NURSING

PHARMACOLOGY
PHARMACOLOGY

• Study of biological effects of chemicals

SOURCES

• Natural sources
• Synthetic sources
DRUG EVALUATION

• CLINICAL TRIALS
• PRE – CLINICAL TRIAL
• PHASE I
• PHASE II
• PHASE III
• PHASE IV
 DRUG NAMES

• CHEMICAL NAME EX: L THYROXINE

• GENERIC NAME LEVOTHYROXINE
• BRAND NAME ELTROXIN
ROUTES OF DRUG ADMINISTRATION

• Enteral
• Parenteral
• Local
PHARMACODYNAMICS

• Basic actions of drugs

• To replace a missing substance
• To increase cellular activities
• To depress cellular activities
• To interfere with the growth of foreign cells
PHARMACODYNAMICS

• DRUG ACTIONS MAYBE

• THROUGH ION CHANNELS
• BY PHYSICAL ACTION
• BY CHEMICAL INTERACTION
• BY ALTERING METABOLIC PROCESS
• THROUGH RECEPTORS
• THROUGH ENZYMES AND PUMP
THROUGH ION CHANNELS

• EXAMPLES
• CALCIUM CHANNELS
• SODIUM CHANNELS
• GABA GATED CHLORIDE CHANNELS
BY PHYSICAL ACTION

• ADSORPTION – ACTIVATED CHARCOAL IN POISONING

• MASS OF THE DRUG – BULK LAXATIVES LIKE
PSYLLIUM
• OSMOTIC PROPERTY – OSMOTIC DIURETICS –
MANNITOL - OSMOTIC PURGATIVES – MAGNESIUM
SULPHATE
BY CHEMICAL INTERACTION

• ANTACIDS
BY ALTERING METABOLIC PROCESSES

• CHEMOTHERAPEUTIC DRUGS
• ANTIMICROBIAL DRUGS
• ANTINEOPLASTIC DRUGS
 THROUGH RECEPTORS

Receptor that
Ion channel G protein coupled Enzymatic receptor regulates gene
receptor transcription
THROUGH RECEPTORS

• AGONISTS
• ANTAGONISTS
• COMPETITIVE ANTAGONIST
• NON COMPETITIVE ANTAGONIST
AUTONOMIC DRUGS
DRUG – ENZYME INTERACTION
PUMP INHIBITORS AND REUPTAKE INHIBITORS
PHARMACOKINETICS

TISSUE STORE

ABSORPTION

DRUG PLASMA SITE OF ACTION

METABOLISM EXCRETION
FACTORS AFFECTING ABSORPTION

• 1. DISINTEGRATION AND DISSOLUTION TIME

• 2. FORMULATION
• 3. PARTICLE SIZE
• 4. LIPID SOLUBILITY
• 5. PH AND IONIZATION
FACTORS AFFECTING ABSORPTION

• 6. AREA & VASCULARITY OF THE ABSORBING SURFACE

• 7. GASTROINTESTINAL MOTILITY
• 8. PRESENCE OF FOOD
• 9. DISEASES
FIRST PASS METABOLISM

• Bioavailability – the fraction of the drug that reaches

the systemic circulation following administration by
any route
DITRIBUTION

• From the blood the drug moves to different tissues

FACTORS AFFECTING DRUG DISTIBUTION

• 1. BLOOD FLOW
• 2. PROTEIN BINDING
• 3. LIPID SOLUBILITY
• 4. BLOOD BRAIN BARRIER
• 5. PLACENTA & BREAST MILK
BIOTRANSFORMATION

• Biochemical alterations of drugs in the body

 BIOTRANSFORMATION

ACTIVE DRUG

INACTIVE ACTIVE METABOLITE

ACTIVE METABOLITE INACTIVATION ACTIVE DRUG
DRUG
BIOTRANSFORMATION

• CYTOCHROME P450 ENZYMES

FACTORS AFFECTING BIOTRANSFORMATION

• 1. GENETIC VARIATIONS
• 2. ENVIRONMENTAL POLLUTANTS
• 3. AGE
• 4. DISEASES OF THE LIVER
EXCRETION

• RENAL EXCRETION
• FECAL AND BILIARY EXCRETION
• PULMONARY EXCRETION
• SWEAT AND SALIVA
HALF LIFE

• THERAPEUTIC LEVEL
• THERAPEUTIC INDEX
TOXICOLOGY

• PRIMARY ADVERSE EFFECT

• SECONDARY ADVERSE EFFECT
• HYPERSENSITIVITY
TYPE 1 HYPERSENSITIVITY
TYPE II CYTOLYTIC REACTION
TYPE III ARTHUS REACTION
TYPE IV HYPERSENSITIVITY
STEVEN JOHNSON SYNDROME
TOXIC EPIDERMAL NECROLYSIS
TERATOGENICITY

• FDA PREGNANCY CATEGORIES

• Category A
• Adequate and well-controlled studies have failed to demonstrate a risk to the fetus in the
first trimester of pregnancy (and there is no evidence of risk in later trimesters).
• Category B
• Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no
adequate and well-controlled studies in pregnant women.
TERATOGENICITY

• FDA PREGNANCY CATEGORIES

• Category C
• Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and
well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant
women despite potential risks.
• Category D
• There is positive evidence of human fetal risk based on adverse reaction data from investigational or
marketing experience or studies in humans, but potential benefits may warrant use of the drug in
pregnant women despite potential risks.
TERATOGENICITY

• Category X
• Studies in animals or humans have demonstrated fetal abnormalities and/or there is
positive evidence of human fetal risk based on adverse reaction data from investigational
or marketing experience, and the risks involved in use of the drug in pregnant women
clearly outweigh potential benefits.
COMPUTATION

• 1. What is the pediatric dose of a 4 year old child if the average adult dose is 100 mg?
• 2. What is the pediatric dose of a 30 pound child if the average adult dose is 250 mg?
• 3. What is the pediatric dose of a 9 month old child if the average adult dose is 300mg?
• 4. Doctor’s order: Ampicillin1 gram IV ANST to be given initially then 500 mg IV every
6 hours. Available Ampicillin is 500 mg powder to be dissolved in 2ml of distilled water.
What is the amount to be given initially?
• 5. Doctor’s order: Amoxicillin to be given at 30mg/kg/day TID. Weight of the patient is
22 pounds. If the available Amoxicillin is 125mg/5ml. What is the amount of Amoxicillin
to be given per dose?
• 6. Doctor’s order: Cefepime 7mg/kg/dose BID. Weight of the patient is 15 kg. If the
available Cefepime is 125mg/5ml. What is the amount of Cefepime to be given per dose?
• 7. Prepare a 30% of 200 ml feeding solution. How much feeding solution and water be
mixed? ( All feeding solution has 100% strength)
• 8. 1.5 liters of IVF to be given for 12 hours. What is the flow rate in ml/hr?
• 9. 2 liters of IVF to be given for 20 hours. At the end of the second shift, how much fluid
is left?
• 10. 500 ML of IVF to be given to a pediatric client for 8 hours. If the drop factor is
60ugtts/ml. What is the flow rate of IVF in gtt/min?