NURSING PHARMACOLOGY

PRELIMS: FIRST QUARTER REVIEWER

Vapor, Jenief L.

PHARMACOLOGY  No interaction
Outlines  Cheap and simple
a. Pharmacology
b. Pharmacotherapeutics ADVERSE EFFECT
c. Pharmacodynamic  Drug effects, sometimes called side
d. Pharmacokinetics effect, that are not the desired
e. Therapeutics therapeutic effects, may be unpleasant
f. Toxicity or even dangerous.
g. Adverse Event
h. Medication Safety Agency for Healthcare Research and
Quality
CLINICAL PHARMACOLOGY  A preventable or accidental injury or
 The branch of pharmacology that uses illness caused by medical
drug to treat, prevent, and diagnose management, which requires additional
disease monitoring, treatment, hospitalization,
or that results in death. Medical
PHARMACOLOGY management includes diagnosis and
 Is the study of biological effects of treatment, failure to diagnose or treat,
chemical and the systems and equipment used
 The science dealing with the to deliver care.
preparation, uses and effects of the
drug What are the responsibilities of the
nurse in drug therapy?
PHARMACOTHERAPEUTICS  Administer Drug
 Clinical pharmacology, the branch of  Assessing Drug Effects
pharmacology that uses drugs to  Intervening to make drug
treat, prevent, and diagnose regimen more tolerable
disease.  Providing patient teaching
about the drug and drug regimens
TWO KEY CONCERNS:  Monitoring the overall patient
THE DRUG’S care plan to prevent medication
 effects on the body error.
 the body’s response to the drug
Goal in Pharmacology
DRUG  Maximum benefit for the patient
 Is a chemical substance used in  Minimum harm to the patient
treatment, cure, prevention, or
diagnosis of disease or used to What are the different sources of
otherwise enhance physical or mental drugs?
wellbeing. NATURAL SOURCES:
 When drugs are administered, the body  Plants
 Animals
begins a sequence of process
 Inorganic Compounds
designed to handle the new chemicals.
DRUG EVALUATION
THE IDEAL DRUG  Pre-clinical Trial: Tested on animals
 Safe  2 main purposes
 Selective  To determine whether they have the
 Effective presumed effects in living tissue
 To evaluate any adverse effects
What do we want drug could be?
 Reversible Discarded if
 Predictable
 No adverse effects
 NURSING PHARMACOLOGY
PRELIMS: FIRST QUARTER REVIEWER
Vapor, Jenief L.

 The chemical lacks therapeutic  Taking these drugs with

activity when used with living animals prescription medications could
 The chemical is too toxic to living result in drug
animals to be worth the risk of  interactions and interfere with
developing into a drug. drug therapy.
 The chemical is highly teratogenic  Not taking these drugs as
(causing adverse effects to a fetus) directed could result in serious
 The safety margins are so small that overdoses.
the chemical would not be useful in the Regulatory Control
clinical setting.  Safety
 Efficacy
AN APPROVED DRUG
Brand Name Trade name by a How much of the drug we can get to the
pharmaceutical that site?
developed it  Dosage of medication
Generic Name Original designation  Route medication is given
that the drug was  Timing in between doses
given when the drug  Unique patient individual
company applied for differences
the approval
 Pharmacokinetics (LADME)
process.
 Pharmacodynamics
Chemical Names reflect in the
Names chemical structure of
the drug Definition of Basic Terms
 Toxicity
Safety during Pregnancy -Manifestation of the harmful effects of
 Category A- no risk the drug after exposure to high levels
 Category B- minimal risk or no studies (“intoxication” or “poisoning”)
done  Therapeutics
 Category C- risk identified -Use of drugs for intended clinical
 Category D- well studied define risk- benefits – cure of a disease, relief of
benefit may out do risk symptoms etc.
 Category X- positive evidence fetal
abnormalities not used. PHARMACODYNAMIC
 Is the study of the interactions
Related Law between the chemical components of
o Republic Act 2382 or the Philippine living systems and the foreign
Medical Act chemicals, including, drugs, that enter
 Physicians are the those systems.
only ones authorized to Drug usually work in one for ways
prescribe medicines  To replace or act as substitutes for
missing chemicals
 To increase or stimulate certain
o Only registered pharmacist can cellular activities
dispense and sell medicines under the  To depress or slow cellular activities
Republic Act 5921 or Pharmacy  To interfere with the functioning of
Law. foreign cells, such as invading
microorganisms or neoplasms leading
Over-the counter (OTC) drugs to cell death (drugs that act in this
 Taking these drugs could mask way are called chemotherapeutic
the signs and symptoms of agents
underlying
 disease, making diagnosis
difficult. DRUG INTERACTIONS
Drug a: Antagonist -binds the receptor sites
 NURSING PHARMACOLOGY
PRELIMS: FIRST QUARTER REVIEWER
Vapor, Jenief L.

