© Paradigm Publishing, Inc. 1 Chapter 3 Pharmacology in Practice.
Chapter 1 Pharmacology
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Transcript of Chapter 1 Pharmacology
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DRUG ACTION: PHARMACEUTIC,
PHARMACOKINETIC, AND PHARMACODYNAMIC
PHASES
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Differentiate the 3 phases of drug actionIdentify the 2 processes that occur before
tablets are absorbed into the bodyDescribe the 4 processes of pharmacokineticsExplain the meaning of pharmacodynamics,
dose response, maximal efficicy, the receptor, and, nonreceptor to drug action
Define the terms protein-bound drugs, half-life, therapeutic index, therapeutic drug range, side effects, adverse rxns, and drug toxicity
Describe the nursing implications of pharmacokinetics and pharmacodynamics
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PharmaceuticDisintegration and dissolution
Rate limiting
The two pharmaceutic phases are disintegration and dissolution.
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AbsorptionProcesses of drug absorption
The three major processes for drug absorption through the gastrointestinal membrane are passive absorption, active absorption, and
pinocytosis.
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AbsorptionWater-soluble vs. lipid-soluble drugsFirst-pass effectBioavailability
Some factors affect rate of drug absorption
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Distribution Protein-bindingFree drugsVolume of drug distribution (Vd)
Drug distribution.
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Metabolism (biotransformation)Half-life (t½); see Table 1-2
Excretion (elimination)Kidneys
Creatinine clearanceLiverFeces, others
What happens when there is slow rate of drug excretion?
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Dose response and maximal efficacyOnset, peak, and duration of action
The time-response curve evaluates three parameters of drug action: (1) onset, (2) peak, and
(3) duration. MEC, Minimum effective concentration; MTC, minimum toxic concentration.
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Receptor theoryAgonists vs. antagonists
Two drug agonists attach to the receptor site. The drug agonist that has an exact fit is a strong agonist and is more biologically
active than the weak agonist.
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Nonspecific drug effect
Cholinergic receptors are located in the bladder, heart, blood vessels, stomach, bronchi, and eyes.
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Nonselective drug effect
Epinephrine affects three different receptors: alpha, beta1, and beta2.
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Categories of drug actionStimulation or depressionReplacementInhibition or killing of organismsIrritation
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The therapeutic index measures the margin of safety of a drug. It is a ratio that
measures the effective therapeutic dose and the lethal dose.
A, A low therapeutic index drug has a narrow margin of safety, and the drug effect should be closely monitored. B, A high
therapeutic index drug has a wide margin of safety and carries less
risk of drug toxicity.
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Therapeutic range (therapeutic window)Peak and trough levels; see Table 1-4Loading doseSide effects, adverse reactions, and
toxic effectPharmacogeneticsTachyphylaxisPlacebo effect
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The three phases of drug action.
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AssessmentNursing interventionsCultural considerationsEvaluation
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Determinants that affect drug therapy.
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TC has liver and kidney disease. He is given a medication with a half-life of 30 hours. You expect the duration of this medication to:
A. increase.B. decrease.C. remain unchanged.D. dissipate.
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Answer: A
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In older adults and those with renal dysfunction, the creatinine clearance is usually:
A. substantially increased. B. slightly increased.C. decreased.D. in the normal range.
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Answer: C