Portage Learning, Pharmacology Exam I (Summary)
Intro to Pharmacology
Dosage Forms: Means by which drugs are delivered to the sites of action within the
body. Classified by:
✓ Route and dosage form impact absorption
✓ Modified release and enteric coated CANNOT be cut Route
✓ IM form NOT always suitable for IV admin Physical Form
Oral, topical, rectal, parenteral,
✓ Avoid IM during anticoagulation therapy (IM hemorrhage) Solid, semisolid, liquid
✓ Suspensions settle. SHAKE WELL (eye and ear drops also) vaginal, inhaled, ophthalmic, otic,
nasal
✓ Patches CANNOT be cut
✓ Dry powder inhalers require inspiration abilities
✓ ODT can be split just prior to admin
✓ Colloidon is FLAMMABLE
✓ Not all parenteral meds given IV. Check ISMP.org Depot preparation
never given IV
Medication Types:
CAM OTC Rx
• “this product is not intended to diagnose, • Provide symptomatic relief (not tx) • Prescription required
treat, cure, or prevent any disease” • FDA regulated {must be safe and effective, • Controlled substances require: record
• Safe until proven hazardous no harmful side effects with proper use, no keeping, prescribing, labeling,
• NOT all CAMs undergo quality professional expertise required} schedules
certification Serious DDIs with some CAMs ➢ Schedules: 1= most restrictive, 5= least
• HARMFUL: Comfrey, Kava, Ma Huang
Nursing Process and Pharmacology
Assessment Baseline data (vitals, labs, system assessment), medical hx, allergies, documentation (orders), diet orders, IV access
Planning Some drugs cannot be given at the same time. DON’T give just because HER says so. Consider 5 rights. Oral meds affected
by FIRST PASS. [IV dose much smaller]
Implementation Give med and document. Document if not given and reason why
Evaluation Know when the intended effect will happen. Reasses and look for adverse effects
Patient education: patient and families need to know intended effects, adverse effects, diet restrictions, interactions, when
to speak to provider or pharmacist
, Pharmacokinetics
What the body does to a drug
Absorption Distribution Metabolism Excretion
Factors affecting: Where the drug goes after Usually occurs in the liver. Usually occurs by way of
1. Rate of dissolution absorbed. Uses hepatic enzymes to make kidneys.
2. Rate of absorption Factors affecting: drug more polar for urine Also: bile, sweat, breast milk,
a. SA, lipid solubility, 1. Blood flow to tissues excretion expired air.
blood flow, pH) 2. Ability of drug to exit Phase I: (non-synthetic, P450) Glomerular filtration: moves
3. Completeness of absorption vascular system (brain, Oxidation, reduction, LMW drugs (unbound) from
a. Anatomy, drug/food fat, lung, eye, etc.) demethylation, hydrolysis blood to urine
interactions 3. Ability of drug to enter cells Phase II: (synthetic) Passive reabsorption: lipid
Major routes: oral, IV, [These factors impact route Conjugation (makes soluble drugs moved back into
IM, SubQ and dose] compound more water blood
Rate and extent of absorption Protein binding: Albumin is soluble) Active transport: tubular
will vary by route. most common for binding. First Pass Effect: 90% of oral pumps for organic acids and
Bioavailability: Amount of Only free drug (unbound) can medication metabolized and bases move drugs from blood
active drug that reaches leave vasculature. destroyed by the liver before to urine
systemic circulation (oral) Low plasma albumin= more it gets to the heart. Slow elimination > LOWER
free drug= potential toxicity Dose conversion between dose
oral and other routes Caused by: poor organ
necessary! function, drug interactions,
genetic predisposition.
, Pharmacodynamics
What the drug does to the body and how
Dose-response relationship: The size of the dose compared to the response it produces.
Maximum Efficacy: How much drug is making a difference.
Relative Potency: Strength of drug needed to produce specific effect.
Drug Receptor Theory:
➢ Agonists- Mimic body processes to activate receptors
➢ Partial Agonists- Mimic body processes to activate receptors less than full agonists
➢ Antagonists- Block body processes by preventing receptor activation by endogenous molecules and drugs (competitive/non-competitive)
Non-Receptor Mediated Reactions: Simple physical or chemical reactions in the body
Examples:
➢ Antacids (bind and neutralize stomach acid)
➢ Saline laxatives (water retention)
➢ Chelation therapy (excrete metal from the body)
➢ Antiseptics (precipitate proteins and antibodies)
Therapeutic Index: Relative safety of a drug based on the difference in effective dose and lethal dose.
Narrow therapeutic index: Small differences in dose may lead to adverse effects or toxicity.
Course of Drugs
Half-Life: Time for the concentration of a particular drug to drop by one-half in a particular patient.
Steady State: Drug in is equal to drug out. Blood concentrations of a drug remain steady. Normally takes 4-5 doses.
