Carmencita R. Pacis, RN Man PHD

Carmencita R.
Pacis, RN MAN PhD

 is the study of the
effect of drugs on the
body.
 Drugs act within the
body to mimic the
actions of the body’s
own chemical
messengers.
 is the body’s physiologic
response to changes in
drug concentration at
the site of action.
 Potency – refers to the
amount of drug needed
to elicit a specific
physiologic response to
a drug.
 Efficacy – magnitude of
effect a drug can cause
when exerting its maximal
effect.
 Maximal efficacy – the
point at which increasing a
drugs dosage no longer
increases the desired
therapeutic response.
 Therapeutic Index –
(TI) describes the
relationship between
the therapeutic dose
of a drug (ED50) and
the toxic dose of a
drug (TD50)
 Therapeutic dose of a
drug – is the dose of a
drug that produces a
therapeutic response in
50% of the population.
 Toxic dose of a drug – is
the dose that produces a
toxic response in 50% of
the population.
 If the ED50 and
TD50 are close-
drug has a narrow
therapeutic index.
 require close
monitoring to
ensure patient
safety.
 Onset – is the time it takes
for a drug to reach the
minimum effective
concentration (MEC) after
administration.
 Time from drug
administration to first
observable effect (T0-T1)
 Peak – occurs
when it reaches its
highest
concentration in
the blood/plasma
concentration. T0-
T2
 Duration of action – is the
length of time the drug
exerts a therapeutic
effect.
 period from onset until
the drug effect is no
longer seen. T1-T3
 Drug concentration can be determined by
measuring peak and trough drug levels.
 peak – highest plasma concentration. 30
minutes after infusion.
 trough – lowest plasma concentration. 30
minutes prior to next infusion.
A. Drug-Receptor Interaction
 Certain portion of drug molecule (active site)
selectively combines with some molecular
structure (reactive site) on the cell to
produce a biologic effect
 Receptor site- drugs act at specific areas on

cell membranes; react with certain
chemicals to cause an effect within the cell
 “Lock and Key Theory”-
specific chemical (key)
approaches a cell
membrane and finds fit
(the lock) at receptor site-
affects enzyme system
within cell- produce
certain effects.
 Drug+Receptor=Effect
B. Drug-Enzyme
Interaction
 Interferes with
enzyme systems
that act as catalyst
from various
chemical reactions
 If single step in
one of enzyme
system is
blocked- normal
function is
disrupted
C. Nonspecific Drug Interaction
 Act by biophysical means that do not affect
cellular/enzymatic reactions.
 drugs do not bind to receptors but instead
saturate the water or lipid part of a cell-
drug actions occurs based on the degree of
saturation.
 Neutralization of stomach acid by antacids.
D. Selective Toxicity
 Specific action on cellular structures that
are unique to the microbe.
 All chemotherapeutic agent would act
only in one enzyme system needed for life
of a pathogen or neoplastic cell.
 It is essential to the pathogen but not to
the host.
Drug Response may be:
1. Primary- always desirable/physiologic
effects
2. Secondary- desirable or undesirable
Example: Diphenhydramine (Benadryl)
Primary effect: antihistamine; treat
symptoms of allergy
Secondary: Drowsiness
1. Rapid- few seconds
to minutes
- IV, SL, Inhalations
2. Intermediate- 1-2
hours after
administration
- IM, SC
3. Delayed/Slow-
several hours
after
administration
- Oral, rectal
1. Stimulation/Depression
 Stimulation- increased rate of cell
activity/ secretion from the gland
 T3/T4 for hypothyroidism
 Depression- decreased cell
activity and function of a specific
organ.
 Iodine, propylthiouracil
2. Replacement- replaces
essential body
compounds
Example: Insulin
3. Inhibition/Killing
of Organism
 Interfere with
bacterial cell
growth
 Example:
Antibiotics
4. Irritation
 Example: Laxative-
irritate the inner wall
of colon---increased
peristalsis---
increased defecation
1. Additive Effect-2 drugs
with similar actions are
taken for a doubled effect
 1+1=2
 Ibuprofen+ paracetamol=
added analgesic effect
 Codeine with
acetaminophen = better
pain control
2. Synergistic- combined effect
of 2 drugs is greater than the
sum of the effect of each drug
given alone; 1+1=3
 Aspirin = 30% analgesic effect
 codeine – 30% analgesic effect
 combination = 90% analgesic
effect
3. Potentiation- a drug that has no effect
enhances the effects of the second drug
 0+1=2
Alcohol enhances the analgesic activity of
aspirin.
Prozac + Zestril
4. Antagonistic- one drug inhibits the effect of
another drug
 1+1=0
 Tetracycline+ antacid= decreased absorption
of tetracycline
 Charcoal in alkaloidal poisoning
1.Side Effects
 Results from the
pharmacologic effects of
the drug
 Most common as a result
of lack of specificity of
action within the
therapeutic range.
2. Allergic Reactions
 Unpredictable adverse drug
effects; more serious
 Response to patient’s
immunological system to the
presence of the drug
 Do not occur unless the patient
has been previously exposed to
the agent/ chemical related
compound
3. Idiosyncratic Reaction
 Occurs when the patient is first exposed to
the drug
 Abnormal reactivity to the drug caused by a
genetic difference between the patient and
normal individual.
 patient with G6PD deficiency will have
anemia by using antioxidants.
4. Toxicity
 The degree to which a drug can be poisonous
and thus harmful to the human body.
5. Iatrogenic
responses
 Unintentional
responses as a result
of medical treatment
 Nephrotoxicity;
ototoxicity

Carmencita R. Pacis, RN Man PHD

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Carmencita R.

Pacis, RN MAN PhD

 Receptor site- drugs act at specific areas on

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