympathetic nervous system increases heart rate and blood pressure, and causes bronchodilation. The parasympathetic nervous system does the reverse.