active recall notes pp1

Introduction to Pharmacology — High-Yield Notes

(Based on your PowerPoint + Learning Objectives)

What is a Drug?

  • Any chemical that affects living processes

  • Used to:

    • diagnose disease

    • prevent disease

    • treat disease

Pharmacology

  • Study of drugs and their effects on the body

Pharmacotherapeutics

  • Use of drugs to treat disease

  • Focuses on therapeutic effects

Sources of Drugs

  1. Plants

    • Example: Digitalis from foxglove plant

  2. Animals

  3. Minerals

  4. Synthetic chemicals

  5. Genetic engineering

    • Personalized medicine

Prototype Drugs

  • Representative drug from a class

  • Usually first drug developed in class

  • Helps learn similar drugs

Example:

  • Morphine = prototype opioid

Why important?

  • If you know the prototype, you can predict:

    • effects

    • side effects

    • nursing implications of related drugs

Drug Nomenclature

Chemical Name

  • Exact chemical makeup

  • Very complex

Example:

  • p-isobutylhydratropic acid

Generic Name

  • Nonproprietary name

  • Used in healthcare settings

  • Lowercase

Example:

  • ibuprofen

Trade Name

  • Brand/proprietary name

  • Given by manufacturer

  • Capitalized

Examples:

  • Advil

  • Motrin

Generic vs Trade Drugs

Bioavailability

  • Rate and extent drug is absorbed and available at site of action

Generic Drugs

  • Less expensive

  • Same active ingredient

  • May have slight bioavailability differences

Important Nursing Point

  • Some substitutions require provider approval

Drug Classifications

Chemical Classification

  • Based on chemical structure

Physiologic Classification

  • Based on body system affected

Therapeutic Classification

  • Based on intended use

Example:

  • Ibuprofen:

    • therapeutic = analgesic

    • physiologic = anti-inflammatory

Clinical Trials / Drug Development

Preclinical Testing

  • Animal testing

Phase 1

  • Healthy volunteers

  • Safety

Phase 2

  • Small group with disease

  • Effectiveness + safety

Phase 3

  • Large populations

  • Compare with current treatments

Phase 4

  • Post-marketing surveillance

  • Watches for long-term adverse effects

Special Drug Terms

Orphan Drugs

  • Drugs for rare diseases

Off-Label Prescribing

  • Drug used for non-FDA-approved indication

Legend Drugs

  • Require prescription

Certain Populations in Clinical Trials

Women

  • Historically excluded from trials

Children

  • Often underrepresented

Elderly

  • Limited data despite high medication use

IMPORTANT:
Older adults are HIGH risk for:

  • adverse effects

  • toxicity

  • polypharmacy complications

Controlled Substances Act

Schedule I

  • No accepted medical use

  • High abuse potential

Schedule II

  • High abuse potential

  • Accepted medical use

Schedule III–V

  • Decreasing abuse potential

Nursing Responsibilities

  • Accurate documentation

  • Proper wasting

  • Secure storage

  • Follow hospital/legal policy

FDA Pregnancy Categories

Category A

  • Safest

Category B

  • No evidence of risk in animals

Category C

  • Risk cannot be ruled out

Category D

  • Evidence of fetal risk

  • Benefits may outweigh risks

Category X

  • Contraindicated in pregnancy

HIGH-YIELD:

  • X = NEVER in pregnancy

OTC Drugs

  • Widely used

  • Can still cause:

    • interactions

    • toxicity

    • adverse effects

Patients often forget to report OTC use.

Complementary and Alternative Medicine (CAM)

Examples:

  • Herbal supplements

  • Natural therapies

IMPORTANT:

  • Not heavily regulated by FDA

  • Can interact with prescription drugs

Black Box Warning

  • MOST serious FDA warning

  • Indicates potentially severe/life-threatening risks

HIGH-YIELD:
Black box ≠ drug banned
It means:

  • use extreme caution

  • monitor carefully

Nursing Implications

Use Generic Names

  • Reduces medication errors

Trade Names Can Sound Alike

  • Increased risk for med errors

7 Rights of Medication Administration

  • Right patient

  • Right drug

  • Right dose

  • Right route

  • Right time

  • Right reason

  • Right documentation

MOST TESTABLE CONCEPTS

  1. Generic vs trade names

  2. Bioavailability

  3. Prototype drugs

  4. Controlled substance schedules

  5. FDA pregnancy categories

  6. Black box warnings

  7. Nursing responsibilities with controlled substances

  8. Phases of clinical trials

  9. Off-label prescribing

  10. CAM safety concerns

HIGH-YIELD NCLEX TRAPS

  • OTC drugs are NOT automatically safe

  • Herbal supplements CAN interact with medications

  • Generic drugs are NOT “fake”

  • Schedule I drugs have NO accepted medical use

  • Black box warning does NOT mean medication is removed from market

  • Pregnancy Category X = contraindicated