Pharmacology- science concerned with history, sources and physical and chemical property of

drugs, as well as the ways in which drugs affect living systems.

Drugs- any chemical substance that affect living systems by changing their structure or function

CLASSIFICATION OF DRUGS
1. Prescription drugs- that have them on label and the prescription legend described
previously
Prescription form
- Client information (name, address, age or date of birth)
- Date when the prescription is written
- Rx symbol
- Name and dosage strength of the prescribed medication
- Dispensing instruction for the pharmacist
- Direction for the client (RPh will place on the prescription label)
- Refill or specialized labeling instruction
- Prescribers signature, address and tel. no.
- PRC #
2. Non prescription drugs/ OTC- may be legally acquired by the client with out a
prescription.
3. Investigational drugs- manufacturer seeks to market a new drug must perform a wide
array of animal studies and carry out clinical testing of the drug in human subject
4. Illicit drugs/street drugs- that are used or distributed illegally

DRUG NAMES
o Chemical name- scientific name that precisely describes its atomic and molecular
structure
o Generic or nonproprietary name- abbreviation of the chemical name
- It reflects same important pharmacological or chemical characteristic of drug
o Brand name or trade name- selected by the drug company selling the product.

DRUG DOSAGE FORM

 Tablet – most popular dosage form and usually the easiest to administer
 Capsules- dosage form in which is drug is enclose in either hard or soft soluble shell,
usually made of gelatin
 Troches/ lozenges- solid dosage forms that are generally disc shaped and should be
dissolved slowly in the mouth. They are designed to release medication that exerts an
antiseptic or anesthetic effect on the tissues of the oral cavity or throat (zinc lozenges)
 Suppositories- dosage form that is to be inserted into one of the external orifices usually
the rectum, vagina or urethra.
 Solutions- clear liquid preparation that contains one or more solvents, usually water,
and one or more dissolved components or solute
 a. Syrups- sweetened solutions that are often used to mask the unpleasant taste of
certain drugs
b. Elixirs- solutions that contain solvent mixture of alcohol and water as well as other
component
c. Tincture- solutions that contain alcohol as primary solvent but which may contain
some water as well
 Suspension- liquid dosage forms that contain solid drug particles that are suspended in a
suitable liquid medium.
 Emulsion- dispersions of the droplets of an oil in water or water in oil. Those that
contain an oil dispersed in water are primarily used orally. (E.g., castor oil or mineral oil)
 Implants- administering in small flexible capsules made of a silastic polymer. (e.g.,
Subdermal implant)
 Parentheral products- (ampule or vial)

ROUTE OF ADMINISTRATION
 Buccal, sublingual or translingual- drugs are given in the pouch between the cheek and
gum (buccal), on the tongue (translingual) or under the tongue (sublingual) to prevent
their destruction or transformation in the stomach or small intestine (e.g., nifedipine)
 Gastric- this route allows direct installation of medication into the GI system who can’t
ingest the drug orally (e.g., NGT feeding)
 Intradermal- injected in the skin (dermis) 15 degrees’ angle. This route is used mainly for
diagnostic purposes when testing for allergies or tuberculosis (e.g, BCG, skin testing)
 Intramascular- allows drugs to be injected directly into various muscle groups at varying
tissues depths in a 40 degrees’ angle. It is used to give aqueous suspensions and
solutions in oil and to give medications that aren’t available in oral form or
intravenously
 Intravenous- allows injections of substances directly to the bloodstream through a vein.
 Oral- safest, most convenient and least expensive route. Drugs are administered to
patients who are conscious and can swallow. (e.g. Tablets and capsules)
 Rectal or vaginal- suppositories, ointment, cream or gels may be instilled into the
rectum or vagina to treat local irritation or infection. Some drugs applied to the mucosa
of the rectum or vaginal can be absorbed systematically (e.g. Cerviprime)
 Respiratory- drugs are available as gases administered into the respiratory system.
Drugs given by inhalation are rapidly absorbed and medications given by devices such as
the metered-dose inhaler. (e.g., fluticasone, nebulizer)
 Subcutaneous- small amounts of a drugs are injected beneath the dermis and into the
subcutaneous tissue, usually in the patient’s upper arm, thigh, or abdomen. (30
degrees)
 Topical- this route used to deliver a drug through the skin or a mucous membrane. Used
for most dermatologic, ophthalmic, otic and nasal preparation (e.g., ophthalmic
ointment, topical anesthesia, lotions)

Pharmakokinetics- drug actions as it moves through the body.

 a. Absorption (taken in the body)- from time of it’s administration, through its passage to
the tissues, until it become available for the use by the body.
b. Distribution (moved from various tissue)- drug is delivered to body tissue and fluids.
Distribution depends on the blood flow.
c. Metabolism/ biotransformation (into form that can be excreted)- the body changes a
drug form its dosage form to more water-soluble form that can then be excreted.
d. Excretion (removed from the body)- elimination of drugs from the body. Mot drugs are
excreted by the kidney and leave the body through urine.

