PharmNotes1&2.docx - Pharmacology Week 1 2 Tuesday Notes...

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Pharmacology Week 1 & 2 Tuesday NotesNursing ProcessSix Major Initiatives of QSEN-patient-centered care-teamwork and collaboration-evidence-based practice-quality improvement-safety-informaticsPharmacological PrinciplesPrinciples-drug: any chemical that affects the physiological processes of a living organism-pharmacology: study or science of drugsDrug Names-chemical name: describes the drug’s chemical composition and molecular structure-generic name: nonproprietary, name given by US Adopted Names Council-used by nurse-trade name: the drug has a registered trademark; use of the name is restricted by the drug’s patent owner (usually manufacturer)-used by patients typicallyPharmaceutics-the study of how various drug forms influence the way in which the drug affects the bodyPharmacokinetics-absorption, distribution, metabolism, excretion-what happens the the drug from entry to exit-peak level: highest blood level of a drug-trough level: lowest blood level of a drug-toxicity: occurs if peak blood level of drug is too high-therapeutic drug monitoringPharmacodynamics-the purpose of the medication, the study of what the drug does to the body-mechanism of drug actions, therapeutic effect, mechanism of action, drug-receptorrelationships, enzymes-agonist, antagonist, etc.Enteral Route-oral, sublingual, buccal, rectal (can also be topical)Parenteral Route-intravenous (fastest delivery into the blood circulation)-intramuscular-subcutaneous-intradermal-intraarterial-intrathecal-intraarticular
Topical Route-skin, eyes, ears, nose, lungs, rectum, vaginaPharmacotherapeutics-adverse reactions & contraindicationsConsiderationsDrug Therapy During Pregnancy-drugs cross placenta by diffusion-factors affecting safety: drug properties, fetal gestational age, maternal factors-FDA has implemented pregnancy safety categoriesPregnancy Safety Categories-A: studies indicate no risk to human fetus-ex. Tylenol-B: studies indicate no risk to animal fetus; information for humans not available-lots of OTC meds-C: adverse effects reported in animal fetus-D: possible fetal risk in humans reported, however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women-if placenta is ripping apart from uterusDrug Therapy During Breastfeeding-breastfed infants are at risk for exposure to drugs consumed by the mother-consider risk-to-benefit ratio-breastfeeding baby after alcohol can cause baby to be sick, nauseous, etc.Neonatal & Pediatric Considerations: Pharmacokinetics-absorption: -gastric pH less acidic until 1-2 yrs old-gastric emptying slowed-intramuscular absorption faster & irregular-distribution-greater water, less fat-decreased level of protein binding-immature blood-brain barrier; more drugs enter brain-metabolism-immature liver; less enzymes-older children may have increased metabolism, requiring higher doses than infants-weight based-excretion:-kidney immaturity-reduced perfusion of kidneys, reduces excretion of drugsFactors Affecting Pediatric Drug Dosages

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