Pharmacologic Principles - PowerPoint Presentation

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Pharmacologic Principles - PPT Presentation

DSN Kevin Dobi MS APRN Copyright 2014 by Mosby an imprint of Elsevier Inc Chapter 2 Drug Any chemical that affects the physiologic processes of a living organism Pharmacology Study or science of drugs ID: 737951

2014 mosby elsevier imprint mosby 2014 imprint elsevier copyright drug patient response effect patch time route drugs therapy therapeutic

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Slide1

Pharmacologic PrinciplesDSN Kevin Dobi, MS, APRN

Chapter 2Slide2

DrugAny chemical that affects the physiologic processes of a living organismPharmacology

Study or science of drugs

Pharmacologic Principles

2Slide3

Chemical name

Describes the drug’s chemical composition and molecular structure

Generic name

(nonproprietary name)

Name given by the United States Adopted Names Council

Trade name

(proprietary name)

The drug has a registered trademark; use of the name is restricted by the drug’s patent owner (usually the manufacturer)

Drug Names

3Slide4

Chemical, Generic, and Trade names and Chemical Structure of Ibuprofen

4Slide5

PharmaceuticsPharmacokineticsPharmacodynamicsPharmacotherapeutics

PharmacognosyPharmacoeconomics

Pharmacologic Principles

5Slide6

The study of how various drug forms influence the way in which the drug affects the body

Pharmaceutics

6Slide7

The study of what the body does to the drugAbsorptionDistribution

MetabolismExcretion

Pharmacokinetics

7Slide8

The nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from IV to PO. The nurse expects the oral dose to be

higher because of the first-pass effect.

lower because of the first-pass effect.

the same as the IV dose.

unchanged

.Slide9

The study of what the drug does to the bodyThe mechanism of drug actions in living tissuesDrug-receptor relationships

Pharmacodynamics

9Slide10

10Slide11

A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route?

Subcut

POSlide12

The clinical use of drugs to prevent and treat diseases

Defines principles of drug actions—the cellular processes that change in response to the presence of drug molecules

Drugs are organized into pharmacologic classes

Pharmacotherapeutics

12Slide13

The study of natural (versus synthetic) drug sources (i.e., plant, animals, minerals)

Pharmacognosy

13Slide14

Different drug dosage forms have different pharmaceutical properties.Dosage form determines the rate of drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract).

Enteric-coated tabletsExtended-release forms

Pharmaceutics

14Slide15

A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow pills. What will the nurse do?

Crush the tablets and mix them with applesauce or pudding.

Call the pharmacy and ask for the liquid form of the medication.

Call the pharmacy and ask for the IV form of the medication.

Encourage the patient to try to swallow the tablets.Slide16

16Slide17

A drug’s time to onset of action, time to peak effect, and duration of actionStudy of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body

Pharmacokinetics

17Slide18

Movement of a drug from its site of administration into the bloodstream for distribution to the tissuesBioavailabilityFirst-pass effect

Pharmacokinetics: Absorption

18Slide19

A drug’s route of administration affects the rate and extent of absorption of that drugEnteral (GI tract)

ParenteralTopical

Routes

19Slide20

The drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestineOral

SublingualBuccalRectal (can also be topical)

Enteral

Route

20Slide21

Intravenous (fastest delivery into the blood circulation)Intramuscular

SubcutaneousIntradermal

Intraarterial

Intrathecal

Intraarticular

Parenteral

Route

21Slide22

Skin (including transdermal patches)EyesEarsNoseLungs (inhalation)Rectum

Vagina

Topical Route

22Slide23

The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do?

Remove the old medication patch and notify the health care provider

Apply the new patch without removing the old one

Remove the old patch and apply the new patch in the same spot

Remove the old patch and apply the new patch to a different, clean areaSlide24

The transport of a drug by the bloodstream to its site of action Protein-binding Water-soluble vs. fat-soluble

Blood-brain barrier Areas of rapid distribution: heart, liver, kidneys, brain

Areas of slow distribution: muscle, skin, fat

Distribution

24Slide25

25Slide26

The biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite, or a less active metabolite

Liver (main organ) Skeletal muscle

Kidneys

Lungs

Plasma

Intestinal mucosa

Metabolism/Biotransformation

26Slide27

27Slide28

Factors that decrease metabolismCardiovascular dysfunctionRenal insufficiency

StarvationObstructive jaundice

Slow acetylator

Ketoconazole therapy

Metabolism/Biotransformation (cont’d.)

28Slide29

Factors that increase metabolismFast acetylatorBarbiturate therapyRifampin therapy

Phenytoin therapy

Metabolism/Biotransformation (cont’d)

29Slide30

The elimination of drugs from the bodyKidneys (main organ)Liver

BowelBiliary excretionEnterohepatic recirculation

Excretion

30Slide31

31Slide32

The time it takes for one half of the original amount of a drug to be removed from the bodyA measure of the rate at which a drug is removed from the bodyMost drugs considered to be effectively removed after about five half-lives

Steady state

Half-life

32Slide33

Drug actionsThe cellular processes involved in the drug and cell interaction

Drug effectThe physiologic reaction of the body to the drug

Includes onset, peak, and duration of action

The Movement of Drugs

Through the Body

33Slide34

Onset

The time it takes for the drug to elicit a

therapeutic response

Peak

The time it takes for a drug to reach its maximum therapeutic response

Duration

The time a drug concentration is sufficient to elicit a therapeutic response

Onset, Peak, and Duration

34Slide35

35Slide36

Peak level

Highest blood level

Trough level

Lowest blood level

Therapeutic Drug Monitoring

36Slide37

Receptor interactionsEnzyme interactionsNonselective interactions

Pharmacodynamics:

Mechanisms of Action

37Slide38

38Slide39

39Slide40

Acute therapyMaintenance therapySupplemental/replacement therapy

Palliative therapySupportive therapyProphylactic therapy

Empiric therapy

Pharmacotherapeutics

Types of Therapies

40Slide41

Any characteristic of the patient, especially a disease state, that makes the use of a given medication dangerous for the patient It is important to assess for contraindications!

Contraindications

41Slide42

Evaluating the clinical response of the patient to the treatmentOne must be familiar with the drug’s:Intended therapeutic action (beneficial)

Unintended but potential adverse effects (predictable, adverse drug reactions)

Monitoring

42Slide43

Therapeutic indexDrug concentrationPatient’s conditionTolerance and dependence

Drug interactions (additive effect, synergistic effect, antagonistic effect, incompatibility)Adverse drug events

Monitoring (cont’d)

43Slide44

Adverse drug reactionsPharmacologic reactions, including adverse effects

Hypersensitivity (allergic) reactionIdiosyncratic reaction