Intro to Pharma-patho Medication (NUPN 1010, Winter 2025) - PDF

Intro to Pharmacology, Pathophysiology & Medication Administration Concepts Pharmacokinetics / Pharmacodynamics NUPN 1010 Winter 2025 Answer questions and return it back to your instructor Quiz Time Class Objectives CSLO16- Explore and identify basic pharm...

Intro to Pharmacology, Pathophysiology & Medication Administration Concepts Pharmacokinetics / Pharmacodynamics NUPN 1010 Winter 2025 Answer questions and return it back to your instructor Quiz Time Class Objectives CSLO16- Explore and identify basic pharmacological terms CSLO17-Define and describe medication classifications CSLO18-Explore and articulating Pharmacokinetic process CSLO19-Explore and articulating Pharmacodynamic of medications CSLO20-Distinguish varies medications names  Lewis, S.L., et al (2019) ; Potter, P. A., Perry, A. G., et al (2019). Chapter 34 P: 728-756 Reading Requirements Recommended: Holland, L., Adams, M.P., Brice, J.L. (2015) p.3-5; 15-21  Pharmacology: The study of medication/drugs What does it mean? In Greek: Pharmakon → Medicine Logos → Study Medications are Chemical products that produce Pharmacology and biologic responses within the body to medication treat/prevent diseases What is the use of medication/drugs? Prevent Diagnose Treat diseases or health conditions  Medicines classification 1- Traditional Drugs: Synthetically produced in laboratory Routinely prescribed and administered by health care workers 2- Biologics: Naturally produced by the people body, animal cells, or in microorganism Routinely prescribed and administered by health care workers 3- Natural Alternative therapies: Naturally produced (Herbs, vitamins, minerals, or dietary supplements). Manipulative and body-based practices Physical therapy Massage Hypnosis Acupuncture…  Drug names Chemical, trade, generic, Medication have more than one name Therapeutic Classification Pharmacological How they work pharmacologically, Concepts preferred effect Medication forms Solid, liquid, topical, instillation into body cavities, parenteral  Drug names Chemical Name: named because of their chemical structure and components E.g., (RS)-2-(4-(2-methylpropyl phenyl) propanoic acid or Sodium Chloride Generic Name: Only one name, use worldwide, e.g., Ibuprofen Trade Name: (Brand name or Proprietary): Manufacturers markets the medications. E.g., Advil , Motrin Therapeutic Classification Medications organized by their therapeutic effect on: Mechanism of action on body The desired effect E.G.,: Non steroid Anti-inflammatory (NSAID): Ibuprofen, Diclofenac Anti-infective: Penicillin Immunostimulant: Vaccines Immunosuppressants: Cyclosporine Nonopioid Analgesics: Acetaminophen Opioid Analgesics: Fentanyl Medication Forms/Availability Solid, Tablets and Capsules( the most common forms) Liquid, Syrups, Dops, Topical, ointments Transdermal (patches) parenteral, (ampule, Vials) instillation into body cavities (suppositories) Inhalation, Spray, What are the trade/generic Names Class Activity What does happen when we take medication? How does the body change the medication? Pharmacokinetics (movement of medication) How does the medication change the body? Pharmacodynamics(change in body under force)  Definition: The study of how medications enter Pharmacokinetics the body, reach their site of action, metabolize, and exit the body. Putting it all together Video (3.47 min): https://www.youtube.com/watch?v=Jiml3iGBs88 Pharmacokinetics: How body changes the medication? Absorption Distribution Metabolism Excretion Billat, et al., (2017) Pharmacokinetics : Absorption Billat, et al., (2017) Drugs move across one or more body The first step how membranes → From the body handles a site of administration dug. to the blood → Reach target cells Factors influencing Absorption: Route of administration (Po vs. IV) Ability for the medication to dissolve (pill vs. liquid) PH: Lower=more absorption Stomach content (Food in stomach will slow down absorption Blood flow to the site of administration Body surface area (stomach vs. intestine) Lipid solubility of the medication (more solubility=more absorption by cells)  Pharmacokinetics : Absorption Distribution Metabolism Excretion Billat, et al., (2017)  Pharmacokinetics : Distribution Transportation to target cells What factors can influence distribution: Circulation Membrane permeability Anatomic barriers: Blood brain barrier, blood placenta barrier, blood testicular barrier. Protein Binding: Degree of binding to serum protein (Albumin) Low albumin (elderly; malnutrition; liver alterations) at risk of increase meds activities/toxicity. Bioavailability: How much medication will be available after administration to produce a biological effect The proportion of drug that enters the circulation and has active effect  Absorption Distribution Metabolism Excretion Billat, et al., (2017) Pharmacokinetics Metabolism Liver is the main site Metabolize to less active/ inactive form to be easily removed from the body Biotransformation: Detoxification, breakdown and removal of biologically active chemical Where Biotransformation of medications occurs? Liver (#1) → Specialized structures oxidizes and transforms many toxic substances/harmful chemicals Others: Lungs, kidneys, blood and intestines Prodrugs: Medications that require metabolism to make them active (e.g., Sulfasalazine)  Pharmacokinetics : Metabolism Factors influencing metabolism: First pass effect Substances that absorbed through Intestinal wall to blood vessels(hepatic portal circulation) →liver → metabolize the drug, less active (can inactivate more than 90%) In some, metabolize can be slowly or quickly Age Genetics Gender BMI Potter, P.A., Perry, A.G., et al. (2019) Kidney disease Liver disease Bioavailability Bioavailability: How much medication will be available after administration to produce a biological effect The proportion of drug that enters the circulation and has active effect Rate and extent of absorption of unchanged drug from its original intake which becomes available at the site of action Determinates of bioavailability Absorption (rate and extent of absorption) First pass metabolism Critical thinking question! Which one has more bioavailability and why? 1. Acetaminophen tablet by mouth OR Acetaminophen suppository by rectal? 2. Morphine pill or injection? How do you decide which one is proper for your pt.?  What does happen in liver disease? Question? Liver disease: ? Absorption Distribution Metabolism Excretion Pharmacokinetics Excretion How are medications normally removed from body? Liver (bile) Kidneys is the main organ(urine) Bowels(Defecation) Lungs (Exhalation) Exocrine glands (Sweating, milk) What is the role of kidneys? Removing non-natural and harmful agents from bloodstream Maintaining balance of other natural substances  What does happen when kidney doesn’t function properly? Question?  Why Pharmacokinetics is important ? Question? Informed the nurse about:?  Medication Dose Response Half-Life: Amount of time it takes to decrease concentration of the drug by 50%. Onset: Time it takes for a medication to produce a response (the amount of time between administration and the appearance of its pharmacological effects) Peak: Time of the highest concentration level in blood Duration: The amount of time it takes for a drug to maintain its desired effect. onset Termination of action Type of Medication Action Therapeutic effects: Expected or predicted physiological response Side effects: (harmless or harmful) Unintended, secondary effect that a medication predictably will cause Adverse effects: (harmful) Severe, negative response to a medication Toxic effects: Prolonged intake or after accumulation (impaired metabolism or excretion) causing excess amount in body Idiosyncratic reactions: Occur rarely and unpredictably Overreaction or underreaction to a medication Allergy Reactions Allergy reactions: Mild Anaphylactic reactions: Sever Unpredictable response to a Severe reaction of body that can be life medication threatening Medication allergy Hyper-response of body defense Depends on individual and medication Signs and Symptoms (Look up P&P, Table 34-2) Urticaria (Hives), Rash, Pruritus, Rhinitis Potter, P.A., Perry, A.G., et al. (2019) Drug Guide Indication: Identifies the conditions and diseases that the drug is commonly used for, approved by FDA (food and drug administration) Action: Describes how the drug produces the therapeutic effects Route: How the drug enters the body Availability: Forms of medication Interactions: When one medication modifies the action of another. A synergistic effect occurs when the combined effect of two medications is greater than the effect of the medications given separately.  