Introduction To Pharmacology

Introduction to
Pharmacology Course
NCM 107-Pharmacology
Learning Outcomes
• Define the common terms related to Pharmacology.
• Explain how drugs are named.
• Explain the concepts of drugs in terms of pharmacokinetics,
pharmacodynamics and pharmacotherapeutics.
• Identify the common drug interactions.
• Identify the common patient variables affecting drug action.
• List the various routes of administration and the role of
nurses in drug administration.
Definition of Pharmacology
• is the study of drugs and its origin,
chemical structure, preparation,
administration, action, metabolism and
excretion.
• The study of drugs that alter

functions of living organisms.
Introduction to Pharmacology
• Pharmacology
– fascinating and multifaceted discipline
– impacts
• chosen career in health care
• personal lives
– plays a part in our lives
• from our role as healthcare team members
• to that of consumers
NCM 107-Pharmacology 4
• Study of pharmacology covers a broad
spectrum of diverse, yet interrelated,
topics:
– botany
– molecular chemistry
– research
– toxicology
– legislation
– patient education
• The study of pharmacology covers:
– botany
– molecular chemistry
– research
– toxicology
– legislation
– patient education
Implication of Pharmacology
to Nursing
– Responsible for drug administration
– Responsible for the administration of

medications that they direct others to give.
– Ethical and legal responsibilities
Origins of Pharmacology Words
• Pharmacology
– the study of drugs and their interactions with
living organisms
– derived from
• the Greek word pharmakon (meaning medicine or
drug)
• suffix –logy (means the study of)
• Molecular pharmacology
– the study of the chemical structures of drugs
and the action of drugs at the molecular level
within cells.
• Pharmacodynamics
– the mechanism of action by which drugs
produce their effects (desired or undesired)
based on time and dosage
• Pharmacogenetics
– how the genetic makeup of different people
affects their responses to certain drugs
• Pharmacogenomics
– using genome technology to discover new
drugs.
• Pharmacokinetics
– how drugs move through the body in the
processes of absorption, distribution,
metabolism, and excretion.
• Pharmacotherapy
– using drugs to affect the body therapeutically.
Figure 1-1 Medications. Medications or medicines are drugs that are used to prevent, diagnose, or
treat symptoms, signs, conditions, and diseases. Steve Bartholomew © Dorling Kindersley.
Medical Uses For Drugs
• Drugs have three medical uses
– prevent disease
– diagnose disease
– treat symptoms, signs, conditions, diseases
• The study of these uses is know as
pharmacotherapy.
• Preventive Use:
– prevent the occurrence of diseases or
conditions.
– prophylaxis (Greek origin: to keep guard
before)
– Examples:
• prevent motion sickness prior to traveling
• prevent pregnancy
• vaccinations
• Diagnostic Use:
– by themselves
– in conjunction with procedures/tests
– Examples:
• Radiopaque contrast dye
• Cardiac Stress Test
Figure 1-2 Preventive use of drugs. Dramamine is an over-the-counter drug that is taken to
prevent motion sickness and vomiting. The word vomiting does not appear on the drug package, but
the word antiemetic, which means pertaining to against vomiting, appears at the top right.
Medical Use for Drugs
• Therapeutic use:
– used for symptoms, conditions, or diseases,
to control, improve, or cure
– Examples:
• antibiotic drugs
• analgesic drugs
• insulin
Drugs in Ancient Times
• Egyptians
– treated diseases – applied moldy
with bread to abrasions
• frogs’ bile • has some therapeutic
• sour milk basis
• Lizards blood • penicillin was extracted
• pigs’ teeth from a mold
• sugar cakes
• dirt
• spiders’ webs
• hippopotamus’ oil
• toads’ eyelids
• Chinese
– practiced healing – Shen Nong:
arts • wrote first Chinese book
• emphasized use of herbs on herbal medicine
and some minerals • contained 365 different
• herbal preparations herbal remedies
were used in
conjunction with
» acupuncture
» massage
» exercise
• few animal products
Figure 1-3 Chinese herbal medicines. This Chinese pharmacist prepares herbal medicines in much the
same way that his ancestors did, by using dried herbs which are then crushed into powder. He is making
four batches of the same medicine, each of which contains the same mixture of herbs. The wall behind
him holds drawers of many different types of dried herbs. In 1970, the Chinese Academy of Medical
Science compiled a collection of traditional herbal remedies. American pharmacists evaluated those
remedies and found that 45 percent of them were therapeutic, according to Western standards of
medicine. © Phil Schermeister/CORBIS.
• Other Cultures
– Native Americans of North America
• Aztec Indians of Mexico
– grew herbs with medicinal properties
– Montezuma maintained royal gardens of
medicinal plants.
– Greeks and Romans
• furthered the study of medicine
• important first steps
• Ancient drugs were prepared according to

