PHARMACOLOGY PARTS OF PRESCRIPTION

- DERIVED FROM 2 GREEK WORDS 1. SUPERSCRIPTION- the heading with the symbol “R” or
 PHARMAKON - STUDY OF MEDICINE “Rx” which stand for the word recipe.
 LOGOS - STUDY
- Study of action of drugs such as PHARMACOKINETICS and 2. INSCRIPTION- which contain the names and quantities
PHARMACODYNAMICS and ingredients
- Study of the biological effects of chemicals
✓ Knowledge from various pharmacologic 3. SUBSCRIPTION- direction for compounding the drug
classes enables the nurse to understand
how drug works in our body, to achieve the 4. SIGNATURE- often to given by the sign ‘S” signa giving the
therapeutic (intended) effects, and to direction to be marked on the container.
anticipate and recognize the potential side
effects (unintended or unavoidable) or 7 COMPONENTS OF DRUG ORDER
toxicities. 1. PATIENS FULL NAME
✓ Nurses deal with pharmacotherapeutics, or 2. DATE AND TIME
clinical pharmacology 3. DRUG NAME
✓ The branch of pharmacology that uses 4. DOSAGE
drugs to treat, prevent and diagnose 5. ROUTE OF ADMINISTRATION
disease 6. TIME AND FREQUENTCY OF ADMINISTRATION
7. SIGNATURE OF PHYSICIAN
PHARMACUETIC
 80% Are taken orally DRUG APPROVAL
 First in GI tract to be in solution to be absorbed - Each drugs may have several names.
 Solid (tablets, capsule) must integrate into small particles  CLINICAL NAMES- describes the drug
to dissolve into liquid  GENERIC NAMES- official name for the drug, not owned by
 Liquid are already solution any company
 Tablets are not 100% drug based  BRAND NAME/ TRADE NAME- registered trademark of the
 Fillers called EXPEIPIENTS are used for size, shape and company, easier to spell and pronounce
dissolution of drugs
DRUG APPROVAL FOR PREGNANT WOMAN
DRUG CLASSIFICATION  A - No risk to fetus based on studies
- drug class is used to describe medication that are grouped  B - little to no risk based on animal studies, some human
together because of their similarities.  C - risk indicate based on animals, study risk vs. Benefit
 D - risk to fetus proved, risk vs. Benefit to mother
4 DOMINANT METHODS  X - risk proved, avoid during pregnancy.
 By their therapeutic use
 By their mechanism of action 10 PATIENT RIGHT
 By their mode of action 1. PATIENT
 By their chemical structure 2. MEDICATION
3. TIME
PURPOSE OF CLASSIFICATION 4. DOSE
 To ensure that you use a drug safely to achieve utmost 5. ROUTE
benefit 6. INFORMATION ON DRUG
 Every time you take drug, body temperature is altered 7. REFUSE MEDICATION
 It can cause side effect that may be harmful 8. ASSESSMENT
 Multiple drugs, body chemistry may be changed the way 9. DOCUMENTATION
the drug is far less effective or the side effect are more 10. EVALUATION
severe
PHARMACOKINETICS
DRUG- DRUG INTERACTION - the study of what the body does to the drug, the activity of
- Effectiveness may be reduced if the action of one drug the drugs
diminishes the action of another. over a period of time.
Sig: dosage - process of movement to achieve drug action.
HX: history - has 4 process LADME ( Liberation, absorption, distribution,
Rx: recipe metabolism, excretion)

