CORTEZ, MARK DARYLL F.

BSN-2A
Assignment no. 1: Fundamental concept of pharmacology
A. Discuss briefly the difference between the following concepts.
1. Pharmacokinetics
2. Pharmacodynamics
Pharmacokinetics deals with what "Body does to the drug" involving the drug's absorption,
metabolism, delivery and excretion. In pharmacokinetics, clinically relevant parameters such as plasma
half-life, plasma protein binding, bioavailability and the clearance rate of any particular drug are included.
While pharmacodynamics deals with what "Drug does to the body," which involves the
mechanism of the drug's action, how the drug can interact with the receptors and how it will change the
physiology of the particular system in which it will act to correct the pathology involved there.
For example. If we think of paracetamol (PCM) then its half-life is 2-3 hours, and excreted in
urine at clearance 5ml/kg/min its plasma protein binding is 25% so this data will be covering the
pharmacokinetic factors of PCM while its antipyretic action via inhibition of COX is showing its
pharmacodynamics.
B. How are you going to apply this concept in the practice of Nursing? (Not more than 500 words)
Nurses are an important group of health care providers in many inpatient and clinical settings and
are in the best position to provide guidance, information and monitor the effect of drugs on patients.
Pharmacokinetic principles are applied in a clinical setting during the treatment process to ensure that
every patient is treated safely and efficiently.
As a nursing student, I am aware that nurses are the one who keeps medical records, tracking
patient outcomes and working with physicians. Nurses play a significant role in prescribing drugs and
ensuring that each patient responds well to these therapies. Because of this significant obligation, it is
crucial for us nurses to understand the principles of pharmacodynamics and pharmacokinetics so that they
can understand from a physiological perspective how drugs interact with the body.
Pharmacokinetic principles are applied in a clinical setting throughout the treatment process to
ensure that every patient is treated safely and efficiently. As a drug administering nurse, one of the key
priorities is to ensure the proper medication and dosage to offer treatment, enhanced performance and
decreased toxicity in the body. In nursing practice, the implementation of pharmacokinetic principles
enables nurses to better understand the physical and chemical properties of drugs and how the reactions
are associated with the body
Nurses need a basic knowledge of pharmacodynamics in order to participate rationally in
achieving the therapeutic objective. In order to educate patients about their drugs, make PRN decisions,
and evaluate patients for drug responses, both beneficial and harmful, you must know about drug actions.
When explaining to prescribers about drug therapy, you will need to consider drug actions: whether you
think a patient is getting inappropriate medicine or a necessary drug is being denied, you may need to
support your conviction with evidence based at least in part on understanding of pharmacodynamics.
 Nurses really need to comprehend and apply pharmacokinetics and pharmacodynamics of drugs
in order to identify and monitor factors that may affect or alter drug absorption or consequent action to
have a proper patient care and management.

C. State at least 3 laws related to giving medications that protect the safety of the patient and of the
nurse, discuss each
I. REPUBLIC ACT NO. 6675 (Generics Acts of 1988)
This is an act to promote, require, and ensure the production of an adequate supply, distribution,
use and acceptance of drugs and medicines identified by their generic names.

The Generic Act of 1988 adheres to the following policies:

 To promote, encourage and require the use of generic terminology in the importation,
manufacture, distribution, marketing, advertising and promotion, prescription and
dispensing of drugs;
 To ensure the adequate supply of drugs with generic names at the lowest possible cost
and endeavor to make them available for free to indigent patients;
 To encourage the extensive use of drugs with generic names through a rational system of
procurement and distribution;
 To emphasize the scientific basis for the use of drugs, in order that health professionals
may become more aware and cognizant of their therapeutic effectiveness; and
 To promote drug safety by minimizing duplication in medications and/or use of drugs
with potentially adverse drug interactions

How this law protects the patient?

