PHARMACOLOGY REVIEWER

PRELIM EXAM
2022-2023

PHARMACOLOGY
- the study of drugs and its origin, chemical structure, preparation, administration, action,
metabolism and excretion
- study of drugs that alter functions of living organisms
- fascinating and having variety of different and important features or elements.
- Impacts: chosen career in health care, personal lives
- plays a part in our lives: from our role as healthcare team members, to that of consumers

ORIGIN:
- the study of drugs and their interactions with living organisms
- derived from the Greek word “pharmakon” (meaning “medicine or drug”)
- suffix – “logy” (means “the study of”)

DEFINITION OF TERMS:
1. Molecular pharmacology
- the study of the chemical structures of drugs and the action of drugs at the molecular level within
cells.

2. Pharmacodynamics
- the mechanism of action by which drugs produce their effects (desired or undesired) based on
time and dosage
- “how body reacts to drugs”

3. Pharmacogenetics
- how the genetic makeup of different people affects their responses to certain drugs

4. Pharmacogenomics
- using genome technology to discover new drugs. ex. Cancer

5. Pharmacokinetics
- how drugs move through the body in the processes of absorption, distribution, metabolism, and
excretion

6. Pharmacotherapy
- using drugs to affect the body therapeutically

7. Medications or medicines
- are drugs that are used to prevent, diagnose, or treat symptoms, signs, conditions, and diseases

IMPLICATION OF PHARMA TO NURSING:

- Responsible for drug administration
- Responsible for the administration of medications that they direct others to give.
- Ethical and legal responsibilities
MEDICAL USES FOR DRUGS
3 Medical uses:
1. prevent disease
2. diagnose disease
3. treat symptoms, signs, conditions, diseases
*The study of these uses is known as pharmacotherapy

1. Preventive Use
- prevent the occurrence of diseases or conditions
- prophylaxis (Greek origin: to keep guard before) ex. antibiotics, vaccines, birth control
- Examples:
- prevent motion sickness prior to traveling
- prevent pregnancy
- vaccinations

*Dramamine is an over-the-counter drug that is taken to prevent motion sickness and vomiting.
*Antiemetic means pertaining to against vomiting, appears at the top right.

2. Diagnostic Use
- by themselves
- in conjunction with procedures/tests
- Examples:
- Radiopaque contrast dye
- Cardiac Stress Test

3. Therapeutic use
- used for symptoms, conditions, or diseases, to control, improve, or cure
- Examples:
- antibiotic drugs
- analgesic drugs
- insulin

DRUGS IN ANCIENT TIMES:

1. Egyptians
- applied moldy bread to abrasions
 has some therapeutic basis
 penicillin was extracted from a mold
- treated diseases with
 frogs’ bile
 sour milk
 Lizards blood
 pigs’ teeth
 sugar cakes
 dirt
 spiders’ webs
 hippopotamus’ oil
 toads’ eyelids
 2. Chinese
- practiced healing arts
 emphasized use of herbs and some minerals
 herbal preparations were used in conjunction with acupuncture, massage, exercise
 few animal products

*Shen Nong: wrote first Chinese book on herbal medicine contained 365 different herbal
remedies
*In 1970, the Chinese Academy of Medical Science compiled a collection of traditional
herbal remedies. American pharmacists evaluated those remedies and found that 45 percent
of them were therapeutic, according to Western standards of medicine

3. Native Americans of North America

- Aztec Indians of Mexico
 grew herbs with medicinal properties
 Montezuma maintained royal gardens of medicinal plants

4. Greeks and Romans

- furthered the study of medicine
- important first steps

ANCIENT DRUGS
 Ancient drugs were prepared according to standard recipes involved drying, crushing, and
combining a variety of plants, substances from animals and minerals

 The symbol Rx
- Latin word for “recipe” (meaning “take”)
- indicates a prescription the combining of ingredients to form a drug

