Adverse events are unintended pharmacologic effects that occur when a medication is

administered correctly (unwanted)

A side effect is a secondary unwanted effect that occurs due to drug therapy (wanted)

Abbreviation

Stats – Immediately

Ac- Before meals

Pc- after meals.

Bid- twice a day

PRN – as needed

Q3h - every 3 hour

QD – every day

Gastrointestinal tract - pathway by which food enters the body and solid wastes are expelled. The
gastrointestinal tract includes the mouth, pharynx, esophagus, stomach, small intestine, large
intestine, and anus.

Capillaries- They transport blood, nutrients and oxygen to cells in your organs and body
systems. Capillaries are the smallest blood vessels in your vascular system.
Pharmacology – Study of drugs and their interaction or effect to the living things
Clinical pharmacology – Study of drug in human for patient and healthy volunteers
Pharmacotherepeutics – the use of drugs to diagnose, prevent or treat disease
Drug- any chemical that can affect living process

6 things in aiming ideal drugs (properties of ideal drugs)

1. effectiveness- elicit the responses for which is given

2. safety- a Drug that cannot produce harmful effect even if administered in high doses and for a very
long time

3. selectivity- elicit only the response for which it is given.

4. Reversible action- a drug action that subside within an appropriate time.

5. predictability- a drug that we can know with certainty how a given patient will respond.

6. Ease of administration- a drug that given conveniently with low needed doses.

5R (Right Patient, drug, dose, route, time)

Other 5 (right, documentation, education, refuse, assessment and evaluation)

Route - (Oral, Intravenous, sublingual, intradermal and intramuscular)

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Enteral Route of Medication

Oral - (taken by mouth, swallowed with fluid, and absorbed via the gastrointestinal tract)

First pass Effect –Eternal route of administration pass from intestinal lumen to the liver via the portal
vein and the liver metabolize drug to an inactive form and are excreted.

Sublingual- (under the tongue -the sublingual route avoids first-pass metabolism by the liver. Under
the tongue there are many Capillaries)

Buccal- (placing a drug between your gums and cheek, where it also dissolves and is
absorbed into your blood. Because of the capillaries)
. Both sublingual and buccal drugs come in tablets, films, or sprays

A rectal route – (allows for rapid and effective absorption of medications via the highly vascularized
rectal mucosa.)

Parenteral Route of Medication 

Intravenous - (medication into the veins using a needle, direct entry of drug into the systemic circulation
and consequently an immediate drug effect. Intravenously administered drugs are given either as a
“bolus” (within 1–30 min)

 Intramuscular - medication route can be administered in different body muscles.

Subcutaneous injections -are administered to the layer of skin referred to as cutis, just below the dermis
and epidermis layers.

Other Routes of Medication

Intranasal – (drug route facilitates drug absorption by passive diffusion across the single-
layered, well-vascularized respiratory epithelium directly into the systemic circulation.)
Inhaled -medication is delivered rapidly across the large surface area of the respiratory tract epithelium.
Drugs absorbed into the pulmonary circulation enter directly into the systemic circulation via the
pulmonary vein, bypassing the first-pass metabolism. (Rapidly absorbed through alveolar capillary
network)

Vaginal -route is an underexplored drug delivery route that is not commonly used but has the
advantages of bypassing the first-pass effect and can serve as an effective method for local and systemic
therapy.

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Patient teaching Card

Ethical consideration

1. Respect for person/ autonomy (right to refuse) Respect their decision

2. Beneficence (giving medication the best interest of the client)
A. Informed consent ( sharing information , respect autonomy)
B. Risk –benefit ratio- ( the patient gain something from what are you doing)
3. Justice (selection of research subject be fair)

Drug name

1. Chemical name (drug chemical structure)

Example: lithium hydroxide monohydrate
2. Generic name (Non-proprietary name or not owned by any company)
Example: lithium
3. Brand name ( Owned by the company or registered as a trademark )
Example: lithobid

Making PRN Decisions

1. PRN (Pro re Nata) – As needed, when to give the drug and in some case, how much to give. To
implement this, the nurse must know the reason the drug is prescribed and able to assess the
patient’s medication needs.

Patience Adherence – a patient behavior coincides with medical advice (Sinusunod)

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Principle of PHARMACOLOGY

1. Absorption- how will get in? – The rate of medication absorption determines how soon the

drug will take effect. The dosage of medication absorbed determine its intensity

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 2. Distribution – where it will go? ( Transporters )

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 3. Metabolism- how is it broken down (liver)

4. Execration- how does it leave)

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Pharmacodynamics is Study of the effect of the drugs on the body (food you take , other drug you take)

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 a1 Vasoconstriction (blood vessel),a2 Insulin (pancreas) B1 Inotropy and chronotropy (heart, cardiac
muscle Contraction of heart) B2 (Lungs)

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 1. Stimulation- key to receive glucose
2. Depression- (blocker) block the channel so you don’t use the glucose
3. Irritation – it can affect in your body
4. Replacement- alternate
5. Cytotoxic action – (cancer drugs) and have many side effect
6. Antimicrobial –(antibiotics) target the cell of microorganism that have effect to the body
7. Modification of immune status (vaccine)

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A – Highly recommend for pregnant

B and C – can be given but have effect

D- More risk but can help

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X – Never give

Schedule 2 to 4 need special prescription

Schedule 5 OTC

Neuropharmacology:

Autonomic System

Different function of nervous system is Monitoring the internal and external environment of the body,
(1st branch of nervous system which is efferent and afferent neurons), Afferent (out to in) send impulse
to the CNS and efferent (in to out) receive impulse transmit though the spinal cord to effector organ
cell.