Construing the provision of the Generic Act of 1988 that the doctors should write down generic
meds in their prescription is clear. The law enjoin doctors in both private and public that they should
follow it.
In addition, the attitude of the patients also depends on what the doctors instructed them to do.
It’s the mindset of the patient should be conditioned. The conduct of information drive should be
emphasize also for the patient’s awareness.
Moreover, the promotion of the generic drugs by the doctors both private and public may create a
large impact on the buying behaviors of the consumers. It create much influence in their decisions.
Therefore, this law allow the patient to have an option to buy a medicine depending on his/her
budget while following the doctors’ prescription.
 II. REPUBLIC ACT 9185 ( COMPREHENSIVE DANGEROUS DRUG ACT OF 2002)
It is the policy of the State to safeguard the integrity of its territory and the well-being of its
citizenry particularly the youth, from the harmful effects of dangerous drugs on their physical and mental
well-being, and to defend the same against acts or omissions detrimental to their development and
preservation. In view of the foregoing, the State needs to enhance further the efficacy of the law against
dangerous drugs, it being one of today's more serious social ills.
How this law protects the patient?
There is some instances that a patient will be worried about the drug that being administered to
them. This law allows them to stop worrying about being killed by administering inappropriate drugs
because according to article 1. Section 3 “Any act of introducing any dangerous drug into the body of any
person, with or without his/her knowledge, by injection, inhalation, ingestion or other means, or of
committing any act of indispensable assistance to a person in administering a dangerous drug to
himself/herself unless administered by a duly licensed practitioner for purposes of medication’’.
In addition, There is no dispute that for many people, prescriptions are beneficial, even lifesaving
in many instances. This law will stop the unnecessary prescription of dangerous drugs because
unnecessary prescribing is an academically gentle euphemism for prescriptions for which the risks
outweigh the benefits, thus conferring a negative health impact on the patient. According to RA Act.
9185. Section 18. Medical practitioners who will prescribe patients whose cases do not require the use or
the dosage of dangerous drugs shall be penalised with imprisonment.
Therefore, this law guaranteed the safety of the patient regarding the drug administration and the
prescription of the assigned physician.
How this law protect the nurse?
This law expects the nurse to document the drug as administered. If giving a narcotics you are
responsible to assess the patient before and after and document it responsibly. This will served as an
evidence to protect yourself from malpractice. We should keep in mind that poor record keeping is a
common cause of duplicate and omitted doses; as such, it shares the responsibility for any harm that such
mistakes might produce. This is a particular problem with pain medications.

III. REPUBLIC ACT NO. 8203 (SPECIAL LAW ON COUNTERFEIT DRUGS)

An act prohibiting counterfeit drugs, providing penalties for violations and appropriating Funds
therefor. It defines counterfeit drugs as any product with the wrong or no active ingredients,
which result in the reduction of the drug’s safety, efficacy, quality, strength, or purity.
How this law protects the patient?

Proliferation of fake and unregistered drugs is a serious problem and the lack of
access to medicines as well as poverty are partly to blame. Drug counterfeiting thrives in
places where people cannot afford the high cost of medicines
 This law allows the individual to be safe in buying legit drugs in any pharmaceutical
store without any doubts or hesitant of buying. You will not be worried about being harm or
kill even if you take the drugs. Death and growing drug threat will be destroyed.

How this law protects the nurse?

As a nurse you are liable in the drugs you administer, this law allows nurses to be
responsible enough in administering drug. If the drug is not familiar, it will give them the
sign to find the reliable source and they can immediately inform the prescriber who ordered
the drug. This will allow the nurse to prevent imprisonment and this is to follow the section 5
of the law.

D. Which is more effective in terms of therapeutic effect; depend your answer;

1. Generic Drugs
2. Branded medications
A generic drug is a medication created to be the same as an already marketed brand-name drug in
dosage form, safety, strength, route of administration, quality, performance characteristics, and intended
use. These direct comparisons tend to demonstrate safety and efficacy, which ensures that a generic drug
works the same way as the brand-name counterpart and has the same health advantage. In other words,
the brand name equivalent can be replaced by a generic medicine similarly.
A lot of us are worried that generic drugs are often generally cheaper than brand-name products.
They ask if quality and efficiency have been compromised in order to make the products less expensive.
Generic drugs are required by the FDA (Food and Drug Administration) to be as safe and effective as
brand-name medicines. Actually, generic drugs are only cheaper because the manufacturers have not had
the expenses of developing and marketing a new drug.
If I have to choose which drugs I would use, definitely the generic drugs because it is less
expensive than the branded medication but the question is “which is more effective” and the answer to
that is both have the same therapeutic effect. And as we all know the generic and branded drugs may
differ on shape, color, packaging, flavoring, and inactive ingredients but these differences don’t mean a
generic drug is any less effective or work differently than a brand one