Two or more medications to treat the same illness Two or more medications from same chemical class two or more medications with the similar actions Polypharmacy Treat several disorders simultaneously Mix nutritional supplements or herbal products with medications Share your experiences Who is in the risk for self-medicate? What does happen when we take medication? How does the body change the medication? Pharmacokinetics (movement of medication) How does the medication change the body? Pharmacodynamics(change in body under force)  What is Pharmacodynamics? Related to the mechanism of drug action or effects How the medication changes the body/ Mechanism of drug action How? 1. Medication bonds to receptor activate specific receptors to produce response (treat) 2. Medication changes the membrane excitability of a nerve or muscle cell  Receptors Structural component of a cell to which a drug binds which locate On Plasma membrane In the Cytoplasm In the Nucleus  How do drugs act at the receptor level? Agonist : Activate the receptors https://rxcamapothecare.wordpress.com/2016/01/30/receptor-interactions- Bind with receptor agonists-and-antagonists/ Causing response Antagonist (Blocker): Block the Receptors Block activation” when they occupy the receptor.  Potency: Medication’s strength at a certain concentration or dose (amount of a drug needed to produce a response) More potent=more intense effect More potent=Less medication (dose) needed Efficacy: Ability of a drug to produce a more intense response as its concentration increased (max response that Describe the ability a drug can produce) of drugs therapy to More efficacy=more clinical effectiveness treat symptoms Example: Providing relief for Headache Ibuprofen 200mg or Aspirin 650mg Equally effective=Same efficacy Ibuprofen (lower dose) to achieve efficacy means more potent However, Morphine has more efficacy than both  Critical Question Which one is more important to have in a drug? (Efficacy OR Potency) Efficacy = clinical effectiveness  Class Activity Review the abbreviation sheet & mix and Match sheet  1. Match the words to their meanings: Prodrugs a) How drugs are moved into or across membranes Absorption b) Drugs change from one form to another in the body Excretion c) Chemical reactions in the body that affect drugs Pharmacokinetic d) Drugs that require metabolism to make s them active Metabolism e) What the body does to drugs Distribution f) How drugs are removed from the body Bio g) How drugs are moved through the body transformation  1. Find the word matching the description. Possible answers: 2. Pharmacodynamics – Receptors – Agonists – Antagonists – Potency - Efficacy The effectiveness of a drug as the concentration is increased Drugs that can attach to receptors and create a response Focus on what the drugs do to the body The strength of a drug at a certain dose Drugs that stop the response of agonists The parts of the cell that the drug attaches to  References Billat, P. A., Roger, E., Faure, S., & Lagarce, F. (2017). Models for drug absorption from the small intestine: where are we and where are we going?. Drug discovery today, 22(5), 761-775. Holland, L. N., Adams, M.P., Brice, J.L. (2015). Core concepts in pharmacology (5th ed). Pearson Prentice Hall Potter, P.A., Perry, A. G., Stockert, P., Hall, A. (2019). Canadian fundamentals of nursing (6th Can ed.). (Astle, B.J. Duggleby, W. Eds.). Elsevier Vallerand, A.H. & Sanoski, C.A. (2020). Davis’s drug guide for nurses (17th ed.). F.A. Davis. https://www.google.com/search?q=tylenol+tablet&rlz=1C1CHBD_enQA942QA942&sxsrf=AOaemvLrDec mPdEsNaaYcvtJ9tZm0DyAoQ:1631021768310&source=lnms&tbm=isch&sa=X&ved=2ahUKEwiHufvI_ezy AhVMTsAKHT8FBkMQ_AUoAXoECAEQAw&biw=1920&bih=912#imgrc=neM6wI8Axx_uPM