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PHARMACOLOGY PHARMACOLOGY • THE STUDY OF DRUG ACTIONS ON AND INTERACTIONS WITH LIVING ORGANISMS. PHARMACOKINETICS • THE INTERACTIONS OF DRUGS WITH BODY TISSUES SYSTEMIC ADMINISTRATION OF DRUG • • • • ABSORPTION DISTRIBUTION BIOTRANSFORMATION EXCRETION ABSORPTION • IN ORDER FOR THE DRUG TO PRODUCE DESIRED EFFECTS ON THE BODY, IT MUST REACH THE INTENDED SITE OF ACTION!!!! DRUG ABSORBED AND CIRCULATIONG IN THE BLOODSTREAM IS CALLED BIOAVAILABLE DISTRIBUTION • FOLLOWING ABSORPTION DRUGS ARE DISTRIBUTED VIA CIRCULATORY SYSTEM. BIOTRANSFORMATION • MOST DRUGS ARE METABOLIZED IN THE LIVER AND EITHER REDUCED OR CHANGED INTO A WATERSOLUABLE SUBSTANCE SO THEY CAN BE EXCRETED BY KIDNEYS EXCRETION • MOST DRUGS ARE EXCRETED BY KIDNEYS. OTHER EXCRETION ROUTES: PERSPIRATION, TEARS, FECES, BREAST MILK, SALIVA FACTORS THAT INFLUENCE DRUG ADMINISTRATION • • • • AGE GENDER HORMONAL DIFFERENCES EMOTIONAL OR PSYCHOLOGICAL STATE • TIME OF DAY • THE CHANNEL OR ROUTE OF ADMINISTRATION DRUG ADMINISTRATION ROUTES • • • • • • • • ORAL TOPICAL PARENTERAL SUBLINGUAL INTRATHECAL RECTAL TRANSDERMAL INHALATION ORAL DRUG ADMINISTRATION TOPICAL DRUGS Advantages • Base (cream, ointment, gel, spray) makes application easy and controllable. • Onset of symptom relief is usually faster than oral preparations. • Symptoms are relieved at a steady rate and relief may last longer. • A smaller amount of medicine may be needed when applied in a topical form. • Formulations diffuse through the skin and enter the bloodstream, initially bypassing the digestive system (called 'first pass'). Many systemic (whole body) side effects, such as irritated stomach lining, may be lessened or eliminated PARENTERAL DRUG ADMINISTRATION • SUBCUTANEOUS • INTRAMUSCULAR • INTRAVENOUS SUBCUTANEOUS For the subcutaneous route, a needle is inserted into fatty tissue just beneath the skin. The drug is injected, then moves into small blood vessels (capillaries) and is carried away by the bloodstream or reaches the bloodstream through the lymphatic vessels. INTRAMUSCULAR The intramuscular route is preferred to the subcutaneous route when larger volumes of a drug product are needed. Because the muscles lie below the skin and fatty tissues, a longer needle is used. Drugs are usually injected into muscle in the upper arm, thigh, or buttock. How quickly the drug is absorbed into the bloodstream depends, in part, on the blood supply to the muscle: The sparser the blood supply, the longer the drug takes to be absorbed. The blood supply is increased during physical activity INTRAVENOUS Intravenous injecting is a highly efficient way of introducing drugs into the body. However, when drugs are injected, the filtering and delaying mechanisms that protect us when things are absorbed via the gastrointestinal tract, lungs or skin are bypassed. The potential for infection and overdose are much increased SUBLINGUAL Sublingual Route A few drugs are placed under the tongue (taken sublingually) so that they can be absorbed directly into the small blood vessels that lie beneath the tongue. The sublingual route is especially good for ANGINA—which is used to relieve angina (chest pain due to an inadequate blood supply to the heart muscle)—because absorption is