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Lecture 1

MUS1301 Lecture 1: lecture 1 notes
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Department
Music
Course Code
MUS1301
Professor
Robertrival

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Description
find more resources at oneclass.com LECTURE 1- PHARMACOLOGY Properties of an ideal drug Pharmacology- a science that draws on info from multiple  Therapeutic objective: disciplines, anatomy, physiology, psych, chem, microbio maximum benefit with Pharmacology informs all aspects of clinical drug use minimum harm 1. Effectiveness: elicits  How drugs produce therapeutic and adverse effects Reponses for which it is given  Reasons for giving a particular drug to a particular pt 2. Safety: minimal harmful  Rational for selection of dosage, route and schedule of effects (ideally none) administration 3. Selectivity: elicits only  Strategies to promote beneficial drug effects response for which drug given  Strategies to minimize undesired effects 4. Reversibility: action subsides  Provide drug related patient education appropriately 5. Predictability: know how the Individual variation in drug response pt will respond  No two patients respond identically to same drug 6. Ease of administration regimen 7. Freedom from drug drug o DDI, physiologic variables, pathologic variable interactions (diminished kidney/liver function), genetic 8. Low cost 9. Chemical stability factors  Tailor drug therapy to individual 10. Simple generic name- for effective communication Factors determining drug response  Administration, pharmacokinetics,  Preadministration assessment pharmacodynamics  Dosage and administration  Evaluating and promoting therapeutic effects Pharmacology in Nursing Practice  Minimize ADR, minimize DDI Nursing responsibilities regarding drugs  Make PRN decisions  Manage toxicity  Right drug, patient, dose, route, time, documentation Application of pharmacology in patient care  Pharmacokinetics- what the body does to the drug  Absorption o See chart on slide 22 o Drug mvmt from site of administration into blood, may require crossage of membranes  Distribution o Tight junctions in walls of CNS capillaries prevent drugs from leaving the blood and reaching the brain/ Absent in other capillary systems o Only drugs that are lipid soluble or have transport system can cross the BBB o Drugs that can cross the placenta can sometime cause serious harm- THALIDOMIDE o Protein Binding  Drugs bind reversibly with various blood proteins, most importantly plasma albumin find more resources at oneclass.com find more resources at oneclass.com  Albumin always remains in the bloodstream  Drugs bound to albumin can’t reach their sites of action  Metabolism o Liver  Convert pharmacologically active compounds to inactive forms  Activation of prodrugs (inactive  active)  Increase therapeutic action of some drugs  Decrease toxicity o Kidney  Accelerate kidney excretion of highly lipid souble drugs, converting them into more polar compounds o Special considerations  Age (infants and elderly)  Nutritional status, drug metabolizing enzymes need cofactors from diet  First Pass effect  If you give a drug orally and enters the bloodstream, the first organ it hits is the liver  Rapid hepatic inactivation of an oral drug o Drug metabolizing enzymes in liver  Hepatic microsomal enzymes (cytochrome P450)  Important: CYP1, CYP2, CYP3  Each has multiple drug specific isoenzymes  Responsible for 75% of all drug metabolism o Drugs can be…  Enzyme substrates- metabolized by an isoenzyme  Enzyme inducer- inc rates of metabolism of a substrate drug  Enzyme inhibitor- decrease rates of metabolism of a substrate drug o  Excretion o Bile: secreted by the liver into small intestine and then leaves body in feces o Urine: kidney is major organ o Breast milk- exposes nursing infant to drugs o Exhaled air- lungs major route for volatile anesthetics o Sweat and saliva Time Course of Drug Responses  Minimum effective concentration (MEC) o Plasma drug level below which therapeutic effect will not occur  Therapeutic range o Between MEC and toxic concentration o Drugs with a wide therapeutic range are easier to use safely  Drug half life o Time required for the amount of drug in the body to
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