Principles Of Pharmacology For Athletic Trainers – Describes the chemical composition and molecular structure of the drug. Common name (unprotected name). The United States Accepted Name is the name assigned by the Council. Trade name (protected name). The drug has a registered trademark; Use of the name is controlled by the patentee of the drug (usually the manufacturer). Each drug has three names. The chemical name describes the chemical composition of the drug and its structure. The generic name commonly used in practice is the name given to the drug by the American Accepted Name Council. The trade name is the name by which most people know the drug. This name is given to the drug patent and is a registered trademark.
(+/-)-2-(p-isobutylphenyl)propionic acid Generic name Ibuprofen Trade name Motrin®, Advil® Here is an example of three names for a drug.
Principles Of Pharmacology For Athletic Trainers
6 Figure 2-1 The chemical, generic, and trade names for the common pain reliever ibuprofen are listed along with the chemical structure of the drug.
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Classification – Nurses learn to classify drugs with similar properties according to their class. Drug classification refers to the effect of the drug on the body system, the symptom relieved by the drug, or the desired effect of the drug (for example, oral hypoglycemia).
A drug belongs to more than one category. Aspirin is an analgesic, antipyretic, anti-inflammatory and anti-platelet agent
Medicines are available in different forms and preparations. The form of the medicine determines the route of its administration. The composition of the drug is designed to improve its absorption and metabolism. Many drugs are available in different forms. Pharmacological Concepts: Forms of Medicines
14 Drugs A study of how different dosage forms affect pharmacokinetic and pharmacodynamic activities. Pharmaceuticals is the study of how different forms of a drug affect the pharmacokinetic and pharmacodynamic activities of the client’s body. It examines the difference between oral formulations and controlled-release drugs such as injections, capsules, and tablets.
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Pharmacokinetics • The study of how the body does drugs. Absorption, Distribution, Metabolism, Excretion. It is important to understand the difference between pharmacokinetics (drug action) and pharmacokinetics (drug action). Pharmacokinetics is how a drug is absorbed, distributed throughout the body, metabolized, and eliminated.
Pharmacodynamics • The study of what drugs do in the body. The mechanism of drug action in living tissues. Pharmacodynamics is the study of how a drug affects living tissues within an organism. That’s why we tell you: you need to know the effect of the drug on the body and what it can do.
Figure 2-2 Phases of drug action. (McKenry LM, Salerno E: Mosby’s pharmacology in Nursing – Revised and updated, Edition 21, St. Louis, 2003, Mosby.)
Use of drugs for the prevention and treatment of disease and clinical indications for drugs. Pharmacotherapy is the study of how and when drugs are used to prevent or treat certain diseases. It describes how a drug works – what changes occur in the cells due to the presence of the drug?
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Study of Natural Pharmacological (Plant and Animal) Sources of Medicines Many medicines have their origin in natural sources. The study of this phenomenon is called pharmacology.
The rate at which a drug leaves the site of its administration and the extent of absorption. Bioavailability, bioequivalence. Let’s talk about phases of pharmacokinetics. The first step is absorption. Absorption rate is the rate at which a drug leaves the site of administration. Bioavailability measures the extent to which a drug is absorbed. If two drugs have the same bioavailability and the same concentration of active ingredients, they are said to be bioequivalent. An example of this is branded drugs and generics.
Route of drug administration Drug intake Food or liquid Digestive ability Body surface Absorptive surface area Speed of blood flow to the small intestine Lipid solubility State of GI motility Many factors affect absorption – r Administration Foods and fluid volume Formation Absorptive surface area (GI mucosa, skin ) Velocity of blood flow to the small intestine. Stomach Acidity (high acidity leads to faster breakdown of drugs) GI motility status (how fast the drug moves through the body)
The route of administration of a drug affects the rate and extent of absorption of that drug. Intestinal (GI tract) Parenteral topical intestinal administration of a drug requires that the drug be broken down in the gastrointestinal tract and transported into the system. With parenteral administration, the drug is injected into the body. When applied topically, the drug must be absorbed by the skin.
