2ND

INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022

Alijah Abigail R. Jayme BSN-RCI

 2ND
INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022

PHARMACOLOGY  Drug Dependence: a person's reliance

or a need to take a drug or substance*
 Is the study of drugs and their effects on  Addiction: the tissues come to require
life processes, science which is the substance for normal functioning*
concerned with the history, sources,  Habituation: the emotional reliance on
physical and chemical properties of a drug to maintain a sense of well-being
drugs as well as the ways in which accompanied by feelings of need or
drugs affect living systems. cravings for the drug
 *Drugs – chemicals which when
absorbed, exhibit specific response or
DRUG NAMES
action; substances administered for the
diagnosis, cure, treatment, relief or  Chemical Name – identifies chemical
prevention of disease; chemical elements and compounds that are found
substances that have an effect on living in the drug (ex. N-acetyl-p-aminophenol)
organisms.  Generic Name – the universally
accepted name and considered the
official proprietary name for the drug
OVERVIEW (ex. acetaminophen)
TERMS  Brand/Trade Name – selected by drug
 Pharmacogenetics: study of genetic companies (ex. acetaminophen =
factors as determinants of drug Tylenol by Johnson & Johnson)
responses
 Pharmacognosy: study of drugs PRESCRIPTION VS OVER-THE-
derived from natural resources COUNTER DRUGS
 Pharmacy: science of preparing,  Prescription Drugs:
compounding* and dispensing* o Those given by injection.
medicines o Hypnotic drugs (drugs that
 Toxicology: study of harmful effects of depress the nervous system)
drugs on living tissues o Narcotics (drugs that relieve
 Posology: the study of dosage or pain, dull the senses and induce
amount of drugs given in the treatment sleep)
of disease o Habit-forming drugs
 Therapeutic Effect: desired or primary* o Drugs that are unsafe unless
positive effect drug has on the body administered under the
 Side Effect: unintended; secondary supervision of a licensed
effect* negative effect drug has on the practitioner.
body o New drugs that are still being
 Drug Allergy: immunologic reaction to a investigated and not considered
drug safe for indiscriminate use by the
 Anaphylactic Reaction: a severe public.
reaction usually occurs immediately o **Is given via prescription from a:
following the drug administration Physician, Resident Doctor,
o Skin reactions, including hives Registered Nurse Practitioner
and itching and flushed or pale  Non-prescription Drugs (OTC) –
skin available without prescription
o Low blood pressure
(hypotension) DRUG SAFETY
o Constriction of the airways and a
swollen tongue or throat, which  *Acute toxicity – the dose that is lethal
can cause wheezing and trouble or kills 50% of the laboratory animals
breathing tested.
o A weak and rapid pulse
o Nausea, vomiting or diarrhea DRUG CATEGORIES
o Dizziness or fainting  CATEGORY A – no risk for fetus (first
 Drug Tolerance: decreased physiologic trimester or later), no evidence of fetal
response to the repeated administration harm
of a drug or chemically related  CATEGORY B – insufficient data to use
substance in pregnancy; animal studies indicate a
 Cumulative Effect: increasing response risk to the fetus; benefits of medication
to the repeated doses of a drug* could outweigh the risks
 Drug Abuse: inappropriate intake of a  CATEGORY C – animal studies indicate
substance either continually or a risk to the fetus; controlled studies on
periodically pregnant women are not available;