E. What is your idea on the preparation of drugs related to:

1. First generation
2. Second generation
3. Third generation
Give at least 3 examples of this drug
I. ANTIHISTAMIENE
 Antihistamines are drugs which treat allergic rhinitis and other allergies. Typically people take
antihistamines as an inexpensive, generic, over-the-counter drug that can provide relief from nasal
congestion, sneezing, or hives caused by pollen, dust mites, or animal allergy with few side effects.

A. 1ST GENERATION
These are the oldest H1-antihistaminergic drugs and are relatively inexpensive and widely
available. They are effective in the relief of allergic symptoms, but are typically moderately to highly
potent muscarinic acetylcholine receptor (anticholinergic) antagonists as well. These agents also
commonly have action at α-adrenergic receptors and/or 5-HT receptors.
This lack of receptor selectivity is the basis of the poor tolerability profile of some of these
agents, especially when compared with the second-generation H1-antihistamines. Patient response and
occurrence of adverse drug reactions vary greatly between classes and between agents within classes.
EXAMPLE:
1. Mepyramine
Also known as pyrilamine, is a first generation antihistamine, targeting the H1 receptor as an
inverse agonist. It rapidly permeates the brain often causing drowsiness. It also has anticholinergic
properties. However, its anticholinergic potency is negligible compared to its antihistaminergic activity; it
has an H1 to muscarinic Ki ratio of 130,000 to 1, compared to a ratio of 20 to 1 for diphenhydramine.
2. Chloropyramine
Chloropyramine is a classical first-generation antihistamine drug approved in Eastern European
countries for the treatment of allergic conjunctivitis, allergic rhinitis, bronchial asthma, and other atopic
(allergic) conditions.
3. Diphenhydramine
Diphenhydramine is an antihistamine mainly used to treat allergies. It can also be used for
insomnia, symptoms of the common cold, tremor in parkinsonism, and nausea
B. 2ND GENERATION
Second-generation H1-antihistamines are newer drugs that are much more selective for peripheral
H1 receptors as opposed to the central nervous system H1 receptors and cholinergic receptors. This
selectivity significantly reduces the occurrence of adverse drug reactions, such as sedation, while still
providing effective relief of allergic conditions.
The reason for their peripheral selectivity is that most of these compounds are zwitterionic at
physiological pH (around pH 7.4). As such, they are very polar, meaning that they are less likely to cross
the blood–brain barrier and act mainly outside the central nervous system. However, some second-
generation antihistamines, notably cetirizine, can interact with CNS psychoactive drugs such as
bupropion and benzodiazepines.
EXAMPLE:
 1. Loratadine
Loratadine, sold under the brand name Claritin among others, is a medication used to treat
allergies. This includes allergic rhinitis and hives.

2. Cerizine
Cetirizine, sold under the brand name Zyrtec among others, is a second-generation antihistamine
used to treat allergic rhinitis, dermatitis, and urticaria. It is taken by mouth. Effects generally begin within
an hour and last for about a day
3. Mizolastine
Mizolastine (Mizollen) is a once-daily, non-sedating antihistamine. It blocks H1 receptors and is
commonly fast-acting. It does not prevent the actual release of histamine from mast cells, it just prevents
it binding to receptors. Side effects can include dry mouth and throat.

C. 3RD GENERATION
Third-generation H1-antihistamines are second-generation antihistamines informally labeled
third-generation because the active enantiomer (levocetirizine) or metabolite (desloratadine and
fexofenadine) derivatives of second-generation drugs are intended to have increased efficacy with fewer
adverse drug reactions. Fexofenadine is associated with a lower risk of cardiac arrhythmia compared to
terfenadine. However, there is little evidence for any advantage of levocetirizine or desloratadine,
compared to cetirizine or loratadine, respectively
EXAMPLE:
1. Levocetizine
Levocetirizine, sold under the brand name Xyzal among others, is an antihistamine used for the
treatment of allergic rhinitis and long term hives of unclear cause. It is less sedating than older
antihistamines. It is taken by mouth.
2. Desloratadine
Desloratadine (trade name Clarinex and Aerius) is a tricyclic H1 antagonist that is used to treat
allergies. It is an active metabolite of loratadine.
3. Fexofenadine
Fexofenadine, sold under the brand name Allegra among others, is an antihistamine
pharmaceutical drug used in the treatment of allergy symptoms, such as hay fever and urticaria.
Therapeutically, fexofenadine is a selective peripheral H1-blocker.

