Pharmacology

Is the study of the biological effects of chemicals. Pharmacotherapeutics Clinical Pharmacology Branch of pharmacology that uses drugs to treat, prevent and diagnose diseases. 2 key concerns of Pharma: 1. drugs effect on the body PHARMACODYNAMICS 2. bodys response to the drug PHARMACOKINETICS Slide #6 > In the clinical practice, health care providers focus on how chemicals act on living organism. Nurses deal with Pharmacotherapeutics adresses two key concerns: the drugs effects on the body and the bodys response to the drug. #7 > Because a drug can have many effects, the nurse must know which ones may occur when a particular drug is administered. Some drug effects are therapeutic or helpful, but others are undesirable or potentially dangerous. The Negative effect is termed as the adverse effect. #9 > Generic drugs: they are generic because they were not so exposed to a quality control just like any other pharmaceutical have. Examples, binders that are used in generic drugs might not be the same as those used in the branded drugs. In that case, the bioavailability of the drug is different from that of the branded drugs. Orphan drugs: are useful in treating a rare disease, or maybe have potentially dangerous adverse effect. Orphan drugs are often abandoned after pre-clinical trials or phase 1 studies. OTC: some things to consider: taking these drugs could mask the sign and symptoms of underlying disease, making diagnosis difficult. It could also result in drug interactions and interfere with drug therapy #10 > Understanding about Pharmacodynamics and Pharmacokinetics makes you knowledgable about the interactions between the chemical component of the living system and the foreign chemicals including drugs that enter those systems, with that, multiple changes and interferences with cell functioning may occur. To avoid such study the pharmaco #11 > Drugs can be absorbed into many different areas: GI ( orally or rectally ) through the mucous membranes, skin, lungs, muscles and subcu. Administration: the oral route is frequently used in clinical practice. This is not invasive and as a rule, it is less expensive than any other drugs that could 1

be administered to other route. (Consider the acidity, high acid if stomach is with food) The recommended dose for oral drugs can be considerably higher than the recommended dose for parenteral drugs, taking the first-pass effect into account.

#13> DISTRIBUTION: Consider the blood flow, ex. DM with lower limb infection- there would be no adequate blood flow to the area-little antibiotic can be delivered to the tissue and little antibiotic effect will be seen. Distribution take as long as several hours depending on blood flow and cardiac output. PLASMA-CHON and VOLUME DISTRIBUTION, most drugs are bound to some extent to CHON in the blood to be carried into circulation; chon-drugs complex is relatively large and cannot enter into capillaries and then into tissues to react. The drug must be freed from the proteins binding site at the tissues. BARRIERS (brain): this are protective system of cellular activity that keeps many things (foreign invaders, poisons)away from the CNS. Drugs that are highly lipid soluble are more likely to pass through the blood-brain barrier. This is clinically significant in treating a brain infection with antibiotics. Almost all antibiotic are not lipid soluble and cannot cross the barrier. Effective antibiotic treatment can occur only when the infection is bad enough to alter the barrier and allow antibiotics to cross. (Placenta): Many drugs readily pass through the placenta and affect the developing fetus in pregnant women. IT is BEST NOT to administer any drugs to pregnant women because of the possible risk to the fetus. Drugs should be given only when the benefit clearly outweighs any risk. #14 > Antagonist is antacid while Agonist is antibiotic SLIDE 15 - Weight: People who are much heavier than that may require larger doses to get therapeutic effect from a drug because they have increase tissues to perfuse and increased receptor sites in some reactive tissues. Toxic effects may occur at the recommended dosage if the person is very small. Age: Age is a factor primarily in children and older adults. Children metabolize many drugs differently than adults do, and they have immature systems for handling drugs. (pediatric doses) 2

Gender: Physiological differences between men and women can influence the drug effect. MEN-have more vascular muscle, so the effects of the drug will be seen sooner than in women. WOMEN- have more fat cells than men do, so drugs that deposit in fat may be slowly released and caused effects for a prolonged period of time. #16 > Patho- GI disorders affect the absorption of many oral drugs. LIVER or kidney diseases affect the way that a drug is biotransformed and excreted and can lead to toxic reactions. IMMUNO- Sensitivity to drugs can range from dermatological effects to anaphylaxis, shock and death. PSYCHO- the patients attitude about a drug has been shown to have real effect on how the drug works. A drug is more effective if the patient thinks it will work than if the patient believes it will not work. This is called the PLACEBO effect. ENVI: the environment can effect the success of drug therapy. Some drugs effects are helped by quiet, cool, non-stimulating environment. (SEDATING DRUGS) HYPERTENSIVE drugs are working well during cold and winter months may become too effective in warmer environment , when natural vasodilation to release heat tends to lower bp. #18 > Therapeutic levels- important goal is for drug to reach therapeutic levels and maintain therapeutic levels Loading Dose sometimes given to raise therapeutic level quickly before drug has change to be eliminated. - for client safety, loading doses are given in several smaller doses over short periods of time - once therapeutic level is achieved, a smaller daily maintenance dose is given to maintain therapeutic levels; digoxin may be given this way Toxicity- occurs when drug is eliminated more slowly than it is absorbed, causing excessive drug concentration #19 > Primary effect- example: imdur for chest pain when chest pain is relieved that is the primary response, headache arises, that is the secondary effect

#26 > A tincture is an alcoholic extract (e.g. of leaves or other plant material) or solution of a non-volatile substance (e.g. of iodine, mercurochrome). To 3

qualify as a tincture, the alcoholic extract is to have an ethanol percentage of at least 40-60% (80-120 proof) (sometimes a 90% (180 proof) pure liquid is even achieved).[In herbal medicine, alcoholic tinctures are often made with various concentrations of ethanol, 25% being the most common. Other concentrations include 45% and 90%. Herbal tinctures do not always use ethanol as a solvent, though this is the most frequent. Other solvents include vinegar, glycerol, ether and propylene glycol, not all of which are used for internal consumption. However, where a raw solvent's pH factor is a sole consideration, the advantage of ethanol is that being close to neutral pH, it is a good compromise as a passive used solvent of both acidic and alkaline constituents where a tincturing methodology is concerned.