DRUG RESISTANCE LIBERATION

 Medication used to treat chronic infection in a specific
way
 Used incorrectly for a long period of time, a drug may lose
its potency as the infection Is resistant to its effect.
 Alter drug of the same class that may also fail to not work
as well
 the release of the drug from it's dosage form.
ABSORPTION
 Passage of drug from its side of administration into blood
circulating body fluids
 Rate of absorption depends on the route of
administration: ENTRAL, PARENTAL, PERCUTANEOUS.
 Passive active and picocytosis are different types of
absorption. (ingestion into cell by the budding of small
vesicles from the cell membrane.)
 BIOAVAILABILITY: subcategory of absorption the
percentage of the administered drug dose that reaches
the systematic circulation.
 Oral is less always less than 100%
 Intravenous route is usually 100%
DISTIBUTION
 Drugs are transported by the circulating body fluids to the
sites of action
 Influenced by blood flow, affinity to the tissue and protein
binding effect.
 Drugs are distributed in plasma (liquid part of lymph
nodes) and are bound to vary degrees with protein
(ALBUMIN)
 Portion of drug bound id inactive- not available to
receptors.
 Portion of drug unbound is free, active
- only free drug can cause in pharmacologic response
- some circulating drugs ( anticonvulsanis, aminoglysosides) are
checked for drug blood levels.
METABOLISM
 Major mechanism of the terminations/ inactivation of
drugs
 Liver disease alter drug metabolism- drug
 Half time- the time takes for 1/2 of the drug to be
eliminated.
 Liver id the primary site where drugs are inactive by liver
enzymes becomes active metabolites of H20 for excretion
DRUG HALF LIFE
 The time it takes for 1⁄2 of the drug to be eliminated.
 This is the period of time required for the concentration
or amount of drug in the body to be reduced by one-half.
 Half life is the time required to reduce the plasma
concentration to 50% of its original value.
 Will determine dosing requirements/ how long drug will
remain in the body
 Used in determining dosing interval
 GOAL- PLATEAU
ER- EXTENDED RELEASE
SR- SUSTAINED RELEASE
EXCRETION
 Drug removal of the body
 Main route id through urine (bile, feces, lungs and breast
milk)
 Urine PH influences excretion
 Kidney disease affects excretion
Half-life
 The half-life of a given medication is how long
it takes for the body to get rid of half of the
Principles of drug administration
 Nurses are accountable for the safe administration of
medication.
 Nurses are legally liable when giving prescribed drugs .
Even if the dosage is incorrect or the drug is
contraindicated.
 Nurses are liable for the predicted effects of a drug once
given.
PHARMACODYNAMICS
 described as what a drug does to the body; would outline
the drugs absorption, bioavailability, distribution,
metabolism and how your body excretes it.
 The drug mechanism of action
 Drug response can cause a primary or secondary
physiologic effect or both.
 PRIMARY- desirable
 SECONDARY- desirable or undesirable
 PEAK, ONSET, DURATION
ONSET OF ACTION
- Time takes to reach the minimum effective concentration
PEAK ACTION
- when the drug reaches its highest blood plasma concentration
DURATION OF ACTION
- Length of time drug drug has an effect
PRINCIPLE OF DRUG ADMINSTRATION
 Nurses are accountable for the safe administration of
medication
 Nurses are legally liable when giving prescribed drugs
even if the dosage is incorrect or the drug is contradicted
 Nurses are liable for the predicted result
NOCEBO EFFECT
- occur when negative expectation of the patient regarding a
treatment cause the treatment to have a more negative effect
than it other wise would have.
PLACEBO EFFECT
- occur when positive expectations improve an outcome.
PSYCHOGENIC (PSYCHIATRY)
 placebo/ nocebo
 Cause by state of mind having a psychological rather than
physiological cause

PARTS OF A DRUG LABEL

1. TRADE NAME/Brand Name
2. GENERIC NAME
3. DOSAGE STRENGTH
4. FORM
5. ROUTE
6. AMOUNT
7. DIRECTIONS

Drug Chemical Names

• MgSO4 – Magnesium Sulfate
• AtSO4 – Atropine Sulfate
• Ca- Calcium do not confuse it w/ CA which is Cancer
• NaHCO3- Sodium Bicarbonate
• K - Potassium
• Na- Sodium Different forms of medications
• Na Cl- Sodium Chloride   Tablet (scored & unscored)
• Fe- Iron   Effervescent tablet
• FeSO4- Ferous Sulfate   Caplet
• KCl- Potassium Chloride   Capsule
• Zn- Zinc   Dragee
• Au- Gold   Vials

Anti-Infective Agents Antibiotics:

 Sulfonamides
 Penicillins
 Cephalosporins
 Tetracyclines
 Aminoglycosides
 Quinolones
 Macrolides

