INTRODUCTION to PHARMACOLOGY

2. INTRODUCTION toPHARMACOLOGY

4. MEDICINE IN ANCIENT EGYPT

5. EARLY MESOPOTAMIAN CULTURE PRIMITIVE AMERICAN INDIAN CULTURES

6. HIPPOCRATES: MEDICINE BECAME A SCIENCE

12. TERMS to REMEMBER • DRUG • PHARMACOLOGY • CLINICAL PHARMACOLOGY • pharmacokinetics • pharmacodynamics • PHARMACOTHERAPEUTICS

13. PROPERTIES OF IDEAL DRUG • EFFECTIVENESS (EFFICACY) • SAFETY • SELECTIVITY • REVERSIBILITY • PREDICTABILITY • EASE OF ADMINISTRATION • LACK OF DRUG INTERACTIONS • LOW COST • Chemical stability • SIMPLE NAME

14. NO DRUG IS IDEAL

15. FACTORS THAT DETERMINEINTENSITY OF DRUG RESPONSES

16. INDIVIDUAL VARIATION Ch.8 • AGE • GENDER • WEIGHT • KIDNEYS • LIVER • GENETIC

17. NURSE’S ROLE(patient care) • PREADMINISTRATION ASSESSMENT • DOSAGE & ADMINISTRATION • EVALUATING & PROMOTING THERAPEUTIC EFFECTS • MINIMIZING ADVERSE EFFECTS • MINIMIZING ADVERSE INTERACTIONS • MAKING PRN DECISIONS • MANAGING TOXCITY

18. NURSE’S ROLE(patient education) • DRUG NAME & THERAPEUTIC CATEGORY • DOSAGE • SCHEDULE • ROUTE OF ADMIN • EXPECTED RESPONSE • MEASURES TO ENHANCE RESPONSE • DURATION OF TX • METHOD OF STORAGE • INTERACTIONS • WHO TO CALL

19. NURSING PROCESS • ASSESSMENT • ANALYSIS (nursing diagnosis) • PLANNING • IMPLEMENTATION • EVALUATION

20. LEGISLATION • 1906 – Pure Food and Drug Act • free of adulterants (nothing @safety or effectiveness) • 1938 – Food Drug and Cosmetic Act • 1st to regulate safety • 1962 – Harris- Kefauver Amendments • proof of effectiveness • 1970 – Controlled Substances Act • regulates drugs with potential for abuse • 1992 – accelerated approval • 1997 – FDA Modernization Act • 2002 – BEST PHARMACEUTICALS FOR CHILDREN ACT • 2003 – PEDIATRIC RESEARCH EQUITY ACT

21. DRUG DEVELOPMENT • PRECINICAL TESTING – 1-5 yrs • evaluation of drug prior to testing in humans (toxicities, pharmacokinetics, useful biological effects) • CLINICAL TRIALS – 2-10 yrs • Phase 1 – nl volunteers • Phase II and III - patients to determine safety, effectiveness and dose ranges • Phase IV- post market surveillance

22. DRUG NAMES

23. EXAMPLES OF LOOK-ALIKE TRADE-NAMES

24. EXAMPLES of SOUND-ALIKE TRADE NAMES

25. WHAT DOES the BODY DO to the DRUG??

26. PHARMACOKINETICS • ABSORPTION • DISTRIBUTION • METABOLISM • EXCRETION

27. DISSOLUTION

28. TYPES OF ABSORPTION • PASSIVE ABSORPTION • ACTIVE ABSORPTION • PINOCYTOSIS

29. FACTORS THAT AFFECTABSORPTION • BLOOD FLOW • PAIN • STRESS • HUNGER • FASTING • FOOD • ph • EXERCISE • ROUTE OF ADMINISTRATION

30. FIRST PASS EFFECT BIOAVAILABILITY

31. FACTORS THAT AFFECTDISTRIBUTION • PROTEIN BINDING • BLOOD FLOW • BODY TISSUE AFFINITY

32. HALF-LIFE 4 – 8 HRS  SHORT HALF-LIFE 24 HRS LONG HALF-LIFE THE TIME IT TAKES FOR HALF OF THE DRUG CONCENTRATION TO BE ELIMINATED STEADY STATEdrug intake = amount excreted…… therefore!!...........serum conc. = therapeutic effect

33. FACTORS THAT AFFECTEXCRETION • RENAL FUNCTION ( GFR, Cr Cl) • LIVER FUNCTION • BILE, FECES, LUNGS, SALIVA, SWEAT, BREAST MILK • URINE ph • DOSAGE

34. WHAT DOES the DRUG DO to the BODY??

35. PHARMOCODYNAMICS • DOSE RESPONSE/MAXIMAL EFFICACY • ONSET, PEAK, DURATION OF ACTION • RECEPTOR THEORY • AGONIST/ANTAGONIST (STIMULATOR/INHIBITOR-BLOCKER ;MIMETIC/LYTIC) • SPECIFIC- NON/SELECTIVE-NON (moa) • CATEGORIES OF DRUG ACTION • STIMULATORS/DEPRESSOR,,REPLACEMENT, INHIBITION/KILLING/IRRITATION • THERAPEUTIC INDEX/RANGE • PEAK AND TROUGH • LOADING DOSE • SIDE EFFECTS • PHARMACOGENETICS • TACHYPHYLAXIS (TOLERANCE) • PLACEBO EFFECT (PSYCHOLOGIC BENEFIT)

37. Oral vaccine could help epilepsy and stroke patients By Emma Reid, February 25, 2000People who suffer from epilepsy, stroke or other brain traumas often have very high levels of brain activity during an episode or an attack. This high level of activity can cause an unpleasant chain of events leading to brain cell death. Researchers from the Jefferson Medical College in Philadelphia, PA have developed a way to reduce the 'high activity' response in rats using an important oral vaccine. The oral vaccine stimulates the production of antibodies which block an important receptor in the brain , preventing glutamate from binding to receptor sites (like on the lower cell in the image and sending messages along the chain.

40. Always remember to check the name (trade and generic), dosage form, strength, and indication (reason the drug is being prescribed) before giving it to a patient. An error may have been made before you received the order! A complete list of more than 800 sound-alike trade names can be found on the United States Pharmacopeia (USP).

41. John G is receiving an experimental drug (AK22) for the treatment of actinic keratosis, a skin lesion that, if untreated, will progress to a skin cancer called squamous cell carcinoma. The drug is delivered in a cream applied to the lesions twice a day.

42. After 3 weeks, John’s lesions have fewer scales and are less red. Some have disappeared. The science of what AK22 does tothe body is called: • pharmacokinetics. • pharmacognosy. • pharmacodynamics. • toxicology.

44. DRUG INTERACTIONS PHARMACOKINETIC PHARMOCODYNAMIC