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Summary NCLEX study guide

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in depth document based on ATI book and questions. mainly pharmacology content but some pathophysiology

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Pharm 09/02/2020
●​ Pharmacology
○​ Study of drugs (chemicals) that alter functions of living organisms
●​ Pharmacotherapy
○​ Drug therapy
○​ Use of drugs to prevent, diagnose, or treat signs & sx, and diseases
●​ General pharmacology terms
○​ Drug classification
■​ Drugs are classified according to their effects on particular body systems,
their therapeutic uses, characteristics
○​ Prototype
■​ Usually first drug class to be developed
■​ An individual drug that represents drug class to be developed
■​ An individual drug that represents a group of drugs
●​ Morphine-opioid
●​ Penicillin- beta lactam antibiotics
●​ Heparin- anticoagulant
○​ Generic (official) vs brand (trade) name
■​ Acetaminophen (tylenol)
○​ Rx- prescription
○​ OTC — over the counter
●​ Important terms ​
○​ Drug: substance that has a physiological effect on the body
■​ Can modify but not create
○​ Adverse effect: a harmful or abnormal result
○​ Side effect: a secondary, typically undesirable effect of a drug or treatment
○​ Pharmacokinetics: process of drug movement through the body to reach sites of
action, metabolism, excretion *ADME: absorption, distribution, metabolism,
excretion
○​ Bioavailability: the proportion of a drug or other substance which enters the
circulation when introduced into the body and so is able to have an active effect
●​ Pharmacokinetics: absorption
○​ Movement of the drug into the bloodstream
○​ Onset of action: when drugs start to work, determined by rate and extent of
absorption
○​ Drug particles go into the cells via passive or active absorption
●​ Pharmacokinetics: distribution
○​ Movement of a drug from blood to various tissues of the body (like fat, muscle,
brain tissues)

, ○​ Distribution → protein binding, blood flow, body tissue affinity →
pharmacological effect
●​ blood brain barrier
■​ Not a lot of medications can get thru- have to be lipid soluble or have a
vehicle to get through
■​ An example would be carbidopa for parkinsons, it has a vehicle to get thru
BBB
○​ placenta
■​ Very easy to transfer things through placenta
●​ Critical thinking
○​ What do you think happens if someone has low serum albumin levels (protein)
and they're receiving a medication that is normally protein bound?
■​ Less effective drug because of fewer bonding sites
■​ Longer duration of action
■​ Drug toxicity more of the drug will be free and available in the
bloodstream because there are not enough spots to bond
●​ Pharmacokinetics: metabolism
○​ Process by which drugs are inactivated and biotransformed by the body
○​ Drugs in the liver are being biotransformed into small metabolites to be
excremented
■​ Can occur in other areas of the body but liver does the bulk of it
●​ Metabolism:
○​ Physiological factors
■​ Physiological factors that can influence drug metabolism including age,
sex, pharmacogenetics, enterohepatic circulation, nutrition, intestinal flora
and the cytochrome p-450 (CYO) enzyme system
●​ This enzyme is a liver enzyme
○​ prodrugs
■​ Inactive drugs that exert NO pharmacological effects until metabolized
■​ Codeine is inactive until converted into morphine (active form) by the
liver
○​ First pass effect
■​ Phenomenon that occurs when an oral drug passes through the GI tract and
is metabolized by the liver before it can be distributed → often smaller
amount or % of the active drug is “put back” into systemic circulation →
reduced bioavailability
●​ Pharmacokinetics: excretion
○​ Elimination of drug from the body
○​ Half life: how long it takes the body to eliminate half of the total amount of drug
administers

, ■​ Can be used to determine what % of the drug remains in body
○​ Example: oxycodone ½ life =3.2 hours so what does this mean?
■​ It takes 3.2 hours for the body to eliminate half the total amount of the
drug originally administered
●​ Serum drug levels
○​ Lab measurement of the amount of a drug in the blood at a particular time
○​ Monitoring needed for drugs that have a narrow therapeutic window:
■​ Vancomycin, digoxin, lithium, tacrolimus, phenytoin
●​ Mechanism of action
○​ How the drug or substance produces an effect on the body
○​ Ex furosemide a loop diuretic
■​ MOA= blocks reabsorption of sodium and chloride in proximal and distal
tubules of kidneys and in the loop of henle by inhibiting NaKCl
cotransporters. This inhibition results in increased excretion of water along
with Na, Cl, Mg, Ca H, and K ions
●​ This can cause dehydration, frequent urination
●​ More terms
○​ Pharmacodynamics: what does the drug do to the body? How the drug acts on our
cells
○​ Agonist: drug that produces effects similar to those produced naturally
■​ Ex: epinephrine acts on the heart to increase heart rate
○​ Antagonist: drug that inhibits cell function by occupying receptor sites and
percents natural body substances from occupying the site and activating functions
■​ Ex: beta blockers to decrease heart rate
○​ Pharmacogenomics: how genes affect a person’s response to drugs
●​ Adverse effect and sensitivity can be used interchangeably
●​ FDA pregnancy risk categories
○​ A: adequate, well controlled studies in pregnant women have not shown increase
risk of fetal abnormalities
○​ B: animal studies but not quite enough info
○​ X: the use of this product is contraindicated in pregnant women
○​ Black box warning: the boxed warning is one of the strongest actions. Serious
risks
●​ Drug antidotes

Connected book
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Assessment Technologies Institute The Comprehensive NCLEX-RN Review 19th Edition
Publisher: Unknown ISBN: 9781565331860 Edition: Unknown

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