* FUNDAMENTAL

CONCEPTS OF
PHARMACOLOGY
 Pharmacology is the study of drugs and
their actions on the body

 Pharmacology is the study of the biological effects of chemicals.

 Drugs are chemicals that are introduced into the body to cause
some sort of change.
 Health care providers focus on how chemicals act on living
organisms.
 Nurses deal with pharmacotherapeutics, or clinical
pharmacology.
 Some drug effects are therapeutic, or helpful, but others are
undesirable or potentially dangerous (adverse effects)
• Pharmacology
Pharmacon Drug
- Study
Logos
-
• It is defined as the study of the substances which
interact with living system by activating or
inhibiting normal body processes.
• Drug : A chemical substance that is used for
diagnosis, prevention & treatment of
disease.
(French: Drogue -Dry herb)
Contraceptives
Alter
General Anaesthetics Physiological
Vaccines State

• WHO : “Any substance or product that is used

or intended to be used to modify or explore
the physiological system or pathological
state for the benefit of the recipient”
* Natural Sources
* Plants
* Synthetic version of the active chemical found in a
plant
* Main component of the growing alternative therapy
movement

*Sources of Drugs
Drug examples : Plants
Sources of Drugs #2
 Natural Sources (cont.)
o Animal products
 Used to replace human chemicals that are not
produced because of disease or genetic problems
 Genetic engineering
 Many of these preparations are now created
synthetically
Sources of Drugs #3
 Natural Sources (cont.)
o Inorganic compounds
 Salts of various elements can have therapeutic
effects in the human body
 Synthetic Sources
o Genetic engineering alter bacteria to produce
chemicals that are therapeutic and effective
o Original prototypes
Drug examples : Inorganic
* therapeutic use (e.g., antidepressants)
* pharmacologic profile (e.g., selective serotonin reuptake
inhibitors).
* Most texts use a combination of therapeutic and
pharmaceutical classifications
* Healthcare workers use both terms when discussing
medications
* Other methods of classification are used for various
purposes.
* For example, the Schedule of Controlled Substances that
classifies drugs by risk for abuse

*Drug Classifications
• Therapeutic classes are broad categories
based on therapeutic intent
examples: Antianginals, sedatives, and
analgesics
• Therapeutic classes include several
pharmacologic classes
The therapeutic class antihypertensive has
at least 13 pharmacologic classes
*THERAPEUTIC
CLASSIFICATION
* Drugs grouped by therapeutic class work in very
different ways
They are not chemically similar
They have different mechanisms of action
* Therapeutic class is useful when speaking of
drugs in a general way
“Antihypertensive drugs save lives”
“You will need antihypertensive medication”
* Pharmacologic classification is based on
mechanism of action and includes only those drugs that
have the same or similar mechanism of action.
For example, “angiotensin-converting enzyme
inhibitors” (ACE inhibitors) tell you exactly how
the drugs works—they inhibit the enzyme that
converts angiotensin I to angiotensin II

*
Pharmacologic Classifications
* Pharmacologic classifications describe a drug’s
properties in a specific way
* Pharmacologic class is necessary when determining
treatment; a nurse might say
“An ACE inhibitor is more desirable than a beta blocker”
“Your heart won’t race as much because the beta blocker
prevents beta-adrenergic receptors in the heart from being
stimulated”
* Generic names of drugs in the same
pharmacologic class often have the same suffix
* Beta blockers, the pharmacologic class of
medications in the therapeutic class of
antihypertensives, end in “-olol”

*Clues to
Pharmacologic Class
* Indications
* Mechanism of action
* Contraindications and precautions
* Interactions
* Adverse reactions and side effects
* These attributes are similar or identical in a
pharmacologic class; if you know about one drug
in a class, you will have some knowledge of
other drugs in the class

*Drugs in a Pharmacologic
Class Have Similar Attributes
* Dosages
* Time action profile
* Availability

* Drugs in a Pharmacologic
Class May Differ
*Indications
 Alone or with other agents in the management of
hypertension

*Actions
ACE inhibitors block the conversion of angiotensin I
to the vasoconstrictor angiotensin II
ACE inactivates the vasodilator bradykinin another
vasodilatory prostaglandins
ACE inhibitors increase plasma renin levels and reduce
aldosterone levels; net result: systemic vasodilation

*
Indication and Action
of ACE Inhibitors
* Law requires that all preparations called by the
same drug name must be uniform strength,
quality, and purity. This ensures that the
patient will obtain the same quality, purity,
and strength of medication from the pharmacy
each time it prescribed with the United States.

