Pharmacology and the Nursing Process7:Pharmacology and the Nursing Process Textbook

ISBN: 9780323087896, 0323087892

1. Right Drug
2. Right Dose
3. Right Time
4. Right Route
5. Right Patient
6. Right Documentation

Describes the drug's chemical composition and molecular structure of a drug

The name given by the United States adopted Name Council. The generic name is much shorter and simpler than the chemical name and is not protected by trademark.

The drug's name has a registered trademark; use of the name is restricted by the drug's patent owner (usually the manufacturer)

1. Pharmaceutics
2. Pharmacokinetics
3. Pharmacodynamics
4. Pharmacotherapeutics
5. Pharmacognosy

Any chemical that affects the physiologic processes of a living organism

Study or Science of drugs

The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body.

Note: Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body.

1. Absorption
2. Distribution
3. Metabolism
4. Excretion

Hint: "ADME"

The study of what the body does to the drug

The study of what the drug does to the body:

• The mechanism of drug actions (MOA) in living tissue

The use of drugs and the clinical indications for drugs to prevent and treat diseases

The study of natural (plant or animal) drug sources

The rate at which a drug leaves its site of administration, and the extent to which absorption occurs:

• Bioavailability (term used to express the extent of drug absorption)
• Bio equivalency

• Food or fluids administered with the drug
• Dosage formulation
• Status of the absorptive surface
• Rate of blood flow to the small intestine
• Acidity of the stomach
• Status of GI motility

Note: Absorption characteristics vary according to the dosage form and route

• Enteral (GI Tract)
• Parenteral
• Topical

Note: A drug's route of administration affects the rate and extent of absorption of that drug

rate and extent of absorption

dosage form and route

• Oral
• Sublingual (under the tongue)
• Buccal (oral mucosa between cheek and gum)
• Rectal

The drug is absorbed into the systemic circulation through the oral or the gastric mucosa or the small intestine

• Intravenous (fastest delivery into the blood circulation)
• Intramuscular
• Subcutaneous (into fat -hypo-dermis)
• Intradermal (muscle beneath the subcutaneous fatty tissue)
• Intraarterial (within an artery)
• Intrathecal (within a sheath)
• Intraarticular (within a joint)

• A drug given via the oral route may be extensively metabolized by the liver "before" reaching the systemic circulation (high first-pass effect)

• The same drug -given IV- bypasses the liver, preventing the first-pass effect from taking place, and more drug reaches the circulation

• Skin (including transdermal patches)
• Eyes
• Ears
• Nose
• Lungs (inhalation)
• Rectum
• Vagina

One of more biochemical reactions involving a parent drug. It occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as metabolism

• The time it takes for one half of the original amount of a drug to be removed from the body
• A measure of the rate at which a drug is removed from the body
• Most drugs considered to be effectively removed after about five half-lives
• Steady state

The initial metabolism in the liver of the drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream

In pharmacokinetics, the time required for half of an administrated dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50% (also called elimination half-life)

The transport of a drug in the body by the bloodstream to its site of action

• Protein-binding
• Water-Soluble vs. fat soluble
• Blood-brain barrier
• Areas of rapid distribution: brain, heart. liver, and kidneys
• Areas of slow distribution: muscle, skin, and fat

Areas of rapid distribution:

• Brain
• Heart
• Liver
• Kidneys

• Accumulation of drugs
• Prolonged action of the drugs - "drug toxicity"

Diminished Pharmacologic effects caused by stimulating drug metabolism

The elimination of drugs from the body.

Note: Whether they are parent compounds or active metabolites, all drugs must eventually be removed from the body.

• Cardiovascular dysfunction
• Renal insufficiency
• Starvation
• Obstructive jaundice
• Slow acetylator
• Erythromycin or ketoconazole drug therapy

• Kidneys (main organ)
• Liver
• Bowels

-Biliary excretion

-Enterohepatic recirculation

• Liver (main organ)
• Skeletal muscle
• Kidneys
• Lungs
• Plasma
• Intestinal mucosa

The biochemical transformation of a drug into an inactive metabolite, a more soluble compound, or a more potent metabolite

• Fast acetylator
• Barbiturate therapy
• Rifampin therapy

The time it takes for the drug to elicit a therapeutic response after dosing

Inactive metabolites lack pharmacologic activity and are simply "drug waste" products awaiting secretion from the body (e.g., via urinary, gastrointestinal, or respiratory tract)

1. An inactive metabolite
2. A more soluble compound
3. A more potent metabolite

The time it takes for a drug to reach its maximum therapeutic response

The time a drug concentration is sufficient to elicit a therapeutic response

1. Receptor interactions
2. Enzyme interactions
3. Nonselective interactions

1. Peak level - Highest blood level
2. Trough level (nadir) - Lowest blood level

• Acute therapy
• Maintenance therapy
• Supplemental/replacement therapy
• Palliative therapy
• Supportive therapy
• Prophylactic therapy
• Empiric therapy

The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug monitoring

The condition of producing adverse bodily effects due to poisonous qualities

A chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug.

The chemical form of a drug that is administered before it is metabolized by the body's biochemical reactions into its active or inactive metabolites. A parent drug that is not pharmacologically active itself is called a prodrug. A prodrug is them metabolized to pharmacologically active metabolites.

1. Plants
2. Animals
3. Minerals
4. Laboratory synthesis