Pharmacology Second yearADN501

Absorption

dependentn the properties of absorption

Bioavailability

refers to the extent a substance or drug becomes completely available to its intended biological destination(s).

First pass metabolism

Drugs enter the hepatic portal system in the liver

The degree of metabolic breakdown of an orally administered drug that occurs in the intestine or liver before it reaches the systemic circulation

Distribution

movement of drugs throughout the body.

Dependent on protein binding

solubility of the drug

Volume of distribution

Pharmacology

refers to the action of drug on the body

Pharmacology various mechanisms

receptors,ion channels,enzymes

antagonist enzymes

An agonist binds to the receptor and produces an effect within the cell

agonist enzymes

An antagonist may bind to the same receptor, but does not produce a response, instead it blocks that receptor to a natural agonistblocks

Metabolism

most drugs are altered by enzymes in the liver where drugs,into metabolites to facilitate their excretion

Enzyme induction

some drugs reduce the activity of the liver enxymes

Enzyme inhibition

process where a molecule called an inhibitor binds to an enzyme, reducing or stopping its ability to function and carry out its normal chemical reaction.

excretion

(in living organisms and cells) the process of eliminating or expelling waste matter.

thereapeutic window

drug eg lithium,: The dose range of a drug that provides safe and effective therapy with minimal adverse effects

Pharmacokinetic interactions

A drug may alter the absorption, distribution, metabolism or excretion of another drug

Grapefruit juice

interacts with a lot of drugs

Pharmacodynamic

one drug acts in a similar way and has similar side effects or work in the opposite way to each other

Drug formulations

Oral(tablets,capsules,liquids,sublingual.Local,ear,eye,nose,inhaler

Injections,

inhaler

rectal

topical

Drug classifications

General sales list(GSL)

Pharmacy medicines(P)

Prescription only medicines(POM)

General sales list

A General Sales List (GSL) refers to a category of medicines that can be bought from various shops, including pharmacies, supermarkets, and convenience stores, without a pharmacist's supervision or a prescription.

interactions

Interactions:

Addiction:

Inappropriate use:

Interactions drugs

Herbal

ibuprofen

Aspirin

vitamins

addiction drug

Addiction:

co-codomal

nasal spray

Antihistamines

inappropriate use

steroid creams

age limits

Parcetamol

eye drops

Generating prescriptions

Types of prescriptions

FP10

EPMA

Drug charts

Private

Generic names

Formulation

Cancel dont modify

Controlled Drugs

Allergies/sensitivities and reaction nature documented

Electronic prescribing pros

Legible

reduces errors

Decision Support

Highlight Contraindications,Safety,interactions,allergies

Easy access to guidance BNF,NICE

Restricts to formulary and specialist only medication

Administration

Safety alerts

Timingreminders

Non-administration record

Records easy to ready

Audit trail

Data collection

Electronic prescribing Cons

unfamiliariality with system

Altered Workflow Patterns

Alert Fatigue

Selection errors

Workarounds(,ay be able to override alerts)

Increased workload due to system(if admin went off ward may represcribe

Working outside scope

Remote Prescribing Primary Care

All the information needed to make a joint decision

Photos/videos call can help

Confidence

Patient capacity

Remote Prescribing secondary care

SBAR

On call doctor may not be on the ward

Diltiazem

Preparations>may not have the same clinical effect.Diltiazem is a calcium channel blocker. It works by affecting the movement of calcium into the cells of the heart and blood vessels. This relaxes the blood vessels, lowers blood pressure, and increases the supply of blood and oxygen to the heart while reducing its workload.

Nifedipine MR

preparations may not have the same clinical effect.

critical medicines

delays or omissions in prescribing or administering some crtical medicines can cause serious harm or death

Critical medicines

Analgesics in severe pain or fever

GTN

Rapid tranquilisation

Clopazine

Antibiotocs

Antiepileptics

Digoxins

Opiods

Lithium

unlicensed off labels meds

medications without marketing authorisation

higher risk

unlicensed off label meds may be necessary to provide optimum treatment for patients but only when use can be clearly justified.

unlicensed

clinical trials

imported

specoals

license suspended

revoked or not renewed made for a specific patient

Adverse Drug Event

Harmful or unpleasant event that the patient

Dose,timing ,susceptability

Hyper susceptibility reactions,Collateral,toxic

Timing

Susceptibility

ADRS

recent change in drug treatments is a trigger dose changes

elderly altered drug handling

Absorption reduced

changes to metabolic processes

loss of brain tissue

distribution

pregnancy meds

not all meds are safe during pregnancy or breastfeeding