standard recipes
– involved drying, crushing, and combining a variety of
• plants
• substances from animals
• Minerals
• The symbol Rx
– Latin word for recipe (meaning take)
– indicates a prescription
• the combining of ingredients to form a drug.
• Because little was known , it was a matter
of much guessing
• Some drug ingredients
– based on medical lore and superstition
– had therapeutic value
– others were worthless or harmful
Figure 1-4 Foxglove plant. This beautiful wild flowering plant is commonly known as foxglove, but
its scientific name is Digitalis lanata. The drug digitalis (which is no longer in use) came from this
plant, as does the modern drug digoxin (Lanoxin), which is used to treat congestive heart failure.
Modern Drugs Derived From
Natural Sources
• Drugs Derived from Plants

– foxglove plant
• derivative, drug digoxin (Lanoxin) for congestive
heart failure
– belladonna plant
• original source of two drugs
– atropine
– scopolamine
Natural Sources

– opium poppy
• used as a painkiller
• recreational drug
• sap from the seedheads contain opium
• source of illegal street drug heroin
• source of the prescription drug morphine
Modern Drugs Derived From Natural Sources
– Colchicine
• drug used to treat gout
• derived from autumn crocus known as Colchicum
autumnale
– Ephedrine
• present in the leaves of a bushy shrub
• Chinese burned leaves to treat respiratory ailments
• ephedrine present in over-the-counter bronchodilators
– Yams
• estrogen hormone replacement therapy drugs
Natural Sources

– daffodil bulbs
• The Alzheimer’s drug galantamine (Razadyne)
– Drugs dissolved into plant sources
• gums
• oils (many drugs contain a type of oil)
• bases
Table 1-1 Other plant sources of some modern drugs Getty Images, Inc.
Modern Drugs From
Natural Sources
• Drugs Derived from Animals

– Thyroid supplement drugs
• composed of dried (desiccated) animal
thyroid gland tissue
• used to treat hypothyroidism
Modern Drugs From
Natural Sources

– Pregnant Mare’s urine
• drug Premarin, a female hormone
replacement
• used to relieve the symptoms of menopause
• Pregnant Mare’s Urine
Modern Drugs From
Natural Sources

– Lanolin
• common ingredient of topical skin drugs
• obtained from the purified fat of sheeps
wool
– Insulin
• In the past, only source from ground-up
animal pancreas
Figure 1-6 NPH Iletin II insulin. The drug label clearly shows that the source of this insulin is
from pork (in vertical capital letters). Copyright Eli Lilly and Company. Used with permission.
Drugs Derived from Minerals
• Minerals
– individual dietary supplements
– Potassium: potassium chloride
• Trace minerals
– included in many multivitamin
supplements
– quinapril (Accupril) contains red iron oxide
as an inert ingredient
Drugs in the 1800s and 1900s
• Pharmacists prepared the drugs they
dispensed
– apothecary system of measurement
• minims
• drams
• ounces
• grains
• scruples
Drugs in the 1800s and 1900s
• Much has changed since then

– Many now completely synthetic
– Other natural drugs, to create new
drugs, have undergone
• chemical modifications
• molecular restructuring
– Pharmacists no longer prepares
medications
• dispenses them
provides
•NCM patient information and
107-Pharmacology 36
education.
Mislabeled and Dangerous Drugs
• Most physicians attempted to treat
patients accurately
– based on what little scientific knowledge was
available
– 2100 B.C., the Code of Hammurabi gave
severe penalties for malpractice
– throughout medical history ineffective,
mislabeled, and dangerous drugs have been
manufactured, advertised, and prescribed
• During the 1700s and 1800s

– commonly sold without regulation
– accompanied by extravagant claims of
cures
– often contained addicting ingredients
without its presence being listed
• opium
• morphine
• cocaine
Figure 1-7 Cocaine in a common drug. This 1885 advertisement was for the drug Cocaine
Toothache Drops. It was not known at that time that cocaine was a highly addictive drug. Children
as well as adults became addicted to this drug. National Library of Medicine.
• Consumer warnings did not exist:

