NUR 210, 242
EXAM 1 STUDY GUIDE
Pharmacology and Medsurge
Galen College of Nursing
, Exam 1 Study Guide
Chap. 2
Two drug phases
1.Pharmacokinetic phase
2.Pharmacodynamic Phase
Pharmacokinetic Phase: is the process of drug movement through the body necessary to
achieve drug action. Includes Absorption, Distribuion, Metabolism, and Excretion.
Pharmacodynamic Phase: is the study of the effects of drug on the body. ( Receptor binding,
post receptor effects, and chemical reactions).
Digestion starts in the mouth-Salvia starts the breakdown!!!!
Pharmacokinetic Phase:
Absorption is the movement of the drug through the blood stream after its administration.
Disintegrations is the breakdown of the oral drug into smaller particles.
Dissolution is the time it takes the drug to disintegrate and dissolve to become available for
absorption.
Acidic is faster than alkaline environment.
Absorption methods
Passive transport
Diffusion: is across the semipermeable membrane high to low concentration.
Requires no energy. It stops when the concentration is equation on both sides of the
membrane. In oral drugs GI (higher concentration) moves to the blood stream (lower
concentration).
Facilitated diffusion: is the same principal but requires a carrier protein to move
the drug.
Active Transport
Requires carrier and energy to move the drug against the concentration gradient.
Pinocytosis
Taking a bit out of the particles and bringing them into the cell.
Lipid soluble drugs and nonionized drugs are absorbed faster than water soluble and ionized
drugs
Factors affecting absorption
Blood circulation (poor circulation, vasoconstrictors, shock or disease), Pain, stress, solid,
hot foods, high fat foods slow gastric emptying, Exercise decreases Blood flow, pH, Route of
administration (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
inactive form and excreted reducing the amount of the active drug available to achieve desired
effect. This is first pass effect (first pass metabolism)
Bioavailability is the percentage of the drug left for activity. May be affected by
absorption and first pass metabolism for oral drugs. Bioavailability is always less than 100%.
Factors affecting Bioavailability
Drug form
Route of administration
, Gastric mucosa and motility
Administration w/food and other drugs
Changes in liver metabolism
Drug distribution: is the movement of the drug form the circulation to tissues.
Protein binding ( highly and weakly protein bound drugs)
Drugs drugs( unbound)
Volume of drug distribution
Competition over protein binding sites leads to more free drug
Low plasma protein levels causes more free drugs floating around
Low albumin same thing (elderly considerations)
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 (biotransformation: changing the drug chemically to form that is ready for
excretion)
Half life: from administration to reduction of the drug in the body to a half. Affected by.-
previous dose, metabolism, and elimination.
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 initial dose of medication (seizure medications) smaller doses to
follow consistent time intervals.
Drug excretion (elimination)
Kidneys
Creatinine clearance
BUN
Glomerular filtration 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 effect-desirable response
Secondary effect- desirable or undesirable response
Ex. Benadryl (primary effect= treatment of allergies, Secondary effect= CNS
depression (sedation))
, Drug response relationship
Potency: the amount of drug needed to elicit specific physiological response
Physiological response at very low concentration=low potency
Therapeutic index
Onset: time it takes for drug to reach minimum effective concentration
Peak: highest concentration in blood
Duration: length of time taken for drug to exert a therapeutic effect
Below therapeutic response= under dose making it ineffective
Above therapeutic response= overdosed maybe toxic
Therapeutic drug monitoring
Peak drug level: highest plasma concentration of drug
Trough drug level: lowest plasma concentration of the drug.
Receptor theory
Drugs bind to receptors
To activate receptors
To produce a response
To inactivate 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
transcription factors
Agonists
Activate receptors
Produce desired response
Pushers/stimulators
Antagonists
Prevent receptor activation
Block response
Preventors/ stimulators
Nonspecific: multiple receptor sites
Nonselective: works on multiple receptors
Cholinergic receptors: eye, heart, blood vessels, stomach, bronchus, and bladder
Mechanisms of drug action
Stimulation
Depression
Irritation
Replacement
Cytotoxic action
Antimicrobial action
Modification of immune status
Side effects
Secondary effects
EXAM 1 STUDY GUIDE
Pharmacology and Medsurge
Galen College of Nursing
, Exam 1 Study Guide
Chap. 2
Two drug phases
1.Pharmacokinetic phase
2.Pharmacodynamic Phase
Pharmacokinetic Phase: is the process of drug movement through the body necessary to
achieve drug action. Includes Absorption, Distribuion, Metabolism, and Excretion.
