Midterms Review- Introduction to Pharmacology PDF

Midterms Review Gianina Concha R. Limbo, M.D.. St. Luke’s College of Nursing Introduction to Pharmacology  History of Pharmacology Stone Ages Ancient Times Middle Ages Renaissance Alchohol – Hippocrates *Medical care Paracelsus – n...

Midterms Review Gianina Concha R. Limbo, M.D.. St. Luke’s College of Nursing Introduction to Pharmacology  History of Pharmacology Stone Ages Ancient Times Middle Ages Renaissance Alchohol – Hippocrates *Medical care Paracelsus – nutrition, – Inorganic taken over by challenged medicine and salts as the Church. Galenic rituals medications. medicine. He Medicine also promoted Primitive men – Galen – became a use of recognized the dogmatic matter of faith chemicals and benefits/toxic approach to and minerals (zinc) effects of plants medicine prescriptions in medicine. and animal became materials prayers.  History of Pharmacology 18th Century 19th Century 20th Century 21st Century Francois Magendie American Civil By the early 1900’s, Rapid growth of & Claude Bernard War – morphine there were an information and – Experimental use estimated 250,000 understanding of Physiology & addicts in the United the molecular Pharmacology. Morphine, States. basis for drug laudanum, action Simultaneous cocaine, heroin Various US laws has developments in were completely been established to botany, zoology, unregulated and address drug addiction chemistry & prescribed freely physiology. by the physicians Nutritional for a wide deficiencies has variety of been addressed ailments. Numerous vaccine discoveries  Pioneers of Pharmacology Edward Jenner-developed smallpox vaccine. Oswald Schmiedeberg- Founder of Modern Pharmacology Felix Hoffman-Developed aspirin Carl Koller-suggested that vitamins are essential to health Photo from: https://phil.cdc.gov/details.aspx?pid=3265  Pioneers of Pharmacology Carl Koller-introduced cocaine as a local anesthetic into surgical procedures. Sir Frederick Gowland Hopkins- vitamins essential to health Edward Mellanby- discovered vitamin D and showed that its absence causes rickets. Photo from: https://phil.cdc.gov/details.aspx?pid=3265  Pioneers of Pharmacology Sir Alexander Fleming discovered penicillin Selman A. Waksman discovers the antibiotic streptomycin Jonas Salk developed the first polio vaccine. Frederick Banting and Charles Best discovered insulin Fidel Pagés pioneered epidural anesthesia Photo from: https://phil.cdc.gov/details.aspx?pid=3265  Drug Regulations Pure Food and Drug Act of 1906 Harrison Narcotic Act of 1914 Surgeon General Warning Comprehensive Drug Abuse Prevention and Control Act of 1970 Anti-Drug Abuse Acts of 1986 and 1988 Drug Regulations RA 9165 EO 218 RA 10640 *RA 6675-Generics Act of 1988 RA 9502  3 Phases of Drug Action Photo from: Pharmacology: A Patient-Centered Nursing Process Approach (L) 9th ed, c2019 by Kee/Hayes Disintegration Vs. Dissolution Photo from: Pharmacology: A Patient-Centered Nursing Process Approach (L) 9th ed, c2019 by Kee/Hayes Disintegration Dissolution Breakdown of tablet Dissolving of into smaller smaller particles in particles the GIT  Half-life (t ½) Time it takes for one-half of the drug concentration to be eliminated Takes approximately six half-lives for a drug to be eliminated around 98%  *Non-specific Drug Effects Drugs that affect multiple receptor sites Photo from: Pharmacology: A Patient-Centered Nursing Process Approach (L) 9th ed, c2019 by Kee/Hayes  *Non-selective Drug Effect Drugs that affect multiple receptor Photo from: Pharmacology: A Patient-Centered Nursing Process Approach (L) 9th ed, c2019 by Kee/Hayes Side Effects Vs Adverse Effects Side Effects Adverse Effects