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Learning objectives After studying this chapter you should be able to: Understand what is meant by pharmacokinetics and pharmacodynamics. Describe aspects of absorption, distribution, metabolism and excretion of a drug. List the principal routes of drug administration. Name the phases in hepatic metabolism. Describe what is meant by the term ‘cell receptor’. Understand the concept of receptor occupancy. Outline how drugs affect the body. Give three examples of different cell receptors. Outline what is meant by ‘ion channel’. Describe the term ‘first pass metabolism’. Understand at a basic level the term ‘affinity’. Differentiate between a drug that is an agonist and a drug that is an antagonist. Use basic maths to calculate simple drug dosages. Introduction Part of the nurse’s role, alongside the pharmacist, is the need to ensure that medicines are administered appropriately. That is why it is essential that the nurse has a good knowledge and understanding of pharmacology and the relevant calculations in terms of patient care. Pharmacology is the study of drugs (chemicals) and their interactions with the body. The term is derived from the Greek pharmakon which can mean both ‘remedy’ and ‘poison’. In modern medical practice we use drugs more and more to treat and manage disease, so it is vital that nurses understand the basic mechanisms of drug action and reaction. The aim of this chapter is to introduce the basic principles of pharmacology in relation to nursing practice. The chapter will give you an appreciation of pharmacodynamics and pharmacokinetics. It will identify the main targets for drug action and allow you to develop an understanding of drug absorption, distribution, metabolism and excretion. Put simply: pharmacodynamics is the effect that drugs have on the body; while pharmacokinetics is the study of the way in which drugs move through the body during absorption, distribution, metabolism and excretion. For drugs to produce their effects they must interact with the body. This can happen in many ways and depends on the properties of the drug, and will be discussed later in this chapter. Pharmacokinetics influences decisions over the route of administration. The processes that occur after drug administration can be broken down into four distinct areas (known as ADME): A Absorption of the drug D Distribution of the drug molecules M Metabolism of the parent drug E Excretion or elimination of the drug and its metabolites
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