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Drugs 101 — Part I


TIPS

During our Joint Commission survey, the nurse surveyor gave us a few tips she had picked up along the way.

Looking for a good, cheap surface barrier? Use wax paper. It is cheaper than paper towels or newspaper and also waterproof.

How to dispose of drugs? If your client has outdated or expired medications which they want to dispose of, take a small plastic container and mix the drugs with “QUIKRETE.” It is relatively inexpensive, easy to mix and dries quickly. Then just throw it into the garbage. It won't go into the water table and won't be diverted. This solution came about by a hospice agency that had a client whose child died from taking some of the client's drugs.

Drugs 101 – AHHC Series

We have decided to present a series of informational articles related to medications. These will be presented by classification. I am of the opinion if you know the classification and its general actions, then you are better prepared to know what to expect from a medication both its actions as well as its side effects. I hope these articles will assist you in your everyday nursing care and safety of the client. These articles are meant to be general information containing only the basics, so you should still review the specific drug information for every medication you are giving. Our first article sets the stage by introducing you to some of the more common terms used in pharmacology.

Introduction to Drug Action

Definition:
A very broad definition of a drug would include all chemicals other than food that affect living processes. If the affect helps the body, the drug is a medicine. However, if the drug causes a harmful effect on the body, the drug is a poison. The same chemical can be a medicine and a poison depending on condition of use and the person using it.

There exist basically 3 sites or categories for the action of a drug.

Enzyme Inhibition: Drugs act within the cell by modifying normal biochemical reactions. Enzyme inhibition may be reversible or non-reversible; competitive or non-competitive. Antimetabolites may be used which mimic natural metabolites. They would take the place of a normal interaction of the cell thus blocking the actual action and causing the desired effect. They may alter the process of cell reproduction.

Drug-Receptor Interaction: Drugs act on the cell membrane by physical and/or chemical interactions. This is usually through specific drug receptor sites known to be located on the cell membrane. A receptor is the specific chemical constituents of the cell with which a drug interacts to produce its pharmacological effects. Some receptor sites have been identified with specific parts of proteins and nucleic acids. In most cases, the chemical nature of the receptor site remains unknown.

Non-specific Interactions: Drugs act exclusively by physical means outside of cells. These sites include external surfaces of skin and gastrointestinal tract. Drugs also act outside of cell membranes by chemical interactions. Neutralization of stomach acid by antacids is a good example.

Drug Interaction with Receptor Site:

A neurotransmitter has a specific shape to fit into a receptor site and cause a pharmacological response such as a nerve impulse being sent. After attachment to a receptor site, a drug may either initiate a response or prevent a response from occurring. A drug must be a close “mimic” of the neurotransmitter in order to produce the desired effect..

An agonist is a drug which produces a stimulation type response. The agonist is a very close mimic and “fits” with the receptor site and is thus able to initiate a response.

An antagonist drug interacts with the receptor site and blocks or depresses the normal response for that receptor because it only partially fits the receptor site and can not produce an effect. However, it does block the site preventing any other agonist or the normal neurotransmitter from interacting with the receptor site.

Our next article will be about Adrenergic drugs…WOW, I'll bet you can't wait. It's one of my favorites, too.




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