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Sources of Drugs:
- Plants
o Red yeast rice: lowers cholesterol
Lovastatin uses same mechanism of action
o Estrogen replacement therapy for bone density increased risk for cancer
Natural product had the same risk
- Animals
- Synthetic chemicals
o Thyroid hormone less adverse effects
- Genetically engineered chemicals
Plants:
- Date to primitive times
- Classified according to their physical and chemical properties
o Alkaloids
o Glycosides
o Gums
o Oils
o Resins
Genetically engineered chemicals
- Genetically engineered drugs: developed using DNA technologies.
o Insulin made from recombinant DNA increased the purity
The more pure the drug the less adverse effects
- Genomics: the study and identification of genes and gene function.
o Researchers are now able to manipulate the chemical formulas of drugs to produce:
Specifically targeted drugs with fewer adverse effects.
- Proteomics: the study of protein structure and function.
o This technology is essential in biomarker discovery.
- Transcriptomics: the study of the transcriptome
o Aids in understanding the development and differentiation of a cell
- Metabonomics: the study of metabolic responses to drugs, environmental changes, and diseases.
o Can possibly predict an individual patients response to drug treatment.
Genetics for drug Metabolism:
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Drug Nomenclature
- Chemical name
o Precisely describes the drugs atomic and molecular structure
- Generic name
o Nonproprietary name; identifies the drugs active ingredient.
Example: Furosemide
Trade name
o Brand or proprietary name
Example: Lasix
Enteric coated drugs and sustained-release form should never be chewed, crushed, or broken.
Sucrose-containing syrups may increase the risk of gingivitis or dental caries (over time)
Check for proper placement NG or G tube prior to administration
Follow the cardinal rules of drug administration.
Parenteral Route
- Intramuscular administration (Flu shot)
o Injecting drugs into certain muscles.
o Onset of action faster than with oral meds
o The most common sites for IM injection:
Ventrogluteal
Deltoid rectus femoris
Vastus lateralis muscles.
- Subcutaneous administration (Insulin or Heprin)
o Under the skin into fat and connective tissue.
o Must be highly soluble, low volume, and nonirritating
- Intravenous administration
o Directly into the bloodstream
o Ensures prompt, sometimes immediate, onset of action
o Eliminates the uncertainty associated with varied absorption rates from other routes.
o One of the most dangerous routes.
IM sites
Subq sites
**Remember**
- Drugs that are highly lipophilic, small, and unionized get across biological membrane
o Opioids potential for abuse b/c go to CNS (cross BBB)
o Anti-diarrheal hydrophilic/ionized slows down receptors to small intestine
- Lack of therapeutic effect absorption was most likely the cause
- Early onset of a drug metabolism most likely the cause
- First Pass Effect: some of the drug is metabolized by the liver deactivates some of the medication
o How much drug you lose going through metabolism
o Lowers the amount of drug to the target area
o Oral meds
- Subq injections: contain a smaller volume
o Ex: insulin
o Rates are varied upon different locations
Stomach arm leg (fastest to slowest)