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Pharmacologic Principles

Drug: Definition Any chemical that affects the processes of living organisms; an be used in the dx, treatment, cure, relief or prevention of disease; Pro Drug-inactive chemical converted by the body to an active drug.
Drug Standards: Purity Drug vs inert ingredients
Drug Standards: Potency Concentration of active drug (strength)
Drug Standards: Bioavailability Absorption efficiency; bioequivalent
Drug Standards: Efficacy Effectiveness
Drug Standards Safety
Comprehensive Drug Abuse Prevention & Control Act of 1970 Regulated distribution of narcotics and drugs; classified according to abuse potential Ex: Schedule 1: highest; schedule 5: lowest
Chemical Name The drug's chemical composition and molecular structure
Generic Name Name given by the US Adopted Name Council
Trade Name The drug has a registered trademark; use of the name restricted by the drug's owner.
Two types of drug classifications Therapeutic and Pharmacologic
Therapeutic Class What is being treated; according to similarities in: effect on the body, symptom relieved, desired effect, body system
Pharmacologic Class How the drug acts; according to chemical similarities; has similar actions, nursing considerations, side effects
Prototype Drug A drug in a class to which all other drugs are compared. By learning this drug's actions, side effects, nursing considerations, etc., other drugs in this class may be predicted.
Combination Drug Drugs with more than one active ingredient Ex: Cozaar
Pharmacodynamics Study of what the drug does to the body
Pharmokinetics The study of what the body does to the drug Ex: Absorption, distribution, biotransformation, excretion
Absorption Rate at which a drug leaves its site of administration and the extent to which absorption occurs.
Factors that affect absorption Route of drug, ability to dissolve, pH of drug, drug concentration, food or fluids administered with the drug, status of GI motility.
First-Pass Effect The metabolism of a drug and its passage from the liver in the circulation.
Routes that bypass the liver Sublingual, buccal, rectal, intravenous, intranasal, transdermal, vaginal, intramuscular, subQ, inhalation.
Distribution The transport of a drug in the body by the bloodstream to its site of action.
Factors affecting distribution Body size, circulation, protein-binding & tissue-binding, water soluble vs fat soluble, blood brain barrier & placenta barrier, areas of slow distribution (muscle, skin, fat).
Biotransformation The biologic transformation of a drug into an inactive metabolite, a more soluble compound, or a more potent metabolite. Ex: Liver, kidneys, lungs, plasma, intestinal mucosa.
Liver Enzyme Inducers Drugs that can cause a decrease in therapeutic level of other drugs
Liver Enzyme Inhibitors Drugs that can cause an increase in therapeutic level of other drugs.
Delayed drug metabolism results in: accumulation of drugs; prolonged action of the effects of the drugs.
Stimulation drug metabolism causes: Diminished pharmacologic effects
Therapeutic Index The ratio between a drug's therapeutic benefits and its toxic effects
Undesirable responses to drug therapy Idiosyncratic, hypersensitivity reactions, drug interactions
Drug Dose Responses Onset; duration of action; peak; therapeutic level/plateau
Onset The time it takes for the drug to elicit a therapeutic response
Peak The time it takes for a drug to reach its maximum therapeutic response
Duration of Action The time a drug concentration is sufficient to elicit a therapeutic response
Therapeutic Level/Plateau Desired concentration after repeated fixed doses
Elimination Half-Life Time it takes for 1/2 of the original amount of a drug in the body to be removed; a measure of the rate at which drugs are removed from the body.
Distribution Half-Life Time required for blood levels to drop by 1/2 because of migration into tissues.
Steady State Drug In=Drug Out
Cumulation Rise in blood levels because drug elimination fails to math rate of absorption.
Developmental Considerations: Infants Immature liver/kidneys; less total body fat; lower drug dosages; longer drug intervals.
Developmental Considerations: Children Dosages calculated individually; lower dosages.
Developmental Considerations: Elderly Decreased kidney function; decreased GI function; decreased plasma proteins; increased ratio of body fat to lean muscle; polypharmacy.
Created by: nglidden