Orientation to Pharmacology

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Orientation to Pharmacology

• Lu-Tai Tien, Ph.D.

Department of Medicine School of Medicine Fu-Jen
Catholic University
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Ready to study pharmacology?

• Pharmacology is a science that draws on
  information from multiple disciplines, including
  anatomy, physiology, psychology, chemistry, and
  microbiology etc.

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Four basic terms

• Drug
• Pharmacology
• Clinical pharmacology
• Therapeutics/pharmacotherapeutics

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Properties of an ideal drug

• Effectiveness
• Safety
• Selectivity

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Additional properties of an ideal drug

• Reversible action
• Predictability
• Ease of administration
• Freedom from drug interactions
• Low cost
• Chemical stability
• Possession of a simple generic name

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No drug is ideal

• No drug is safe.
• All drugs produce side effects.
• Because medications are not ideal, all members of
  the healthcare team must exercise care to promote
  therapeutic effects and minimize drug-induced
  harm.

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Why should a nursing student learn about drugs?
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Key point

• You are the patients last line of defense
  against medication errors.

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Evolution of nursing responsibilities reading
drugs

• Right drug
• Right patient
• Right dose
• Right route
• Right time

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Contributions from a nurse

• Patient care and patient education
• Achieving the therapeutics objective of maximum
  benefit with minimum harm
• Application of the nursing process in drug
  therapy is directed at individualizing treatment,
  which is critical to achieving the therapeutic
  objectives.

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Pharmacokinetics

• ?????
• ???????????????????????????????

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????

• ????????
• ??
• ????
• ??????
• ??????????
• ????
• ????
• ????
• ?????????
• ??
• ????
• ??????
• ?????????
• ??????????

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?????????

• ????? (Absorption)
• ????? (Distribution)
• ????? (Metabolism)
• ???? (Excretion/elimination)

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?? (Absorption)

• ??????????????????, ??????????????????
• ??????????
• ???? ????
• ???? ????
• pH ?????????
• ?????????????
• ???????????
• ???????
• ?????????
• ??????????

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????? (Bioavailability)

• ????????????????
• ?? ?? 100 ??????????????, ?? 70 ????????????,
  ??????? 70

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????????

• ??????????????? 100 ??
• ??????? (????)?????????????????????????
• AUC area under curve ??????

From Lippincotts 3rd edition
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??????????

• ???????
• ????????????????????
• ??????
• ???? No
• ???? No
• ???? ????? Yes
• ??????
• ?? Penicillin G ??? pH ???????????
• ?????
• ????,????,??????

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?? (Distribution)

• ?????????????????????(????)???????????
• ???
• ???????
• ????????

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???? (Vd)

• ????????????
• Vd D/C
• C ?????????
• D ???????

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Example

• ?? 25 mg ????????,????????? 1 mg/L ,???????

25 mg
Vd

25 L
1 mg/L
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?? (Metabolism)

• ??????? (biotransformation)
• ?????(????)?????????????????
• ??????????? (prodrugs), ???????????????????
• ??????????????

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?? (Excretion/elimination)

• ????????????????????
• ????????????????????????

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??? (Clearance)

• ??????,????????????????
• ????? (Clp)
• Clp Vd (????) Kel (??????)
• ?????????
• ?????? ????? ????? ????? ???????

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Pharmacodynamics

• ?????
• ?????, ????????????
• ????, ?????????????????????

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????? (Drug receptors)

• ?????????????????????????? (Receptor)

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The four primary receptor families
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Agonist and antagonist

• Agonist (???)
• ??????????????????????, ????????
• Antagonist (???)
• ????????????????, ????????????????????????

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???????????

• ?????????
• ?????????????
• ???????????????????

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??????
Logarithmic scale
Linear scale
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Efficacy (????)Potency (??)
Potency Morphine gt Meperidine
Efficancy Meperidine gt Pentazocine
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Affinity (???)

• The strength of the attraction between a drug and
  its receptor
• ????????????
• ???? Kd ??

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ED50

• The dose for average effective dose
• The dose at the middle of the frequency
  distribution curve

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LD (Lethal dose)

• ????
• LD50 ?? 50 ???????

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The therapeutic index

• ????
• ??????????????????????????
• Therapeutic index (TI)LD50/ED50
• ???????????????

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Study question

• ???????, ??????????
• (A) ????
• (B) ????
• (C) ??
• (D) ????
• Answer (C)