and produces an effect  Excretion from the body

Drug b -cannot bind to receptor
sites on the cell and ABSORPTION
produces effect 1. Oral Administration
Molecule of Drug a -bound to the receptor
 Ideally given 1 hour before or 2
sites
hours after meal
Drug c: An antagonist of -binds to the same
Drug A receptor sites as Drug A 2. Intravenous Administration
and prevents Drug A from  Immediate onset and are fully
binding. absorbed at administration
3. Injected
Selective Toxicity  IM / SC
 property of a chemotherapeutic ROUTE FACTORS AFFECTING
agent that affects only systems found ABSORPTION
in foreign cells without affecting 1. Intravenous None: direct entry into the
healthy human cells (e.g., specific venous system
antibiotics can affect certain proteins or 2. Intramuscular -perfusion of blood flow to
the muscle
enzyme systems used by bacteria but
3. Subcutaneous -perfusion or blood flow to
not by human cells). the tissue
4. PO (oral) -acidity of the stomach
PHARMACOKINETICS -blood flow to
 involves the study of absorption, gastrointestinal tract
distribution, metabolism 5. PR (rectal) perfusion of blood flow to the
(biotransformation), and excretion rectum
of drugs. 6. Mucous -prefusion or blood flow to
membranes the area
 the onset of how long it will take to (sublingual, -integrity of the mucous
drug action see the beginning of the buccal) membranes
therapeutic effect 7. Topical (skin) -perfusion or blood flow to
 drug half life the area
 timing of the how long it will take to -integrity of skin
peak effect see the maximum effect8. Inhalation -perfusion or blood flow to
of the drug the area
 duration of drug how long the patient will -integrity of lung lining
effects experience the drug
effects ABSORPTION PROCESS
 metabolism or of the drug  Active Transport
biotransformati  A process that
on uses energy to actively move a
 the site of
molecule across a cell membrane.
excretion

DISTRIBUTION
CRITICAL CONCENTRATION Factors that can affect distribution
The amount of drug that is needed to
  The drug’s lipid solubility and
cause therapeutic effect ionization
Loading Dose  The perfusion of the reactive
 A higher than that usually used for tissue
treatment to reach the critical  Protein binding
concentration.  Blood-Brain Barrier
-is a protective barrier system of
DYNAMIC EQUILIBRIUM cellular activity that keeps many
 Absorption from the site of entry things (eg., foreign invaders, poisons)
 Distribution to the active site away from the CNS; Lipid soluble.
 Biotransformation (metabolism) in
the liver
BIOTRANSFORMATION (METABOLISM)
 NURSING PHARMACOLOGY
PRELIMS: FIRST QUARTER REVIEWER
Vapor, Jenief L.

 First-Pass Effect interfering with the enzyme systems in

-a phenomenon in which drugs given the body.
orally are carried directly to the
liver after absorption, where they
may be largely inactivated by liver
enzyme: before they can enter the
general circulation; oral drugs
frequently are given in higher doses
than drugs given by other routes
because of this early breakdown.
Hepatic Enzyme System
 The intracellular structures of the
hepatic cells are lined with the
enzymes packed together- hepatic
microsomal system.
Enzyme Introduction:
 presence of chemical that is
metabolized by a particular enzyme
system often increases the activity of
that enzyme system.
 Pharmacokinetics affects the
amount of a drug that reaches
reactive tissues. Very little of
an oral does of a drug reaches
reactive sites.
PHARMACOKINETICS
 Absorption
 Distribution
 Metabolism
 Excretion

PHARMACODYNAMICS
 Efficacy
 Toxicity

Half Life
 The half-life of a drug is the time it
takes for the amount of drug in the
body to decrease to one half of the
peak level it previously achieved.

CLEAR POINTS
 Pharmacodynamics
-is the process by which a drug
works or affects the body.
 Drugs may work by replacing a
missing body chemical, by stimulating
or depressing cellular activity, or by
interfering with the functioning pf
foreign cells.
 Drugs are thought to work by reacting
with the specific receptor sites or by