NUR 155
EXAM 1 STUDY GUIDE
Foundations of Nursing
Galen College of Nursing
, Exam 1 Study Guide
Chap. 2
Two drug phases
1.Pharmacokine>c phase
2.Pharmacodynamic Phase
Pharmacokine>c Phase: is the process of drug movement through the body necessary to
achieve drug ac>on. Includes Absorp>on, Distribuion, Metabolism, and Excre>on.
Pharmacodynamic Phase: is the study of the eIects of drug on the body. ( Receptor binding,
post receptor eIects, and chemical reac>ons).
Diges>on starts in the mouth-Salvia starts the breakdown!!!!
Pharmacokine,c Phase:
Absorp>on is the movement of the drug through the blood stream aOer its administra>on.
Disintegra>ons is the breakdown of the oral drug into smaller par>cles.
Dissolu>on is the >me it takes the drug to disintegrate and dissolve to become available for
absorp>on.
Acidic is faster than alkaline environment.
Absorp>on methods
Passive transport
DiIusion: is across the semipermeable membrane high to low concentra>on.
Requires no energy. It stops when the concentra>on is equa>on on both sides of the
membrane. In oral drugs GI (higher concentra>on) moves to the blood stream (lower
concentra>on).
Facilitated diIusion: is the same principal but requires a carrier protein to move
the drug.
Ac>ve Transport
Requires carrier and energy to move the drug against the concentra>on gradient.
Pinocytosis
Taking a bit out of the par>cles and bringing them into the cell.
Lipid soluble drugs and nonionized drugs are absorbed faster than water soluble and ionized
drugs
Factors aIec>ng absorp>on
Blood circula>on (poor circula>on, vasoconstrictors, shock or disease), Pain, stress, solid,
hot foods, high fat foods slow gastric emptying, Exercise decreases Blood Uow, pH, Route of
administra>on (IV, Oral, IM)
Drug movement from GI tract to liver
From mouth to the gut to portal vein and the liver drugs may be metabolized to an
inac>ve form and excreted reducing the amount of the ac>ve drug available to achieve desired
eIect. This is Yrst pass eIect (Yrst pass metabolism)
Bioavailability is the percentage of the drug leO for ac>vity. May be aIected by
absorp>on and Yrst pass metabolism for oral drugs. Bioavailability is always less than 100%.
Factors aIec>ng Bioavailability
Drug form
Route of administra>on
, Gastric mucosa and mo>lity
Administra>on w/food and other drugs
Changes in liver metabolism
Drug distribu>on: is the movement of the drug form the circula>on to >ssues.
Protein binding ( highly and weakly protein bound drugs)
Drugs drugs( unbound)
Volume of drug distribu>on
Compe>>on over protein binding sites leads to more free drug
Low plasma protein levels causes more free drugs Uoa>ng around
Low albumin same thing (elderly considera>ons)
BBB (blood brain barrier)
Water soluble drugs do not cross the BBB
You want to be careful with those who are pregnant some drugs cross the placenta and cause
damage
Drug metabolism (biotransforma>on: changing the drug chemically to form that is ready for
excre>on)
Half life: from administra>on to reduc>on of the drug in the body to a half. AIected by.-
previous dose, metabolism, and elimina>on.
Ex. Ibuprofen= 2hr 6am
200mg in two hrs= 100mg 8am
100mg in 2 hrs= 50mg 10am
50mg in 2hrs= 25mg 12pm
25mg in two hrs=12.5mg 2pm
12.5mg in 2 hrs= 6.25mg 4pm
Steady state=plateau=amount administered= amount eliminated usually achieved by 4-
5th half life if given consistently
Loading dose= large ini>al dose of medica>on (seizure medica>ons) smaller doses to
follow consistent >me intervals.
Drug excre>on (elimina>on)
Kidneys
Crea>nine clearance
BUN
Glomerular Yltra>on rate lower in older and female due to decreased muscle
mass
Urine pH 4.6-8
Liver (bile)
Feces
Lungs
Saliva, sweat, breast milk
Pharmacodynamics Phase:
Primary eIect-desirable response
Secondary eIect- desirable or undesirable response
Ex. Benadryl (primary eIect= treatment of allergies, Secondary eIect= CNS
depression (seda>on))
, Drug response rela>onship
Potency: the amount of drug needed to elicit speciYc physiological response
Physiological response at very low concentra>on=low potency
Therapeu>c index
Onset: >me it takes for drug to reach minimum eIec>ve concentra>on
Peak: highest concentra>on in blood
Dura>on: length of >me taken for drug to exert a therapeu>c eIect
Below therapeu>c response= under dose making it ineIec>ve
Above therapeu>c response= overdosed maybe toxic
Therapeu>c drug monitoring
Peak drug level: highest plasma concentra>on of drug
Trough drug level: lowest plasma concentra>on of the drug.
Receptor theory
Drugs bind to receptors
To ac>vate receptors
To produce a response
To inac>vate a receptor
Drugs can compete for the same receptor site. If one is bound the other one is going to be free.
Four receptor families
Cell membrane-imbedded enzymes
Ligand-gated ion channels
g-protein-coupled receptor systems
transcrip>on factors
Agonists
Ac>vate receptors
Produce desired response
Pushers/s>mulators
Antagonists
Prevent receptor ac>va>on
Block response
Preventors/ s>mulators
NonspeciYc: mul>ple receptor sites
Nonselec>ve: works on mul>ple receptors
Cholinergic receptors: eye, heart, blood vessels, stomach, bronchus, and bladder
Mechanisms of drug ac>on
S>mula>on
Depression
Irrita>on
Replacement
Cytotoxic ac>on
An>microbial ac>on
ModiYca>on of immune status
Side eIects
Secondary eIects
EXAM 1 STUDY GUIDE
Foundations of Nursing
Galen College of Nursing
, Exam 1 Study Guide
Chap. 2
Two drug phases
1.Pharmacokine>c phase
2.Pharmacodynamic Phase
Pharmacokine>c Phase: is the process of drug movement through the body necessary to
achieve drug ac>on. Includes Absorp>on, Distribuion, Metabolism, and Excre>on.