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23 Enteral route A drug is absorbed into the systemic circulation either orally or through the gastric mucosa, small intestine, or rectum. Oral Sublingual Buccal Rectal
24 The first-pass effect is the metabolism of a drug and its passage from the liver to the bloodstream. An orally administered drug can be extensively metabolized in the liver before reaching the systemic circulation (high first-pass effect). The same drug – given by IV – bypasses the liver, preventing a first-pass effect and preventing more of the drug from entering the circulation. An orally administered drug must first pass through the liver before entering the circulatory system. When a drug is administered intravenously, the liver is bypassed and more of the drug enters the bloodstream or more of the drug is bioavailable.
Parenteral route Intravenous (rapid blood stream distribution) Intramuscular Subcutaneous Intravenous (or injection) Routes include: Intravenous – Intravenous – Intramuscular – Intramuscular Subcutaneous – Intradermal – Intradermal – Subarachnoid space (used for anesthesia ) Intra-Joint – Within a joint
29 Distribution Transport of a drug in the body through the bloodstream to its site of action. Protein binding. Water soluble and fat soluble. Blood-brain barrier. Places of rapid distribution: heart, liver, kidney, brain. Areas of slow distribution: Muscles, skin, fat Due to protein binding, only a small amount of the drug is available. The rest is protein bound. Patients with low albumin levels have high levels of circulating drugs and are at high risk of drug toxicity. Since the body is composed mostly of water, drugs that are more soluble in water have a higher concentration in the blood. Lipid-soluble drugs are attracted to the low water content of tissues and therefore have low blood concentrations. The blood-brain barrier prevents the delivery of certain drugs to the brain (eg dopamine). Organs with a large blood supply, such as the heart, liver, kidneys, and brain, distribute drugs rapidly. People with limited blood supply, such as muscles, skin and fat, distribute the drug more slowly.
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The biological transformation of a drug into an inactive metabolite, a more soluble compound, or a more active metabolite. Liver (main organ), kidney, lung, plasma, intestinal mucus
Delayed drug metabolism leads to: accumulation of drugs. Long-term effects of the drug. Induced factors of drug metabolism: Reduction of pharmacological effects. The delayed metabolism of the drug leads to the accumulation of drugs in the system and causes a long-term effect. If the metabolism of the drug is stimulated, the drug is used faster and its effect is reduced.
Excretion Excretion of drugs from the body Kidney (major organ) Liver Intestine Biliary excretion Enterohepatic circulation Most drugs are eliminated from the body through urine. The liver is also involved in drug excretion. During biliary excretion, drugs are absorbed by the liver, excreted in the bile and excreted in the stool. During enterohepatic recycling, drugs in the bile are reabsorbed into the bloodstream, returned to the liver, and excreted a second time in the bile.
34 1. You are caring for a client with diabetes complicated by kidney disease. When giving medications, you must perform a comprehensive assessment because this client may have problems with: A. Absorption B. Biotransformation C. Distribution D. Excretion Answer: D
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The effect of a particular drug depends on the cells or organs targeted by the drug. Once the drug reaches the “site of action,” it changes the rate of movement of a cell or tissue. Mechanism of action
It involves the selective association of a drug molecule with a reactive site on the cell surface, producing a biological effect. A receptor is a reaction site in a cell or tissue. When the substance binds and interacts with the receptor, a pharmacological response is produced. receptor interaction
A drug with a better “match” or affinity induces a better response. The drug mimics the body’s own substances, which usually bind to the receptor site. Drugs that bind to receptors interact with receptors in different ways to inhibit or stimulate a response. receptor interaction
Drugs can interact with enzyme systems to change the reaction. Inhibits enzyme activity – Enzymes are “tricked” into binding to the drug instead of the target cell. Protects the target cell from the action of the enzyme (ACE inhibitor). Enzyme interaction
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There is no involvement of a receptor site or change in enzyme activity. The main place of action is the cell membrane or cell process. Drugs physically disrupt or chemically alter cellular processes. The end product is altered, leading to cell defects or death. Cancer drugs, antibiotics
The nurse is administering a drug with a high first-pass effect. The doctor changed the route from IV to PO. The nurse expects the oral dose to be: 1. High due to the first-pass effect. 2. Because of the below
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