Post on 24-Feb-2016
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Pharmacology Day 1
Elizabeth Keele, RN/BSN
Course Objective #2
• Describe the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance.
“Dynamic Process”
• dy·nam·ic• dīˈnamik/• adjective• 1. ( process or system) characterized by
constant change, activity, or progress.
“Dynamic Process”
• Giver • Receiver
“Mutual process”
• Key characteristics:–Knowledge– Teaching–Communication–Observation skills– Evaluation skills
Turn to your neighbor and take turns…
• Describing the dynamic process between the giver and the receiver of medications, which promotes positive medication compliance. • (Course objective #2)
Course Objective #1
• Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive.
Limitations to “mutual process” of medication administration
• Understanding• Communication• Awareness
• Knowledge• Teaching• Communication• Observation• Evaluation
Limitations to “mutual process” of medication administration
• The NURSE must “account and compensate” for these limitations
Medication Administration is…
• Invasive• Risk to benefit
Turn to your neighbor and take turns
• Identify limitations/deficits commonly seen in D.D. clients that prevent them from asking questions or reporting adverse effects regarding medications they receive.
• (Course objective #1)
Course Objective #3
• Describe the importance of patient teaching with regard to prescribed medication regimen.
Why is patient teaching important?
Teaching / Learning Process
• Teaching– Interactive process
• Learning– Acquiring new
knowledge• Motivation– Desire
3 Domains of Learning
• Cognitive– Intellectual activities
• Affective–Attitudes & beliefs
• Psychomotor–Physical skills
Turn to your neighbor and…
• Describe the importance of patient teaching with regard to prescribed medication regimen.
• (Course objective #3)
Course Objective #4
• Describe the electrochemical processes of the central nervous system, which allow CNS drugs to cause their desired effects.
Course objective #12
• Explain how chemicals and electrical impulses interact to make up the electrochemical properties of the nervous system.
The nervous system consists of:
• Divided system– Central Nervous System (CNS)• Brain & Spinal Cord
– Peripheral Nervous System (PNS)• Nerves (peripheral & Cranial)
Nervous System
• Controls and coordinates the body
• By transmission of electrical impulses (Electrical-chemical system)
Nerve Impulse
• The nervous system is powered by electrical and chemical energy– K+– Na+– Cl-– (Ca+)
Course objective #9
• Differentiate between afferent and efferent neuron.
Neuron
• Basic functional unit– Afferent neuron
• Sensory• Carry info from PNS CNS
– Efferent neuron• Motor• Carry into from CNS PNS
Neuron structure
• Cell body/ Soma– Nucleus– Neurotransmitters synthesized
• Dendrites– Carry impulses toward the cell
body• Axons
– Carry impulses away from the cell body
Cool Fact Damaged Neuron
• CNS = – Irreversible
• PNS = –will repair itself if
the cell body is not destroyed
Course Objective #10
• Describe the role played by neurotransmitters in nerve impulse transmission within the synapse.
Synaptic Junction
• Neuron connect to each other end to end
• Where two neurons come together– Synaptic junction– Synapse– Inter-neuron space
Anatomy of the NS
• Synapse = the space between one neuron & the next
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Pre-synaptic neuron
Post-synaptic neuron
Synaptic Junction
• Terminal end of Axon = Pre-Synaptic Vesicles
• Nerve impulse reaches the vesicle release substance neurotransmitters (nt) into the synaptic junction
• Nerve impulses must have a receptor site
Synaptic events
• Electrochemical message received• Vesicle opens• NT are released into synapse• NT finds its receptor site that it fits into on the next
neuron• Activation of receptor nerve impulse in post-
synaptic vessel • Re-uptake of NT
– MAO action
Neurotransmitters
• Synthesized in the soma • Special Properties
– Excitability – Inhibitory
• 30+ neurotransmitters
Course objective #11
• Describe the role played by monoamine oxidase in nerve impulse transmission within the synapse.
