CARDIORESPIRATORY PHARMACOLOGY

INTRODUCTION TO
PHARMACOLOGY
ETTA C. CATACUTAN
FEBRUARY 6, 2021

OUTLINE • stat - now

I. Pharmacology • Every – q
II. Drugs
A. Role V. DRUG EVALUATION
III. Ten Rights of Giving Medicines • PRECLINICAL TRIALS
IV. Drug Timing o purpose: to determine whether they have the presumed
V. Drug Evaluation effects in living tissue to evaluate any adverse effects
VI. Drug Uses
• PHASE 1 – uses human volunteers to test the drug
VII. Routes of Administration
o They are informed of the risk
o Paid for participation
I. PHARMACOLOGY • PHASE 2
• From Greek, pharmakon, “drug”; and -logia, “study” o Allows clinical investigators to try the drug in patients
• how drugs interact within biological systems to affect function who have the dse.
• deals with all aspects regarding drugs • PHASE 3
o chemicals that are introduced into the body to cause o Use of drug in a vast clinical market
some sort of change o Prescribers are informed of all the known reactions and
• concerned with the HISTORY, PHYSICAL & CHEMICAL precautions required for its safe use
properties of drugs including ways in which drug affect living • FDA – evaluates after phase 3
systems
• More specifically, it is the study of the interactions that occur VI. DRUG USES
between a living organisms and exogenous chemicals that • Symptomatic treatment (relieve)
alter normal biochemical function • Preventive – avoid diseases
• Diagnostic drugs
II. DRUGS • Curative
• Treatment – remedy to a health problem • Health maintenance drugs
• Cure – substance that ends the medical condition • Contraceptive Drugs

