attached is the information needed for work

Kendall Komeng posted May 20, 2024 11:11 AM

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Step 1: Drug binding

 When a drug attaches to an intracellular molecule, the initial step in the mechanism of drug action involves the interaction between the drug, which can be a small molecule or a ligand, and the intracellular receptor or target molecule. Through this specific binding process, the drug is tailored to precisely fit into a designated site on the receptor, ensuring a uniquely designed connection.

Step 2: Conformational change

 The precise binding of the drug with the receptor creates a consequential conformational alteration that occurs within the receptor's structure. This structural modification signifies a shift in the shape of the receptor, ultimately enabling it to engage with other molecules in a different manner than before.

Step 3: Activation or inhibition

 The interaction between the drug and receptor can result in either activation or inhibition based on the characteristics of the drug and the receptor. The outcomes manifest distinctly start with:

Activation: In instances where the drug binds to an inactive receptor, it can activate the receptor's signaling cascade, thereby triggering a specific biological response.

Inhibition: Conversely, if the drug binds to an active receptor, it can impede the receptor's signaling pathway, diminishing, or obstructing the biological response.

Step 4: Signaling pathway activation.

Upon activation or inhibition of the receptor, an intricate signaling cascade is set into motion, encompassing a sequence of biochemical reactions. These cascading reactions have the potential to induce alterations in cellular behavior, including:

Regulation of ion channels and pumps

Modulation of enzymatic activity

Regulation of protein-protein interactions

Changes in gene expression

Step 5: Biological response

 The ultimate consequence of the initiated signaling pathway is contingent upon the distinct biological response incited by the interplay between the drug and receptor. The outcomes may encompass a spectrum of effects, including:

Therapeutic effects that ameliorate conditions such as pain relief and reduction in blood pressure.

Incidence of side effects like allergic reactions and gastrointestinal disturbances.

Cellular responses are characterized by modifications in cell growth, differentiation, or survival.

REFERENCE 

Adams, M. P., Holland, L.N., & Urban, C.Q (2020). Pharmacology for nurses. A Pathophysiological approach (5th ed.). Pearson. (p.240-243). 

Heather Neahr posted May 20, 2024 3:40 PM

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Being knowledgeable in pharmacology is of the utmost importance for nurses practicing in the field. It allows us to provide safe medication administration and patient education and enhances our ability to assess and monitor patient response to treatment. We play a vital role in preventing medication errors which can have deadly consequences for our patients. According to Adams et al. (2020), learning the applications of existing medications and staying current with new drugs introduced every year are among the formidable but necessary tasks of the nurse (p. 4). Pharmacology knowledge leads to improved patient outcomes, improved safety and enhances the quality of healthcare delivery.

            The 5 medications I have chosen to research for this module are as listed below, and I chose them because these are the medications I most commonly see in my practice.

Aspirin

            Chemical name: Acetylsalicylic acid

            Generic name: Aspirin

            Trade name: Bayer Aspirin, Ecotrin, Bufferin

            Pharmacologic classification: Salicylate, cyclooxygenase (COX) inhibitor

            Therapeutic classification: Nonopioid analgesic, non-steroidal anti-inflammatory (NSAID), antipyretic (Hazard et al. 2017)

Prednisone

            Chemical name: 17,21-dihydroxypregna-1,4-dienne-3,11,20-trione

            Generic name: Prednisone

            Trade name: Rayos, Deltasone

            Pharmacologic classification: corticosteroid

            Therapeutic classification: anti-inflammatory, Immunosuppressant (Hazard et al. 2017)

Lisinopril

            Chemical name:  (S)-1-[N2-(1-carboxy-3-phenylpropyl)-L lysyl]-L-proline dihydrate.

            Generic name: Lisinopril

            Trade name: Prinivil, Zestril

            Pharmacologic classification: Angiotensin-converting enzyme (ACE) Inhibitor

            Therapeutic classification: Antihypertensive (Hazard et al. 2017)

Simvastatin

            Chemical name: 2,2-dimethylbutyric acid, 8-ester with (4R,6R)-6-(2-((1S,2S,6R,8S,8aR)-1,2,6,7,8,8a-hexahydro-8-hydroxy-2,6-dimethyl-1-           naphthyl)ethyl)tetrahydro-4-hydroxy-2H-pyran-2-one

            Generic name: Simvastatin

            Trade name: Zocor

            Pharmacologic classification: HMG-CoA Reductase Inhibitor (Statins)

            Therapeutic classification: Antihyperlipidemic (Hazard et al. 2017)

Metformin

            Chemical name:  1,1-Dimethylbiguanide hydrochloride

            Generic name: Metformin

            Trade name: Glucophage

            Pharmacologic classification: Biguanide

            Therapeutic classification: Antidiabetic (Type II Diabetes Mellitus) (Hazard et al. 2017)

            The initiation of the Affordable Healthcare Act has had lasting implications for the way medications are prescribed since it was enacted by the Obama administration. This act enhanced access to health insurance and thus allowed patients who were previously lacking coverage increased access to healthcare and medications. It also encouraged a shift which promoted preventative care leading to an increase in vaccinations and preventative medications. According to Gosh et al. (2017), it was found that within the first 15 months of expansion, Medicaid-paid prescription utilization increased by 19 percent in expansion states relative to states that did not expand; this works out to approximately seven additional prescriptions per year per newly enrolled beneficiary. Due to the increase in amount of medications being consumed in the United States, there was greater push by the government to control the cost and production of medications.