Alijah Abigail R. Jayme BSN-RCI

 2ND
INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022
benefits of medication could outweigh  Generic and trade name: The generic
the risk name is the official name of the drug
 CATEGORY D – risk to fetus exists, but while the trade name is the drug’s brand
the benefits of the medication could name.
outweigh possible risks; could be used  Clinical uses and indications for use:
in life-threatening conditions Describes the purpose of the drug and
 CATEGORY X – avoid use in pregnancy when the drug is to be given to a patient.
or those who may be pregnant; potential  Mechanism of action: Describes how
risks to the fetus outweigh the potential the drug works.
benefits  Adverse and side effects and toxicity:
Identifies the effects the drug has other
DRUG SCHEDULING than the therapeutic effect.
 SCHEDULE I – drugs with no currently  Signs and symptoms to monitor:
accepted medical use and a high Identifies the patient’s physiological
potential for abuse. response that must be evaluated after
o Ex. heroin, lysergic acid the drug is administered.
diethylamide (LSD), marijuana  What to teach the patient: Specifies
(cannabis), ecstasy, instructions that must be given to the
methaqualone, and peyote. patient before and after the drug is
administered.
 SCHEDULE II – drugs with a high
potential for abuse, with use potentially
leading to severe psychological or LEGAL ASPECTS OF DRUG
physical dependence; considered ADMINISTRATION
dangerous  Philippines Drug Legislation
o Ex. combination products with  Dangerous Drugs Act (2002) RA 9165;
less than 15 milligrams of (1972) RA 6425: states that sale,
hydrocodone per dosage unit administration, delivery, distribution and
(Vicodin), cocaine, transportation of prohibited drugs are
methamphetamine, methadone, punishable by law
hydromorphone (Dilaudid),  Generics Act (1988) RA 6675:
meperidine (Demerol), promotes, requires, and ensures
oxycodone (OxyContin), identification of medicines by their
fentanyl, Dexedrine, Adderall, generic names
and Ritalin  Cheaper Medicines Act (2008) RA
 SCHEDULE III – drugs with a moderate 9502: providing for cheaper and quality
to low potential for physical and medicines
psychological dependence; drugs abuse  Nursing Law (2002) RA 9173: focuses
potential is less than Schedule I and on independent and coordinated
Schedule II drugs but more than function of the nurse pertaining to the
Schedule IV application and execution of written legal
o Ex. products containing less orders of physician concerning
than 90 milligrams of codeine treatment and medication.
per dosage unit (Tylenol with
codeine), ketamine, anabolic 12 RIGHTS OF DRUG ADMINISTRATION
steroids, testosterone
 SCHEDULE IV – drugs with a low 1. Right Patient
potential for abuse and low risk of 2. Right Medication/Drug
dependence. 3. Right Time
o Ex. Xanax, Soma, Darvon, 4. Right Route of Administration
5. Right Dose/Dosage
Darvocet, Valium, Ativan,
6. Right Response
Talwin, Ambien, Tramadol
7. Reason/Indication
 SCHEDULE V - drugs with lower
8. Right Documentation
potential for abuse than Schedule IV
9. Right Assessment and Evaluation
and consist of preparations containing
10. Right Patient Education
limited quantities of certain narcotics;
11. Right of Patient to Refuse
generally used for antidiarrheal,
12. Right Expiration Date
antitussive, and analgesic purposes.
o Ex. cough preparations with less
than 200 milligrams of codeine DRUG ORDERS
or per 100 milliliters (Robitussin  **Providers such as a physician, dentist,
AC), Lomotil, Motofen, Lyrica, podiatrist, advanced practice nurse (in
Parepectolin most states), and other authorized
licensed healthcare providers can write
LOCATING DRUG INFORMATION a drug order. Physician assistants can
also write a drug order but require the
co-signature of a physician.