A. ROLE VII. ROUTES OF ADMINISTRATION

1. Administer the drug
2. Assess for drug effects A. ENTERAL
3. Intervene to make the drug more tolerable
Oral or Per OS (P.O.)
4. Provide pt. teaching about drugs and the drug regimen
• The most common route of drug administration.
5. Monitoring the overall pt. care plan to prevent medication
errors • Drug is given through oral cavity.
• po (from the Latin per os) is the abbreviation used to indicate
oral route of medication administration
III. TEN RIGHTS OF GIVING MEDICINES
• two methods of administration:
1. Right client o applying topically to the mouth
2. Right drug o swallowing for absorption along the gastrointestinal (GI)
3. Right dose
tract into systemic circulation
4. Right time
5. Right route
6. Right assessment i. ADVATNAGES
7. Right documentation • Safe
8. Right to education • Convenient – self-administered, pain-free, noninvasive, easy
9. Right evaluation to take, and does not require the services of a skilled
10. Right to refuse personnel
• Economical – compared to other parenteral routes
IV. DRUG TIMING • Absorption – takes place along the whole length of the GI
• OD – once a day tract
• BID – twice a day • Cheap – compared to most other parenteral routes
• TID – thrice a day • No need for sterilization
• QID – four times a day
• ac – before meals ii. DISADVANTAGES
• pc – after meals • Some drugs are unpalatable and cause irritation of the
• hs – hours of sleep, bedtime intestinal tract resulting in nausea, vomiting and diarrhea, in
• Every 4 hrs – 12 am, 4 am, 8 am, 12 pm, 4 pm, 8 pm particular if these are given before meal.
• Every 6 hrs – 12 am, 6 am, 12 pm, 6 pm • Slow absorption – slow action – cannot used in emergency
• Every 8 hrs – 6 am, 2 pm, 10 pm • Cannot be used uncooperative, vomiting and unconscious
• Every 12 hrs – 12 am, 12 pm patients
• RTC – round the clock • Some drugs are destroyed by intestinal enzymes e.g., insulin
is destroyed by intestinal enzymes
• prn – give it as necessary, as needed
• Sometimes inefficient drug absorbed, some drugs are not
• SD – single dose
absorbed like streptomycin
1
• In case of emergency, when quick action of a drug is desired • this route of administration bypasses the alimentary canal
this route is not suitable. Inhalation
• This route is not suitable in the cases of unconscious • absorption through the lungs
patients. Intradermal (I.D.)
• There is a necessity for cooperation on the part of patient. • into skin
• A very important factor is that blood from intestinal tract • injection into skin raising bleb
passes via portal vein to the liver where the drug may be • drug is given within skin layers (dermis)
metabolized to a great extent before being distributed to the • painful
site of action. Thus, oral routes are not recommended for • mainly used for testing sensitivity to drugs (e.g., penicillin,
drug undergoing extensive first pass effect. anti-tetanus serum)
• BCG vaccine, sensitivity test
iii. ORAL DOSAGE FORMS Subcutaneous (S.C.)
• Common dose forms for oral administration • into subcutaneous tissue
o Tablets • absorption of drugs from the subcutaneous tissues
o Capsules • injected under the skin
o Liquids • absorption is slow, so action is prolonged
o Solutions • drug is deposited in loose subcutaneous tissue – rich nerve
o Suspensions supply – irritant drugs cannot be injected
o Syrups • less vascular, slow absorption than IM route
o Elixirs Intramuscular (I.M.)
• into skeletal muscle
B. SUBLINGUAL/BUCCAL ROUTE • absorption reasonable uniform
• Tab or pellet containing the drug is placed under tongue or • rapid onset of action
crushed in mouth and spread over the buccal mucosa. • mild irritants can be given
• Where the dosage form is placed under the tongue and is • first pass avoided
rapidly absorbed by sublingual mucosa • gastric factors can be avoided
• This route has special importance for certain drugs. • Large skeletal muscles: deltoid, triceps, gluteus maximus,
• For example, nitroglycerine is effective when given rectus femoris
sublingually but ineffective when administered orally. Intravenous (I.V.)
• The reason is that the drug has very high lipid solubility. • the most common parenteral route for drugs that are not
absorbed orally
i. ADVANTAGES • avoids first-pass metabolism by the liver
• The major advantage of this route is that venous drainage • Intravenous delivery permits a rapid effect and a maximal
from mouth (buccal cavity) is poured into the superior vena degree of control over the circulating levels of the drug.
cava and the drug is saved from first-pass effect. Titration of dose with response.
• Drug absorption is quick. • large quantities can be given, fairly pain free
• Quick termination • absorption phase is bypassed
• Can be self-administered • However, unlike drugs in the GI tract, those that are
• Economical injected cannot be recalled by strategies such as emesis or
by binding to activated charcoal.
ii. DISADVANTAGES • IV injection may also induce hemolysis or cause other
adverse reactions by the too-rapid delivery of high
• Unpalatable and bitter drugs
concentrations of drug to the plasma and tissues also vital
• Irritation of oral mucosa organs like heart, brain, etc.
• Large quantities not given • Thrombophlebitis of vein and necrosis of adjoining tissue if
• Few drugs are absorbed extravasation occurs.

C. RECTAL ROUTE
• Drugs that are administered rectally as a suppository.
• In this form, a drug is mixed with a waxy substance that
dissolves or liquefies after it is inserted into the rectum.
• Example: diazepam, indomethacin, paraldehyde,
ergotamine

i. ADVANTAGES
• Used in children
• Little or no first pass effect
• Used in vomiting or unconscious
• Higher concentrations rapidly achieved
ii. DISADVANTAGES
• Inconvenient
• Absorption is slow and erratic
• Irritation or inflammation of rectal mucosa can occur

D. PARENTERAL ROUTES
• Direct delivery of drug into systemic circulation without
intestinal mucosa
• Parenteral administration is injection or infusion by means
of a needle or catheter inserted into the body
• The term parenteral comes from Greek words:
o para – meaning outside
o enteron – meaning the intestine