– against the misuse of drugs
– possibility of addiction
– dangerous drug side effects
– prevailing dictum was “Let the buyer
beware”
Basic Concepts of
Pharmacology
• Drugs
– are chemicals that
alter
physiochemical
processes in body
cells.
– They can stimulate
or inhibit normal
cellular functions.
– Used
interchangeably with
medicines.
Drug Names
1. Generic or Nonproprietary Name:
name approved by the Medical or Pharmaceutical
Associations in the original country of manufacture
and is adopted by all countries.
e.g. Paracetamol
2. Brand name or trade name:
name given by the manufacturer of the drug
e.g. Adol or Panadol
3. Chemical name
name that describes the atomic or chemical
strucuture 42
Drug Names
Meperidine
Demerol
Ethyl-1-methyl-4-
phenylisonipecotate 43
hydrochloride
44
Example
Exercise 1: Reading the Label
45
• The drug label
and package
inserts
contain
information
needed to
perform
dosage
calculations.
• Read the
label carefully.
NCM 107-Pharmacology 6-46
Locating Information
• Drug name
• Form of the drug
• Dosage strength
• Total amount in the
container
• Warnings
• Route of administration
• Storage requirements
• Manufacturing information

Drug Name
• Generic Name Levothyroxine Sodium
(generic name)
– Official name
– Must appear on label
– National listings
• United States Pharmacopeia (USP)
• National Formulary (NF)

Drug Name (cont.)
• Trade Name
Synthroid
– Brand name (trade name)
– Used to market the drug
– Property of drug company
• Registered mark ® - name registered with the
U.S. Patent and Trademark Office
– Drug may be manufactured by more than one
company.

Drug Name (cont.)
Rule 6-1
You must know both the generic and trade
names of drugs.
Example
Example Vicodin® is a narcotic painkiller
Generic name: hydrocodone bitartrate and
acetaminophen
Other trade names: Anexsia®, Lortab®, Zydone®
Form of the Drugs
• Solid oral medications
– Tablets, capsules, gelcaps, caplets
• Liquids
– Oral, injections, inhalants, drops, sprays,
mists
• Other
– Ointments, creams, lotions, patches,
suppositories, shampoos
Dosage Strength
• Labels include information about the
amount of drug present.
• The amount of drug present per dosage

unit combined with information about the
form identifies the drug’s dosage
strength.

Dosage Strength (cont.)
• Solid medications
– Dosage strength is the amount of drug
present per tablet, capsule, or other form.
Dosage strength
10 mg/1 tab

Dosage Strength (cont.)
• Liquid medications
– Dosage strength is the amount of drug
present in a quantity of solution.
– Amount of solution varies per dosage unit.
– Pharmaceutical companies manufacture

meds with dosage strengths that match
commonly prescribed doses.
• Reduces the risk of error when calculating
dosages.

Combination Drugs
• Generic names and

dosage strengths
of all components
must appear on the
label.
• If available, the trade name may be used to

order combination drugs.

Total Number or Volume in
Container
Many meds are packaged in unit doses
One tablet / section of package
Vial with 2 mL of solution for injection
Multiple-dose containers
Prescription medications
Non-prescription medications

Total Number or
Volume in Container
(cont.)
Rule 6-2
Do not confuse the total amount of drug in
the container with the dosage strength.
The
The container
container may
may hold
hold 100
100 tablets
tablets and
and each
each
tablet
tablet has
has aa dosage
dosage strength
strength of
of 2.5
2.5 mg
mg per
per tablet.
tablet.

Route of Administration
Directions for route of administration
may be on the label.
Tablets, capsules, gelcaps, caplets
Swallow
Sublingual
Liquid medications
Chewable
Oral
Injections
Inhalants
Topical / transdermal
Error Alert!
Give the right medication by the

right route.
– Do not administer drugs by any route

other than described in the drug label
or on the order.

Warnings
• Help to administer drugs safely
• Types of warnings
– For specific groups, i.e. children, elderly
– For controlled substances
– About combining with other drugs or
products
• Proper disposal following facility

guidelines
Storage Information
• Maintain the drug’s potency and

effectiveness
• Information on label
– Storage temperature
– Exposure to light
– Length of time drug will remain potent after
container has been opened
• Improper storage can trigger a chemical

reaction and make the drug unusable
Manufacturing Information
• Labels
– Regulated by the U.S. Food and Drug
Administration (FDA)
– Must include:
• Name of the manufacturer
• Expiration date
• Lot number
–
When and where a drug was produced
–
Trace problems

Manufacturing
Information (cont.)
Rule 6 - 3
Never use a drug after the expiration date
has passed.
Older drugs may become chemically
unstable or altered.
Incorrect dose
Effect different than intended one
Educate patients to check expiration dates.

Information About
Reconstituting Drugs
• Powder forms must be reconstituted and
other drugs require dilution prior to use.
• Directions for reconstituting or diluting
are on the label.
– Type and amount of diluent
– Solution strength once reconstituted
– Time period for safe administration

Error Alert!
Consider the age and health needs of

the patient when administering a drug.
– If another form of a drug is better suited to a

patient’s needs, consult the physician or
pharmacist about changing the order.