 Because little was known, it was a matter of much guessing

 Some drug ingredients

- based on medical lore and superstition
- had therapeutic value
- others were worthless or harmful

*Foxglove plant
- scientific name is Digitalis lanata. The drug digitalis (which is no longer in use) came from this
plant, as does the modern drug digoxin (Lanoxin), which is used to treat congestive heart failure

MODERN DRUGS DERIVED FROM NATURAL SOURCES

DRUGS DERIVED FROM PLANTS:
1. Foxglove plant
- derivative, drug digoxin (Lanoxin) for congestive heart failure

2. Belladonna plant
- original source of two drugs: atropine, scopolamine
 3. Opium poppy
- used as a painkiller
- recreational drug
- sap from the seed heads contain opium: source of illegal street drug heroin, source of the
prescription drug morphine

4. Colchicine
- drug used to treat gout
- derived from autumn crocus known as Colchicum autumnale

5. Ephedrine
- present in the leaves of a bushy shrub
- Chinese burned leaves to treat respiratory ailments
- ephedrine present in over-the-counter bronchodilators

6. Yams
- estrogen hormone replacement therapy drugs

7. Daffodil bulbs
- The Alzheimer’s drug galantamine (Razadyne)

8. Drugs dissolved into plant sources

- Gums
- oils (many drugs contain a type of oil)
- bases

DRUGS DERIVED FROM ANIMALS:

1. Thyroid supplement drugs
- composed of dried (desiccated) animal thyroid gland tissue
- used to treat hypothyroidism

2. Premarin
- Pregnant Mare’s urine
 - drug Premarin, a female hormone replacement
- used to relieve the symptoms of menopause

3. Lanolin
- common ingredient of topical skin drugs
- obtained from the purified fat of sheep’s wool

4. Insulin
- In the past, only source from ground-up animal pancreas

DRUGS DERIVED FROM MINIRALS:

1. Minerals
- individual dietary supplements
- Potassium: potassium chloride

2. Trace minerals
- included in many multivitamin supplements
- quinapril (Accupril) contains red iron oxide as an inert ingredient

DRUGS IN THE 1800s and 1900s

 Pharmacists prepared the drugs they dispensed
- apothecary system of measurement
- minims
- drams
- ounces
- grains
- scruples

 Much has changed since then

- Many now completely synthetic
- Other natural drugs, to create new drugs, have undergone chemical modifications and molecular
restructuring
- Pharmacists no longer prepares medications, dispenses them and provides patient information and
education

MISLABELED AND DANGEROUS DRUGS

 Most physicians attempted to treat patients accurately

- based on what little scientific knowledge was available
- 2100 B.C., the Code of Hammurabi gave severe penalties for malpractice
- throughout medical history ineffective, mislabeled, and dangerous drugs have been manufactured,
advertised, and prescribed

 During the 1700s and 1800s

- commonly sold without regulation
- accompanied by extravagant claims of cures
- often contained addicting ingredients without its presence being listed: opium, morphine, cocaine
*This 1885 advertisement was for the drug Cocaine Toothache Drops. It was not known at that
time that cocaine was a highly addictive drug. Children as well as adults became addicted to this
drug
  Consumer warnings did not exist:
- against the misuse of drugs
- possibility of addiction
- dangerous drug side effects
- prevailing dictum was “Let the buyer beware”

BASIC CONCEPTS OF PHARMACOLOGY

DRUGS
- are chemicals that alter physiochemical processes in body cells.
- They can stimulate or inhibit normal cellular functions.
- Used interchangeably with medicines.

DRUG NAMES
1. Generic or Nonproprietary Name
- name approved by the Medical or Pharmaceutical Associations in the original country of
manufacture and is adopted by all countries.
- Official name
- Must appear on label
- National listings: United States Pharmacopeia (USP), National Formulary (NF)
- e.g. Paracetamol

2. Brand name or trade name

- name given by the manufacturer of the drug
- Brand name
- Used to market the drug
- Property of drug company: Registered mark ® - name registered with the U.S. Patent and
Trademark Office
- Drug may be manufactured by more than one company.
- e.g. Adol or Panadol

3. Chemical name
- name that describes the atomic or chemical structure

NOTES:
DRUG LABEL - The drug label and package inserts contain information needed to perform dosage
calculations. Read the label carefully.