II. ANTIBIOTICS
 An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important
type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in
the treatment and prevention of such infections. They may either kill or inhibit the growth of bacteria.
A. 1ST GENERATION
Have a narrow spectrum of clinical use (this means there are only a few organisms that they are
able to successfully treat with this class of penicillin) good for common gram-positive bacteria that cause
ear and throat infections, venereal diseases of gonorrhea and syphilis, and staph infections due to
Staphylococcus aureus that cause abscesses, endocarditis and pneumonia
EXAMPLE:
1. Cefazolin
Cefazolin, also known as cefazoline and cephazolin, is an antibiotic used for the treatment of
a number of bacterial infections. Specifically it is used to treat cellulitis, urinary tract infections,
pneumonia, endocarditis, joint infection, and biliary tract infections.

2. Benzylpenicillin
Benzylpenicillin, also known as penicillin G, is an antibiotic used to treat a number of bacterial
infections. This includes pneumonia, strep throat, syphilis, necrotizing enterocolitis, diphtheria, gas
gangrene, leptospirosis, cellulitis, and tetanus. It is not a first-line agent for pneumococcal meningitis
3. Phenoxymethylpenicillin
Phenoxymethylpenicillin, also known as penicillin V and penicillin VK, is an antibiotic useful for
the treatment of a number of bacterial infections. Specifically it is used for the treatment of strep throat,
otitis media, and cellulitis.
B. 2ND GENERATION
Have an extended or intermediate spectrum of clinical. Work equally as well as penicillin G class
plus effective against Escherichia coli, Proteus mirabilis and Haemophilus influenzae which are
associated with urinary, respiratory and ear infections. Not very effective against penicillinase- producing
organisms.
EXAMPLE:
1. Amoxicillin
Amoxicillin is an antibiotic used to treat a number of bacterial infections. These include middle
ear infection, strep throat, pneumonia, skin infections, and urinary tract infections among others. It is
taken by mouth, or less commonly by injection.
2. Ampicillin
Ampicillin is an antibiotic used to prevent and treat a number of bacterial infections, such as
respiratory tract infections, urinary tract infections, meningitis, salmonellosis, and endocarditis. It
may also be used to prevent group B streptococcal infection in newborns.

3. Loracarbef
 Loracarbef is a drug which is used to treat upper respiratory tract bacterial infections, chronic
bronchitis, pneumonia, sinusitis, pharyntitis and tonsillitis, skin absceses, urinary tract infections and
pyelonephritis caused by e. coli, s.

C. 3RD GENERATION
Third generation cephalosporin drugs are broad spectrum and the effective against both gram
positive and gram negative bacteria. However their optimum activity is against gram negative bacteria.
Used in the treatment of serious urinary, respiratory and bacteremic infections due to gram-negative
Pseudomonas aeruginosa and Proteus vulgaris not resistant to penicillinase-producing organisms.
EXAMPLE:
1. Carbenicillin
Carbenicillin is a drug which is used for the treatment of acute and chronic infections of the
upper and lower urinary tract and in asymptomatic bacteriuria due to susceptible strains of bacteria.

2. Ticarcillin

Ticarcillin is an antibiotic in a group of drugs called penicillins. Ticarcillin fights bacteria in the
body.The combination of ticarcillin is used to treat many different infections caused by bacteria, such as
urinary tract infections, bone and joint infections, severe vaginal infections, stomach infections, and skin
infections
3. Ceftazidime
Ceftazidime, sold under the brand names Fortaz among others, is an antibiotic useful for the
treatment of a number of bacterial infections.