Monoamine oxidase (MAO)
• ENZYME • Released into the synaptic space• Action–breakdown or inactivates NT
• Result–i NT levels
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Course Objective #5
• Differentiate between the following neurotransmitters:– Acetylcholine– Norepinephrine– Dopamine– Serotonin– Gamma-aminobutyric acid– Glycine
Neurotransmitters
• Synthesized in the soma • Special Properties
– Excitability – Inhibitory
• 30+ neurotransmitters
Excitatory Neurotransmitters
• Serotonin– Sleep– Sensory perception– Temperature– Mood– Inhibits pain
Excitatory Neurotransmitters
• Dopamine– Subconscious
movement– Fine motor skills– Emotional responses
Excitatory Neurotransmitters
• Norepinepherine– Maintains arousal – Overall activity– Mood
• Acetylcholine– Vital for short term
memory
Inhibitory Neurotransmitters
• Cholinergic– Stabilizers
Inhibitory Neurotransmitters
• Gammaamniobutyricacid• GABA– #1 – h concentration in • brain
– Stop/slow firing of neurons
• Glycine– h concentration in • Spinal Cord
Inhibitory Neurotransmitters
• Dopamine– Basal Ganglia– Dopamine &
Acetylcholine are opposites which work together to create homeostasis
Course Objective #6
• Identify psychiatric disorders that appear to be related to the body’s inability to regulate the availability of neurotransmitters.
h or i Neurotransmitters
• Imbalance disease or disorder
Schizophrenia
• h dopamine
Depression
• i Serotonin
Alzheimer’s Disease
• i acetylcholine
Generalized Anxiety Disorder
• Norepinephrine • Serotonin
ADHD(Attention deficit hyperactivity disorder)
• Imbalance–Norepinephrine–Dopamine
Drug Addictions
• Affects dopamine areas of the brain
Alcohol
• Interacts with GABA receptors
Course Objective #7
• Describe the ‘principle of opposition’ between the operation of the sympathetic and parasympathetic branches of the autonomic nervous system.
The nervous system consists of:
• Divided system–Central Nervous System
(CNS)• Brain & Spinal Cord
–Peripheral Nervous System (PNS)• Nerves (peripheral &
Cranial)
Nervous System
CNS PNS
Autonomic Nervous System
Somatic Nervous System
Peripheral Nervous System
PNS comprised of Cranial and Spinal Nerves
Somatic Nervous SystemProcess: VoluntaryFunction: Respond to changes in external environmentEffector site: skeletal muscle
Autonomic Nervous systemProcess: InvoluntaryFunction: Respond to changes in the internal environmentEffector sites: Internal organs
Sympathetic NS Parasympathetic NS
Autonomic Nervous System
Sympathetic Nervous System
• Chemical process:– Adrenergic
• Function– Energize
Parasympathetic Nervous System
• Chemical Process– Cholinergic
• Function– Stabilize
Sympathetic NS Parasympathetic NS
Rate Heart rateDilates Vessels of
Skeletal muscles
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Dilates Bronchi Constricts secretions Lung
secretions secretionsPeristalsis
Salivary secretions
Sympathetic NS Parasympathetic NS
Closes Anal sphincter OpensRelaxes Bladder ContractsCloses Urinary
sphincter OpensDilate Pupil Constrict far vision Eye
accommodation
near vision
secretions Pancreas secretionsRelease glucose Liver 0 secretions Adrenal
Medulla0
Principle of Opposition
Sympathetic Parasympathetic“Fight or Flight” “Rest & Digest”Energizes StabilizesAdrenergic Cholinergic(Adrenal gland) Epinephrine Norepinephrine
Acetylcholine
Adrenergic vs. Cholinergic Agents
Adrenergic CholinergicSympathetic N.S. Parasympathetic N.S.Norepinephrine / Epinephrine
Acetylcholine
Adrenergic Agent Cholinergic AgentDrug that mimicsSympathetic stim.
Drug that mimicsParasymathetic stim.
Course Objective #8
• Differentiate between an agonistic drug and an antagonistic drug.
Agonist
• Bind with receptor • Enhances response
Antagonist
• Binds with receptor • Blocks response
Course objective #13
• Describe the variable responses seen depending on the fit of drugs to receptor sites.
Drug Action
• “Target” cells
Drug Action
• Rx fits / “binds” receptor site • Influences
reaction• Mimics natural
body chemicals
• “BIND”– Similar shape–Closer the fit Stronger the effect
Types of Antagonists
Competitive• “Push off” agonist• h dose • Block action of agonist
Non-competitive• Does not “push off an
agonist from receptor• h dose …