pharm- everything

pharmacologic classification is based off of

mechanism of action

there is _ chemical name

one

there is _ generic name

one

there is _ trade name

multiple

preclinical investigation

drug tested on lab animals, human cells, microorganisms

preclinical investigation

gives you the lethal dose

clinical investigation

takes place in 3 different stages/clinical trials

clinical investigation

longest part of drug approval and regulation

review of the NDA

trade name finalized

drug is either approved or not

post marketing surveillance

severe for harmful drug effects in larger populations

nurse becomes involved

schedule 1 drugs

not accepted for medical use

high potential for abuse

schedule 1

heroin, marijuana

schedule 2

high potential for abuse, accepted with restrictions

schedule 2

opioids, cocaine, methamphetamine, methadone, fentanyl

schedule 3

moderate to low potential for dependence and abuse

schedule 3

codeine, ketamine, testosterone

schedule 4

lowest potential for abuse and dependence

schedule 4

robitussin, motofen

category A drug

no evidence of risk to the fetus

studies have not shown

Category A drug

insulin, folic acid

category b drug

animal studies shown no fetal risk but not enough info on pregnant women

category b drug

acetaminophen, ibuprofen, amoxicillin

category c

adverse effects on fetus

given if benefit justifies the risk

(some antibiotics, like tetracyclines)

category d

positive evidence of fetal harm, but should only be given when mother seriously needs it

side effect

unintended effects of a medication that are generally mild and managable

adverse effect

unintended and potentially harmful effect, always negative and require med attention

can range from mild to severe

5 rights of drug administration

right patient

right medication

right dose

right route

right time

3 checks of drug administration

check the MAR

check during prep

check before administering

first pass effect

occurs when a drug is metabolized by the liver before it reaches the systemic circulation

This reduces the bioavailability of the drug

STAT order

immediately and only once

ASAP order

within 30 minutes of order

single order

given once and at a specific time

routine order

carried out within 2 hours of order

standing order

written in advance of a situation that is carried out under specific circumstances

enteral routes

oral, sublingual, buccal, NG tube, GT tube

topical routes

transdermal, ophthalmic, otic, nasal, vaginal, rectal

parenteral routes

intradermal

subcutaneous

intramuscular

intravenous

oral route

Drugs are swallowed and absorbed through the gastrointestinal tract. This is the most common route of administration.

oral advantages

simple

convenient

generally safe

oral disadvantages

Slow onset of action, subject to first-pass metabolism, and can be affected by food and other medications.

sublingual advantages

Rapid onset of action, bypasses first-pass metabolism.

sublingual disadvantages

Limited to drugs that can be readily absorbed through the oral mucosa.

transdermal advantages

Provides sustained release of medication, avoids first-pass metabolism.

nasal advantages

Rapid onset of action, bypasses first-pass metabolism, direct delivery to the nasal passages.

rectal advantages

Bypass first-pass metabolism, can be used for patients who cannot take oral medications.

pharmacokinetics components

(ADME)

absorption

distribution

metabolism

excretion

median effective dose

ed50

ed50

middle of the frequency distribution curve

amount it takes to produce a therapeutic response in 50% of a group

median lethal dose

ld50

ld50

determined in preclinical trials- tested on animals and microorganisms, lethal dose in 50% of a group of animals 

medican toxicity dose

td50

td50

 taken from animals and patients, dose that will produce toxicity in 50% of group of patients 

ti calculation

ld 50 divided by ed 50

sympathethic NS

dilates pupils

sympathethic NS

inhibits salivation

sympathethic NS

accelerated HR

sympathethic NS

dilates bronchioles

sympathethic NS

inhibits digestion

sympathethic NS

stimulates glucose release

sympathethic NS

secretes NE and Epi

sympathethic NS

relaxes bladder

sympathethic NS

stimulates ejaculation and orgasm

parasympathetic NS

constricts pupils

parasympathetic NS

stimulates salivation

parasympathetic NS

slows HR

parasympathetic NS

constricts bronchioles

parasympathetic NS

stimulate digestion

parasympathetic NS

stimulate gallbladder function

parasympathetic NS

contracts bladder

parasympathetic NS

stimulates erection and lubrication

cholinergic nerves

release acetylcholine

cholinergic drugs/cholinergic agonists

produce rest and digest symptoms

stimulate parasympathetic nervous system

bethanechol is a

cholinergic agonist

bethanechol causes

smooth muscle contraction and bladder emptying

causes sweating

anticholinergic drugs

inhibit the action of ACH

primary neurotransmitter of sympathetic nervous system

norepinephrine

adrenergic nerves

release epinephrine

monoamine oxidase

destroys norepinephrine

alpha 2 receptors

• Location: presynaptic adrenergic nerve terminals 

• Inhibit release of norepinephrine and decrease activity of SNS

  • Treats hypertension

alpha 1 receptors

• Location: all sympathetic target organs except heart 

• Constricts blood vessels and dilate pupils

  • Treats nasal congestion or hypotension 

beta 1 receptors

• Location: heart and kidneys 

• Increase heart rate + force of contraction and release of renin 

  • Treats cardiac arrest, heart failure, and shock

beta 2 receptors

• Location: all sympathetic target organs except heart 

• Inhibits smooth muscle 

  • Treats COPD, asthma and preterm labor contraction

cardiac/lower esophageal sphincter

prevents stomach contents from moving back into the esophagus

pyloric sphincter

• : located at the entrance of the small intestine and regulates the flow of substances leaving the stomach 

chief cells

• secrete pepsinogen, inactive form of pepsin that breaks down proteins

parietal cells

 secrete 1-3 liters of hydrochloric acid each day which breaks down food, activates pepsinogen, ad kills ingestive microbes

peptic ulcer

• Lesion located in either the stomach (gastric) or small intestine (duodenal) 

  • Most common cause: overuse of NSAIDs and infection by gram - bacteria (H pylori)

duodenal ulcer

• Gnawing or burning upper abdominal pain 

• Pain is worse when the stomach is empty but disappears after eating 

• Usually occurs in a younger population 

• Often related to H. pylori 

  • Nighttime pain, bright red blood in vomit, black tarry stools 

gastric ulcer

• Pain is relieved by food but pain my continue after a meal 

• More common in older population + women over 60 

• Could lead to stomach cancer 

  • Loss of appetite, weight loss

proton pump inhibitors

• Block the enzyme responsible for secreting hydrochloric acid in the stomach 

proton pump inhibitors

• Bind to H+, K+ -ATPase to reduce acid secretion 

proton pump inhibitors

• Take 20-30 minutes before major meal 

  • AE: headache, abdominal pain 

Peptic ulcer disease (PUD) is caused by

an erosion of the mucosal layer of the stomach or duodenum

PUD occurs most commonly in what age group

30-50

h2 agonists

drugs work by blocking receptors in the stomach to decrease acid production

used to treat peptic ulcer disease

people taking MAOIs should not take

food containing tyramine

vasopressin causes

decreased urine output

h2 receptor agonists

These drugs bind to H2 receptors on the parietal cells of the stomach lining.

Upon binding, the agonists activate the receptors, leading to increased production and secretion of gastric acid.

do not take antacids

with h2 receptor drugs

give h2 receptor drugs

after meals