Antibiotics
 Medications used to treat bacterial infections
 Ideally, before beginning antibiotic therapy, the suspected
areas of infection should be cultured (bld. culture &
sensitivity)to identify the causative organism and
potential antibiotic susceptibilities.
 Empiric therapy: treatment of an infection before specific
culture information has been reported or obtained
 Prophylactic therapy: treatment with antibiotics to
prevent an infection, as in intrabdominal surgery
 Bactericidal: kill bacteria
 Bacteriostatic: inhibit growth of susceptible bacteria,
rather than killing them immediately; will eventually lead
to bacterial death
Antibiotics: Sulfonamides  Penicillins: Side Effects (nausea, vomiting, diarrhea,
- One of the first groups of antibiotics abdominal pain)
- Prevent synthesis of folic acid required for
synthesis of purines and nucleic acid
- Does not affect human cells or certain  Natural penicillins
bacteria—they can use preformed folic - penicillin G, penicillin V potassium
Acid
- Body System Penicillinase
Effect Blood Hemolytic and aplastic -resistant penicillins cloxacillin, dicloxacillin, methicillin,
anemia, thrombocytopenia Integumentary Photosensitivity, nafcillin, oxacillin
exfoliative dermatitis, Stevens-Johnson syndrome, epidermal
necrolysis  Penicillinase-resistant penicillins

 Sulfadiazine
 Aminopenicillins
 Sulfamethizole - amoxicillin, ampicillin, bacampicillin

 Sulfamethoxazole  Extended-spectrum penicillins

Azo-Gantanol Extended
- Combined with phenazopyridine -spectrum penicillins
(an analgesic-anesthetic that affects the mucosa piperacillin, ticarcillin, carbenicillin, mezlocillin
of the urinary tract).
-Used to treat urinary tract infections (UTIs) and to reduce
the pain associated with UTIs.
Antibiotics: Cephalosporins
Bactrim  Semisynthetic derivatives from a fungus
- Combined with trimethoprim.  Structurally and pharmacologically related to penicillins
- Used to treat UTIs, Pneumocystis carinii pneumonia, ear  Bactericidal action
infections, bronchitis, gonorrhea, etc.  Broad spectrum
 Divided into groups according to their antimicrobial
 Sulfisoxazole activity
Azo-Gantrisin  broad-spectrum antibiotic refers to an antibiotic that acts
-Combined with phenazopyridine against a wide range of disease-causing bacteria.
-Used for UTIs  A broad-spectrum antibiotic acts against both Gram
positive and Gram-negative bacteria,
Pediazole
- Combined with erythromycin
- Used to treat otitis media  First Generation
cefadroxil
cephalexin
Antibiotics: Penicillins cephradine
 First introduced in the 1940s cefazolin
 Bactericidal: inhibit cell wall synthesis cephalothin
 Kill a wide variety of bacteria cephapirin
 Also called “beta-lactams” - used for surgical prophylaxis, URTI, otitis media
 Bacteria produce enzymes capable of destroying
penicillins. These enzymes are known as beta-lactamases.  Second Generation
as a result, the medication is not effective. cefaclor
 Chemicals have been developed to cefonicid
 inhibit these enzymes: clavulanic acid, tazobactam, cefprozil
sulbactam ceforanide
 - Penicillin-beta-lactamase inhibitor combination drugs: cefamandole
ampicillin + sulbactam = Unasyn cefmetazole
amoxicillin + clavulanic acid = Augmentin cefoxitin
ticarcillin + clavulanic acid = Timentin cefotetan
piperacillin + tazobactam = Zosyn, Tazocin cefuroxime
 Prevention and treatment of infections caused by - Better gram-negative coverage than first generation
susceptible bacteria, such as: gram-positive bacteria
Streptococcus, Enterococcus, Staphylococcus species  Third Generation
 Allergic reactions occur in 0.7% – 8% of treatments cefpodoxime proxetil
urticaria, pruritus, angioedema ceftriaxone
 10% of allergic reactions are life-threatening and cefoperazone
 10% of these are fatal Ceftazidime
  lomefloxacin (Maxaquin)
cefotaxime  norfloxacin (Noroxin)
moxalactam  ofloxacin (Floxin)
- Most potent group against gram-negative
-Less active against gram-positive
Antibiotics: Macrolides
 Fourth Generation
cefepime (Maxipime)
- Newest cephalosporin agents.  erythromycin
-Broader spectrum of antibacterial activity than third  azithromycin (Zithromax)
generation, especially against gram-positive bacteria.  clarithromycin (Biaxin)
- Cephalosporins S/E is similar to penicillins  dirithromycin
 troleandomycin

