INTRODUCTION TO NURSING • Animal (insulin, heparin)

PHARMACOLOGY • Mineral (sulphate, iodine)

• Microorganism (penicillin)
Ø Definition • Synthetic drugs (aspirin)
• Pharmacology - study of drugs
• Drug - substance used in the diagnosis,
Value of studying pharmacology:
treatment, and prevention of a disease.
• Pharmacokinetics – what the body does to the - Allows better understanding of drug toxicity
drug. It involves distribution, metabolism, and and drug interactions.
excretion of drugs.
• Pharmacodynamics – interactions between the Ø How do drugs get their names?
chemical components of living system ang • Chemical name = compound make up.
foreign chemicals. What drug does to the body.
• Generic name = breakdown of chemical
It involves mechanism of drug action in living
compound into simple terms.
tissues.
• Brand name = trademarked name
• Pharmacotherapeutics - focuses on the clinical
use of drugs.
Ø Food Drug Administration
TYPES OF THERAPY
- regulates the development and sales of drugs.
a. Supplemental therapy
- approves drug for clinical safety before brought
- supply the body with substance
to the market of drugs.
needed.
- to protect the patient and ensure drug
b. Acute therapy
effectiveness.
- more intense drug treatment.
• FDA pregnancy categories:
c. Maintenance therapy
a) Category A
- prevent progression of a disease.
- Adequate and well-controlled studies have
d. Palliative therapy
failed to demonstrate a risk to the fetus in
- make the patient as comfortable as
the first trimester of pregnancy.
possible.
b) Category B
e. Supportive therapy
- Animal reproduction studies have failed to
- maintains integrity of the body while
demonstrate a risk to the fetus and there are
recovering from illness.
no adequate and well-controlled studies in
f. Prophylactic therapy
pregnant women.
- provided to prevent illness.
c) Category C
g. Empiric therapy
- Animal reproduction studies have shown an
- involved drug administration when a
adverse effect on the fetus and there are no
certain pathologic condition has an
adequate and well-controlled studies in
uncertain, but likelihood of occurrence
humans.
based on the patient’s initial presenting
d) Category D
symptoms.
- Positive evidence on human fetal risk based
• Pharmacognosy – natural vs synthetic drug
on adverse reaction data.
sources.
e) Category X
• Pharmacoeconomics – economic factors
- Studies in humans and animals have
influencing the cost of drug therapy.
demonstrated fetal abnormalities and
• Orphan drugs – discovered but not financially
positive evidence on human fetal risk.
viable.
• 5 drug enforcement agency schedules
• Over the counter drugs – viable drugs without
for controlled drugs:
prescription.
a) Schedule I – high abuse and no
Ø Sources of Drugs accepted medical use.
• Plant (atropine)
 b) Schedule II – high abuse with severe - temporary or reversible adverse effects.
dependence liability. c) Class 3 Recall
c) Schedule III – less abuse and - no adverse effect and not likely to cause
moderate dependence liability. injuries.
d) Schedule IV – less abuse and limited
dependence liability. PRINCIPLES OF DRUG ACTION & DRUG
e) Schedule V – limited abuse. INTERACTIONS/DRUGS & THE BODY
Ø Factors in Influencing Responses Drugs
o Expedited Drug Approval (fast track) – to make a
1. Weight – if infant is heavier, prescribe
certain life- saving investigational drug therapies
higher dose of medication to achieve
available sooner than usual.
therapeutic effect.
1. Preclinical Investigation
2. Age – the younger the patient the lower
f. In vitro Studies—using tissue samples and
the dose than the adult patient.
cell cultures. It includes testing of the
3. Gender – men could metabolize more
response of various types of mammalian
concentrated medicines than women.
(including human) cells and tissues to
4. Physiological – diurnal rhythm,
different concentrations of the
electrolyte balance, acid base balance,
investigational drug.
hydration affect the distribution and
g. Animal Studies
excretion of the medicine.
2. Clinical Investigation 5. Pathological – disease, low blood
pressure could alter the metabolism of
Informed Consent—involves the careful
the medicine.
explanation to the human test patient or research
6. Genetic – races such as African
subject of the purpose of the study, the procedures
Americans are higher risk for adverse
to be used, the possible benefits, and the risks
effects.
involved. This explanation is followed by written
7. Immunological – allergy.
documentation on a consent form.
8. Psychological – placebo effect, health
Investigational New Drug (IND) study—the study beliefs, compliance.
of new drug with potential health hazards as well as 9. Environmental – temperature, light.
possible health benefits of new therapy. Medicines that are sensitive and
exposed to extreme temperature, its
Investigational new drug study potency will decrease.
a. Laboratory studies - cell or animal studies test to 10. Drug tolerance – patients who develop
see if the new treatment will be safe and will tolerance, it will result to drug
work on people. combination therapy to achieve the
b. Phase 1 - safety of medication and treatment on therapeutic effect.
people. 11. Cumulation effects – other drugs are
c. Phase 2 - safety and effectiveness on people. more effective if administered with
d. Phase 3 - safety, effectiveness and dosing on another drug because of the synergistic
people. effect of both drugs. Resulting to lesser
e. Phase 4 - long-term effectiveness and compares adverse effects.
to new treatment. 12. Interactions – drugs could interact with
other drugs or with food.
Classes of drug recall

