LM 1 Intro to Pharm & Patho PDF

Learning Module 1 – Intro to Pharmacology & Pathophysiology NUR 370 Rebecca Young, MS, RN, CCRN  Learning Objectives By the end of this module, you will be able to: 1. Summarize the nurse’s multifaceted role encompassing drug administration, prioritizing...

Learning Module 1 – Intro to Pharmacology & Pathophysiology NUR 370 Rebecca Young, MS, RN, CCRN  Learning Objectives By the end of this module, you will be able to: 1. Summarize the nurse’s multifaceted role encompassing drug administration, prioritizing patient safety, and fulfilling educational responsibilities in pharmaceutical and non-pharmaceutical therapies. 2. Describe the mechanism of action, indications(s), and expected/unexpected outcomes of medications and the drug approval process (Pharmacokinetics/pharmacodynamics) 3. Differentiate between normal and abnormal anatomy of cells and tissues 4. Describe the cell cycle and strategies to prevent/protect the cells within the human body. 2  What is Pharmacology? The study of biological effects of chemicals 3  Clinical Pharmacology What are the drug’s effects on the body? What is the body’s response to the drug? Role of the nurse: Administration Assessment of effects Interventions Client education Prevention of medication errors 4 Drug Evaluation and Approval Regulated by the Food and Drug Administration (FDA) Preclinical Trials o No human participants o Must have a large enough safety margin 4 Phases of Drug Trials o Phase 1: Uses human participants – test safety, dosage, and effects o Phase 2: Study the drug in clients with the specific disease the drug is intended to treat o Phase 3: Increase the sample size of clients treated o Phase 4: Continually evaluated 5 Phases of Drug Development 6  Drug Names Trade name: Also referred to as “brand name”, given by the pharmaceutical company who first markets the drug o Capitalized, above generic name Generic name: original drug name at start of drug approval process o Cost less o Same active ingredients o May have different inactive ingredients 7  Pharmacodynamics How do the chemicals in the body interact with foreign chemicals that enter the body? Receptor sites: sensitivity of receptors or amount/duration of chemical that acts on receptors o Affects enzyme systems within the cell Drugs work by: o Replacing/substituting a missing chemical o Increasing/stimulating cellular activity o Depressing/slowing cellular activity o Interfering with the function of foreign cells 8  Pharmacokinetics How do drugs travel through the body? o Absorption o Distribution o Metabolism o Excretion How concentrated the drug is in the body is dependent on these 4 factors Ensure we have the right dose and frequency 9  Question Which route of administration of a drug is the fastest? A. Oral B. Subcutaneous C. Intravenous D. Intramuscular 10  Pharmacokinetics Absorption: time it takes for a drug to reach the circulating fluids (blood) and tissues GI tract, skin, mucous membranes, veins, lungs, muscle, subcutaneous tissue Route impacts the speed and amount of absorption o Oral drugs have many barriers, IV drugs have no barriers 11  Pharmacokinetics Distribution: Movement of drug to body tissues Tissue perfusion Protein binding o Tightly bound: act slowly, slow release into bloodstream o Loosely bound: act quickly, quick release into bloodstream o If a drug is bound, it cannot be used by the body Cell membrane permeability 12  Pharmacokinetics Metabolism: Conversion of drugs into nontoxic substances Liver is the main site of drug metabolism o Processes drugs to be less active and more easily excreted o If a client has liver damage, often given lower doses of drugs to prevent toxicity o Certain drugs can cause liver damage, therefore impacting metabolism: acetaminophen First-pass effect: decrease in an oral drug’s concentration in circulation 13  Pharmacokinetics Excretion: elimination of drugs from the body Kidneys are the main site, though skin, saliva, lungs, bile, stool also play a role Monitor clients with kidney Feces Bile Urine damage for toxic effects of drugs: drugs will build up in the body 14 Pharmacokinetics Summary 15  Pharmacodynamics vs. Pharmacokinetics 16  Question What factors can influence drug effects? Weight Environmental factors Age Tolerance Sex Accumulation Physiological factors Interactions Drug-drug or Drug-Alternative Therapy Pathological factors Interactions Drug-Food Interactions Drug-Laboratory Test Interactions Genetic factors Immunological factors Psychological factors 17  Other Drug Considerations Pregnancy categories: potential or actual teratogenic effect of the drug Herbal therapies: not regulated by the FDA Vitamins, minerals, herbs Can cause significant interactions with other drug therapy: supratherapeutic vs. subtherapeutic Not all ingredients are known 18  Other Drug Considerations Over-the-counter (OTC) medications Do not need a prescription (acetaminophen, aspirin, etc.) Can contribute to drug interactions or interfere with other drug therapy Can mask symptoms of disease Easy to overdose Ask your client specifically!!! 