Alijah Abigail R. Jayme BSN-RCI

 2ND
INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022
 **All drug orders are written on a milligrams q 4 h by mouth or per rectum
prescription pad or on an order sheet if for a temperature > 101.4°F.
written in a healthcare institution.
Sometimes orders are written into a
computerized drug order system. A DRUG ACTION & DRUG
verbal drug order is sometimes given INTERACTIONS
but must be followed up with a written
drug order within 24 hours. DRUG ACTIONS
 Must contain:  Drug action is the physiochemical
o Date and time the order interaction between the drug molecule
(prescription) was issued and molecules in the body that alters a
o Name of drug and whether or physiological process of the body in one
not a generic form of the drug of three ways.
can be substituted for a brand- o Replacement: The drug
name drug replaces an existing
o Drug dose physiological process such as
o Route of administration estrogen replacement.
o Frequency and duration of o Interruption: The drug interferes
administration with a physiological process.
o Special instructions such as **This occurs when an
withholding or adjusting antihypertensive (high blood
dosage based on nursing pressure) drug interferes with
assessment, laboratory the process that constricts blood
results, or drug effectiveness vessels and may cause blood
o Signature of the prescriber pressure to rise. The blood
o Signature of the healthcare vessels remain dilated and
providers who took the order pressures remain normal or
and transcribed it drop.
o Potentiation: The drug
stimulates a physiological
TYPES OF DRUG ORDERS
process as in the case of
 Routine orders: ongoing order given for *furosemide (Lasix) which is a
a specific number of doses or days diuretic and stimulates the
o Ex. 1/31/05 7:30 P.M. Lasix kidneys to excrete urine.
(furosemide) 40 mg., PO, qd  **A drug action begins when the drug
(signature) enters the body and is absorbed into the
 One-time order: single dose given at a bloodstream where the drug is
particular time transported to receptor sites throughout
o Ex. Demerol 50 mg with Vistaril the body.
25 mg IM at 10 A.M. or 2 h  Three Phases:
before call to the OR o PHARMACEUTIC PHASE: This
 PRN: an order to give a medication if phase occurs after the drug is
specific criteria exist given and involves disintegration
o Ex. Advil 600 mg po q 6 h prn for and dissolution of the dosage
mild to moderate knee pain form.
 STAT: a single dose order to give at o PHARMACOKINETIC PHASE:
once or immediately This is the way the drug is
o Ex. Give Benadryl 50 mg po absorbed, distributed, and
Stat. eliminated.
o PHARMACODYNAMIC PHASE:
TYPES OF PROTOCOLS This is the effect the drug has on
the body.
 Standing Orders – are an officially
accepted sets of orders to be applied by
nurses, physician assistants, and PHARMACEUTIC
paramedics in the care of patients with  The form of the drug such as a tablet,
certain conditions or under certain capsule, liquid, elixirs, or syrups.
circumstances  *The drug in solid form must
 *For example, if a patient is not disintegrate before dissolution, which is
breathing and has no heartbeat, an the process by which a drug goes into
algorithm has been developed to solution before it becomes available for
administer different medications such as absorption.
epinephrine and other cardiac  Ingredients:
stimulants to resuscitate the individual. o Active ingredient – causes the
 **Other standing orders include orders pharmaceutical response
for Tylenol (acetaminophen) 600

