Pharmacologic Principles

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Pharmacology and the Nursing Process7:Pharmacology and the Nursing Process Textbook

ISBN: 6, 0323087892


List the six (6) Rights of Medication Administration (pgs.11-15)

  1. Right Drug
  2. Right Dose
  3. Right Time
  4. Right Route
  5. Right Patient
  6. Right Documentation

Define a Chemical Name (pg. 19)

Describes the drug's chemical composition and molecular structure of a drug


A Generic Name (nonproprietary name) (pg. 19)

The name given by the United States adopted Name Council. The generic name is much shorter and simpler than the chemical name and is not protected by trademark.


Define a Trade Name (proprietary name) (pg. 19)

The drug's name has a registered trademark; use of the name is restricted by the drug's patent owner (usually the manufacturer)


Five (5) Pharmacologic Principles (pgs. 21-36)

  1. Pharmaceutics
  2. Pharmacokinetics
  3. Pharmacodynamics
  4. Pharmacotherapeutics
  5. Pharmacognosy

Definition of a Drug (pg. 19)

Any chemical that affects the physiologic processes of a living organism


Definition of Pharmacology (pg. 19)

Study or Science of drugs


Definition of Pharmacokinetics (pg. 20)

The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body.

Note: Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body.


What are the four (4) processes of Pharmacokinetics

  1. Absorption
  2. Distribution
  3. Metabolism
  4. Excretion

Hint: "ADME"


Define Pharmacokinetics (pg. 20)

The study of what the body does to the drug


Define Pharmacodynamics (pg. 20)

The study of what the drug does to the body:

  • The mechanism of drug actions (MOA) in living tissue

Define Pharmacotherapeutics (pg. 31)

The use of drugs and the clinical indications for drugs to prevent and treat diseases


Define Pharmacognosy (pg. 35)

The study of natural (plant or animal) drug sources


What is Pharmacokinetics: Absorption (pg. 22)

The rate at which a drug leaves its site of administration, and the extent to which absorption occurs:

  • Bioavailability (term used to express the extent of drug absorption)
  • Bio equivalency

List factors that affect Absorption (pg. 22)

  • Food or fluids administered with the drug
  • Dosage formulation
  • Status of the absorptive surface
  • Rate of blood flow to the small intestine
  • Acidity of the stomach
  • Status of GI motility

Note: Absorption characteristics vary according to the dosage form and route


List the three (3) Routes (pgs. 22-25)

  • Enteral (GI Tract)
  • Parenteral
  • Topical

Note: A drug's route of administration affects the rate and extent of absorption of that drug


A Drug's route of administration will affect the _____ and _____ __ _______ of that drug

rate and extent of absorption


Absorption characteristics vary according to the ______ ____ and _____

dosage form and route


Where is an Enteral (GI Tract) Route located? (pg. 22)

  • Oral
  • Sublingual (under the tongue)
  • Buccal (oral mucosa between cheek and gum)
  • Rectal

How is a drug absorbed in a Enteral (GI Tract) Route? (pg. 22)

The drug is absorbed into the systemic circulation through the oral or the gastric mucosa or the small intestine


List the Parenteral Routes (pg. 23)

  • Intravenous (fastest delivery into the blood circulation)
  • Intramuscular
  • Subcutaneous (into fat -hypo-dermis)
  • Intradermal (muscle beneath the subcutaneous fatty tissue)
  • Intraarterial (within an artery)
  • Intrathecal (within a sheath)
  • Intraarticular (within a joint)

Describe the metabolism of a drug and its passage from the liver into the circulation in connection to the first-pass effect

  • A drug given via the oral route may be extensively metabolized by the liver "before" reaching the systemic circulation (high first-pass effect)
  • The same drug -given IV- bypasses the liver, preventing the first-pass effect from taking place, and more drug reaches the circulation

List the Topical Routes (pg. 25)

  • Skin (including transdermal patches)
  • Eyes
  • Ears
  • Nose
  • Lungs (inhalation)
  • Rectum
  • Vagina

Definition of Biotransformation (pg. 27)

One of more biochemical reactions involving a parent drug. It occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as metabolism


List some characteristics of Half-life (pg. 29)

  • The time it takes for one half of the original amount of a drug to be removed from the body
  • A measure of the rate at which a drug is removed from the body
  • Most drugs considered to be effectively removed after about five half-lives
  • Steady state

Definition of First-pass Effect (pg. 22)

The initial metabolism in the liver of the drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream


Definition of Half-life (also called elimination half-life) (pg. 29)

In pharmacokinetics, the time required for half of an administrated dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50% (also called elimination half-life)


What is Distribution (pg. 26)?