*DRUG STANDARDS
The process of testing, developing and
marketing of medicines has to regulated
to protect the interests of the public.
Major regulatory bodies include the Food
& Drug Administration (FDA) in the US
and the European Medicines Agency
(EMA) in Europe. *
Drug regulation
Drug Evaluation
 Preclinical Trials
o Chemicals tested on laboratory animals
 Phase I Studies
o Chemicals tested on human volunteers
 Phase II Studies
o Drug tried on informed patients with the disease
 Phase III Studies
o Drug used in vast clinical market
 Phase IV Studies
o Continual evaluation of the drug
Legislation
Pregnancy Categories
Controlled Substances #1
 The Controlled Substances Act of 1970
o Control over the coding of drugs and the
enforcement of these codes to the FDA and the Drug
Enforcement Agency (DEA), a part of the U.S.
Department of Justice.
 Prescription, distribution, storage, and use of these
drugs are closely monitored.
 Local policies and procedures might be even more
rigorous.
Controlled Substances #2
Generic Drugs
 Chemicals that are produced by companies involved
solely in the manufacturing of drugs
 Bioavailability of the drug
 “Dispensed as written”
o Important in drugs that have narrow safety margins
Orphan Drugs
 Drugs that have been discovered, but are not financially
viable and therefore have not been “adopted” by any
drug company
 The Orphan Drug Act of 1983
Over-the-Counter Drugs #1
 Products that are available without prescription for self-
treatment of a variety of complaints.
o Some of these agents were approved as prescription drugs.
o Later were found to be very safe and useful for patients
(example: loratidine).
o Many of these drugs were “grandfathered.”
Over-the-Counter Drugs #2

 Nurses should consider several problems related to OTC drug

use:
o Taking these drugs could mask the signs and symptoms of
underlying disease, making diagnosis difficult.
o Taking these drugs with prescription medications could
result in drug interactions and interfere with drug therapy.
o Not taking these drugs as directed could result in serious
overdoses.
Sources of Drug Information #1
 Drug Label
o Drug labels have specific information that identifies a
specific drug
o Understanding how to read a drug label is essential
 Package Insert
o Prepared by the manufacturer
o Contains all of the chemical and study information that led
to the drug’s approval
o Difficult to understand and read
Sources of Drug Information #2
 Reference Books
o Physician’s Drug Reference (PDR)
o Drug Facts and Comparisons
o AMA Drug Evaluations
o Lippincott’s Nursing Drug Guide (LNDG)
 Journals
 Internet
• The study of what the drug does to the
body
• It is the quantitative study of the
biological and therapeutic effects of
drugs.

*PHARMACODYNAMICS
*Drug actions:
The cellular processes involved in the drug and cell interaction.
*Drug effect:
The physiologic reaction of the body to the drug.
* Onset
The time it takes for the drug to elicit a
therapeutic response
* Peak

*TERMS
The time it takes for a drug to reach its maximum therapeutic
response
* Duration
The time a drug concentration is sufficient to elicit therapeutic
response
• Toreplace or act as substitutes for missing
chemicals.
• To increase or stimulate certain cellular
activities
• To depress or slow cellular activities
• To interfere with the functioning of foreign cells,
such as invading microorganisms or neoplasms
leading to cell death. (chemotherapeutic drugs).

*
Four ways on how drugs works in the body
*Receptor Sites
*Drug – Enzyme
Interactions
*Selective toxicity
• Affinity: Inherent ability of the drug to bind with
the receptor

• Efficacy (Intrinsic activity): Inherent ability of the

drug to induce a physiological response

• Potency: An expression of the activity of the drug,

in terms of the concentration or amount needed to
produce a defined effect
• Specific macromolecular components of the
cell which when binds with ligand produces
positive or negative biological response
• Situated - on the surface / inside the cell

*Receptors
*THERAPEUTIC INDEX