Pharmacology made easy: Intro to pharmacology.
Terms in this set (91)
Drugs that affect the neurological system
Depressants, stimulants, anesthetics, anticonvulsants, neurodegenerative, and psychotherapeutics
Drug category information
Pharmaceutics, pharmacokinetics, pharmacodynamics, expected pharmacologic and therapeutic effects, side and adverse effects, contraindications, precautions, and interactions
drug-drug and drug food interactions, tolerance, cumulative effect, toxicity and special populations: pregnant women, infants and children and older adults.
Drug in the same category
Act in similar manner, share many of same: therapeutic effects, side and adverse effects, contraindications and precautions and administration considerations
company develops drug and gives it official name. for ex: acetaminophen
Brand or trade name
Drug's commercial name, which may vary (tylenol). varipus manufacturers give the same drug different .... name
usually cheaper than brand or trade name drugs. patients and insurance companies prefer generic drugs. helps decrease cost of drugs. have same chemical composition as brand or trade name drugs, is interchangeable with brand name drug. each drug has only one ...... name
over-the-counter drugs, do not require a prescription, are relatively safe to take without supervision, can be purchased at drug stores or grocery stores.
drugs federal government identifies as harmful if there is no supervision of administrations. must have prescription form from physician, nurse practitioner or physician's assistant.
examples of prescriptions drugs
antibiotics, antihypertensives, diuretics, narcotic analgesics
drugs to treat infection, ex: ceftriaxone (Rocephin)
drugs to treat high blood pressure: captopril (Capoten)
drugs that promote urination: furosemide (lasix)
drugs for pain relief: fentanyl (Sublimaze, Duragesic)
Examples of Nonprescription drugs
Acetaminophen (tylenol), Ibuprofen (Advil), Diphenhydramine, loratadine (Claritin)
and Ranitidine (Zantac)
address how various drug forms affect: Dissolution, absorption rate and onset of action
tablets, capsules and liquid, through mouth but inhaled into lungs, usually powder form. often larger than IV doses of the same drug because of the first-pass effect by the liver, which reduces the bioavailability of the drug.
drugs with quickest absorption rate
liquid, suspension, powder and capsule
drugs with a slow absorption rate
Tablet, coated tablet and enteric-coated tablet ( DO Not Crush or Chew Tablet)
drugs that have a delayed release
Enteric coated (EC): dissolves when drug reaches intestine.
Extended release (ER): releases drug over a period of time.
Extended length (XL).
Sustained release (SR or XR)---- patients can take less frequently.
Sustained action (SA).
drugs that can be administered intravenously: into a vein (IV).
Subcutaneously: into Subcutaneous tissue (SubQ).
Intramuscularly: into muscle tissue (IM).
come in form of liquid or dry (needs liquid added: reconstitution)
absorption is immediate and complete
Subcutaneous/ intramuscular drugs
Absorption and onset varies:
absorption is rapid if highly water soluble and good circulatory blood flow.
absorption is slow if poorly water soluble and/or circulatory blood flow is slow or impaired.
Topical or trans-dermal drugs
Apply directly to skin.
if it act directly on skin: it has immediate onset of action.
if it absorb through skin: it has delayed onset of action.
Drugs that do not go through the digestive system for distribution/Metabolism
Intravenous, subcutaneous, Trans-dermal and inhalation
are distributed and metabolized in the lung and is eliminated through exhaled air
Process that oral drugs go through
Stomach------Portal system-----Liver-----Blood and from blood is eliminated through the kidney by urination or from the blood is eliminated through the skin by sweating. Or from the GI system is eliminated through feces.
movement of drug from site of administration to various tissue of body.
