Transcript Document

Week 1:
Seminar Overview,
Basic Concepts
1
Course Policies and Procedures
References
 Books - must be current ...
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
Published within the last 2 years
Websites - these 3 are very useful ...
 www.rxlist.com
 www.webmd.com
 https://online.epocrates.com/
 manufacturer’s

website
when information about a specific brand name
drug product is needed, (for example ... go to
Lilly.com for detailed info on Prozac)
Course Policies and Procedures
References
 Must be reputable
 Must be sited
 Take
the Plagiarism Policy very seriously!
 Any drug-information you turn in that you had
to look up ...


Must be referenced using APA format
Unsure how to reference?
 Seek
help by going to the ‘Writing Center’
Chapter 2 critical thinking case
of
Basics of Pharmacology

Yvette, a new patient, has been diagnosed by the
physician as hypertensive. The physician has
prescribed two new medications for her to take.
Yvette is also taking several other medications for
osteoarthritis and allergies; these were prescribed
by another physician, but she cannot remember all
of the names. What can you do to make certain you
have all the right information about Yvette’s new
medications so that they will not cause any adverse
or toxic reactions?
What is a Drug?

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a chemical used for a therapeutic application
Drug Indications
 Therapeutic
 Diagnostic
 Replacement
 Supplemental
 Preventative/Prophylactic
 Curative
 Maintenance
 Supportive
Traditional Medication
Indications
Therapeutic = to relieve symptoms
 Diagnostic = to diagnose a disease, or
the disease’s progression
 Replacement = to replace missing
chemicals needed by the body ...
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
Example: thyroid preparations; hormones
Traditional Medication
Indications (cont.)

Supplemental = to prevent deficiencies

Example: Vitamins
Preventative = example: Vaccines
 Palliative = reduce symptoms, but no ‘cure’
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Example: pain medications
Traditional Medication
Indications(cont.)
Curative = Example: antibiotics
 Maintenance = to maintain health that has
been put at risk
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Example: medicine for high blood pressure
Supportive
 Maintain
body in “homeostasis” until disease
process can be resolved

Asthma rescue inhaler
Drug Components

Active ingredient
 pure,
undiluted form of chemical having an effect
on body function
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Inert ingredient
 little
or no effect on body function
 adds flavor, bulk, color

Vehicle
 inactive
agent carrying an active medicinal
ingredient
Pharmacognosy—The Origins of Drugs
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Historically, drugs came from ...
 plants
 animals
 minerals
 synthetic substances (chemicals)
Recently, ...
 recombinant DNA technology (gene
splicing) is being used to create drugs
Pharmacokinetics: How the
Body Processes Drugs
Involves four processes (A-D-M-E):
 Absorption—movement
of a drug from its
administration site into the blood
 Distribution—movement of a drug from the
blood into tissues and cells
 Metabolism—physical and chemical alteration
of a drug in the body
 Excretion—removal of waste products from
the body
Absorption = ‘A’
Medications are administered by three routes.
Modified from Leahy, JM, Kizilay, PE (1998).
Foundations of nursing practice. Philadelphia:
Saunders.
Physical Properties and Absorption Rates
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Solubility—tendency of a drug to dissolve
pH—acidic drugs are easily absorbed in the
stomach
Absence or presence of food in stomach—
food slows absorption rate
Fat solubility—medications high in fat are
easily absorbed in the stomach
Length of Contact

Topical drugs’ absorption depends on:
 Length
of time in contact with skin
 Skin thickness
 Composition/medium-ointment, cream, lotion

Topical medications can be dangerous in
elderly patients, because their skin may be so
thin that absorption is greater than desired.
Distribution = ‘D’
• Drug is delivered to
tissues through
blood vessels and
capillaries.
• Drug’s effect takes
place in tissues,
not blood vessels.
Modified from Leahy, JM, Kizilay, PE (1998).
Foundations of nursing practice. Philadelphia:
Saunders.
Drug Blood Level
• Amount of drug
circulating in
bloodstream
• Physicians
monitor blood
levels with
therapeutic drug
level test
Synergism
Two drugs taken together boost each other’s effect
more than either alone could accomplish
Drug A 
 Drug B
Antagonism
One drug counteracts, or reduces the effect of
another drug when the two are taken together
Drug A 
Drug B
Summation, Cumulation, Tolerance