19  Nursing Role in Drug Therapy Right Right client medication Right dose Right route Right Right Right time Right storage documentation preparation 20  Basics of the Cell Basic structural unit of the body that forms tissues and organs Structures of a cell Nucleus: contains DNA and RNA Cell membrane: keeps cell intact, maintains homeostasis Cytoplasm: Site of cellular metabolism, contains organelles Organelles: specific functions – produce proteins and energy 21  Homeostasis: The Cell’s Main Goal! Cell needs a way to get substances in as well as get rid of waste/toxins Cell membrane plays a large role Receptor sites: protein that reacts with chemical to create a reaction inside the cell Surface antigens (histocompatibility antigens): proteins that determine self vs. non-self Channels: pores in the cell membrane that allow ions and water in and out of the cell 22  Movement Across the Cell Membrane No Energy Expended Facilitated Diffusion: Osmosis: water (solvent) Diffusion: solute solute moves through moves from higher moves from higher to lower protein channels or water concentration or water to lower carriers. Carriers will concentration moves from lower to higher transport and release solute concentration; solute inside the membrane. stays Higher to lower concentration 23  Movement Across the Cell Membrane Active transport: energy required to move contents across the concentration gradient Moves substances from low to high concentration Normal cell function needs high intracellular concentration of K+ and low intracellular concentration of Na+ to be electrically charged 24  Question Which phase is the resting phase of the cell cycle? 1. S 2. G1 3. G0 4. M 5. G2 25  The Cell Cycle Cells reproduce through mitosis: hours to months Four active phases: G1, S, G2, M One resting phase: G0 G0: resting phase, cell is stable G1: cells stimulated to begin reproduction S: synthesis, DNA made and doubled G2: gathers material to help with mitosis M phase: cell divides, 2 daughter cells formed 26  Tissue Types Groups of cells that work together form tissues Epithelial: covers the body, lines body surfaces, forms glands Connective/Supportive: binds to or supports structures tendons, ligaments, dermis, adipose, blood Nervous: communication neurons and supporting cells Muscle: movement, changes shape of organs skeletal, cardiac, smooth 27  Cellular Adaptation Any change in environment may cause cells to change in shape, number, or type: threat, workload changes. Cell should resume its normal function once stimulus stops Atrophy, hypertrophy, hyperplasia, metaplasia, dysplasia 28  Cellular Adaptation Atrophy: decrease in cell size due to decrease in workload or threatened environment Decrease to more efficient size while still allowing survival: less oxygen and energy requirements Apoptosis can occur: programmed cell death Hypertrophy: increase in cell size and tissue mass due to increased workload Often seen in muscle: healthy weight lifting, unhealthy-thickened cardiac muscle Hyperplasia: increase in number of cells Breast and uterus enlargement during pregnancy Liver regrows when lobe removed 29  Cellular Adaptation Metaplasia: epithelial cells are replaced by other epithelial cells, to attempt to survive chronic irritation or inflammation Reprogramming of undifferentiated stem cells Smoking Reversible once irritant is removed Dysplasia: Change in shape, size, and organization related to chronic irritation or inflammation Potentially reversible once irritant is removed Cervical cell changes, precursor to some cancers 30  Apoptosis Regulates number of cells in a tissue through programmed cell death Eliminates injured or old cells, destroyed by phagocytosis Roles: embryo development, cytotoxic T cells, immune cell death, destruction of replicating tissues If it is inhibited, leads to cancer and autoimmune disease Some drugs may aid in apoptosis 31 32