Pharmacology and Implications for Nurses
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| What is pharmacokinetics? | The study of drug movement throughout the body. (These processes determine how much of an administered dose gets to its sites of action.)
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| What is absorption? | The movement of a drug from its site of administration into the blood.
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| What does the rate of absorption determine? | How soon the drug's intended effects will occur.
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| What does the amount of absorption determine? | The intensity of the drug's intended effects.
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| In terms of absorption, which drugs will be absorbed the quickest? | Drugs with higher rates in higher amounts will be absorbed the quickest therefore causing the effects of the drugs quickly.
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| What factors can affect absorption? | Rate of dissolution, Surface area, Blood flow, Lipid solubility and pH partioning.
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| How does the rate of dissolution affect drug absorption? | Drugs that have a faster dissolution will also have a faster onset.
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| How does the amount of surface area affect drug absorption? | The larger the surface area, the faster the absorption.
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| How does blood flow affect drug absorption? | Drugs are absorbed fastest where blood flow is the highest. This is due to the replacement rate of drug-free blood as well as the concentration gradient.
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| How does lipid solubility affect drug absorption? | Highly lipid-soluble drugs are absorbed quickest because they can cross the membranes faster. In order for drugs to penetrate membranes, they must be lipid soluble (lipophilic).
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| How will your knowledge of absorption affect your patient care? | Oral medication takes the longest to cause intended effect but is the safest, IVs are the opposite. With this knowledge, choice of meds should be dependent upon needs of the patient. i.e. you would not give someone with a minor headache IV meds.
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| How does pH partitioning influence drug absorption? | Drug molecules will accumulate on the side that favors their ionization. Acidic drugs will accumulate on the alkaline side while basic drugs will accumulate on the acidic side.
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| What is distribution? | The movement of a drug from the blood to the interstitial space of tissues and then to the cells. "The movement of drugs throughout the body."
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| What is metabolism? | The chemical reaction that breaks down drugs into compounds (metabolites) that are easier to eliminate. The p450 enzyme system is usually responsible for this conversion.
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| What is excretion? | The removal of drugs and their metabolites out of the body. Can exit the body through urine, bile, sweat, saliva, breast milk and expired air.
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| What is a drug's half-life? | The time required for the amount of drug in the body to decrease by 50%.
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| What is elimination? | Metabolism plus excretion.
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| What is a drug's onset? | The length of time needed for a drug to become effective.
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| What is a drug's peak? | The peak plasma concentration of the drug.
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| What is a drug's duration? | The length of time the drug delivers therapeutic response to the body.
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| What is pharmacodynamics? | The study of what drugs do to the body and how they do it. The study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced.
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| What are the four major pharmacokinetic processes? | drug absorption, drug distribution, drug metabolism and drug excretion
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| What is the definition of a mechanism of action? | The specific biochemical interaction through which a drug produces its pharmacological effect. Usually includes mention of the specific molecular targets to which the drug binds to, such as an enzyme or receptor.
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| What are drug effects? | The effects, whether good or bad, that a drug has on the body.
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| What are therapeutic uses? | Desired effects of a drug.
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| What are side and adverse effects? | Undesired effects of a drug.
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| What are interactions? | A drug's interactions with other drugs, the body or food.
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| What is a drug? | Any chemical that can affect living processes. This can also include supplements.
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| What is pharmacology? | The study of drugs and their interactions with living systems.
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| What is clinical pharmacology? | The study of drugs in humans.
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| What is an ideal drug? | DOESN'T EXIST. If it did, it would have the three following qualities: Effectiveness, Safety and Selectivity. Other properties: reversible action, predictability, low cost, simple generic name (easy to pronounce) and would have no drug interactions.
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| What is effectiveness in a drug? | Most important property of a drug - a drug that elicits the response for which it is given. If a drug is not effective, it should NOT be used.
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| What is safety in a drug? | No such thing as a safe drug, however, a safe drug would be one that does not produce any harmful effects, regardless of the amount of dose or length of time it is given.
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| What is selectivity in a drug? | No such thing as a selective drug,however, a selective drug would elicit only the response for which it is given without causing side effects.
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| What is therapeutics? | No such thing as a selective drug, however, a selective drug would elicit the response for which it is given without causing side effects.
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| What is the Therapeutic Objective of Drug Therapy? | To provide the maximum benefit minimum harm.
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| What is an adverse drug interaction? | A negative reaction between a drug and almost anything else.
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| What is toxicity? | Occurs when a patient has received too much of the drug, or has decreased renal and hepatic function.
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| What is enteral? | Absorption through the intestines, esophagus or stomach (GI tract).
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| What is parenteral? | Absorption through any other means than through the GI tract, mostly through injections.
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| What is protein binding? | Occurs when the drug binds to the albumin in the blood stream. Causes a decrease in distribution.
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| What is maximal efficacy? | The largest effect that a drug can produce. Must match the intensity of the drug response to the patient's level of pain. (Ex. Do not give diuretics with high maximal efficacy to those that don't need it to avoid dehydration.)
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| What is a therapeutic index? | Measure of a drug's safety.
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| What is an effective dose? | How much of a drug it takes to create the therapeutic action.
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| What is an agonist? | Agonists are molecules that activate receptors. Drugs that are agonists must have affinity (allows the agonist to bind to receptors) and high intrinsic activity (allows the bound agonist to "activate" receptor function.)
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| What is an antagonist? | Drugs that are antagonists block the binding of endogenous regulatory molecules or agonist drugs in order to produce their effects. Have affinity but no intrinsic activity. Example=antihistamines
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| What is a partial agonist? | An agonist that only has moderate intrinsic activity.
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| What are drug-food interactions? | Interactions between drugs and food which may either increase or decrease all pharmacokinetics.
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| What are drug-drug interactions? | Two or more drugs that can interact and either augment or reduce drug response.
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| What is the Grapefruit Juice Effect? | Raises drug levels by inhibiting metabolism causing blood levels of the drugs to rise, causing peak effects that intensify either risks of toxicity or therapeutic effects.
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| What are allergic reactions? | An immune reaction to a drug ranging from itching to anaphalaxis.
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| What is an idiosyncratic effect? | An uncommon response to a drug because of a genetic predisposition.
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| What is an iatrogenic disease? | An illness caused by a medication or physician.
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| What is physical dependence? | Body has grown accustomed to having a drug and experiences adverse reactions when the drug is not present.
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| What is a carcinogenic effect? | Certain medications and environmental chemicals that cause cancer.
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| What is a teratogenic effect? | Drug-induced birth defect. Examples of teratogens: alcohol, tetracycline
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| What does hepatotoxic mean? | Damaging or destructive to liver cells. Ex. INH, PZA, Rifampin
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| What does pharmacodynamic tolerance mean? | Requires increased dosages due to prolonged exposure to the drug.
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| What does metabolic tolerance mean? | Tolerance associated with accelerated drug metabolism.
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| What is a placebo effect? | Psychosomatic response to a perceived dosage of medication.
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| What is bioavailability? | Ability of a drug to reach systemic circulation from the site of administration, occurs primarily in oral preparations.
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| What is a contraindication? | A pre-existing condition that precludes use of a particular drug under all but the most desperate circumstances.
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| What is a precaution? | A pre-existing condition that significantly increases the risk of an adverse reaction to a particular drug, but not to a degree that is life threatening.
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