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Pharmacology for Nurses

Pharmacology for Nurses

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Published by Raf Luis
Nclex Review Guide!
Nclex Review Guide!

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Published by: Raf Luis on Nov 21, 2010
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the study of drug movement through the body. The effect of the body on thedrug.
the movement of a drug from its administration site into the circulation
Rate of Absorption
how soon the effects of a drug will begin
Amount of Absorption
intensity of the drugs effects
Factors affectingabsorption
rate of dissolution, surface area, blood flow, lipid solubility, pH partitioning,
Rate of dissolution
drugs in formulations that have rapid dissolution have a faster onset thandrugs with slower rate of dissolution
Surface Area
the larger the surface area the faster the absorption. Small intestine hasfastest absorption of oral administered drugs
Blood Flow
the more vascular a site the quicker the absorption. Works on concentrationgradient, blood containing newly absorbed drug will be replaced rapidly bydrug free blood.
Lipid Solubility
Highly lipid soluble drugs absorb more rapidly.
pH partitioning
drug absorption and elimination ca be affected by acid/base concepts. Alsoworks on concentration gradient. Acid drugs are drawn toward alkaline andvice versa. Important in treatment of overdoses.
Routes of administration
enteral and parenteral and less commonly topical etc.
Enteral Administration
via the gastrointestinal tract
Parenteral Administration
drugs given by penetration of the skin and entry into the underlying tissue
rapid effect maximal degree of control over circulating drug. Usually aqueous.Not reversible.
Drawbacks of IV
Infection, repeat dosage requires patent iv line.
May be used for drugs that are aqueous and non-aqueous. Deltoid andVastus lateralis quicker than dorso-gluteal or ventro-gluteal admin. Related toblood flow to tissue
Dependent on blood flow to the tissue. Slow and constant absorption, non-irritating requires absorption into capillaries.
most common. Variable in terms of availability. Efficacy may be limited bymetabolism. Food in system may affect efficacy/action or delay gastricemptying leading to destruction of drugs.
The movement of drugs throughout the body. Dependent upon blood flow totissues, the availability of the drug to exit the vascular system and to a lesser extent, the ability of the drug to enter the cells.
Speed of Blood flow
Well perfused organs such as brain, heart, kidney and liver receive most of the drug in the first few minutes. Muscle, most viscera, skin and fat are slower 
to receive drug, from minutes to hours.
Diffusion into InterstitialCompartments
rapid diffusion occurs in most areas because of permeable capillaries. E.g..Liver capillaries have much of basement membrane exposed by slit junctionswhich enables rapid diffusion including large plasma proteins.
Blood brain Barrier 
no slit junctions in brain so drugs must either pass directly through (lipidsoluble) or via active transport.
Drug metabolism. The most important consequence of metabolism ispromotion of renal excretion.
Most important factor inbiotransformation
Renal excretion
Factors affectingbiotransformation
Induction, first pass effect, extremes of age, nutritional status, competitionamong drugs.
Some drugs, acting on the liver, can increase the rate of their own or another drug's metabolism. E.G.. Phenobarbital the classic enzyme inducer 
First Pass
rapid inactivation of oral drugs due to liver metabolism.
Metabolism relating tolipophilic drugs
Lipophilic properties that promote a drug's passage through biologicmembranes and subsequent access to their sites of action also hinderselimination of the drug.
Usual biotransformation of drugs
usually biotransformed into more polar, inactive metabolites that are easilyexcreted by body.
Hepatic Metabolism
Metabolites with increased biologic activity or even toxic properties may becreated through metabolism E.G.: Tylenol has a hepatotoxic metabolite.
Hepatotoxic definition
chemical-driven liver damage. It is a possible side-effect of certainmedications
Renal, billiary, fecal, breast milk, lungs, saliva, sweat
Renal Excretion
glomerular filtration, proximal tubule secretion, distal tubular secretion, renalexcretion
Plasma Drug Levels
there is a direct relationship between therapeutic and toxic responses and theamount of drug present in plasma
Minimum effective concentration
MEC definition
the plasma drug level below which therapeutic effects will not occur 
Toxic Concentration
the plasma drug level at which toxic effects occur 
Therapeutic Window
the range of plama drug levels falling between the MEC and the toxicconcentration. Drugs with narrow range of therapeutic window are more apt tocause toxicity. Digoxin is the classic example
Drug Half life
the time required for the amount of drug in the body to decrease(eliminated)by 50%. Drugs with a short half-life but a long dosing interval will lose theMEC
when the amount of drug eliminated between doses equals the doseadministered. Average drug levels will remain constant and plateau will havebeen reached.
Techniques for reducingfluctuations in plasmadrug levels
Continuous infusion (plasma levels kept constant), constant daily dose reducesize and interval of dosage.
Loading Dose
Large initial dose which achieve plateau rapidly
Maintenance Dose
small doses to maintain plateau
the study of the biochemical and physiologic effects of drugs and themolecular mechanisms by which those effects are produced. In short, whatthe drug does to the body.
Dose ResponseRelationship
Graded relationships. As the dosage increases the response becomes greater 
Maximal Efficacy
the largest effect a drug can produce
the amount of drug that must be given to elicit a response
Drug Receptor 
any functional macromolecule in a cell to which a drug binds to produce itseffect
Receptor Compatibility
the ability of a drug to bind to it's receptor depends on the size and shape of the drug and it¶s receptor, a single receptor can be responsible for regulatingseveral physiologic activities. Drugs mimic or block the actions of the body'sown regulatory mechanisms.
Intrinsic Activity
the ability of a drug to activate a receptor following binding and is linked toefficacy.
drugs that bind with and activate receptors.
drugs with affinity for receptors but no intrinsic activity
reduction in responsiveness brought on by repeated doses in short period of time. Rapid tolerance. The MEC is elevated can occur from days to weeks of administration. Metabolic tolerance is caused by the effects of the enzymeinduction on drugs. Accelerated metabolism can occur after days or weeks.
Additive Effect
2 drugs with similar properties are taken together.1+1=2 E.G. aspirin andcodeine boost analgesic properties if taken together 
Synergistic Effect
The response of two drugs taken together is greater than the response of thesame drugs taken alone. 1+1=3 E.G. lasix and beta-blockers. Lasix removesfluid and b-blockers block vasoconstriction causing a sharp decrease in bp

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