Review Guides (all in 1 pdf) | latest Updated 2026-2027 | A+ Guide.
PHARMACOLOGY UNIT 1 NOTES
Pharmacodynamics – how does it work on you?
Pharmacokinetics – how does it move through you?
Pharmacokinetic Phases:
o 1. Absorption – through GI tract into vascular
o 2. Distribution – via bloodstream to organs/receptors/extremities
o 3. Metabolism – hepatic/splenic
o 4. Excretion – renal
ANTIPSYCHOTICS AND ANXIOLYTICS
Typical and Atypical
PEARL: Acetylcholine has grossly inhibitory effects on movement, and dopamine has grossly
excitatory effects on movement.
Treatment for Psychosis
o Psychosis S/S
Loss of perception of reality
Hallucinations +
Delusions +
Catatonia -
Anhedonia –
Self-care deficit –
Social withdrawal -
Positive – exaggeration of normal function
Negative – loss of normal function
Atypical Antipsychotics
o Newer
o Fewer side effects
o Decreased dopamine and serotonin
o Increased cost
o EPS
o Aripiprazole, Zyprexa, etc.
Typical Antipsychotics
o Extrapyramidal symptoms
o Been in use longer
o Decrease dopamine
o Inexpensive
o More side effects/adverse reactions
o Can cause metabolic syndrome - high cholesterol, high bp, high bg
o Haloperidol, Geodon
, Haloperidol (Haldol)
Antipsychotic (butyrophenone)
o Action: block dopamine receptors
o Use: treat psychosis, ADHD, Tourette’s
o Side effects: drowsiness, headaches, photosensitivity, urinary retention,
orthostatic hypotension, sexual dysfunction
o Adverse reactions: tachycardia, EPS, NMS, blood dyscrasias
o Contraindications: narrow-angle glaucoma, CNS depression, severe renal,
hepatic, cardiac disease, Parkinson’s disease, blood dyscrasias
o Interactions: increased sedation with alcohol, CNS depressants
Aripiprazole (Abilify)
Atypical antipsychotic (quinolonone)
o Action: blocks serotonin and dopaminergic receptors
o Use: positive and negative psychotic symptoms
o Side Effects: orthostatic hypotension, drowsiness, headache, tremor,
constipation, cough
o Adverse Reactions: EPS, NMS,
o Contraindications: dysrhythmias, blood dyscrasias, liver damage, diabetes,
Parkinson’s
o Interactions: increases the effect of hypertensives, diabetic drugs, other
antipsychotics, grapefruit juice, St. John’s Wort
NEUROLEPTIC MALIGNANT SYNDROME (NMS)
**Autonomic nervous system instability d/t prolonged antagonism of dopamine
receptors**
o S/S: Diaphoresis, labile bp, tachypnea, flushing, pallor, incontinence, AMS,
muscle rigidity, rhabdomyolysis, respiratory failure, hyperthermia
o Agitation and exhaustion of predisposing factors
o Potentially fatal
o TREATMENT:
Hydration, Behr hugger, discontinuation of antipsychotic
BLOOD DYSCRASIAS
- Imbalance of WBC, RBC, other blood products (ex. leukopenia, neutropenia,
thrombocytopenia)
- CBC and CMP can detect these
,EXTRAPYRAMIDAL SYNDROME
- S/S: stooped posture, facial rigidity, tremors at rest, shuffling gait, pill-rolling hand
motions, bradykinesia
- Acute Dystonia
o S/S: Involuntary contractions of muscles in extremities, face, neck, abdomen,
pelvis, larynx (laryngeal dystonia can be life-threatening)
o Dopaminergic-cholinergic imbalance in the basal ganglia
o Anticholinergic agents and benzodiazepines used to reverse or reduce symptoms
PHARMACOLOGY UNIT 1 PART 2
Pharmacokinetics
How does the drug move through you?
o Disintegration
Breakdown starts in the mouth
Time varies by compound, product, and pH of secretions
Enteric coated – takes longer to disintegrate; protective of gastric mucosa
o Dissolution
Drug particles combine with saliva/gastric liquid to form a solution
o Drug Absorption
Drug movement -> GI tract -> bloodstream
Factors Affecting Absorption
Pain, stress, exercise
Body composition
Blood circulation
Fat content, temperature
pH
Route of administration
Factors Affecting Oral Administration
First Pass Effect
o Metabolization of drug through the liver, lungs,
vasculature, GI tract, etc. before reaching the intended
receptors or systemic circulation
o Reduces the amount of the active drug available
o Varies between patients
Bioavailability
, o How much of the drug is available to do the intended
effect
o Factors Affecting Bioavailability
Absorption
First pass effect
Drug form
Route
Gastric mucosa and motility
Administration with food or other drugs
Changes in liver metabolism
Protein binding
Competition for receptors
Nutrition (low protein, anorexia, cachectic,
hydration status)
High Protein Binding Drugs (over 90% of the drug binds to a protein)
o Warfarin, Sertraline, Furosemide, Diazepam, etc.
Weak Protein Binding Drugs (less than 10% of the drug binds to a protein)
o Gentamycin, Metformin, Metoprolol, Lisinopril, etc.
**If two highly competitive protein binding drugs are given at the same time = less of
the desired effect for both drugs d/t competition = more free drugs in system = toxicity
in patient**
DRUG METABOLISM
o The process of the body chemically changing the drug into a form that can be
excreted
o Liver is the primary site of drug metabolism
o Half-life - the amount of time it takes for the drug in the body to be reduced by
half
o Loading Dose – bolus – a single larger dose of a medication to treat s/s. Drug
level maintained by therapeutic dosing
DRUG EXCRETION
o Elimination of the drug through the urinary tract
o Kidneys are the primary site of excretion.
Can also occur through saliva, sweat, expiration, breastmilk, feces, bile
o Creatinine clearance (CrCl) – the volume of blood plasma cleared of creatinine
per unit of time.