LOCATING INFORMATION
Drug name
Form of the drug
Dosage strength
Total amount in the container
Warnings
Route of administration
Storage requirements
Manufacturing information
Rule 6-1: You must know both the generic and trade names of drugs.
EX. Vicodin® is a narcotic painkiller
Generic name: hydrocodone bitartrate and acetaminophen
Other trade names: Anexsia®, Lortab®, Zydone®

FORMS OF DRUGS
1. Solid oral medications
- Tablets, capsules, gelcaps, caplets

2. Liquids
- Oral, injections, inhalants, drops, sprays, mists

3. Other
- Ointments, creams, lotions, patches, suppositories, shampoos

DOSAGE STRENGHT
- Labels include information about the amount of drug present.
- The amount of drug present per dosage unit combined with information about the form identifies
the drug’s dosage strength.
- Solid medications
 Dosage strength is the amount of drug present per tablet, capsule, or other form.
- Liquid medications
 Dosage strength is the amount of drug present in a quantity of solution.
 Amount of solution varies per dosage unit.
- Pharmaceutical companies manufacture meds with dosage strengths that match commonly
prescribed doses.
 Reduces the risk of error when calculating dosages.

COMBINATION DRUGS
- Generic names and dosage strengths of all components must appear on the label.
- If available, the trade name may be used to order combination drugs.

TOTAL NUMBER OR VOLUME IN CONTAINER

 Many meds are packaged in unit doses
- One tablet / section of package
- Vial with 2 mL of solution for injection

 Multiple-dose containers
- Prescription medications
- Non-prescription medications

*Rule 6-2: Do not confuse the total amount of drug in the container with the dosage strength.
ROUTE OF ADMINISTRATION
 Directions for route of administration may be on the label.
- Tablets, capsules, gelcaps, caplets
 Swallow
 Sublingual
 Chewable

- Liquid medications
 Oral
 Injections

- Inhalants
- Topical / transdermal

ERROR ALERT
 Give the right medication by the right route.
- Do not administer drugs by any route other than described in the drug label or on the
order.

WARNINGS
 Help to administer drugs safely
 Types of warnings
- For specific groups, i.e. children, elderly
- For controlled substances
- About combining with other drugs or products
 Proper disposal following facility guidelines

MANUFACTURING INFORMATION
 LABEL
- Regulated by the U.S. Food and Drug Administration (FDA)
- Must include:
- Name of the manufacturer
- Expiration date
- Lot number
- When and where a drug was produced
- Trace problems

*Rule 6 – 3: Never use a drug after the expiration date has passed.
Older drugs may become chemically unstable or altered
- Incorrect dose
- Effect different than intended one
Educate patients to check expiration dates.
RECONSTITUTING DRUGS
 Powder forms must be reconstituted and other drugs require dilution prior to use.
 Directions for reconstituting or diluting are on the label
- Type and amount of diluent
- Solution strength once reconstituted
- Time period for safe administration

ERROR ALERT: Consider the age and health needs of the patient when administering a drug.
If another form of a drug is better suited to a patient’s needs, consult the physician or pharmacist
about changing the order.

PACKAGE INSERTS
 Complete and authoritative information about a medication
 Sections
- Description – chemical and physical
- Clinical Pharmacology – actions of the drug
- Indications and Usage
- Contraindications
- Warnings – serious side effects
- Precautions
- Adverse Reactions – anticipated side effects
- Overdosage – effects and instruction for treatment
- Dosage and Administration
- Preparation for Administration
- Manufacturer Supply – dosage strength and form availability