Alijah Abigail R. Jayme BSN-RCI

 2ND
INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022
o Inactive ingredient – excipient;  Oral Drugs
substance that has no o Delayed release
pharmaceutical response yet o Enteric coated (EC) dissolve
helps in the delivery of the drug when drug reaches intestine
(ex. Fillers, inert substances) o Extended Release (ER) - release
 Rate Limiting Time – time necessary drug over a period of time
for the drug to disintegrate and dissolve o Extended length (XL)
so it can be absorbed o Sustained Release (SR or XR)
o **A drug has a higher rate o Sustained action (SA)
limiting time if it is absorbed in o Immediate release form -
acidic fluids rather than alkaline expedites release of drug
fluids. Children and the elderly  ORAL
have a lower pH in their GI tract
o Barriers To Absorption:
and therefore drugs are
Medications must pass through
absorbed more slowly than in a
the layer of epithelial cells that
healthy adult.
line the GI tract.
o Absorption Pattern (Varies
Rate limiting time rating for drug forms
greatly due to):
Absorption Rate  Stability and solubility of
Preparation (fastest to the medication
slowest)  GI pH and emptying time
 Presence of food in the
Lipid soluble non- stomach or intestines
ionized liquids, 1  Other concurrent
elixirs, syrups medications
 Forms of medications
Water soluble
(enteric‐coated pills,
ionized liquids, 2
liquids)
elixirs, syrups
 SUBLINGUAL, BUCCAL (ex.
Suspension Catapres) (*sublingual - placed under
3
solutions the tongue; buccal - cheek)
o Barriers to Absorption:
Powders 4 Swallowing before dissolution
Capsules 5 allows gastric pH to inactivate
the medication.
Tablets 6 o Absorption Pattern: Quick
absorption systemically through
Coated tablets 7 highly vascular mucous
membranes
Enteric-coated  OTHER MUCOUS MEMBRANES
8
tablets (RECTAL, VAGINAL)
o Barriers to Absorption: Presence
 *Some drugs are more effective if of stool in the rectum or
absorbed in the small intestine rather infectious material in the vagina
than the stomach. However, the limits tissue contact.
stomach is more acidic than the small o Absorption Pattern: Easy
intestine. absorption with both local and
o Pharmaceutical manufacturers systemic effects.
place an enteric coating around  PARENTERAL DRUGS
the drug that resists o Administration:
disintegration in the stomach.  Intravenously (IV)
The coating disintegrates in the  Subcutaneously (SubQ)
alkaline environment of the small  Intramuscularly (IM)
intestine. o Forms of Parenteral drugs:
o Enteric coating is also used to  Liquid
delay the onset of the  Dry (Needs to be
pharmaceutical response and to reconstitution)
prevent food in the stomach from  SUBCUTANEOUS (AAB - rapid),
interfering with the dissolution INTRAMUSCULAR (Deltoid muscle -
and absorption of the drug. abundance of vascular circulation)
 Tip: Never crush a capsule that contains o Barriers to Absorption: Capillary
enteric release beads or is coated for walls have large spaces between
timed-release. cells. Therefore, there is no
significant barrier.
DRUG ABSORPTION PATTERNS o Absorption Pattern:

Alijah Abigail R. Jayme BSN-RCI

 2ND
INTRODUCTION | PHARMACOLOGY 1
SEMESTER
Source: Pharmacology Demystified & ClassNotes A.Y. 2021 -
2022
 Solubility of the o Active Diffusion – against the
medication in water: natural flow; there is a higher
Highly soluble concentration of plasma than
medications have rapid drug particles; expands energy
absorption (10 to 30 min); via an enzyme or protein
poorly soluble o Pinocytosis – engulfing the drug
medications have slow particle
absorption.
 Blood perfusion at the ABSORPTION RATE
site of injection: Sites with
high blood perfusion have  Begins where the drug is administered.
rapid absorption; sites
with low blood perfusion
have slow absorption.
 INTRAVENOUS
o Barriers to Absorption: No
barriers
o Absorption Pattern:
 Immediate: enters directly
into the blood
 Complete: reaches the
blood in its entirety
 TOPICAL OR TRANSDERMAL
o Apply direct to the skin
o Apply direct on skin immediate
onset action
o Absorbed through skin: delayed
onset of action
 INHALATION VIA MOUTH, NOSE
o Barriers to Absorption:
Inspiratory effort
o Absorption Pattern: Rapid
absorption through alveolar
capillary network
 INTRADERMAL, TOPICAL
o Barriers to Absorption: Close
proximity of epidermal cells
o Absorption Pattern:
 Slow, gradual absorption
 Effects primarily local, but
systemic as well,
especially with lipid‐
soluble medications
passing through
subcutaneous fatty tissue

PHARMACOKINETICS
 The study of the drug concentration
during absorption, distribution, and
elimination of a drug in the patient.
(ADME)
 About 80% of all drugs are administered
orally and flow through the
gastrointestinal tract (GI) into the small
intestine where the membrane of the
intestine absorbs drug particles passing
them into the bloodstream, where
plasma circulates the particles,
throughout the body.
 Three ways in which drug particles are
absorbed:
o Passive Diffusion – high
concentration to low
concentration; no energy
expanded

Alijah Abigail R. Jayme BSN-RCI