Pharmacodynamic Phase: is the study of the eIects of drug on the body. ( Receptor binding,
post receptor eIects, and chemical reac>ons).
Diges>on starts in the mouth-Salvia starts the breakdown!!!!
Pharmacokine,c Phase:
Absorp>on is the movement of the drug through the blood stream aOer its administra>on.
Disintegra>ons is the breakdown of the oral drug into smaller par>cles.
Dissolu>on is the >me it takes the drug to disintegrate and dissolve to become available for
absorp>on.
Acidic is faster than alkaline environment.
Absorp>on methods
Passive transport
DiIusion: is across the semipermeable membrane high to low concentra>on.
Requires no energy. It stops when the concentra>on is equa>on on both sides of the
membrane. In oral drugs GI (higher concentra>on) moves to the blood stream (lower
concentra>on).
Facilitated diIusion: is the same principal but requires a carrier protein to move
the drug.
Ac>ve Transport
Requires carrier and energy to move the drug against the concentra>on gradient.
Pinocytosis
Taking a bit out of the par>cles and bringing them into the cell.
Lipid soluble drugs and nonionized drugs are absorbed faster than water soluble and ionized
drugs
Factors aIec>ng absorp>on
Blood circula>on (poor circula>on, vasoconstrictors, shock or disease), Pain, stress, solid,
hot foods, high fat foods slow gastric emptying, Exercise decreases Blood Uow, pH, Route of
administra>on (IV, Oral, IM)
Drug movement from GI tract to liver
From mouth to the gut to portal vein and the liver drugs may be metabolized to an
inac>ve form and excreted reducing the amount of the ac>ve drug available to achieve desired
eIect. This is Yrst pass eIect (Yrst pass metabolism)
Bioavailability is the percentage of the drug leO for ac>vity. May be aIected by
absorp>on and Yrst pass metabolism for oral drugs. Bioavailability is always less than 100%.
Factors aIec>ng Bioavailability
Drug form
Route of administra>on
, Gastric mucosa and mo>lity
Administra>on w/food and other drugs
Changes in liver metabolism
Drug distribu>on: is the movement of the drug form the circula>on to >ssues.
Protein binding ( highly and weakly protein bound drugs)
Drugs drugs( unbound)
Volume of drug distribu>on
Compe>>on over protein binding sites leads to more free drug
Low plasma protein levels causes more free drugs Uoa>ng around
Low albumin same thing (elderly considera>ons)
BBB (blood brain barrier)
Water soluble drugs do not cross the BBB
You want to be careful with those who are pregnant some drugs cross the placenta and cause
damage
Drug metabolism (biotransforma>on: changing the drug chemically to form that is ready for
excre>on)
Half life: from administra>on to reduc>on of the drug in the body to a half. AIected by.-
previous dose, metabolism, and elimina>on.
Ex. Ibuprofen= 2hr 6am
200mg in two hrs= 100mg 8am
100mg in 2 hrs= 50mg 10am
50mg in 2hrs= 25mg 12pm
25mg in two hrs=12.5mg 2pm
12.5mg in 2 hrs= 6.25mg 4pm
Steady state=plateau=amount administered= amount eliminated usually achieved by 4-
5th half life if given consistently
Loading dose= large ini>al dose of medica>on (seizure medica>ons) smaller doses to
follow consistent >me intervals.
Drug excre>on (elimina>on)
Kidneys
Crea>nine clearance
BUN
Glomerular Yltra>on rate lower in older and female due to decreased muscle
mass
Urine pH 4.6-8
Liver (bile)
Feces
Lungs
Saliva, sweat, breast milk
Pharmacodynamics Phase:
Primary eIect-desirable response
Secondary eIect- desirable or undesirable response
Ex. Benadryl (primary eIect= treatment of allergies, Secondary eIect= CNS
depression (seda>on))
, Drug response rela>onship
Potency: the amount of drug needed to elicit speciYc physiological response
Physiological response at very low concentra>on=low potency
Therapeu>c index
Onset: >me it takes for drug to reach minimum eIec>ve concentra>on
Peak: highest concentra>on in blood
Dura>on: length of >me taken for drug to exert a therapeu>c eIect
Below therapeu>c response= under dose making it ineIec>ve
Above therapeu>c response= overdosed maybe toxic
Therapeu>c drug monitoring
Peak drug level: highest plasma concentra>on of drug
Trough drug level: lowest plasma concentra>on of the drug.
Receptor theory
Drugs bind to receptors
To ac>vate receptors
To produce a response
To inac>vate a receptor
Drugs can compete for the same receptor site. If one is bound the other one is going to be free.
Four receptor families
Cell membrane-imbedded enzymes
Ligand-gated ion channels
g-protein-coupled receptor systems
transcrip>on factors
Agonists
Ac>vate receptors
Produce desired response
Pushers/s>mulators
Antagonists
Prevent receptor ac>va>on
Block response
Preventors/ s>mulators
NonspeciYc: mul>ple receptor sites
Nonselec>ve: works on mul>ple receptors
Cholinergic receptors: eye, heart, blood vessels, stomach, bronchus, and bladder
Mechanisms of drug ac>on
S>mula>on
Depression
Irrita>on
Replacement
Cytotoxic ac>on
An>microbial ac>on
ModiYca>on of immune status
Side eIects
Secondary eIects