Package Inserts
• Complete and authoritative information
about a medication
• Sections
– Description – chemical and physical
– Clinical Pharmacology – actions of the
drug
– Indications and Usage
Package Inserts (cont.)
– Contraindications
– Warnings – serious side effects
– Precautions
– Adverse Reactions – anticipated side

effects

Package Inserts (cont.)
– Overdosage – effects and instruction for
treatment
– Dosage and Administration
– Preparation for Administration
– Manufacturer Supply – dosage strength

and form availability
Practice
What is the generic name of the drug?
Answer celecoxib
What is the
dosage strength?
Answer 50 mg capsules
How should this

drug be stored?
Answer At 25°C (77°F) excursions
permitted to 15-30°C (59-86°F)
Oral Drugs
• Solid or liquid forms
• Tablets
– Scored – can be broken into equal portions
– Chewable – should be chewed to be effective
– Enteric-coated – must be swallowed whole
– Capsules
•
Some should be swallowed whole
•
Others may be opened and mixed with food
– Controlled-release – usually swallowed whole
Oral Drugs (cont.)
Rule 6 - 4
Tablets may be broken to give a partial
dose only when the tablets are scored.
Never crush or break
Enteric-coated medications
Controlled-release medications (CR)
Extended-release medications (ER or XL)
Sustained-release medications (SR)

Oral Drugs (cont.)
• Liquids
– Oral solutions
– Syrups – Dosage strength

corresponds to a
– Elixirs specific volume of
the solution –
– Oral suspensions
500 mg / 10 mL
– Simple liquids

Oral Drugs (cont.)
Rule 6 - 5
When reconstituting a drug, you must
write your initials and the time and date
of reconstitution on the label.
shf 7/21/08
@ 1400
Practice
What is the trade name of
the drug?
Answer Zetia®
What is the
usual
dosage?
Answer 1 tablet
daily
What is the dosage strength? 10 mg/tablets

Parenteral Drugs
• Packaged as
– Single-use ampules or vials
– Single-use prefilled syringes
– Multi-use vials
• Small containers have small labels

– Difficult to read
– Review package insert

Parenteral Drugs (cont.)
• Routes
– Intradermally (ID)
– Intramuscularly (IM)
– Intravenously (IV)
– Subcutaneously (Sub-q)
– Inhalants
– Transdermal Delivery

Parenteral Drugs (cont.)
• Dosage strength is the amount of

drug per dosage unit
– Examples
 mg / tablet – units / mL
 mg / mL – gm / mL
 mEq / mL – gm / tablet

6-78
Practice
What is the dosage strength
of the drug?
Answer 20 mg/2 mL
What is the drug’s name?
Answer Furosemide
What is the route of administration?
Answer IM or IV
Drugs Administered by Other
Routes
• Sublingual (under the tongue)
• Buccal (between the tongue and cheek)
• Rectal
• Vaginal • Eye or Ear drops
• Topical • Transdermal
• Inhalants

6-80
Drugs Administered by Other

Routes (cont.)
• Dosage strength varies with type of
drug and how it is administered
– Examples
• Transdermal – 0.2 mg/hr (the amount
absorbed over time through the skin)
• Inhalent – 84 mcg / metered spray
6-81
Apply Your Knowledge
1. What is another name for the brand

name?
Answer trade name
2. What is the official name of a drug?
Answer generic name
6-82

True or False
F Enteric-coated tablets can be crushed and
mixed with food. This would allow the drug to be
absorbed sooner than intended.
F All capsules may be opened and mixed with
food. Some capsules should be swallowed
whole.
T Parenteral forms of drugs includes transdermal

and inhalants.
6-83

True or False (cont.)
T The warnings section of a package insert lists
the more serious, possibly fatal, side effects of
a drug.
F You may administer a drug after the

expiration date has expired if you do not
have any new ones.
It may not provide correct dosage strength or have
an effect different than intended.
True or False (cont.)
F You can use as much solution as you need to

reconstitute a powdered medication.
You must follow the directions for reconstituting a

drug that are on the label or in the package insert.
The amount of drug in a container is not the
T same as the dosage strength.

