1 Week 1: Seminar Overview, Basic Concepts

Welcome to Pharmacology! Dr Armando Martinez.... just call me “Dr. A” MBA Healthcare Administration – University of Miami MS Occupational Medicine – University of London MD University of Trujillo, Peru Some background on myself:

Seminar Reminders We begin promptly at 9.00pm EST  On Monday evenings  Class is one hour ( pm EST) Please do not announce yourself or apologize if:  you arrive late  you get bumped out due to technical issues

Syllabus Review Textbook and Workbook p2 Course Calendar p3 Grading Criteria/Course Evaluation p4 Rubrics p9 Seminars: Option 2 p7

Reminder References Books - must be current... Published within the last 2 years Websites - these 3 are very useful...    manufacturer’s website when information about a specific brand name drug product is needed, (for example... go to Lilly.com for detailed info on Prozac)

Instructor’s Beliefs Process and Results Course Success Strategy Learn and Earn Principle

What is a Drug? Chemical used for a therapeutic application:  Treating an illness  Relieving a symptom  Diagnostic testing

Drug Components Active ingredient  Pure, undiluted form of chemical having an effect on body function Inert ingredient  Little or no effect on body function  Adds flavor, bulk, color Vehicle  Inert primary base carrying an active medicinal ingredient (may contain preservatives, flavorings, colorings)

PharmacologyPharmacology Categories  Pharmacognosy  Pharmacokinetics  Pharmacodynamics  Pharmacotherapeutics  Toxicology

Pharmacognosy—The Origins of Drugs Historically, drugs came from...  Plants  Animals  Minerals  Synthetic substances (chemicals) Recently,...  Recombinant DNA technology (gene splicing) is being used to create drugs Table 2-1

Pharmacokinetics: How the Body Processes Drugs Involves four processes (A-D-M-E):  Absorption—movement of a drug from its administration site into the blood  Distribution—movement of a drug from the blood into tissues and cells  Metabolism—physical and chemical alteration of a drug in the body  Excretion—removal of waste products from the body

Absorption = ‘A’ Medications are administered by three routes. Table 2-4 Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

Variation of Absorption Rates Solubility—tendency of a drug to dissolve pH—acidic drugs are easily absorbed in the stomach Absence or presence of food in stomach—food slows absorption rate Fat solubility—medications high in fat are easily absorbed in the stomach Length of contact—topical drugs and the skin Inhalation factors—most rapid form Drug concentration—higher concentration Administration technique

Distribution = ‘D’ Drug is delivered to tissues through blood vessels and capillaries. Drug’s effect takes place in tissues, not blood vessels. Blood drug level, amount of drug circulating in bloodstream Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

Metabolism = ‘M’ Biotransformation, chemical reactions altering a drug into a water-soluble compound for excretion Primary site: liver Oral route: first-pass effect, limited amount of medication to reach site of action Drug half-life: time inactivate half of available drug Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

Excretion = ‘E’ Elimination, may occur through... respiration, perspiration, urination, and/or defecation Modified from Leahy, JM, Kizilay, PE (1998). Foundations of nursing practice. Philadelphia: Saunders.

Pharmadynamics—Drug Actions in the Body Drug action...  Physiological changes in the body  Response to the pharmacological effect Desired effect—intended response to a medication Side effect—mild, undesirable response to a medication, for example... Site of action: local, systemic Table 2-5

Pharmacotherapeutics— Indications/Effects of Medication Use Action...  How and where the drug acts Effect...  Biological, physical and psychological changes as a result of the drug’s action Contemporary indications …  Table 2-7

Toxicology—Poisonous Effect of Drugs on the Body Dose...  Mean the difference therapeutic/toxic effect Adverse reaction...  symptoms more severe that side effects: unintended, undesirable, unpredictable Allergic reaction …  Type of hypersensitivity reaction: previous exposure Anaphylaxis …  Severe, potentially fatal allergic reaction  Occurs a short time after drug administration

Drug Nomenclature(naming) Chemical-based on molecular - structure  Ex: 2-(4-isobutylphenyl)propionic acid Generic/nonproprietary - always in lowercase, easier than chemical name  Ex: ibuprofen Trade/Brand/Proprietary name - owned by original manufacturer, patent rights for 20yrs (given a registered trademark ®)  Ex: Motrin®, Advil®

Sources of Drug Information US Pharmacopoeia/Dispensing Information  Information for professionals and advice for patients Package Inserts  Comprehensive and concise information of the drug  Reading the package insert: Table 3-1 Physicians Desk Reference (PDR)  Used in a physician’s office

Drug Forms and Delivery Systems Solid oral preparations  Tablets – Table 3-2  Capsules – Table 3-3 Liquid oral medications  Solutions – Table 3-4  Dispersions - Table 3-5 Percutaneous medications  Table 3-6