NURS472A NURSING PHARMACOLOGY: General Principles of Pharmacology; Legislation of Drugs
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Course
NURSING PHARMACOLOGY
Institution
NURSING PHARMACOLOGY
Canadian Food and Drugs Act
• Amended several times since inception in 1953
• Prohibits the sale of certain drugs unless approved by the federal government.
• Drugs must comply with certain standards outlined in specific pharmacopeias and formularies
• Physicians, nurses, & pharmacists ...
• Prohibits the sale of certain drugs unless approved by the federal government.
• Drugs must comply with certain standards outlined in specific pharmacopeias and
formularies
• Physicians, nurses, & pharmacists depend on these standards to ensure a client receives
drugs in safe and effective dosages.
Controlled Drugs and Substances Act (CDSA)
• Replaced the Narcotic Control Act in 1997
• Provides requirements for the control and sale of narcotics, controlled drugs, and substances of
misuse
• The letter N is printed on the label of every narcotic drug.
• Controlled drugs may be legally obtained only with a prescription from a licensed medical
practitioner
Controlled Substance Schedules
5 schedules
• Based on potential misuse or harm or how easy they are to manufacture into illicit substances
Schedule I
Most dangerous drugs --- high abuse potential --- No medical use
Example: opiates ( heroin and LSD )
Schedule II
High abuse potential --- Severe dependence liability
Example: Opioids
Schedule III
Less abuse potential than schedule I and II
Example: Anabolic steroids
What is Pharmacology?
Drug
• Any chemical that affects the physiological processes of a living organism
Pharmacology
, • Broadest term for the study or science of drugs
Names of Medications
Chemical Name
• Describes the drug’s chemical composition and molecular structure
Generic Name
• Nonproprietary
• Official name
• Name assigned by the manufacturer that first developed the drug
• Name approved by Health Canada
Brand/Trade Name
• Proprietary name
• Name chosen by the drug company that sells the drug
• Registered trademark
• Names of Medications
Type of Medications:
• What is a prescription medication? An antibiotic, birth control, heart medication
• What is a non-prescription medication? Tylenol, anything over the counter
• What is a controlled medication? Morphine, hydromorphone
Pregnancy Safety Categories
• In 2014 the Food and Drug Administration (FDA) published:
• Pregnancy and Lactation Labeling Rule
• Information about using medications during pregnancy & breastfeeding
What is Pharmaceutics?
• How various dosages forms influence the way in which the drug affects the body
• Dosage forms determines the rate at which drug dissolution occurs
What is Pharmacotherapeutics?
• Focuses on clinical use of drugs to prevent disease
• Defines principles of drug actions
What is Pharmacodynamics?
• Focuses on the effects of the drug and their mechanism of action
What is Pharmacokinetics?
, • What happens to the drug from the time it enters the body until the drug & metabolites have left
the body
• Onset, peak and duration
• Based on drug’s absorption, distribution, metabolism & excretion
Absorption
• Movement of drug from its site of administration into the bloodstream for distribution to the
tissues
Bioavailability
• Extent of drug absorption
• The percentage of the administered drug dose that reaches the systemic circulation
• Based on first pass effect and the route of administration
Route of Administration
Enteral
• Oral
• Sublingual
• Buccal
• rectal
Parenteral
• Intradermal
• Subcutaneous
• Intramuscular
• Intravenous
Topical
• Ointments
• creams
• drops (ears, nose and eyes)
• Transdermal
• Inhalation
First Pass Effect
• The process in which the drug passes to the liver first
Distribution
• Transport of a drug by the bloodstream to its site of action
, • Once a drug enters the circulating blood, it is distributed throughout the body
• Drugs are distributed first to areas with extensive blood supply
• Heart, brain, kidney & liver
Factors Affecting Distribution
Rate of Perfusion
• Capillary permeability to the drug
• Blood-brain barrier is poorly permeable to water-soluble drugs.
• Some drugs have trouble getting through the CNS
• Whereas the placenta is not a selective barrier and drugs move readily through the
placenta to the fetus.
• Organs with more blood supply Receive Medication First
Albumin
• is the most common blood protein
• Carries the majority of protein-bound drug molecules
• If a given drug binds to albumin, only a limited amount of the drug is not bound
• This unbound portion is active and is considered “free” drug
Metabolism
Biotransformation
• Chemical alteration of the drug into an inactive metabolite
• In other words ---- the breakdown of a drug to an inactive form
• This allows the drug to be eliminated
Liver
• The organ most responsible for metabolism
Excretion
• Elimination of a drug from the body
• All drugs must be eliminated from the body
Kidney
• The organ most responsible for elimination
Stop and Consider
Why would your patient, who is 67 years old be ordered a lower dosage of a drug?
• An older adult is a person 65 years of age & older
• There are physiology changes with aging
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