Summation - two drugs given together result in
expected effect of combination, for example ...
 Summation: 1+1 = 2, vs. Synergy: 1+1= >2

Cumulation/accumulation - occurs when the drug
administered is still residing in the body when another
dose is given (can lead to toxicity)
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Tolerance - occurs after long-term use of some
drugs ... results in less than expected effects (subtherapeutic?)
Metabolism (Biotransformation)= ‘M’
Series of chemical reactions altering a drug
by converting it into a water-soluble compound for
excretion
Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing
practice. Philadelphia: Saunders.
Excretion (Elimination) = ‘E’
May occur through ... respiration, perspiration,
urination, and/or defecation
Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia:
Saunders.
Effects of Drugs
• Desired effect—intended response to a
medication, for example ...
– Amoxil (an antibiotic) clears up Kyle’s strep throat.
• Side effect—mild, undesirable response to a
medication, for example ...
– Amoxil causes Kyle to become slightly nauseated
Unwanted Effects of Drugs
• Adverse reaction—unintended, undesirable,
often unpredictable effects causing unwanted
symptoms, for example ...
– Amoxil causes Kyle to have recurring episodes of
diarrhea.
• Allergic reaction—”hypersensitivity” to a drug,
often after just one dose, for example ...
– Amoxil causes Kyle to break out in a rash.
Anaphylaxis-the most dangerous
type of allergic reaction
• Severe, potentially fatal, allergic
response
• Occurs a short time after the drug is
taken, for example ...
• Shortly after Kyle takes his first dose of
Amoxil, his mouth and throat begin to
swell, and he has difficulty breathing.
Drug Nomenclature(naming)
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Chemical name-based on molecular-structure
 Ex:
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Generic/nonproprietary name - always in
lowercase, easier than chemical name
 Ex:

2-(4-isobutlyphenyl)propionic acid
ibuprofen
Trade/Brand/proprietary name - owned by the
original manufacturer, who holds the Patent
rights for 20yrs after FDA approval(given a
registered trademark ®)
 Ex:
Motrin®, Advil®
Tablets—Dried Compressed Powder
• Unscored
• Scored (for division)
• Layered (to allow
incompatible drugs to
be given in one
medication)
Enteric-Coated Tablets
• Special coating to allow drug to dissolve in
intestines rather than stomach
• Prevent inflammation of gastric mucosa
• Always swallowed whole
• Example: enteric-coated aspirin(EC-ASA)
Various Tablet Forms
• Chewable—Sugared or flavored (antacids,
antiflatulents, children’s medications)
• Sublingual(SL)—dissolve under tongue for rapid
absorption, - ex: nitroglycerin tabs
• Buccal—place between cheek and gum
***Instruct patients taking SL or buccal tablets ...
Do NOT:
1. take with H2O – too quickly absorbed
2. Chew or Swallow tablet – not as effective
Capsules
• Small, cylindrical gelatin containers
• Two pieces fit together
• Used when medication has unpleasant taste,
odor
• Can pull apart and add to food
Sustained-Release Capsules
• Medication released over period of time
• Tiny beads designed for release or
disintegration at different times
• Swallow whole
• Also called time-release or delayed-action
• Never open— overdose may occur due to
altered absorption rates
Gelcaps
• Soft gelatin shells made in one piece
• Hold a liquid form of medication
• Do not chew!—medicine often tastes
unpleasant
• Can squeeze into oral cavity, following
physician’s advice
• May stick to inside of mouth if mouth is dry
Troche or Lozenge
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Hard medications (flat tablet or ‘disc’)
Candy or fruit base
Dissolve in mouth for local effect
Examples: cough drops, sore throat lozenges
Liquid Oral Preparations
• Active ingredients in liquid medium
• Two major categories
– Solutions—active ingredient dissolved in liquid
– Suspensions—medication particles suspended
in liquid (Shake Well!)
cont. -- Liquid Preparations
• Syrups—water based, sweetened with sugar
or sugar substitutes
• Elixirs—contain sweetener, alcohol, and
water
– use with caution in diabetics and patients taking
Antabuse (Disulfarim reaction)
• Extracts—highly concentrated preparation
achieved through evaporation of a solution
Percutaneous Medications
• Lotions—free-flowing liquids or suspensions
in water base
– treat skin conditions (calamine lotion)
• Creams—semisolids in water base
– corticosteroid cream
• Ointments—semisolids in oil base
– triple antibiotic ointment
Questions
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