rapid and the drug immediately enters the bloodstream without first passing through the intestinal wall and liver. However, most drugs cannot be taken this way because they may be absorbed incompletely or erratically INTRATHECAL For the intrathecal route, a needle is inserted between two vertebrae in the lower spine and into the space around the spinal cord. The drug is then injected into the spinal canal. A small amount of local anesthetic is often used to numb the injection site. This route is used when a drug is needed to produce rapid or local effects on the brain, spinal cord, or the layers of tissue covering them (meninges)—for example, to treat infections of these structures. Anesthetics are sometimes given this way. RECTAL Rectal Route Many drugs that are administered orally can also be administered rectally as a suppository. In this form, a drug is mixed with a waxy substance that dissolves or liquefies after it is inserted into the rectum. Because the rectum's wall is thin and its blood supply rich, the drug is readily absorbed. A suppository is prescribed for people who cannot take a drug orally because they have nausea, cannot swallow, or have restrictions on eating, as is required after many surgical operations. Drugs that are irritating in suppository form may have to be given by injection TRANSDERMAL Drugs can be administered transdermally by a patch applied to the skin. The drug penetrates the skin and is absorbed into the bloodstream. INHALATION Drugs can be administered using inhalers, which deliver the drugs directly to the airways ADVERSE EFFECTS OF DRUGS • AN UNINTENDED EFFECT THAT IS EXPECTED TO OCCUR IS CALLED: • SIDE EFFECT • ANY EFFECT THAT IS NOT BENIGN IS CALLED AN ADVERSE REACTION DRUGS INCOMPATIBILITY • WHEN MIXED SOME DRUGS CAN BECOME EITHER TOXIC OR INACTIVE!!!!! RT HAS AN OBLIGATION: • TO KNOW THE LOCATION OF THE EMERGENCY CART. • TO SUMMON EMERGENCY HELP IN TIMELY MANNER • TO MAINTAIN COMPLETENESS OF THE EQUIPMENT ON THE EMERGENCY CART EMERGENCY CART DRUG NAMES • • • • TRADE NAME CHEMICAL NAME GENERIC NAME OFFICIAL NAME TRADE NAME • NAME ASSIGNED BY THE MANUFACTURER CHEMICAL NAME • EXACT CHEMICAL FORMULA GENERIC NAME • GIVEN BEFORE THE OFFICIAL APPROVAL FOR USE OFFICIAL NAME • GENERIC AND OFFICIAL NAMES ARE USUALLY THE SAME • USED IN THE OFFICIAL PUBLICATIONS DRUG CLASSIFICATIONS • • • • • • • ANT-INFECTIVE ACTING ON THE NERVOUS SYSTEM ANALGESICS ANTIPYRETICS TO TREAT CARDIO-VASCULAR DISEASE TO TREAT GI TO TREAT ALLERGIC RESPONSES ANTI-INFECTIVE • ANTIBIOTICS- (PENICILLIN, ERYTHROMYCIN) ACTING ON THE NERVOUS SYSTEM • CHLORAL HYDRATE – SEDATIVEORAL, RECTAL • MORPHINE SULFATE – CONTROL OF SEVERE PAIN- ORAL, PARENTERAL • LIDOCAINE – ANESTHETIC- PAIN BLOCKER – TOPICAL, PARENTERAL ANALGESICS, ANTIPYRETICS, ANTI-INFLAMMATORY • ASPIRIN • ACETOMINOPHEN • IBUPROFEN ORAL TO TREAT CARDIOVASCULAR DISEASE • LASIX- ( DIURETIC ACTION)- IV, ORAL • HEPARIN - IV AND COUMARIN(ANTICOAGULANTS) ORAL • NITROGLYCERIN – (VASODILATOR) ANGINA PECTORIS – SUBLINGUAL, TOPICAL TO TREAT GI • SODIUM BICARBONATE pH ORAL • CASTOR OIL- CATHARTIC- ORAL • MILK OF MAGNESIA- CATHARTICORAL TREATMENT OF ALLERGIC RESPONSES • EPINEPHRINE (ADRENALIN)BRONCHODILATORVASOCONSTRICTOR-PARENTERAL , INHALATION • BENADRYL – ORAL , PARENTERAL