Physiologic effects Range of not related to untoward effects desired drug of drugs that may effects, which can cause mild to be desirable or severe side undesirable effects, these are always undesirable  Placebo Effect Beneficial effect that cannot be attributed to the properties of the placebo itself and must therefore be due to the patient's belief in that treatment. Causes of Therapeutic Failure Poor Compliance Quality of Drugs Factors affecting Inappropriate Biotransformation Indication Factors affecting Untoward effects Bioavailability Drug Interactions Drug Tolerance ANS  Autonomic Nervous System Sympathetic Parasympathetic Nervous System Nervous System Adrenergic* Cholinergic* System System Photo from: Pharmacology: A Patient-Centered Nursing Process Approach (L) 9th ed, c2019 by Kee/Hayes Types of Receptor Drugs Agonist Antagonist Selective Non- Selective  Adrenergic Agonists AKA sympathomimetic, catecholamines* Drugs that stimulate the adrenergic receptors to mimic sympathetic effect *Catecholamines – hormones produced by the adrenal glands Photo from: Pharmacology for Nurses, A Pathophysiological Approach, 4th Edition by Michael Adams  Adrenergics Antagonists AKA symphatolytics, adrenergic blockers Action: drugs that block effects of neurotransmitters in adrenergic receptor sites Directly: by occupying receptors Indirectly: by inhibiting release of neurotransmitters epinephrine and norepinephrine Photo from: Pharmacology for Nurses, A Pathophysiological Approach, 4th Edition by Michael Adams Cholinergic Agonists AKA parasympathomimetics, cholinomimetics, cholinergic stimulants Drugs that stimulate cholinergic receptors, mimicking the action of acetylcholine  Glaucoma Cholinergic Atonic bladder* Post-op and postpartum urine Agonists: retention Indications Abdominal distension and GI atony Salivary gland hypofunction Photo from: Pharmacology for Nurses, A Pathophysiological Approach, 4th Edition by Michael Adams Cholinergic Antagonists AKA parasympatholytics, anticholinergics, cholinergic blockers Action: Inhibit action of ACh by occupying Photo from: Pharmacology: A Patient-Centered Nursing Process ACh receptors Approach (L) 9th ed, c2019 by Kee/Hayes Photo from: Pharmacology for Nurses, A Pathophysiological Approach, 4th Edition by Michael Adams CNS  Arachidonic Acid Pathway Arachidonic acids released from phospholipids in cell membrane from the event/injury and metabolized by either prostaglandin (PG) pathway or leukotriene (LT) pathway. Prostaglandin – induces inflammation and promotes alteration in vascular responses Types of CNS Stimulants Amphetamines Analeptics Anorexiants Examples of Amphetamines ADHD Narcolepsy Methamphetamine Modafinil (Provigil) (Desoxyn) Pemoline (Cylert) Amphetamine (Adderall) Dextroamphetamine (Dexedrine) Methylphenidate (Concerta, Ritalin)  Examples of Analeptics Methylxanthines Aminophylline NoDoz Theophylline Caffeine Doxapram (Dopram)  Anorexiants Action: suppress the appetite control center in the brain Indication: obesity Ex. Phentermine, Benzphetamine, Buproprion Classifications of CNS Depressants Barbiturates Benzodiazepines Non- benzodiazepines  Types of Barbiturates Ultrashort-acting Used as a general anesthetic Ex. thiopental sodium (Pentothal) Short-acting Induce sleep, controls convulsion, and no residual drowsiness Ex. pentobarbital (Nembutal), secobarbital (Seconal)  Types of Barbiturates Intermediate-acting Induce and sustain sleep, for convulsion, but causes residual drowsiness (hangover effect) Ex. amobarbital (Amytal), butabarbital (Butisol) Long-acting Used to control seizures Ex. phenobarbital  Non-benzodiazepines Action: neurotransmitter inhibition Indication: treat short-term (