Lecture 11

Pharmacoeconomics

Cost of drug therapy; includes production and dispensing

Pharmacogenomics

Studying how an individual responds to medications r/t genetics

Pharmaceutics

Branch of pharmacology, concerned with the preparation, use, or sale of medical drugs

Generic name

Official name of the drug, universal name for the medication may be a chemical name, usually reflects the drug grouping

Trade/brand name

Name given by manufacturer

Prototype drugs

The first drug in a class to be produced

Drug classifications

Drugs are grouped according to their general outcomes in the body, chemical make up and therapeutic outcomes

Opioids

Morphine, codeine, oxycodone, fentanyl

Beta blockers

Metoprolol, labetalol, propranolol

Proton pump inhibitors

Omeprazole, pantoprazole, lansoprazole

Nurses are responsible_______________ When administering controlled substances such as narcotics

For following legal guidelines

Schedule 2 meds

Pharmacokinetics

Movement of drugs throughout the body

• absorption

• Distribution

• Metabolism

• Excretion

Absorption

Please, a huge part in determining onset of the medication,

Dosage and type of medication, Root of administration, Functioning of the G.I. tract and presence of blood

Bioavailability

The amount of the drug that reaches the blood stream

Oral vs IV medication

Distribution

Affected by circulation, Protein binding

Water soluble vs Lipid soluble medications

Only lipid soluble medications can cross the blood brain barrier (cns)

Metabolism

Done mostly in liver, also known as biotransformation, Invades the drug prior to excretion

First pass effect, Portions of the drug are broken down in the G.I. tract and transported straight to the liver through the portal circulation, This effect reduces the amount of medication available for distribution

Excretion

Locations: Kidneys, bowel, skin, lungs

When dosing medication’s for older pt…

Make sure body weight and organ function are considered

Pharmacodynamics

A study of biochemical and physiological interactions of drugs at the sites of activity

Therapeutic effects

What we expect the drug to do, Loading dose vs Maintenance dose

Idiosyncratic effects

Opposite response of a therapeutic effect

Additive effects

Effect when multiple substances with the same expected, response responses are taken simultaneously, Combine meds to get effect

Synergistic effects

Effect when 2 drugs with different receptors or MOA are taken to enhance the desired effect

Agonistic medications

Drugs that have the same effect as something else (natural/artificial)

Antagonist medications

Drugs that get in the way and prevent other effects (bp controlling meds)

Antidote

Substance given to antagonized toxic effects of a drug, blind/block receptors

Variables that affect drug actions

Dosage, root of administration, drug diet interactions, drug drug interactions

Pt related variables

Age, bodyweight, pharmacogenetics, sex, pre-existing Conditions, psychological factors

Adverse drug events

Any undesirable response to medication

Idiosyncratic (opposite) response, Medication, error, adverse effect, allergic reaction, carcinogenic effects

Blackbox warnings

Strongest FDA, given warning, medication may cause serious or life-threatening adverse effects, antidepressant, drugs, non-opioid analgesics, immediate release opioid analgesics

Therapeutic monitoring

Does the drug need therapeutic lab monitoring?, Can this mad affect other things in the body? Electrolytes, renal function, hepatic function

Serum drug levels

Monitor to reduce risk of toxicity

Digoxin, phenytoin, lithium

Peak and trough Blood levels

Used to monitor a desired concentration for effect

Vancomycin, gentamycin