Introduction to Pharmacology and Drug Classifications

Therapeutic Classification

Intended use or effect of a drug.

Pharmacological Classification

Mechanism of action of a drug.

Complementary and Alternative Therapy (CAM)

Non-conventional therapies alongside traditional medicine.

Controlled Substance Schedule I

High abuse potential, no medical use (e.g., heroin).

Controlled Substance Schedule II

High abuse potential, restricted medical use (e.g., morphine).

Controlled Substance Schedule III

Moderate abuse potential (e.g., anabolic steroids).

Controlled Substance Schedule IV

Low abuse potential (e.g., diazepam).

Controlled Substance Schedule V

Lowest abuse potential (e.g., cough preparations with codeine).

Black Box Warning

Alerts about severe adverse effects or risks.

Routes of Medication Delivery

Methods include oral, sublingual, and intravenous.

Therapeutic Range

Concentration between effectiveness and toxicity.

Safety Margin

Gap between effective and toxic doses.

Agonist

Activates receptors to produce a response.

Antagonist

Blocks receptors to inhibit a response.

Pharmacokinetics

What the body does to the drug.

Pharmacodynamics

What the drug does to the body.

Adverse Effects of Ibuprofen

GI upset, bleeding, renal toxicity.

Adverse Effects of Aspirin

GI bleeding, tinnitus at high doses.

Adverse Effects of Acetaminophen

Liver toxicity.

Adverse Effects of Prednisone

Immunosuppression, hyperglycemia, weight gain.

Autoimmune Disorders

Conditions like rheumatoid arthritis and lupus.

Vaccination Boosters

Re-expose immune system to an antigen.

Aricept (donepezil)

Inhibits acetylcholinesterase to enhance neuron communication.

Parasympathetic Division

Decreases heart rate, promotes digestion.

Sympathetic Division

Increases heart rate, dilates bronchi.

Adverse Effects of Anticholinergics

Dry mouth, blurred vision, urinary retention.

Effects of Adrenergic Drugs

Vasoconstriction, increased blood pressure.

Adverse Effects of Benzodiazepines

Sedation, dizziness, respiratory depression.

Adverse Effects of SSRIs

Nausea, insomnia, sexual dysfunction.

Pain Assessment

Evaluate pain level, location, and quality.

Adverse Effects of Opiates

Respiratory depression, constipation, dependence.

Modifiable Risk Factors for Hypertension

Smoking, obesity, high sodium intake.

Contraindications for Beta Blockers

Asthma, bradycardia, certain heart block conditions.

Factors Responsible for Blood Pressure

Cardiac output, blood volume, vascular resistance.

Purpose of Multiple Antihypertensive Medications

Target different pathways for better control.

Adverse Effects of Diuretics

Dehydration, electrolyte imbalance, hypotension.

Heart Failure Effects on Lungs

Causes fluid buildup and pulmonary congestion.

Effective Drug Classes for Heart Failure

ACE inhibitors, beta-blockers, diuretics, digoxin.

Angina vs. Myocardial Infarction

Angina: temporary pain; MI: permanent damage.

Nitroglycerin Administration

Sublingually, transdermally, or intravenously.

Considerations for Renal Failure Patients

Adjust medication dosage to prevent toxicity.

Contraindications for Spironolactone

Hyperkalemia, renal failure.

Functions of the Kidneys

Filter waste, regulate electrolytes, produce hormones.

Adverse Effects of Corticosteroid Inhalers

Oral thrush, hoarseness.

Best Inhaler for Immediate Relief

Short-acting beta-agonist (e.g., albuterol).

Adverse Effects of Albuterol

Tremors, palpitations, tachycardia.

GERD Treatment

Lifestyle changes (e.g., weight loss, avoiding trigger foods), antacids, H2 blockers, and proton pump inhibitors (PPIs).

H2 Blockers

Reduce stomach acid by blocking histamine (e.g., ranitidine).

Proton Pump Inhibitors (PPIs)

Inhibit proton pumps, reducing acid secretion more effectively (e.g., omeprazole).

Primary Function of the Colon

Absorb water and electrolytes, form and store feces.

Effect of Stomach Acid Suction

Loss of acid can lead to metabolic alkalosis and electrolyte imbalances.

Causes of Constipation

Low fiber diet, dehydration, certain medications (e.g., opioids), inactivity.

Causes of Diarrhea

Infections, medications (e.g., antibiotics), food intolerances, inflammatory bowel conditions.

Function of the Endocrine System

Regulates growth, metabolism, reproduction, and homeostasis through hormone release, controlled by the hypothalamus and pituitary gland.