Movement of drug by circulatory system to intended site of action
areas that have a rich supply of blood
Heart, kidney and liver
change that occurs in a drug: To a more or less potent form. To a more soluble form. To an inactive form. liver is responsible for most of metabolism occuring in the body.
change that occurs in chemical nature during metabolism.
new or altered version of drug ( a by-product of metabolism)
is the elimination of a drug or it metabolites through various parts of the body. for instance, the kidney eliminates many drugs through the urine. the kidney may even reabsorb some drugs to the kidneys allowing it to pass through the body again before it is excreted in the urine
half-life of Drug
time it takes for drug to decrease in amount by half: this reflets how quickly and efficiently a drug metabolizes and excretes.
Short half-life drug administration: could be once per day.
Decrease in functioning of liver or kidneys increases half-life of drugs
Onset of drug action
time it takes the drug to demonstrates a therapeutic response.
Drug peak effect
time it takes the drug to demonstrates full therapeutic effect
through level of drug
the drug lowest level in the body.
Biochemical changes that occur in body as result of taking a drug
intended effects of drug
Side or adverse effects
Non-therapeutic, unintended effects of drug that occurs at a therapeutic dose. unintended effects that commonly occur and are mild in nature.
adverse effects: unintended and unexpected effects that are more severe and can be life-threatening in nature.
effects from drugs
occur secondary to changes in:
how cells function, cellular environment and action of enzymes in body.
drugs that bind with receptor and precipitate greater than typical response. it elicit an action in the body instead of blocking an action.
drugs that bind with receptor and block response less than typical response
can have competitive or noncompetitive effect.
competitive: completes with agonist for receptor sites, Noncompetitive: blocks agonist's access to receptor site.
(reduces the effect of another drug)
A process that change target molecule's typical response (inhibit or enhance action of an enzyme)
Example of a drug that has more than one therapeutic effect: used for allergies (antihistamine effect), used for Motion sickness (anti-emetic effect), use for hypnotic (sedative effect), use for treatment of Parkinson's disease (anticholinergic effect)
side effect of diphenhydramine
dry mouth and drowsiness
adverse effect of diphenhydramine
In older adults: confusion, incoordination, dizziness, convulsions (irregular movement of the limb, involuntary muscle contraction).
In children: hyperactivity, excitation.
Most severe type of adverse drug reaction.
severity range: itching, rash, hives, anaphylactic shock. previous exposure increases sensitivity ( second exposure could be more severe.
Exaggerated response of body's immune system to a drug. It precipitates massive release of histamine and other chemical mediators. Itching can indicate drug hypersensitivity and a more severe allergic reaction can develop with future exposures
Symptoms of anaphylactic shock
swelling of eyes, face, mouth and throat.
difficulty breathing, wheezing.
Rapid heart rate
Extremely low blood pressure and cardiac arrest.
Treatment of Anaphylactic shock
Re-astablishment of airway and oxygen therapy. Administration of epinephrine to raise blood pressure and dilate bronchi. Administration of diphenhydramine to block additional release of histamine.
Effects to monitory during drug therapy
Body's decreased response to drug it receives over a period of time. because of this providers must increase dosage for therapeutic effect.
.........to narcotic pain drugs can results after 10-14 consecutive days of therapy.
Cumulative drug effects
occur when amount of drug patient receives is greater than rate it's excreted.
this is common in:
Older adults who have decrease in cardiac and kidney function.
patients who have liver or kidney disease.
Need decrease in drug dosages.
When patient receives excessive dosages.
When impaired excretion of drug allows drug to build up in the body.
When a drug given over a long period of time gradually builds up in the body.
When a drug with a small margin of safety is given.
May be irreversible and life-threatening.
Vancomycin (vancocin) toxicity
causes permanent damage to cranial nerve 8.
Decreased hearing or deafness
Acetaminophen (tylenol) toxicity
Temporary or permanent damage to the liver. may result in liver failure.
drugs providers should not prescribe because they have potential to cause serious or life-threatening adverse effects. can be due to population or in combination with other drugs and certain foods.
decreases enzimatic metabolism of certain drugs. it increases their potency and risk for toxicity. for example, avoid ...... in patient taking the antidepressant: sertraline (Zoloft).