Routes of Drug
Administration
1: Enteral Medications
• administered directly into the G.I.T. through
the oral, nasogastric (NG) or rectal routes
Advantages:
Convenience for nurse & patient
Most medications are available in oral route
Inexpensive to make oral preparations
Can be removed by gastric lavage or make to
vomit
Disadvantages
• cannot be administered to very
nauseated/vomiting or unconscious
persons
• some loose their effectiveness if mixed
with gastric secretions
• onset of action may vary due to changes in
absorption in the GIT
Forms of Oral Medication
• Capsules-are gelatin containers that hold
powder or liquid medicine.
• Elixirs- clear liquids made up of drugs dissolved
in alcohol & water with coloring & flavoring
agents added.
• Emulsions-are solutions that have small
droplets of water & medication dispersed in oil,
or oil & medication dispersed in water.
• Lozenges- are medicines mixed with a
hard sugar base to produce a small,
hard preparation of various shapes &
sizes.
• Suspensions- are liquids w/ solid,

insoluble drug particles dispersed
throughout.
89
• Syrups-are liquids w/ a high sugar content
designed to disguise the bitter taste of a
drug. Pediatric use.
• Tablets-dried, powdered drugs compressed

into small shapes.
2.Parenteral Administration
• Reasons:
1. When the patient cannot take an oral
medication
2. When the medication must be given quickly
3. When medication might be destroyed by
gastric enzymes
4. When medication must be given at a
controlled rate
5. When the medication is not available in an
enteral form.
Parenteral Medications
• INTRAMUSCULAR – 90 °
– Provides faster medication absorption because of
muscle’s greater vascularity
• SUBCUTANEOUS- 45 °
– Placing medications in the loose connective tissue
under the dermis
• INTRADERMAL- 15 °
Other Routes of
Administration
• Topical administration – skin
– Cleanse
– Soften
– Disinfect
– Lubricate
– E.g. clotrimazole –cream
dermatophytosis
– atropine- eye-dilate the pupil
• Transdermal route -
nitroglycerin (skin patch) systemic
vasodilation in angina
Other Routes of
Administration
• Inhalation – provides rapid delivery of
drugs to a large area of mucus
membranes & tissues of the respiratory
system.
– Anesthesia
– Bronchodilators
• Intranasal – desmopressin for diabetes
insipidus
– Calcitonin- a peptide hormone for tx of
osteoporosis
Other Routes of
Administration
• Intrathecal injection- introduction of hypodermic
needle into the subarachnoid space for the purpose
of instilling a material for diffusion throughout the
spinal fluid.
• Intraventricular- space into the ventricle
– Both gains access to the CSF e.g. amphotericin B

–in meningitis

Introduction To Pharmacology

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Introduction To Pharmacology

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Introduction to

• The study of drugs that alter

– Responsible for drug administration

– Responsible for the administration of

– Ethical and legal responsibilities

• Ancient drugs were prepared according to

• Drugs Derived from Plants

• Drugs Derived from Plants

• Drugs Derived from Plants

• Drugs Derived from Animals

• Drugs Derived from Animals

• Drugs Derived from Animals

• Much has changed since then

• During the 1700s and 1800s

• Consumer warnings did not exist:

NCM 107-Pharmacology 6-47

NCM 107-Pharmacology 6-48

NCM 107-Pharmacology 6-49

• The amount of drug present per dosage

NCM 107-Pharmacology 6-52

NCM 107-Pharmacology 6-53

– Amount of solution varies per dosage unit.

– Pharmaceutical companies manufacture

NCM 107-Pharmacology 6-54

• Generic names and

• If available, the trade name may be used to

NCM 107-Pharmacology 6-55

NCM 107-Pharmacology 6-56

NCM 107-Pharmacology 6-57

Give the right medication by the

– Do not administer drugs by any route

NCM 107-Pharmacology 6-59

• Help to administer drugs safely

• Proper disposal following facility

• Maintain the drug’s potency and

• Improper storage can trigger a chemical

NCM 107-Pharmacology 6-62

Educate patients to check expiration dates.

NCM 107-Pharmacology 6-63

NCM 107-Pharmacology 6-64

Consider the age and health needs of

– If another form of a drug is better suited to a

NCM 107-Pharmacology 6-65

– Warnings – serious side effects

– Adverse Reactions – anticipated side

NCM 107-Pharmacology 6-67

– Dosage and Administration

– Preparation for Administration

– Manufacturer Supply – dosage strength

How should this

NCM 107-Pharmacology 6-71

– Syrups – Dosage strength

NCM 107-Pharmacology 6-72

What is the dosage strength? 10 mg/tablets

• Small containers have small labels

NCM 107-Pharmacology 6-75

NCM 107-Pharmacology 6-76

• Dosage strength is the amount of

NCM 107-Pharmacology 6-77

NCM 107-Pharmacology 6-79

Drugs Administered by Other

• Inhalent – 84 mcg / metered spray

Apply Your Knowledge