III. CEPHALOSPORINS
Cephalosporins are a type of antibiotic. Antibiotics are medications that treat bacterial infections.
There are many types, often called classes, of antibiotics available. Cephalosporins are a type of beta-
lactam antibiotic. They can be taken orally or injected into a vein (intravenous injection), depending on
the infection.

What are the different generations?

Cephalosporins are grouped together based on the type of bacteria that they’re most effective
against. These groups are referred to as generations. There are five generations of cephalosporins.
To understand the differences between the generations, it’s important to understand the difference
between Gram-positive and Gram-negative bacteria.
One of the main distinctions between the two is their cell wall structure:
 Gram-positive bacteria have thicker membranes that are easier to penetrate. Think of their cell
wall as a chunky, loose-knit sweater.
Gram-negative bacteria have thinner membranes that are harder to penetrate, making them
more resistant to some antibiotics. Think of their wall as a piece of fine chain mail.

A. 1ST GENERATION

First-generation cephalosporins are very effective against Gram-positive bacteria. But they’re
only somewhat effective against Gram-negative bacteria.
 First-generation cephalosporins might be used to treat:
o Skin and soft tissue infections
o UTIS
o Strep throat
o Ear infections
o Pneumonia

EXAMPLE:
1. Cefalexin
Cephalexin is used to treat certain infections caused by bacteria such as pneumonia and other
respiratory tract infections; and infections of the bone, skin, ears, genital, and urinary tract. Cephalexin is
in a class of medications called cephalosporin antibiotics.
2. Cefadroxil
Cefadroxil is a broad-spectrum antibiotic of the cephalosporin type, effective in Gram-positive
and Gram-negative bacterial infections. It is a bactericidal antibiotic. It was patented in 1967 and
approved for medical use in 1978.
3. Cephradine
Cephradine is a beta-lactam, first-generation cephalosporin antibiotic with bactericidal activity.
Cephradine binds to and inactivates penicillin-binding proteins (PBP) located on the inner membrane of
the bacterial cell wall.
B. 2ND GENERATION
Second-generation cephalosporins also target some types of Gram-positive and Gram-negative
bacteria. But they’re less effective against certain Gram-positive bacteria than first-generation
cephalosporins are. They’re often used to treat respiratory infections, such as bronchitis or pneumonia.
EXAMPLE:
1. Cefaclor
Cefaclor, sold under the trade name Ceclor among others, is a second-generation cephalosporin
antibiotic used to treat certain bacterial infections such as pneumonia and infections of the ear, lung, skin,
throat, and urinary tract. It is also available from other manufacturers as a generic
 2. Cefuroxime

Cefuroxime, sold under the brand name Zinacef among others, is an antibiotic used to treat and
prevent a number of bacterial infections. These include pneumonia, meningitis, otitis media, sepsis,
urinary tract infections, and Lyme disease. It is used by mouth or by injection into a vein or muscle.

3. Cefprozil
Cefprozil is a second-generation cephalosporin antibiotic. It can be used to treat ear infections,
skin infections, and other bacterial infections. It comes as a tablet and as a liquid suspension.
C. 3RD GENERATION
Third-generation cephalosporins are more effective against Gram-negative bacteria compared to
both the first and second generations. They’re also more active against bacteria that may be resistant to
previous generations of cephalosporins.
The third generation also tend to be less active than previous generations against Gram-positive
bacteria, including Streptococcus and Staphylococcus species.
EXAMPLE:
1. Cefixime
Cefixime, sold under the brand name Suprax among others, is an antibiotic medication used to
treat a number of bacterial infections. These infections include otitis media, strep throat, pneumonia,
urinary tract infections, gonorrhea, and Lyme disease. For gonorrhea typically only one dose is required.
2. Ceftibuten
Ceftibuten is a third-generation cephalosporin antibiotic. It is an orally administered agent, with
two dosage forms, capsule or oral suspension. It is marketed by Pernix Therapeutics under the trade name
Cedax.
3. Cefpodoxime
Cefpodoxime is an oral, third-generation cephalosporin antibiotic. It is active against most Gram-
positive and Gram-negative organisms. Notable exceptions include Pseudomonas aeruginosa,
Enterococcus, and Bacteroides fragilis.
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https://www.citizen.org/article/misprescribing-and-overprescribing-of-drugs/

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