Terms Definitions
What is pharmacology?
The study of drugs and how they react with living systems.
Any chemical that can effect a living process.
Clinical pharmacology
study of drugs in humans, not just in pt w/ health problems but in healthy individuals as well
How drugs are used to diagnose prevent or treat disease, also how medications are used to prevent pregnancy (infertility is a disorder so it is under the disease category).
Most important property of an 'ideal' drug.
Effective - if it doesn't work nothing else really matters, even if it is safe.
Ideal Drug
effective, safe, selective, reversible, predictable, minimal drug interactions, minimal adverse effects, minimal side effects etc...
What determines how much of a drug gets to a receptor cite within the body? – several factors determine how moved through bodyo Absorptiono Distributiono Metabolismo Excretion
Once drug is at the receptor site, what determines what effect the drug will have on the body?
name some roles of nurses in drug therapy...
1. preadministrationinistration assessment2. dosage and 3. administrationinistration4. evaluating and promoting the therapeutic effects5. minimize adverse effects – ie. Side effects6. minimize adverse reactions – ie. Drug interactions7. making prn decision
What are the 5 rights of drug administration?
Right PatientRight DrugRight DoseRight RouteRight Timeoh and if you don't know what it is or what it does - don't give it...
Schedule one
opiatesopiate derivatives:like heroin, morphine hallucinogens: peyote, mescaline, marihuana there are many listed on fda's website...
schedule II
opium and opium salts, Coca and all it's derivitives-cocaine opiates: methadone, fentanyl, dihydrocodeinemethamphetamine injectables
schedule III
amphetamines, phenmetrazine
What determines how much of a drug gets to a receptor cite within the body?
Pharmacokinetics: Absorptiono Distributiono Metabolismo Excretion
once drug is at the receptor site – what determines what effect the drug will have on the body
What factors influence a drugs intensity?
Administrationpharmacokineticspharmacodynamicsindividual variations
What is the main goal of pharmacologic treatment?
Provide the maximum benefit with the minimum drug therapy.
Why are infants under one year at high risk when treating with drugs?
Their liver and renal systems are not fully matured until about 12 mos.
Why are the elderly at risk in drug therapy?
Their organs have begun to deteriorate from age.
many drugs have more than one use
ex. Lanoxin and Digoxin lower HR but also effects the squeeze.
Name some ways to reduce adverse effects
ID high risk pt - monitor closelyknow the adverse effects and when they will occurknow early warning s/s intervene when they occur
name some ways to reduce adverse interactions
find out what drugs they are onknow the drug interactionstake a THOROUGH drug history assess allergy history
pro re nataas needed
educate patient
drug's generic and trade namefamily of drugdosagewhen to take itroute technique-any special instrxnhow to storedrug to drug interactionsdrug to food interactions
What we have to know on each drug:
classintended therapeutic effecthow effect is achievedside effects and adverse reactionscontraindications and cautionsexamples of drugs - brand & genericspecific nursing axn rt class of drug
controlled drug act of 1970 did what?
set rule for manufacture and distribution of drugs w/ potential abuse.
list the 5 schedules for degrees of abuse
i- heroin, cocaine, marijuanaii oxycodone, percoset, morphineiii benzo's, zanax, hydrocodoneiv tallisan, darvosetv ? he did not list any...
chemical name
chemical description of the drug
generic name
assigned by the US adopted names council USANC
trade name
proprietary or brand name
cholesterol med
how drugs are moved through the body
drug moved from site of administration into the blood stream
drug movement from the blood to the interstitial space of tissues and from there into cells.
enzymatically mediated alteration of drug structure
metabolism = biotransformation
movement of drugs and their metabolites out of the body
what efects absorption
rate of dissolutionsurface areablood flowlipid solubilitypH partitioning
rate of dissolution
of more easily dissolved will increase the absorption rate
absorption rate vs amount...
Absorption: rate of absorption effects how fast will work Amt. absorbed determines how much effects
surface area?
the larger the surface area the faster the rate of absorption (more effective but not faster)– small intestine (30ft of intestine). Oral disintegrating are very fast w/n 8 min. IM takes 15-20 min.
Blood flow and absorption
drugs are absorbed faster in areas of high blood flow
lipid sol and absorption?
o Lipid solubility: highly lipid soluble drugs absorbed more rapidly Prime example- Diprivan knocks out a pt on a vent – mother’s milk. Titrate it up a little
What does pH have to do w/ absorption?
o pH partitioning: acid/base attraction increases absorption
What is enteral?
GI tract - po
what is parenteral?
outside the GI- sc, im, iv
what is the barrier in PO meds?
epithelial lining--> capillary walls -->blood stream
advantages of po?
easy administration, inexpensive, safer than parenteral, possible to reverse absorption (charcoal)
disadvantages of po?
variable rateinactivates as it passes through GI pt requirements: have to be able to take PO...
enteric coating
saves the absorption until reaches small intestine
sustained release?
allows for more consistent drug levels - slowly brks down
iv - no barrier to absorption -
advantages of iv: rapid onset, administration of large amt of fluids w/ drug (dilute), complete administration of drug, can regulate easier
iv disadvantages
increased cost, diff in administering, fluid overload, IRREVERSIBLE, infection at site, air embolism, sediment can embolize when meds not mixed well,
How long should all drugs IV be pushed
over one full minute: dilutes through the blood stream - it takes a minute for the blood to cycle in body. that way you don't over load the heart with a heavy dose of a drug.
IM barriers
capillary lining
IM rate of absorption
faster than po not as fast as iv
disadv/adv of IM or SC injxn
no embolism, deliver of slow period of time possible - depopain, inconvenience, nerve dmg
topical absorption
absorbed into skin, capillaries then blood.
inhaled absorption
fast absorbing b/c air sacs in lungs to capillaries
suppository absorption
faster than POconsidered a PO med
What determines distribution?
blood flow to tissues, exit the vascular sys, and entering cells
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