Antibiotics: Tetracyclines Antibiotics: Nursing Implications

 Natural and semi-synthetic
 Obtained from cultures of Streptomyces  Before beginning therapy, assess drug allergies;
 Bacteriostatic—inhibit bacterial growth Inhibit protein hepatic, liver, and cardiac function; and other lab studies.
synthesis  Be sure to obtain thorough patient health history,
 Stop many essential functions of the bacteria including immune status.
 Assess for conditions that may be contraindications to
 demeclocycline (Declomycin) antibiotic use, or that may indicate cautious use.
 oxytetracycline  Assess for potential drug interactions. It is ESSENTIAL to
 tetracycline obtain cultures from appropriate sites BEFORE beginning
 doxycycline (Doryx, Doxy-Caps, Vibramycin) antibiotic therapy.
 minocycline

Antibiotics: Aminoglycosides

 Natural and semi-synthetic

 Produced from Streptomyces
 Poor oral absorption; no PO forms
 Very potent antibiotics with serious toxicities
 Bactericidal Kill mostly gram-negative; some gram-positive Definition Of Terms
 Used to kill gram-negative bacteria such as Pseudomonas
spp., E. coli, Proteus spp., Klebsiella spp., Serratia spp. synthetic drugs – created using man-made chemicals
Often used in combination with other antibiotics for
synergistic effect. over- the –counter (otc) drugs - drugs that are available
 Three most common (systemic): without a prescription for self-treatment of a variety of
gentamicin, tobramycin, amikacin complaints deemed to be safe when used as directed.
 Cause serious toxicities:
Nephrotoxicity (renal failure) adverse effect - drug effects that are not the desired
Ototoxicity (auditory impairment and therapeutic effects, maybe unpleasant or dangerous.
vestibular [eighth cranial nerve]) tinnitus
side effect - any effect of a drug, chemical , or other medicine
 gentamicin (Garamycin) that is in addition to its intended effect
 kanamycin
 neomycin drugs - chemicals that are introduced into the body to bring
 streptomycin about some sort of change.
 tobramycin
 amikacin (Amikin) hypoxia- gas suffocation
 netilmicin
serum - blood
Antibiotics: Quinolones
 Excellent oral absorption therapeutic - good effect, potential side effect, intended
 Absorption reduced by antacids
 First oral antibiotics effective against gram-negative neprotoxic - kidney are affected
bacteria
 Alter DNA of bacteria, causing death hepototoxic - liver are affected
 Do not affect human DNA
disintegration - breakdown of the tablet into smaller particles
 ciprofloxacin (Cipro)
 enoxacin (Penetrex)
dissolution - dissolving of the smaller particles into gi fluid
before absorption Bronchodilators – Dilates the bronchi and
bronchioles.
rate limit - time it takes to disintegrate and dissolve to become
available for the body to absorb Diuretics – Increases excretion of
water/sodium from body.
stat - urgent
Laxatives – Loosens stools and increases
bowel movements.
epistaxis - nosebleed
Miotics – Constricts pupils of the eye.
phorpahylaxis - prevent
Mydriatics – Dilates the pupils
diagnosis - to know
Narcotics/analgesics – Relieves pain.
supression - to lesion
Antipyretic -lowers body temperature.
OD - once a day

BID - two times a day

TID - three times a day

QID- four times a day

HS -hours of sleep

PRN -whenever necessary

STAT -immediately, ASAP

RTC - round the clock

Antacids – Reduce hydrochloric acid located in

the stomach.

Antianemics – Increases the production of red

blood cells.

Anticholinergics – Decreases oral secretions.

Anticoagulants – Prevents the formation of

clots.

Antidote – medicine taken or given to counteract the effect of

a certain drug.

Anaphylactic shock –a severe potentially life threatening

allergic reaction. It will occur w/in seconds or minutes of
exposure to something you’re allergic to. If not treated
immediately it can be fatal. Tx is epinephrine

Antiemetic -drugs used to treat for nausea and

Vomiting

Anticonvulsants – Management of seizures or

bipolar disorders.

Antidiarrheals – Reduce water in bowels and

gastric motility.

Antihistamines – Blocks the release of

histamine.

Antihypertensives – Decreases blood pressure.

Anti-infectives – To get rid of infections.