Avoid...... in patient taking the antihistamine Fexofenadine (allegra).
avoid.... in patient taking the calcium channel blocker Nifedipine (Procardia).
Wine and processed meats that contain tyramine
can cause a hypertensive crisis in patient taking isocarboxazid (Marplan) and tranylcypromine (Parnate).
the calcium in this product when bind to tetracycline reduces its effects
Eating dark green vegetables that are high in vitamin K
can reduce the anticoagulant effect of warfarin (comadin)
Ingestion of a meal high in protein
can decrease the absorption of levodopa (dopar) causing symptoms of parkinson to abruptly arise.
when one drug changes the way another drug affects the body.
when the combine effect of a drug is the same as each drug you give alone in similar doses. drugs that interact to cause a similar action. patients can achieve desired effects with the use of lower dosages. For example when a patient takes 2 drugs that are central nervous system depressants such as alcohol and opioids, this puts the patient at risk for severe risk of central nervous system depression
When the effect of one drug is greater when you give it with another drug that can initiate the same effect. for example, when you give aspirin with the prescription blood thinner warfarin (coumadin), the affects of warfarin intensifies and severe bleeding can occur.
When the effect of one drug is decreased or blocked if you give it with another drug. for example, if you give a drug for asthma to open a patient airway and another drug for its cardiovascular effect that has a side effect that constrict the patient airway, the action of the second drug antagonizes or interferes with the action of the first drug.
when food changes the way a drug affects the body.
Women who are pregnant
Only drugs heath care provider prescribes. Teratogenic drugs during first trimester: fetus at risk for birth defects
pregnancy safety categories
there are 5. the last 2 are D and X
Possible fetal risk; must weigh potential benefits against risks. women of childbearing age should use contraception while taking these drugs to avoid harm to the fetus.
Positive fetal risk; not normally used during pregnancy
drug in breast milk
levels are lower than levels in blood (but some transfer of drug can occur).
size of infant and amount of milk infant consumes: amount of drug that transfers and its effects.
patients under one month of age. intramuscular drug have a delayed absorption
patients between age of 1 month and one year. intramuscular drug have an increased absorption.
patient between age of 1 year to 12 years . intramuscular drugs have an increased absorption.
slower until 8 months of age
higher until 2 years of age
the liver fully matures at....
1 year of age
Their higher water/lower body fat and also have a less effective blood-brain barrier than adults which allows drugs to enter the brain easier.
what effects the distribution of drugs in neonates, infants and children?
Kidneys and GI track changes with aging
decrease in blood flow to kidneys, glomerular filtration rate, gastric pH and emptying, intestinal absorption, slowed peristalsis
Liver changes with aging
decrease in blood flow to the liver (reduced hepatic blood flow) and enzyme production.
Circulatory system changes with aging
decrease in cardiac output and tissue perfusion
How providers prescribes drug dosages for children
based on their body surface area, age, and weight, along with drug properties such as metabolism and excretion.
Adverse effect of digoxin (Lanoxin)
Ace-inhibitor that is eliminated by the kidneys. before administering drug, the patient should check creatinine clearance,
When prescribing drugs for a woman who is breastfeeding, the provider should consider:
the properties of the drugs: because certain drugs can transfer more easily into breast milk, for ex, fat solubility.
the new borns weight , the lower the new born weight, the greater the effects of the amount of drug absorbed into the newborn's circulation.
How much breast milk the newborn consumes each day, the more breast milk the newborn consumes means more of the drug is likely to be adsorbed into the newborn's circulation. whether or not the benefits to the mother outweigh the risks to the newborn.
what can increase the patient's ability to learn
and Readiness to learn
Peak and trough level help monitor
minimum effective dose
and constant therapeutic level
Increasing fluids will not reduce risk for drug toxicity. Explain:::::
Increasing fluids can change the urine's specific gravity but it will not alter glomerular filtration, passive tubular reabsorption, or active tubular secretion (3 mechanism by which drugs care excreted renally)