CA1: PHARMA

• Medication is a substance administered for diagnosis, cure, treatment, relief of symptoms, or prevention of disease
• Prescription is a written direction for the preparation and administration of a drug
• Drug Nomenclature:

  • Used throughout the drug's lifetime
  • Non-proprietary name is the generic name
  • Trade name (brand name) is given by the drug manufacturer to identify it as their property
  • Chemical name describes the constituents of the drug precisely
• Types of Drug Orders:

  • Aerosol spray/foam: liquid powder or foam deposited on the skin by air pressure
  • Aqueous solution: one or more drugs dissolved in water
  • Aqueous suspension: one or more drugs finely divided in a liquid like water
  • Caplet: solid form shaped like a capsule, coated and easily swallowed
  • Capsule: gelatinous container for powder, liquid, or oil
  • Cream: nongreasy, semisolid preparation for the skin
• Types of Drug Preparations:

  • Elixir: sweetened and aromatic alcohol solution
  • Extract: concentrated form of a drug from vegetables or animals
  • Gel or jelly: clear semisolid that liquifies on the skin
  • Liniment: medication mixed with alcohol, oil, or emollient for the skin
  • Lotion: liquid suspension medication for the skin
  • Lozenges: flat, round preparation that dissolves in the mouth
  • Ointment: semisolid preparation for the skin and mucous membrane
• Types of Drug Preparations:

  • Paste: similar to ointment but thicker, penetrates the skin less
  • Pill: drugs mixed with a cohesive material in various shapes
  • Powder: finely ground drug for internal or external use
  • Suppository: drugs mixed with a base for insertion into the body
  • Syrup: aqueous solution of sugar to disguise unpleasant-tasting drugs
  • Tablet: powdered drug compressed into a small disk
• Types of Drug Preparations:

  • Tincture: alcoholic or water-and-alcohol solution from plant-derived drugs
  • Transdermal patch: membrane disk containing a drug for absorption through the skin
• Mechanism of Drug Action:

  • Pharmacotherapeutic, pharmacokinetics, pharmacodynamics
• Effects of Drugs:

  • Therapeutic effect: desired effect, primary effect intended by the drug
  • Drug types:
  • Palliative: relieves symptoms but doesn't affect the disease
  • Curative: cures a disease or condition
  • Supportive: supports body function until other treatments take over
  • Substitutive: replaces body fluids or substances
  • Chemotherapeutic: destroys malignant cells
  • Restorative: returns the body to health
• Effects of Drugs:

  • Secondary effect: unintended, usually predictable, may be harmless or harmful
  • Side effects: adverse effects/reactions, more severe side effects may lead to discontinuation of the drug
• Drug Toxicity:

  • Harmful effects of a drug on an organism or tissue
  • Overdosage, ingestion of a drug intended for external use, buildup in the blood, toxic effects
• Drug Allergy:

  • Immunologic reaction to a drug
  • Mild and severe allergic reactions with symptoms like swelling, shortness of breath, hypotension, and tachycardia
• Drug Allergy Symptoms:

  • Skin rash, pruritus, angioedema, rhinitis, lacrimal tearing, nausea, vomiting, wheezing, dyspnea, diarrhea
• Drug Tolerance:

  • Unusually low physiologic response to a drug, requires increased dosage for effect
  • Commonly seen with opioids, barbiturates, and ethyl alcohol
• Drug Tolerance:

  • Increasing response to repeated doses when administration rate exceeds metabolism or excretion
  • Cumulative effect, idiosyncratic effect due to genetic differences
• Drug Interaction:

  • Occurs when one drug alters the effect of another, can be beneficial or harmful
• Drug-to-Drug Interaction:

  • Additive effect: two drugs with similar actions for a double effect
  • Synergistic effect: combined effect greater than the sum of individual effects
  • Potentiation effect: one drug enhances the effects of another
  • Antagonistic effect: one drug inhibits the effect of another
• Drug interactions:

  • Synergistic effect: one drug enhances the effects of the second drug
  • Example: PROZAC (Antidepressant) + ZESTRIL (Antihypertensive)
  • Antagonistic effect: one drug inhibits the effect of another drug
  • Example: Tetracycline (Antibiotic) + Antacid = decreased absorption
• Half-Life:

  • Time interval required for the body’s elimination processes to reduce the concentration of the drug in the body by one-half
  • To maintain a constant drug level in the body, repeated doses are required
  • Example: Paracetamol Half-Life is 8 hours
  • Initially = 100%
  • After 8 hrs = 50%
  • After 16 hrs = 25%
  • After 24 hrs = 12.5%
  • After 32 hrs = 6.25%
• Actions of Drugs on the Body:

  • Receptor: drug’s specific target, protein in the cell membrane or within the cell
  • Drug binds to the receptor to enhance or inhibit normal cellular function
  • Agonist: drug produces the same type of response
  • Antagonist: drug inhibits cell function by occupying receptor sites
• Pharmacodynamics:

  • Study of the absorption, distribution, metabolism, and excretion of drugs
  • Absorption: process by which a drug passes into the bloodstream
  • Factors affecting the rate of drug absorption: food, acids in the stomach, small intestine, tissues of the mouth, first-pass effect
• Pharmacokinetics:

  • Distribution: transportation of a drug from its site of absorption to its site of action
  • Metabolism: process by which a drug is converted to a less active form
  • Excretion: process by which drugs are eliminated from the body
• Types of Medication Orders:

  • STAT Order: medication is to be given immediately and only once
  • Single Order: one-time order for medication to be given once at a specified time
  • Standing Order: may or may not have a termination date
  • PRN Order: nurse judgment when to give the medicine
• Routes of Administration:

  • Oral: most common, least expensive, most convenient, safe method
  • Sublingual, Buccal, Parenteral
  • Topical: local effect on skin or mucous membranes
• 10 Rights of Medication Administration:

  • Right Medication, Dose, Time, Route, Client, Client Education, Documentation, Refuse, Assessment, Evaluation
• Dosage Calculation:

  • Conversion: move the decimal point three places to the left
  • Basic Formula: Amount to administer = (Desired Dose x Vehicle) / Dose on Hand