- protect the public from potentially harmful product. Ø Toxic Effects of Drugs
• Adverse Effects
a) Class 1 Recall
- Undesired effects that may be unpleasant or
- serious adverse effects or death.
dangerous.
b) Class 2 Recall
 - Drug may have other effects on the body. • Alterations in Glucose Metabolism –
- Patient may be sensitive to the drug. hypoglycemia, hyperglycemia
- Patient may be taking too much or too little • Electrolyte Imbalances – hypokalemia,
of drug. hyperkalemia
• Types of Adverse Effects: • Sensory Effects – ocular damage, auditory
1) Primary Actions damage
- development of adverse effects from • Neurological Effects – nervous system effects,
simple overdose. atropine-like effects
- patient suffers from effects that are • Teratogenicity – effect of the drug to the
merely an extension of the desired developing fetus on pregnant mothers
effect.
2) Secondary Actions
- wide variety of effects in addition to the CHEMOTHERAPEUTIC AGENTS
desired pharmacological effect
3) Hypersensitivity Ø Anti-infective agents
- excessive response to either primary or - Target foreign organisms infecting the body
secondary effects of a drug. of a human host.
- may result from pathological or - Do not possess selective toxicity, is the
underlying condition. ability to affect certain proteins or enzyme
• Drug Allergy used only by infecting organism but not by
- Occurs when the body forms antibodies to a human cells.
particular drug, causing an immune
Therapeutic Actions
response.
- 4 Classifications: - Act on the cells of invading organisms in
1. Anaphylactic Reaction (IgE) several different ways.
- antibody that reacts with specific
sites in the body to cause the release • Specific Mechanism of Action
of chemicals, that can lead to 1. Some anti-infectives interfere with
respiratory distress and arrest. biosynthesis of the pathogen cell wall.
2. Cytotoxic Reactions (IgG & IgM) 2. Some anti-infectives prevent the cells of the
- antibodies that circulate in the invading organism from using substances
blood and attack antigens, causing essential to their growth and development.
death of the cell. 3. Some anti-infectives interfere with DNA
3. Serum Sickness (IgG & IgM) synthesis in the cell.
- antibodies that circulate in the 4. Many anti-infectives interfere with the steps
blood and cause damage to tissues. involved in protein synthesis.
4. Delayed Reactions (T cell) 5. Other anti-infectives alter the permeability
- antibodies that are bound to of the cell membrane.
specific white blood cells. It occurs
several hours after exposure. • Spectrum – effectiveness against invading
organisms/
Ø Drug-Induced Tissue and Organ Damage • Bactericidal – so active anti-infectives against
• Dermatological reactions – adverse reactions microorganisms that they cause the death of the
involving the skin (rashes, hives) cells.
• Superinfections – infections caused by organisms • Bacteriostatic – not aggressive anti-infectives
that are usually controlled by the normal flora. against invading microorganisms; they interfere
• Blood Dyscrasia – bone marrow suppression with the ability of the cells to reproduce or
caused by drug effects. divide.
• Toxicity – liver injury, poisoning
• Human Immune Response • CARBAPENEMS
- The goal of anti-infective therapy is - new class of broad- spectrum antibiotics
reduction of population of the invading effective against gram- positive and gram-
organism which human immune response negative bacteria.
can take care of the infection. Eg. Doribax
- Immune response involves a complex
interaction chemical mediators…, released • Azole Antifungals
enzymes and chemicals. - large group of antifungals used to treat
• Resistance systemic and topical.
- Can be natural or acquired, the ability over Eg. Nizoral
time to adapt to anti-infective drug and
produce cells. • FLOROQUINOLONES, TETRACYCLINES,
- Microorganisms develop resistance SULFONAMIDES
including: - antibiotics having an adverse effect of
a. Producing an enzyme that deactivates photosensitivity.
the antimicrobial drug.
b. Changing cellular permeability to • MEBENDAZOLE- ANTIHELMENTIC
prevent drug from entering cell. - used to treat pinworms, roundworms,
c. Altering binding sites on the membranes whipworms, and hookworms.
which then no longer accepted the drug. - When patient is taking anthelminthics- health
d. Producing a chemical that acts as teaching should include the use of contraceptive
antagonist to the drug. because it reduces plasma estrogen
• VANCOMYCIN - the I.V. drug of choice for serious concentrations.
resistant staphylococcal infections in the patient
who is allergic to penicillin. Ø TEACHING TO PATIENT RECEIVING ANTIBIOTICS
a. The need to complete the full course of drug
• CEPHALOSPORINS therapy
- taken with food, Antabuse effect b. The possibility of oral contraceptive failure
- interfere with the cell wall building ability of c. When to take the drug related to food and
bacteria when they divide. other drugs
Eg. Cephalexin d. How to detect superinfections and what to
do if they occur
• FLAGYL
- side effect red brown urine.
GRAM NEGATIVE BACTERIA ARE USUALLY FOUND IN
• RIFAMPICIN, ISONIAZIDE, PYRANIZAMIDE, GASTROINTESTINAL AND GENITOURINARY.
ETHAMBUTOL, STREPTOMYCIN
GRAM POSITIVE BACTERIA ARE USUALLY FOUND IN THE
- examples of antituberculosis drugs (used in
UPPER RESPIRATORY.
combination of two or more agents).
• ANTIBIOTICS - Chemicals that inhibit specific
bacteria.
Eg. GENTAMICIN, CEPHALEXIN Ø BACTERIAL RESISTANCE TO AN ANTI- INFECTIVE
RESULT TO:
A. Natural intrinsic property
• AMINOGLCOSIDES - group of powerful
B. Changes in cellular permeability
antibiotics for serious gram-negative infection.
C. The production of the chemicals that
Eg. Gentamicin
antagonize the drugs