Phramocology

Pharmocology

Pharmocotheraputics (clinical pharmacology)

Pre-clinical trials- animals, Phase 1- healthy humans, Phase 2- target patients, Phase 3- clinical setting, Marketing approval by FDA committee of experts, Phase 4- continual evaluation

Preclinical trials

Phase 1

Phase 2

Phase 3

Marketing approval by FDA committee of experts

Phase 4

The official or nonproprietary name, Name is not capitalized, ONLY one generic name, Example=acetaminophen

The brand or proprietary name given by the manufacturer, The name will be followed by a symbol, Name is capitalized, MANY trade names, Example=Tylenol

Non prescription, Prescription (uncontrolled and controlled)

True

Uncontrolled drugs

Controlled drugs

Teratogenic effects

Pharmacodynamics

Pharmacokinetics

Selective toxicity

Drug-Enzyme Interactions

Agonists (morphine)

Antagonists (Naloxone)

Agonist

Critical concentration

Loading dose

Dynamic equilibrium

Pharmaceutic phase

Enteric coated, Time released

Solid form

Oral route

Intravenous (IV)

Intramuscular (IM), Subcutaneous (SQ)

Rectal

Sublingual, Buccal (SL)

Topical

Inhilation

Distribution

Perpherial vascular, Cardiac Disease

Cross the blood-brain barrier (most abx are NOT)

The drug to cross cell membranes

Circulation, Cell Membrane, Plasma protein binding

Metabolism (biotransformation)

Liver

P-450

True

They will not be able to break down the drug effectively and levels can become toxic quickly (or ineffective)

Age, Nurtritional status, First-pass effect

First-pass effect

Excretion

Factors that influence excretion

Glomerular filtration rate (GFR)

Therapeutic Index (TI)

Peak

Trough

Side effects

Adverse effects

Toxic effects

Medications interactions

Allergic reaction

Contrindication

Forseen

Adverse effects

Blood thinner causing excessive bleeding (drug work “too well”)

Dermatological reactions/ rash because drugs can deposit in the skin. (nothing to do with the therapeutic effect of the drug)

Hypo/hyperglycemia, Electrolyte imbalances, Ocular/ Auditory damage, CNS effects, Antichollinergic effects, Parkinson-like syndrome, Neuroleptic malignant syndrome

Itching-puritus, Skin rashes, Hives, Angioedema (can also be an allergic reaction)

Life-threatening immediate allergic reaction, Provide respiratory support if necessary, O2 or CPR

Rapid onset, Dyspnea, Feelings of apprehension, Tingling/ swelling in mouth, face, throat, and tongue, Itching, Decrease BP, Increase HR (tachycardia)

Suffix- olol, USed for HTN, HF, irregular heart rhythm, Check HR, BP prior to giving, Side effects: light headedness, bradycardia, hypotension, fatigue

Suffix- pril, Used for HTN or HF, Check BP before giving, SE: Light headedness, Hypotesntion, chronic cough, fatigue, hyperkalemia, angioedema

Suffix- sartan, Used for HTN and HF, Check BP before giving, SE: light headed, hypotension, fatigue, hyperkalemia, angioedema, Typically no cough side effect

Suffix- dipine, Check BP and HR before giving, Decreases HR, Decreases BP, Decreases demand for oxygen, SE: Bradycardia, may precipitate AV block, headache, abdominal discomfort (constipation, nausea), peripheral edema, Very Nice Drugs

Verapamil, Nifedipine, Diltiazem

Suffix- ide, Check BP and K+ before giving, Clinical uses: (HE) Heart failure, Hypertension, Edema, SE: Hyponatremia, Hypokalemia, Hypomagnesemia, Ototoxicity, Strict I&Os and daily weights

They can ALL cause hyperkalemia, so together increases the risk

High loop, Potassium sparing diuretics

Potassium sparing diuretics, Amilorde, Spirnolactone, Triamterene, Epleronome

Suffix- thiazide, Used for HTN, Check K and BP before giving, SE: Light headed, hypotension, fatigue, low K, low magnesium, low sodium, high calcium, Usually take at bed time

Many types: rapid, short, medium, long acting, Check blood glucose within an hour before giving, Fr insulin that is too high pt does not need food in front of them, Prandial with meals to cover carbs in food, SE: hypoglycemia, weight gain, edema

Hydrocodone, oxycodone, hydromorphone, morphine, Analgesic, suppress cough, Evaluate pain before and after administering, Potentialky addictive, Narcan antidote, MORPHINE mnemonics

Myosis, Out of it, Respiratory depression, Pneumonia, Hypotension, Infrequency (costipation, urinalysis retention less common), Nausea, Emisis

Just know bleeding precautions, maybe avoid NSAIDs, aspirin, IM injections. Monitor hgb/hct,Plt, PT/INR, occult blood, aptt. Suffixes:rin, aban, atran

Suffix-one, anti inflammatory, SE: weight gain mood swings pm insomniam, fluid retention, high BP, can increase blood sugar. HAVE TO WEAN OFF!!!

Suffix- grel, given for pt with stent, makes blood “slippery”, check platelets and CBC, no nsaids and PPIs.

Suffix- azolam - azepam, SE: Drowsiness, confusion, light headed, fall risk, addictive, SAMA

Sedation, Anit convulsive, Muscle relaxant, Anti- anxiety

Different classes, can tell class by suffix. Have to finish full coarse of abx.

-prazole, inhibit gastric secretion, give before meal (can be preventive after surgery), SE: headache, N/V/D long term use- B12 deficiency