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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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LECTURE 1- PHARMACOLOGY
Pharmacology- a science that draws on info from multiple
disciplines, anatomy, physiology, psych, chem, microbio
Pharmacology informs all aspects of clinical drug use
How drugs produce therapeutic and adverse effects
Reasons for giving a particular drug to a particular pt
Rational for selection of dosage, route and schedule of
administration
Strategies to promote beneficial drug effects
Strategies to minimize undesired effects
Provide drug related patient education
Individual variation in drug response
No two patients respond identically to same drug
regimen
o DDI, physiologic variables, pathologic variable
(diminished kidney/liver function), genetic
factors
Tailor drug therapy to individual
Factors determining drug response
Administration, pharmacokinetics,
pharmacodynamics
Pharmacology in Nursing Practice
Nursing responsibilities regarding drugs
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
Preadministration assessment
Dosage and administration
Evaluating and promoting therapeutic effects
Minimize ADR, minimize DDI
Make PRN decisions
Manage toxicity
Properties of an ideal drug
Therapeutic objective:
maximum benefit with
minimum harm
1. Effectiveness: elicits
Reponses for which it is given
2. Safety: minimal harmful
effects (ideally none)
3. Selectivity: elicits only
response for which drug given
4. Reversibility: action subsides
appropriately
5. Predictability: know how the
pt will respond
6. Ease of administration
7. Freedom from drug drug
interactions
8. Low cost
9. Chemical stability
10. Simple generic name- for
effective communication
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 decline by 50%
o Drugs with short half life need to be administered more frequently
o When drug administration is discontinued, most of the drug will be eliminated over four
or five half lives
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find more resources at oneclass.com

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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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