Consequences of Diabetes Insipidus

Excessive thirst and urination due to lack of antidiuretic hormone (ADH).

Desmopressin

Mimics ADH to reduce urine production and prevent dehydration.

Assessment Findings for Cushing's Syndrome

Weight gain, moon face, buffalo hump, hyperglycemia, hypertension, muscle weakness.

Function of Thyroid Hormone

Regulates metabolism, heart rate, and energy levels.

Differences Between Type 1 and Type 2 Diabetes

Type 1: Autoimmune destruction of insulin-producing cells; requires insulin therapy. Type 2: Insulin resistance and impaired insulin production; managed with lifestyle changes and oral/injectable drugs.

Risk Factors for Type 2 Diabetes

Obesity, sedentary lifestyle, family history, hypertension.

Function of Insulin

Facilitates glucose uptake into cells, lowers blood glucose levels, promotes glycogen storage.

Household to Metric Measurements

Example: 1 teaspoon = 5 mL, 1 tablespoon = 15 mL.

Volumes and Weights in Metric Measurement

Example: 1 liter = 1,000 milliliters; 1 kilogram = 1,000 grams.

Enteral Administration

Via the GI tract (e.g., oral, rectal).

Topical Administration

Applied to skin/mucous membranes.

Parenteral Administration

Injection or infusion (e.g., IV, IM, subcutaneous).

Three Ways to Give IV Medications

Bolus/Push: Single, rapid injection. Intermittent Infusion: Administered over a set time. Continuous Infusion: Steady delivery over time.

Tablet Calculation Example

Order: 500 mg; Available: 250 mg/tablet → Give 2 tablets.

Medication in a Cup Example

Order: 10 mL; Pour 10 mL into a medication cup using proper measurement tools.

Medication in a Syringe Example

Order: 2.5 mL; Draw 2.5 mL into the syringe.

Pump Calculation Example

Order: 1,000 mL over 8 hours → 1,000 ÷ 8 = 125 mL/hour.

Thiazide Diuretics

Generic Name: Hydrochlorothiazide; Trade Name: Microzide; Mechanism of Action: Acts on the early distal convoluted tubule (DCT) to block the reabsorption of sodium, chloride, and water, increasing potassium excretion.

ACE Inhibitors

Generic Names: Lisinopril, Enalapril; Trade Names: Zestril, Vasotec; Mechanism of Action: Inhibits the angiotensin-converting enzyme (ACE), preventing the conversion of angiotensin I to angiotensin II, leading to vasodilation and reduced aldosterone secretion.

Angiotensin II Receptor Blockers (ARBs)

Generic Name: Losartan; Trade Name: Cozaar; Mechanism of Action: Blocks angiotensin II receptors on blood vessels, preventing vasoconstriction.

Calcium Channel Blockers

Generic Names: Amlodipine, Diltiazem; Trade Names: Norvasc, Cardizem; Mechanism of Action: Blocks calcium channels in myocardial and vascular smooth muscle, causing coronary and peripheral vasodilation.

Loop Diuretics

Generic Name: Furosemide; Trade Name: Lasix; Mechanism of Action: Inhibits the reabsorption of sodium, chloride, and water in the ascending limb of the loop of Henle.

Potassium-Sparing Diuretics

Generic Name: Spironolactone; Trade Name: Aldactone; Mechanism of Action: Inhibits aldosterone in the late distal tubule and collecting ducts, preventing sodium reabsorption and potassium excretion.

Adrenergic Blockers (Beta Blockers)

Generic Names: Metoprolol, Propranolol; Trade Names: Lopressor, Inderal; Mechanism of Action: Blocks beta-adrenergic receptors, reducing heart rate and contractility, thus decreasing cardiac output and blood pressure.

Vasodilators

Generic Name: Hydralazine; Trade Name: Apresoline; Mechanism of Action: Direct vasodilation of arterial smooth muscle.

Nitroglycerin

Trade Name: Nitrostat, Nitrobid; Mechanism of Action: Causes vasodilation by relaxing vascular smooth muscle, particularly in veins, reducing preload and myocardial oxygen demand.

Aspirin

Generic Name: Aspirin; Trade Name: Bayer, Ecotrin; Mechanism of Action: Inhibits cyclooxygenase (COX), reducing thromboxane A2 production, which inhibits platelet aggregation.

Morphine

Generic Name: Morphine; Trade Name: MS Contin, Roxanol; Mechanism of Action: Binds to opioid receptors in the CNS, inhibiting ascending pain pathways.