Plasma Drug Levels: Amount of drug in the blood.
Intro to Pharmacology
Dosage Forms: Means by which drugs are delivered to the sites of action within the
body. Classified by:
✓ Route and dosage form impact absorption
✓ Modified release and enteric coated CANNOT be cut Route
✓ IM form NOT always suitable for IV admin Physical Form
Oral, topical, rectal, parenteral,
✓ Avoid IM during anticoagulation therapy (IM hemorrhage) Solid, semisolid, liquid
✓ Suspensions settle. SHAKE WELL (eye and ear drops also) vaginal, inhaled, ophthalmic, otic,
nasal
✓ Patches CANNOT be cut
✓ Dry powder inhalers require inspiration abilities
✓ ODT can be split just prior to admin
✓ Colloidon is FLAMMABLE
✓ Not all parenteral meds given IV. Check ISMP.org Depot preparation
never given IV
Medication Types:
CAM OTC Rx
• “this product is not intended to diagnose, • Provide symptomatic relief (not tx) • Prescription required
treat, cure, or prevent any disease” • FDA regulated {must be safe and effective, • Controlled substances require: record
• Safe until proven hazardous no harmful side effects with proper use, no keeping, prescribing, labeling,
• NOT all CAMs undergo quality professional expertise required} schedules
certification Serious DDIs with some CAMs ➢ Schedules: 1= most restrictive, 5= least
• HARMFUL: Comfrey, Kava, Ma Huang
Nursing Process and Pharmacology
Assessment Baseline data (vitals, labs, system assessment), medical hx, allergies, documentation (orders), diet orders, IV access
Planning Some drugs cannot be given at the same time. DON’T give just because HER says so. Consider 5 rights. Oral meds affected
by FIRST PASS. [IV dose much smaller]
Implementation Give med and document. Document if not given and reason why
Evaluation Know when the intended effect will happen. Reasses and look for adverse effects
Patient education: patient and families need to know intended effects, adverse effects, diet restrictions, interactions, when
to speak to provider or pharmacist
, Pharmacokinetics
What the body does to a drug
Absorption Distribution Metabolism Excretion
Factors affecting: Where the drug goes after Usually occurs in the liver. Usually occurs by way of
1. Rate of dissolution absorbed. Uses hepatic enzymes to make kidneys.
2. Rate of absorption Factors affecting: drug more polar for urine Also: bile, sweat, breast milk,
a. SA, lipid solubility, 1. Blood flow to tissues excretion expired air.
blood flow, pH) 2. Ability of drug to exit Phase I: (non-synthetic, P450) Glomerular filtration: moves
3. Completeness of absorption vascular system (brain, Oxidation, reduction, LMW drugs (unbound) from
a. Anatomy, drug/food fat, lung, eye, etc.) demethylation, hydrolysis blood to urine
interactions 3. Ability of drug to enter cells Phase II: (synthetic) Passive reabsorption: lipid
Major routes: oral, IV, [These factors impact route Conjugation (makes soluble drugs moved back into
IM, SubQ and dose] compound more water blood
Rate and extent of absorption Protein binding: Albumin is soluble) Active transport: tubular
will vary by route. most common for binding. First Pass Effect: 90% of oral pumps for organic acids and
Bioavailability: Amount of Only free drug (unbound) can medication metabolized and bases move drugs from blood
active drug that reaches leave vasculature. destroyed by the liver before to urine
systemic circulation (oral) Low plasma albumin= more it gets to the heart. Slow elimination > LOWER
free drug= potential toxicity Dose conversion between dose
oral and other routes Caused by: poor organ
necessary! function, drug interactions,
genetic predisposition.
, Pharmacodynamics
What the drug does to the body and how
Dose-response relationship: The size of the dose compared to the response it produces.
Maximum Efficacy: How much drug is making a difference.
Relative Potency: Strength of drug needed to produce specific effect.
Drug Receptor Theory:
➢ Agonists- Mimic body processes to activate receptors
➢ Partial Agonists- Mimic body processes to activate receptors less than full agonists
➢ Antagonists- Block body processes by preventing receptor activation by endogenous molecules and drugs (competitive/non-competitive)
Non-Receptor Mediated Reactions: Simple physical or chemical reactions in the body
Examples:
➢ Antacids (bind and neutralize stomach acid)
➢ Saline laxatives (water retention)
➢ Chelation therapy (excrete metal from the body)
➢ Antiseptics (precipitate proteins and antibodies)
Therapeutic Index: Relative safety of a drug based on the difference in effective dose and lethal dose.
Narrow therapeutic index: Small differences in dose may lead to adverse effects or toxicity.
Course of Drugs
Half-Life: Time for the concentration of a particular drug to drop by one-half in a particular patient.
Steady State: Drug in is equal to drug out. Blood concentrations of a drug remain steady. Normally takes 4-5 doses.
Plasma Drug Levels: Amount of drug in the blood.