Nervous system is divided into 2 Central (spinal and brain) and peripheral (Afferent/sensory
Efferent/Motor)

Efferent somatic and autonomic

Somatic nervous system (nerves that provide voluntary control of skeletal muscle)

Autonomic nervous system (involuntary control in the hearth digestion respiratory and anything that
you can’t control in your body is autonomic)

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Autonomic 3 major function regulate the hearth rate, regulation of secretory glands and regulation of
smooth muscle,

Autonomic is divided into 2 parts (sympathetic/ adrenergic and parasympathetic/ Cholinergic)

Sympathetic (Flight or Fight) adrenergic drug

Sympathetic-dominate purely by adrenaline,

Sympathetic- must on the core para mabiles mag karon ng effect

Sympathetic -has a short preganglionic but have long postganglionic

Sympathetic -Postganglionic neuro transmitter is Norepinephrine with receptor organ (Alpha 1 and 2

Beta 1 and 2)

Alpha 1. Alpha 2

Beta 1 Beta 2

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–synaptic transmission (Postganglionic)

Synaptic transmission step 1 is synthesis of the transmitter Step 2 is the storage step 3 is the release of

the neuro transmitter step 4 is action at the receptor 5 step is Terminate, (3 ways to terminate 5a -Re

Aptic or re absorb back 5b-enzymatic lad ration degrade by enzyme 5c- diffusion away from the gap

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Parasympathetic (Rest and digest) cholinergic drug

Parasympathetic- for Postganglionic neuro transmitter is acetylcholine with receptor organ (nicotinic,

and muscarinic)

Ace = enzyme

Parasympathetic- has a long preganglionic the postganglionic near on the effector organ.

Mas mabiles dapat ang effect ng sympa kaysa sa Para

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Preganglionic – Bundle of neuron in CNS Postganglionic -bundle of neuron in Effector organ

Preganglionic neurotransmitter to autonomic ganglion then to postganglionic neurotransmitter to the

effector organ,

For SYMPA and Parasympa Preganglionic neuro transmitter all of this is acetylcholine (ACH)
For Parasympa Postganglionic neuro transmitter is acetylcholine.
For SYMPA Postganglionic neuro transmitter is Norepinephrine (NE)

If the receptor fit in the drug its agonist

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If the receptor don’t fit the drug its antagonist

Adrenergic agonist produces SYMPA effect Adrenergic antagonist produce para effect

Cholinergic agonist produce para effect cholinergic antagonist produces SYMPA effect.

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Direct acting – Direct to the receptors

Indirect acting – increase Produce of NE

Mixed - mixed

Other ways to categorist the andrenergic antagonist true their chemical structure

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If we want to administer a medicine must be selective there for it targets the receptor we want and to

avoid many side effect

Alpha 1 agonist (

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Norepinephrine

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Pag alpha wala sa parasympa Nicotinic and muscarinic ang receptors

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For patient taking adrenergic antagonist lower the BP don’t give Hold the medicine and call the Doctor

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PARASYMPATHETIC – CHOLINERGIC AGONIST AND ANTAGONIST

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Step 1 is synthesis the ACH Step 2 is storage Step 3 is release step 4 action at the receptor sight so ACH is

bind in the postsynaptic cell or receptor sight and kapag na detach na yung ACH at umipekto na si ACH

at lalabas na si acetylcholinesterase para I degrade ACH at ma dedevide na to sa dalawa Choline ay

reabsorb while si acetyl pwede magamit sa ibang cite or ma dissolved nlng.

Indirect- Didikit sya sa acetylcholinesterase hindi ma dedegrade si acetylcholine

Cholinergic agonist has two –Direcet and indirect acting

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Tensilon use differentiate cholinergic mystinic crisis

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Anti-cholinergic effect

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The effect of sympathomimetic- is andrenergic agonist and produce sympa effect

Parasympathomimetic - it mimics your Parasympathetic Nervous system and produce para Effect

Antagonist both Sympa and paramimetic

Sympatholytic - (andrenergic antagonist) Produce para effect

Parasympatholytic (antagonist)- produce sympa effect

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Antagonist both sympa and parathoyltic

Sympa and para Both give sympa effect

Sympa and para sympa give para effect

CNS Drugs

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Monoamine -are actually very good at playing role of any motor responses

Amino acid – Parkinson and seizures

Purine- emergency drug

Opioid peptides – Usually for pain no opioid peptides- have role in GIT

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Effect of using CNS Drug for a long time

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Treatment For respiratory