Pharmacodynamics- study of drug mechanism that produce biochemical or physiologic changes

in the body.
 Agonist – drug displays an affinity for a receptor and stimulates it
 Intrinsic activity- drug’s ability to initiate a response after binding with the receptor
 Antagonist- has an affinity for a receptor but displays little or no intrinsic activity

Pharmacotherapeutics- study how drugs are used in treatment of an illness

 Acute therapy- patient is critically ill and requires acute intensive therapy
 Empiric therapy- based on practical experience rather than on pure scientific data
 Maintenance therapy- with chronic conditions that don’t resolve (HIV & Diabetes
treatment)
 Supplemental or replacement therapy- replenish or substitute for missing substances in
the body (IV fluid replacement)
 Supportive therapy- don’t treat the cause if the disease but maintains other threatened
body systems until the patient’s condition resolves
 Palliative therapy- used for end-stage or terminal disease to make the patient as
comfortable as possible

Intrvenous therapy- liquid solutions are introduced directly into the bloodstream.
Uses:
- Restore and maintain F & E balance
- Provide medication and chemotherapeutic agents
- Transfuse blood and blood products
- Deliver parenteral nutrients and nutritional supplements

Risk:
- Bleeding
- Blood vessel damage
- Infiltration (infusion of IV solution into surrounding tissues rather than blood vessel)
- Infection
- Overdose (due to rapid response of IV drugs)

Fluid- 60% of the body is composed of

- Solutes in body fluid includes electrolytes and non-electrolytes (such as protein)
Composition:
  Solvent-water
 Solute- dissolved substance
Function
- Regulate body temperature
- Transport nutrients and gases throughout the body
- Carry cellular waste products to excretion sites

Understanding body fluid distribution

1. Extracellular fluid(ECF)- 20% of body weight
 Interstitial fluid (ISF)- 20% of body weight
 Intravascular fluid (plasma)- 5% of body weight
2. Intracellular Fluid- 40% of body weight

Electrolytes

Sodium (Na)- major Cation ECF (135 to 145 mEq/L

- Influence H2O distribution (with chloride)
- Affects concentration, excretion, and absorption of potassium and chloride
- Aids nerve and muscle-fiber impulse transmission
- Hyponatremia (muscle weakness, muscle twitching, decrease skin turgor, tremor,
seizures, coma)
- Hypernatremia (thirst, fever, flushed skin, oliguria, dry, sticky membrane

Potassium (K)- major Cation in ICF (3.5 to 5.0 mEq/L

- Maintains cell electroneutrality & osmolarity
- Assist in conduction of nerve impulses
- Affect cardiac muscle contraction
- Hypokalemia( decreased GI, skeletal muscle and cardiac muscle function; decreased
reflexes, muscle weakness, decrease blood pressure
- Hyperkalemia (nausea, diarrhea, oliguria, pareshtesia (altered sensation)

Calcium (Ca)- major cation in ECF of teeth and bone (8.9- 10.1 mg/dl
- Affects excitation, activation and contraction of cardiac and skeletal muscles
- Participates in neurotransmitter release at synapse
- Activate specific steps in blood coagulation
- Activates serum complement in immune system function

Chloride(cl)- major Anion in ECF (96-106 mEq/L

- Maintains serum osmolarity with (Na)

Phosphorus (P)- major anion in in ICF (2.5- 4.5 mg/dl)

- Maintain bones and teeth
- Major role in acid-base balance
 - Promotes energy transfer to cells
- Essential role in muscle, RBC, and neurologic function

Magnesium (Mg)- major Cation in ICF (1.5 – 2.5 mg/dl)

- Influences Ca level
- Facilitate Na & K movement across all membranes

Fluid movement
Movement Definition Composition Motion
Diffusion (passive - Does not require - Solute - Higher to lower
transport) energy concentration

Active transport - Moved thru - Solute - Lower to higher

physiologic pump concentration
Osmosis - when solute is not - solvent - higher concentration
equal to lower
- capillary to cell concentration
Capillary filtration - Fluid from solute - fluid and solute - High hydrostatic
and reabsorption thru capillary wall (filtration) pressure to lower
- Albumin remain - albumin and
and re absorb solvent
water back (reabsorption)

IV Solutions

Measured in “Miliosmols of solute per liter of solution (mOsm/L)”

Normal serum osmolarity- 300mOsm/L (240-340)
Solution Description Examples Consideration
Isotonic - Same osmolarity (tonicity) - Lactated Ringer - Monitor fluid overload esp.
- Stay infused inside the blood (LR) hypertensive or with heart
vessel (expands this - Ringer’s failure
compartment without pulling - Normal Saline (NS) - Liver converts lactate to
from other compartment - Dextrose 5% in bicarbonate, do not give LR
- Stays in intravascular space water (D5W) with 7.5 above PH
and it expands intravascular - 5% albumin - No D5W in patient with ICP
compartment - Hetastarch because it acts like
- Normosol hypotonic
Hypotonic - Osmolarity is lower than - Half normal saline - Cause a fluid shift from
serum osmolarity - 0.33% sodium blood to vessels into cells.
- Fluid shifts out of the blood Chloride Could cause cardiovascular
vessel into cells and IS spaces - Dextrose 2.5 % in collapse from intravascular
- Hydrate cells while reducing water fluid depletion and
fluid in circulatory system increased ICP
 - NO to patient at risk of 3rd-
space fluid shift- patient
suffering burn
Hypertonic - Osmolarity higher than - Dextrose 5% un - closely monitor the patient
serum osmolarity. half-normal saline for circulatory overload
- Casues fluid to be pulled - Dextrose 5% in - don’t give them to patient
from interstitial and normal saline which cause a cellular
intracellular compartment (D5NSS) dehydration- diabetic
into the blood vessels - 3% Sodium ketoasidosis
- Makes cell to shrink Chloride - no to patient with impaired
- 25% albumin heart and kidney function
- 7.5 sodium
chloride