The transport of a drug in the body by the bloodstream to its site of action

  • Protein-binding
  • Water-Soluble vs. fat soluble
  • Blood-brain barrier
  • Areas of rapid distribution: brain, heart. liver, and kidneys
  • Areas of slow distribution: muscle, skin, and fat

List RAPID distribution of a drug in the body by the bloodstream to its site of action

Areas of rapid distribution:

  • Brain
  • Heart
  • Liver
  • Kidneys

What is caused by DELAYING drug metabolism (referred to as biotransformation)? (pg. 27)

  • Accumulation of drugs
  • Prolonged action of the drugs - "drug toxicity"

What is caused by STIMULATING drug metabolism (referred to as biotransformation)? (pg. 27)

Diminished Pharmacologic effects caused by stimulating drug metabolism


Definition of Excretion (pg. 27)

The elimination of drugs from the body.

Note: Whether they are parent compounds or active metabolites, all drugs must eventually be removed from the body.


What are the factors that DECREASE metabolism (referred to as biotransformation)? (pg. 27)

  • Cardiovascular dysfunction
  • Renal insufficiency
  • Starvation
  • Obstructive jaundice
  • Slow acetylator
  • Erythromycin or ketoconazole drug therapy

What are the organs responsible for drug excretion? (pgs. 27-28)

  • Kidneys (main organ)
  • Liver
  • Bowels

-Biliary excretion

-Enterohepatic recirculation


Where can metabolism (referred to as biotransformation) take place? (pg. 27)

  • Liver (main organ)
  • Skeletal muscle
  • Kidneys
  • Lungs
  • Plasma
  • Intestinal mucosa

What is metabolism (also referred to as biotransformation)? (pg. 27)

The biochemical transformation of a drug into an inactive metabolite, a more soluble compound, or a more potent metabolite


What are the factors that INCREASE metabolism (referred to as biotransformation)? (pg. 27)

  • Fast acetylator
  • Barbiturate therapy
  • Rifampin therapy

What is onset of action? (pg. 29)

The time it takes for the drug to elicit a therapeutic response after dosing


What is an inactive metabolite? (pg. 34)

Inactive metabolites lack pharmacologic activity and are simply "drug waste" products awaiting secretion from the body (e.g., via urinary, gastrointestinal, or respiratory tract)


List three (3) biologic transformations of a drug (reference metabolism/biotransformation on pg. 27)

  1. An inactive metabolite
  2. A more soluble compound
  3. A more potent metabolite

What is peak effect? (pg. 29)

The time it takes for a drug to reach its maximum therapeutic response


What is duration of action? (pg. 29)

The time a drug concentration is sufficient to elicit a therapeutic response


List the three (3) Pharmacodynamics: Mechanisms of Action (MOA) interactions (pg. 30)

  1. Receptor interactions
  2. Enzyme interactions
  3. Nonselective interactions

List the two (2) levels of therapeutic drug monitoring

  1. Peak level - Highest blood level
  2. Trough level (nadir) - Lowest blood level

List the types of Pharmacotherapeutics Therapies (pg. 31)

  • Acute therapy
  • Maintenance therapy
  • Supplemental/replacement therapy
  • Palliative therapy
  • Supportive therapy
  • Prophylactic therapy
  • Empiric therapy

Definition of Trough level (pg. 30)

The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug monitoring


Definition of toxicity (pg. 30)

The condition of producing adverse bodily effects due to poisonous qualities


Definition of Metabolite (pg. 34)

A chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug.


Definition of parent drug (pg. 22)

The chemical form of a drug that is administered before it is metabolized by the body's biochemical reactions into its active or inactive metabolites. A parent drug that is not pharmacologically active itself is called a prodrug. A prodrug is them metabolized to pharmacologically active metabolites.


List four (4) drug sources for drugs

  1. Plants
  2. Animals
  3. Minerals
  4. Laboratory synthesis

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