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adverse effects:

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drug effects that are not the desired therapeutic effects; may be unpleasant or even dangerous

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brand name:

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name given to a drug by the pharmaceutical company that developed it; also called a trade name

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chemical name:

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name that reflects the chemical structure of a drug

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generic name:

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the original designation that a drug is given when the drug company that developed it applies for the approval process

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genetic engineering:

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process of altering DNA, usually of bacteria, to produce a chemical to be used as a drug

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over-the-counter (OTC) drugs:

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drugs that are available without a prescription for self-treatment of a variety of complaints; deemed to be safe when used as directed

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pharmacology:

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the study of the biological effects of chemicals

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pharmacotherapeutics:

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clinical pharmacology—the branch of pharmacology that deals with drugs; chemicals that are used in medicine for the treatment, prevention, and diagnosis of disease in humans

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phase I study:

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a pilot study of a potential drug done with a small number of selected, healthy human volunteers

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phase II study:

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a clinical study of a proposed drug by selected physicians using actual patients who have the disorder the drug is designed to treat; patients must provide informed consent

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phase III study:

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use of a proposed drug on a wide scale in the clinical setting with patients who have the disease the drug is thought to treat

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phase IV study:

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continual evaluation of a drug

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teratogenic:

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having adverse effects on the fetus

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Pharmacokinetics

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How the body acts on the drug (what does the body do to the drug once its inside the body)

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Pharmacodynamics

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How the drug affects the body

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Efficacy

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the ability to produce a desired or intended result

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Dynamic Equilibrium

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Absorption (stomach) Distribution (circulation) Biotransformation (metabolism) (liver) Excretion (kidneys)

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Pharmacokinetics Absorption

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Process by which a drug is transferred from its site of entry into the body to the bloodstream (circulating fluids) and tissues

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Oral meds-

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most frequently used, longest to start working, acid in stomach is involved, food stimulates more acid and prolongs gastric emptying.

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Injected Meds-

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faster than oral, IM is absorbed into the muscles then into the bloodstream.

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Pharmacokinetics Distribution

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Movement of drug to the body's tissues Influences on drug distribution Blood flow to tissues Lipid solubility and ionization Protein binding- drug binding to proteins in the plasma in the circulation prevents the drug from reaching its Blood-brain barrier- a structure that is protective made of tightly spaced capillary walls that supply's blood to the brain. Preventing toxins and poisons to effect the brain. Placenta and lactation- most drugs readily move across the placenta, try to not administer drugs to a pregnant woman unless the benefit outweighs the risk.

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PharmacokineticsBiotransformation

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(metabolism) Change of a drug from its original form to a new form Occurs in many tissues Liver primary site where metabolism occurs.

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Liver metabolism

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Inactivated by the liver and broken down into something that is inert

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First pass effect

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(Orally) Goes first to the liver where it is being transformed by the liver and transformed into other things so it can be excreted. Doesn't't happen with Intra muscular Injections or IV. Oral drugs are increased in size when compared to IV or IM.

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Hepatic enzymes

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The interaction of some drugs increase the reaction of liver enzymes. Speeding up the metabolism of the drug. Some drugs cant be given together because some speed up the metabolism of the liver enzymes or slow down the liver enzymes which can cause the drug to linger.

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PharmacokineticsExcretion

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Excretion process of removing a drug or its metabolites from the body Occurs in several tissues Kidneys primary site Before distributing a drug we must know the pt's kidney functions/problems.

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Critical Concentration and Onset of Action-

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amount of drug needed to cause a therapeutic effect.

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Loading Dose-

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higher dose than used for normal treatment to initiate a quicker onset of action

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Peak Effect-

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highest concentration of blood after which declines

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Half-life-

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time it takes the drug to decrease to one half of the peak. (part of dosage)

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Duration of Effect-

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the length of time that the drug is effective.

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Factors Affecting Drug Action

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Weight- determines drug dosing Age (developmental factors) Gender Illness Genetic and Cultural factors Ethnopharmacology- the study of response to drugs based on ethnicity. Pharacogenetics-people that have genetic variations that indicate the pt might be more receptive to the drug Psychological patients expectations Environmental

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Tolerance-

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higher dose needed to cause the same effect. Cross tolerance- b/c u have a tolerance to one drug u might be tolerant to another that is similar one as well.

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Allergic Effect-

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hypersensitivity, body interprets drug as a foreign invaded and builds antibodies against it. Anaphylaxis-respiratory distress, life threatening.

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Interactions

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Drug-drug- something happens between taking two drugs together. Getting unanticipated effects. Drug-food- could inhibit or enhance absorption Drug-laboratory test- some drugs interfere in laboratory tests

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Toxic Effect

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Hepatotoxicity- liver damage Nephrotoxicity-kidney damage Cardiotoxicity-heart damage Cumulative effect- cant metabolize the drug before the next dose is given.

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Idiosyncratic-

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occurs unexpectedly usually after the first time the person is given the drug.

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Carcinogenicity-

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drugs that have adverse effects that can cause cancer

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Teratogenicity-

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drugs that can cause abnormal fetal development.

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Black Box Warning

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Potential to cause serious or life-threatening adverse effect Added after significant serious adverse effects have occurred Strongest warning

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Nursing Responsibilities and Drug Therapy

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Knowledge Therapeutic effect Drug-drug interactions Indication Lifespan and cultural considerations Contraindication Nursing Considerations Adverse effect Relevant patient education Administer drugs Prevent medication errors Assess for therapeutic and adverse drug effects Act to make the drug regimen more tolerable/increase compliance Provide patient teaching about drug and regimen Nursing Process in drug therapy to ensure that the patient receives the best, safest, most efficient, scientific and evidence-based holistic care.

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Challenges to Effective Drug Therapy

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Consumer Awareness OTCs Alternative Therapies and Herbals Financial Considerations

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Weight-based Drug Calculation

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Pediatric Dosing Wide variations in size Adult Dosing Small margin of safety High potential for toxicity Safe Range Specified amount of drug for each unit of weight

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Drug Evaluation

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Regulated by FDA Preclinical Trials Chemicals tested on laboratory animals Phase I Studies Chemicals tested on human volunteers Phase II Studies Drug tried on informed patients Phase III Studies Drug used in vast clinical market

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Drug Regulation

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FDA - U.S. Food and Drug Administration Regulation of development of drugs Regulation of sale of drugs Drug approval for marketing and use Stages of Development

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Sources for Drugs

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Natural Plants, animals, inorganic compounds Synthetic Manufactured Genetic engineering

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Nursing Responsibilities and Pharmacotherapeutics

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Knowledge about drugs Administer drugs Prevent medication errors Assess for therapeutic and adverse drug effects Act to make the drug regimen more tolerable/increase compliance Provide patient teaching about drug and regimen

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Pharmacotherapeutics (clinical pharmacology) -

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branch of pharmacology that uses drugs to treat, prevent, and diagnose disease.

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Key concerns:

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the drug's effects on the body the body's response to the drug

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Importance for nursing:

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Apply to clinical setting Patients often have complex drug regimens and receive potentially toxic drugs Drug can have many effects and need to know which ones may occur when administering a drug Some drug effects are therapeutic, meaning helpful, others are undesirable or potentially dangerous

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Pharmacology

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The science of drugs including their origin, composition, pharmacokinetics, therapeutic use, and toxicology (Merriam Webster) The study of the biological effects of chemicals (Karch) Chemicals = drugs Drugs are chemicals introduced into the body to cause some sort of change

Ch1. Intro to Drugs

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