Pharmacodynamic Phase: is the study of the effects of drug on the body. ( Receptor binding,
post receptor effects, and chemical reactions).
Digestion starts in the mouth-Salvia starts the breakdown!!!!
Pharmacokinetic Phase:
Absorption is the movement of the drug through the blood stream after its administration.
Disintegrations is the breakdown of the oral drug into smaller particles.
Dissolution is the time it takes the drug to disintegrate and dissolve to become available for
absorption.
Acidic is faster than alkaline environment.
Absorption methods
Passive transport
Diffusion: is across the semipermeable membrane high to low concentration.
Requires no energy. It stops when the concentration is equation on both sides of the
membrane. In oral drugs GI (higher concentration) moves to the blood stream (lower
concentration).
Facilitated diffusion: is the same principal but requires a carrier protein to move
the drug.
Active Transport
Requires carrier and energy to move the drug against the concentration gradient.
Pinocytosis
Taking a bit out of the particles and bringing them into the cell.
Lipid soluble drugs and nonionized drugs are absorbed faster than water soluble and ionized
drugs
Factors affecting absorption
Blood circulation (poor circulation, vasoconstrictors, shock or disease), Pain, stress, solid,
hot foods, high fat foods slow gastric emptying, Exercise decreases Blood flow, pH, Route of
administration (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
inactive form and excreted reducing the amount of the active drug available to achieve desired
effect. This is first pass effect (first pass metabolism)
Bioavailability is the percentage of the drug left for activity. May be affected by
absorption and first pass metabolism for oral drugs. Bioavailability is always less than 100%.
Factors affecting Bioavailability
Drug form
Route of administration
, Gastric mucosa and motility
Administration w/food and other drugs
Changes in liver metabolism
Drug distribution: is the movement of the drug form the circulation to tissues.
Protein binding ( highly and weakly protein bound drugs)
Drugs drugs( unbound)
Volume of drug distribution
Competition over protein binding sites leads to more free drug
Low plasma protein levels causes more free drugs floating around
Low albumin same thing (elderly considerations)
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 (biotransformation: changing the drug chemically to form that is ready for
excretion)
Half life: from administration to reduction of the drug in the body to a half. Affected by.-
previous dose, metabolism, and elimination.
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 initial dose of medication (seizure medications) smaller doses to
follow consistent time intervals.
Drug excretion (elimination)
Kidneys
Creatinine clearance
BUN
Glomerular filtration 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 effect-desirable response
Secondary effect- desirable or undesirable response
Ex. Benadryl (primary effect= treatment of allergies, Secondary effect= CNS
depression (sedation))
, Drug response relationship
Potency: the amount of drug needed to elicit specific physiological response
Physiological response at very low concentration=low potency
Therapeutic index
Onset: time it takes for drug to reach minimum effective concentration
Peak: highest concentration in blood
Duration: length of time taken for drug to exert a therapeutic effect
Below therapeutic response= under dose making it ineffective
Above therapeutic response= overdosed maybe toxic
Therapeutic drug monitoring
Peak drug level: highest plasma concentration of drug
Trough drug level: lowest plasma concentration of the drug.
Receptor theory
Drugs bind to receptors
To activate receptors
To produce a response
To inactivate 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
transcription factors
Agonists
Activate receptors
Produce desired response
Pushers/stimulators
Antagonists
Prevent receptor activation
Block response
Preventors/ stimulators
Nonspecific: multiple receptor sites
Nonselective: works on multiple receptors
Cholinergic receptors: eye, heart, blood vessels, stomach, bronchus, and bladder
Mechanisms of drug action
Stimulation
Depression
Irritation
Replacement
Cytotoxic action
Antimicrobial action
Modification of immune status
Side effects
Secondary effects
