Pharmacology & Therapeutics Notes

Essential Texts and Resources

  • Essential Text: Roach, Sally S: Introductory Clinical Pharmacology, 11th edition (2018).
  • Recommended Texts:
    • Olson, James. Clinical Pharmacology Made Ridiculously Simple, 4th Edition (2015).
    • Katzung, Bertram G. Basic and Clinical Pharmacology, 14th Edition (2018).
  • Suggested Readings/Texts: Students advised to use UWIlinc service of the Medical Sciences Library and e-resources.

Course Aim and Learning Outcomes

  • Aim: Develop knowledge and understanding of medicines used in patient care.
  • Learning Outcomes:
    • Understand basic concepts of Pharmacology.
    • Discuss key concepts of Pharmacokinetics, Pharmacodynamics, and Pharmacotherapeutics.
    • Understand different drug interactions and adverse reactions.
    • Identify client and drug-related factors influencing drug effects.
    • Discuss accurate drug administration and client teaching for therapeutic drugs.
    • Apply the nursing process in caring for clients receiving therapeutic drugs.

Introductory Pharmacology

Definition of Pharmacology
  • The scientific study of the origin, nature, chemistry, effects, indications, contraindications, and adverse effects of drugs. Essential for safe and accurate medicine administration.
Drug Development and Approval
  • FDA Overview:
    • Established for consumer protection in the US since 1848, with significant regulatory acts in 1906 and 1938 that required drug efficacy and safety studies.
    • Drug Development Phases:
    1. Preclinical Research: Laboratory testing for toxicity/efficacy.
    2. Clinical Trials (Phases I - III):
      • Phase I: Safety and dosage (20-100 normal volunteers).
      • Phase II: Efficacy and side effects (200-300 participants with condition).
      • Phase III: Efficacy and adverse effects (300-3000 participants) before market approval with NDA (New Drug Application).
    3. Phase IV (Post-Marketing Surveillance): Monitoring drug effects after approval.

Drug Classifications

  • Names:
    • Chemical name: Describes the drug's molecular structure.
    • Generic name: Derivative of the chemical name.
    • Trade name: Brand name set by the manufacturing company.
  • Drug classes based on function:
    • Pharmacologic Class: Similar mechanisms of action.
    • Therapeutic Class: Similar chemical origins.
  • Biologics: Medicines from living organisms (proteins, sugars, DNA).

Pharmacokinetics

Definition
  • The study of how the body handles drugs, involving four major processes (ADME):
    • Absorption: How the drug enters the bloodstream.
    • Distribution: Dispersion throughout the body.
    • Metabolism (Biotransformation): Chemical alteration of the drug.
    • Elimination: Removal of the drug from the body.
Major Concepts
  • Bioavailability: The percentage of active drug reaching systemic circulation (critical in dosage forms).
  • Half-Life (t₁/₂): Time taken for the plasma concentration to halve, important for dose frequency calculation.

Pharmacodynamics

Definition
  • The study of the biochemical, physiological, and molecular effects of drugs, involving:
    • Receptor binding and sensitivity.
    • Post-receptor effects and chemical interactions.
Key Components
  • Dose-Response Relationship: The correlation between drug dosage and its pharmacological effect.
  • Adverse Drug Reactions (ADR): Unintended effects of medications, can be mild to severe.
    • Types of ADRs: Allergic reactions, idiosyncrasies, dependence, and tolerance.

Conclusion and Further Considerations

  • Importance of understanding pharmacology in nursing and patient care.
  • Continuous updates in pharmacology through learning, research, and regulatory changes are crucial for safe practice.
  • Collaboration with healthcare teams and patients for effective drug therapy management.

Questions for Review

  1. What is the role of the FDA?
  2. Define alkaloid and give an example.
  3. Describe drug therapy synergism.
  4. Explain the phases of drug administration in pharmacokinetics.
  5. What factors can alter clearance of a drug?
  6. Discuss the implications of pharmacogenomics in drug therapy.