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PHARMACOLOGY FOR NURSES
A Pathophysiologic Approach
FIFTH EDITION
Chapter 1
Introduction to
Pharmacology
Murad Y. Amro
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Pharmacology
• Simply defined, from the Greek, as the study of medicine
• Pharmacology is an expansive subject encompassing:
➢ How drugs are administered
➢ Where drugs travel in the body
➢ Responses that drugs produce
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Interrelated Subject Areas
➢Anatomy and physiology
➢Chemistry
➢Microbiology
➢Pathophysiology
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Pharmacology Is Challenging and Always Changing
• 10,000 drugs currently available
• Each drug has its own characteristics:
➢ Therapeutic applications
➢ Interactions
➢ Adverse effects
➢ Mechanisms of action
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Pharmacology Is Challenging and Always Changing
• Many drugs prescribed for more than one disease
• Drugs elicit different responses depending on individual factors:
➢ Age
➢ Sex
➢ Body mass
➢ Health status
➢ Genetics
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Nursing and Pharmacology
• Knowledge of pharmacology essential to the nursing profession
• Nurses are health care providers most often directly involved in patient
care
➢ Applies to nurses in all settings from clinics and hospitals to home care
➢ Applies to nurses who teach and to students entering nursing profession
• Study of pharmacology is gradual process that continues throughout life
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Therapeutics and Pharmacology Are Closely Connected
• Therapeutics is concerned with
➢Prevention of disease
➢Treatment of suffering
• Pharmacotherapy is the application of drugs for
➢Disease treatment
➢Alleviation of suffering
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Therapeutic agents:
• Therapeutic agents may be classified as drugs,
biologics, or complementary and alternative medicine
(CAM) therapies:
• Traditional drugs are chemical agents: Synthesized in a laboratory.
• Produce biological responses in the body
• If desirable response—therapeutic
• If undesirable response—adverse
• After a drug is administered, it is called a medication
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Biologics
• Biologics are agents naturally produced in animal cells, by
microorganisms, or by the body itself.
• Examples:
✓Hormones
✓Monoclonal antibodies
✓Natural blood products and components
✓Interferons
✓Vaccines
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Complementary and Alternative Therapies
• Natural plant extracts, herbs, vitamins, minerals, dietary supplements
• Physical therapy, manipulations, massage, acupuncture, hypnosis,
biofeedback
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Drug Are Organized in Two Ways:
• Therapeutic classification: Based on therapeutic usefulness in treating
particular diseases or disorders. Ex: Antidepressants.
• Pharmacologic classification: Based on the way a drug works at the
molecular, tissue, or body system level. Ex: Diuretics
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Table 1.1 Therapeutic Classification
Table 1.1 Therapeutic Classification
FOCUS: CARDIOVASCULAR FUNCTION
Usefulness
Drug Classification
Influence blood clotting
Anticoagulant
Lower blood cholesterol
Antihyperlipidemic
Lower blood pressure
Antihypertensive
Restore normal cardiac rhythm
Antidysrhythmic
Treat angina
Antianginal
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Table 1.2 Pharmacologic
Classification
Table 1.2 Pharmacologic Classification
FOCUSING ON THERAPEUTIC APPLICATION:
PHARMACOTHERAPY FOR HYPERTENSION
Mechanism of Action
Drug Classification
Lowers plasma volume
Diuretic
Blocks heart calcium channels
Calcium channel blocker
Blocks hormonal activity
Angiotensin-converting enzyme Inhibitor
Blocks physiological reactions to stress
Adrenergic antagonist
Dilates peripheral blood vessels
Vasodilator
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“Prototype” Drug: serves as model for a drug class:
• Is well understood
• Has known action and adverse effects
• Is used to compare other drugs in the same pharmacologic class
• May not be the most widely used drug in its class
• Disagreements may exist over which drug should serve as prototype drug
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Newer Drugs in the Same Class:
• Newer drugs in the same class may replace the prototype drug because
they:
– Are more effective
– Have a more favorable safety profile
– Have longer duration of action
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Most drugs have three names:
1. Chemical name: drug has one chemical name, often
complicated, and difficult to remember or pronounce. Ex: Chemical
name for diazepam: 7-chloro-1, 3-dihydro-1-methyl-5-phenyl-2H1, 4-benzodiazepin-2-one
2. Generic name: each drug has one generic name, less
complicated and easier to remember. Ex: Ibuprofen
3. Trade name: a drug has several trade names, assigned by
company marketing the drug, short, easy to remember, also called
proprietary, product, or brand name. Ex: Trufen, Ibufen, Advil.
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Drug Has One Chemical Name
• Assigned using standard nomenclature
established by International Union of Pure and
Applied Chemistry (IUPAC)
• Describes physical and chemical properties of
drug
• Sometimes helpful in predicting a substance's
physical and chemical properties
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Each Drug Has One Generic Name
• Used by many organizations
– U.S. Food and Drug Administration (FDA)
– U.S. Pharmacopoeia
– World Health Organization (WHO)
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Trade Names
• Trade names can be difficult because many drugs contain similar
ingredients
– Combination drug contains more than one active generic ingredient
– Rule of thumb is that active ingredients in a drug are described by their generic
name, which is lowercase
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Table 1.3 Examples of Trade-Name Products Containing
Popular Generic Substances
Table 1.3 Examples of Trade-Name Products Containing
Popular Generic Substances
Generic Substance
Trade Names
aspirin
Acuprin, Anacin, Aspergum, Bayer, Bufferin,
Ecotrin, Empirin, Excedrin, Maprin, Norgesic,
Salatin, Salocol, Salsprin, Supac, Talwin,
Triaphen-10, Vanquish, Verin, Zorprin
diphenhydramine
Allerdryl, Benadryl, Benahist, Bendylate, Caladryl, Compoz,
Diahist, Diphenadril, Eldadryl, Fenylhist, Fynex, Hydramine,
Hydril, Insomnal, Noradryl, Nordryl, Nytol, Tusstat, Wehdryl
ibuprofen
Advil, Amersol, Apsifen, Brufen, Haltran,
Medipren, Midol 200, Motrin, Neuvil, Novoprofen, Nuprin,
Pamprin-IB, Rufen, Trendar
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Prescription Drugs and OTC Drugs
• Prescription drugs require that the recipient obtain a written order from a
person with the legal authority to write such a prescription.
• OTC drugs: over the counter drugs.
• Prescription: written direction for preparation and administration of
a drug
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Advantages and Disadvantages of Prescription Drugs
• Advantages:
✓ Health care provider or nurse practitioner examines the patient, determines a
specific diagnosis, and orders the proper drug
✓ Amount and frequency of drug is controlled
✓ Instructions on use and side effects of drug are discussed
• Disadvantages:
✓ Require a prescription to obtain
✓ Need for health care provider appointment
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Advantages and Disadvantages of OTC Drugs
• Advantages:
✓ No health care provider appointment required
✓ Often less expensive than prescription drugs
• Disadvantages:
✓ Patient may choose wrong drug
✓ Patient may not know reactions or interactions
✓ Ineffective treatment may result in progression of disease
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