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Pharmacology Notes Chapter –1 Pharmacology- study of history, sources, and physical chemical property of drugs. Also includes how drugs affect living systems. Pharmacogenetics – study of how each individual will respond to specific drugs Pharmacodynamics - is the study of biochemical and physiological effects of drugs. Pharmacokinetics – is the Absorption, distribution, bio transf (metabolism) and excretion of drugs (liberation) Pharmacotherapeutics - how drugs might be used in the treatment of illnesses (prevent & treat) Pharmacognosy – study of herbal drugs, or other natural sources, such as insulin Toxicology – Study of poison and poisonings History of Pharmacology - Ancient Egypt, more than 3000 years ago, listed more than 700 different remedies that were used to treat ailments. - In the first century, Dioscorides prepared “De Materica medica” which prescribed 600 different plants and classified them by substance, rather then the disease that they were used for. Sources of drugs - Natural - digoxin, metamucil - Semi synthetically – antimicrobial agents - Synthetic – made on lab, Drug Usage - Symptomatic, such as taking acetaminophen for a headache, or aspirin - Preventive, - vaccines - Diagnostics – Dye and such - Curative Drugs – antibiotics - Health maintenance drugs – Insulin - help body works normally - Contraceptive – prevent pregnancy Dosage Forms Tablets – is the most common dosage form, many are scored to facilitate division Time released, sustained – controlled drug release Capsule – drug enclosed on a hard or soft shell, could be gelatin also Troches – Lozenges, dissolves slowly with an anesthetic, or antiseptic on the oral cavity/throat. Suppsitories – solid medicine, will melt at body’s temperature, to be inserted on a external body orifices. Solutions – clear liquids with one or more solvents, such as syrup, tinctures or elixir. Suspensions – are liquid dosages that contain solid drugs. Shake well! Emultions – are dispersion of water in oil, or oil in water. Topical – Patches, Lotions, Creams. Ampules – sterile, single dose, don’t contaminate it! Drug names Drugs come to the market with a trade name, when that expires, low cost generics are usually available, keep in mind that they could be 20% off more or less ingredients than the brand trade name, but FDA allows them to say they are equal! It is important to know drugs by more than one mane, trade and generic! Controlled substances Schedule I Lsd, heroin Schedule II Morph. Cocaine Oxycodone Ritalin Meperidine Schedule III Tylenol with codeine Hydrocodone Schedule IV Librium Schedule V Lomotil Valium Robitussin A-C Schedule VI Marijuana in some states Distribution A number of drugs are capable of being bound to plasma proteins, particularly albumin. While in this bound state, the drug is incapable of eliciting a pharmacological effect The physical and chemical characteristics of a drug usually determine precisely how the drug will be distributed. Those are highly soluble in fatty tissue, may accumulate rapidly in fat. In some cases fat can become reservoir for certain drugs, slowly releasing the drug into the blood Stream Biotransformation (Metabolism) Drug molecules that are bound to protein are pharmacologically inactive, whereas those that are unbound (not stuck to the protein) are active! Most biotransformation reactions occur in the Liver (remember, babies and elderly do not have the same liver capacity as healthy adults!) Drug elimination Drug will be excreted in the kidney, while some can be through feces, breathing, breast milk, saliva, or sweat The pH of the urine might affect the rate of the excretion by changing the chemical form of a drug to one that can be reabsorbed back into the circulatory system. Weak acid drugs, barbiturates, penicillins, and other drugs that are available as sodium or potassium salts, tend to be better excreted if the urine is less acid. Measuring Drug Action “Drug half life” how long does it take for a certain medicine to process and excrete half what was taken. Individual variations of pharmacological response Consider: - Age Sex Body weight & (BSA) BMA (basal metabolic rate) Disease states Time of administration Tolerance Environmental factors (sun/weather exposure) Idiosyncratic responses Drug interactions It is when a drug interacts to another drug (could also be herbal) and the pharmacological response is greater that what would be expected, they are acting SYNERGISTICALY, And if they are dimishing the action of another drug, it is said to act ANTAGONISTICALLY Pharmacology Notes Chapter –2 The Nursing Process and Medication Administration Assessment - data are systematically collected and analyzed, using interviews, observations, lab reports, and other sources, it is basically a overall examination with all that you have available Nursing Diagnosis - It is the analysis of the collected data in which the nurse will legally prescribe interventions based on the practice act. Planning - It is the process in which the nurse will set priorities and determine nursing interventions, set goals and objectives, and also plan on educating the patient on self administration of drugs. Implementation - Is the actual administration of the medication, or the initiation of a medication schedule, or client education program. Some times the nurse does not perform the task, but will supervise whoever is implementing the plan. Evaluation - It is the comparison of actual client outcomes with expected outcomes. It includes assessing the effectiveness of the medication in alleviating signs and symptoms of illnesses, determining adverse effects that result from the use of the drug, and determining the client’s ability to self administer the medication. Measure equivalents 1kg – 1.000g grams 1g – 1.000mg milligrams 1mg – 1.000mcg microgram 1mcg – 1000ng nanograms 1 liter (L) equal to 1000mL METRIC TO APOTHECARY 30 mL – 250 mL – 500 mL – 1000 mL - 1 fluid ounce 8+ Floz 1+ pint 1+ quarts household measures 1 teaspoon (tsp) 5mL 1 tablespoon (tbsp) 15 ML *REMEMBER – 1 oz = 30 mL, then 2 tbsp or = 6 tsp* Other Equivalents 1kg = 2.2lbs 4g = 60 grain 1g = 15 grain 0.3g = 5grain 60mg = 1grain 30mg = 1/2grain Remember the rights of medication administration You must check: The right drug to be administrated at The right dose for The right patient at The right time by The right route using The right documentation although the client has The right to refuse Diagnosis and Planning - State relevant nursing diagnoses. Identify desired outcomes of nursing intervention Focus on: Why is the drug needed How will the drug be administered Common indications of adverse effects Other nursing measures that will enhance the likelihood of achieving desired outcomes.