References

Adams, M. P., Holland, L.N., & Urban, C.Q (2020). Pharmacology for nurses. A Pathophysiological approach (6th ed.). Pearson.

April Hazard Vallerand, Sanoski, C. A., & Judith Hopfer Deglin. (2017). Davis’s drug guide for nurses (15th ed.). F.A. Davis Company.

Ghosh, A., Simon, K., & Sommers, B. D. (2017, January 16). The Effect of State Medicaid Expansions on Prescription Drug Use: Evidence from the Affordable Care Act. Www.nber.org. https://www.nber.org/papers/w23044

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Briana DeRosa posted May 20, 2024 6:02 PM

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Efficacy refers to the maximum effect a drug can produce, regardless of the amount of the dose. While potency is the amount of drug needed to produce a given effect. During this discussion I will be talking about the similarities and differences between morphine, heroin and demerol. Morphine is used for severe pain management. Heroin has extremely high abuse potential and legal status. Heroin is highly potent and has a rapid onset of action, which contributes to its high potential for addiction to a lot of people. Both morphine and heroin act as opioid receptors in the brain and spinal cord to produce analgesia, euphoria, and sedation. Heroin is a prodrug that converts to morphine in the brain. Both morphine and heroin act similarly but heroin is more rapid and  intense due to its higher lipid solubility. Whereas, demerol also known as meperidine acts primarily on mu-opioid receptors but also has some activity on kappa-opioid receptors. It has a shorter duration of action compared to morphine and has unique side effects, such as the risk of seizures due to the accumulation of its metabolite, normeperidine. Morphine, heroin, and Demerol (meperidine) vary significantly in their potency and efficacy, understanding the differences helps the professionals choose the appropriate opioid for pain management based on their patient's needs and the clinical situation. 

1. Morphine:

Efficacy: High. Morphine is considered a standard opioid used for severe pain relief, providing significant analgesia.

Potency: Morphine is less potent compared to heroin but is a standard for opioid potency.

Clinical Use: It is widely used for managing acute and chronic severe pain.

Dosage: Typically range from 10-30 mg every 4 hours for pain relief.

Common side effects: includes respiratory depression, constipation, nausea, and potential for addiction and tolerance.

1. Heroin:

Efficacy: Very high. Heroin is rapidly converted to morphine in the body, leading to potent analgesic effects.

Potency: Heroin is more potent than morphine. It crosses the blood-brain barrier more rapidly, leading to a quicker and more intense onset of action.

Clinical Use: Not used therapeutically in most countries due to its high abuse potential and legal status.

Dosage: Not applicable in a clinical context, but illicit doses are much lower than morphine due to higher potency.

Common side effects: Similar to morphine, but with a higher risk of addiction, overdose, and withdrawal symptoms due to its potency and rapid onset.

1. Demerol (Meperidine):

Efficacy: Moderate to high. Meperidine is effective for moderate to severe pain, but it is less effective than morphine.

Potency: Less potent than morphine. It requires higher doses to achieve similar analgesic effects.

Clinical Use: It is used for short-term pain relief but is less favored due to its side effect profile and the risk of neurotoxicity with long-term use.

Dosage: Typically range from 50-150 mg every 3-4 hours for pain relief.

Common side effects: Carries a risk of neurotoxicity and seizures, especially with prolonged use.

References: 

Adams, M., Holland, L. N., Jr., & Urban, C. Q. (2020). Pharmacology for nurses: a pathophysiologic approach. Sixth edition. Hoboken, N.J., Pearson

April Hazard Vallerand, Sanoski, C. A., & Judith Hopfer Deglin. (2017). Davis’s drug guide for nurses (15th ed.). F.A. Davis Company.

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Camille Lloyd posted May 20, 2024 6:16 PM

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For this module, I will be covering the five common drugs used and their chemical and generic name. I will also cover how the Affordable Healthcare Act (ACA) has changed the process of prescribing medication.

     The Affordable Care Act bill was signed and enacted on March 23, 2010. It was a historic bill that promised to facilitate lower-income-driven Americas, with affordable health insurance to provide access to better healthcare for many Americans. This would mean easier access to doctors and an inexpensive way to afford their medications. Thanks to the ACA over 20 million Americans now have access to affordable health insurance coverage, which provides them with better medical treatment and medication. The ACA created several new programs that facilitated easier access.  "  The statute (section 1302) eun-merates and moderates many different categories of services that essential health benefits must, at a minimum, include 1. Ambulatory patient services 2. Emergency services 3. Hospitalization 4. Maternity and newborn care" (Bagley 2014).

      Over the Years studies have shown the ACA has contributed to lowering the cost of several medications, among these I will highlight the cost of hypertension medication and how the ACA has reduced the disparities and created easier access and more affordable treatment. Many minority groups have benefited from this change, one study showed how it has reduced the disparities in the Mexican/Latino community, " the implementation of ACA in California has helped reduce some of the disparities in health access, utilization, and medication use with hypertension" (McKenna 2017).

 Bagley, N., & Levy, H. (2014). Essential Health Benefits and the Affordable Care Act: Law and Process. Journal of Health Politics, Policy & Law, 39(2), 441–465. https://doi-org.ncc.idm.oclc.org/10.1215/03616878-2416325 

McKenna, R. M., Alcalá, H. E., Lê-Scherban, F., Roby, D. H., & Ortega, A. N. (2017). The Affordable Care Act Reduces Hypertension Treatment Disparities for Mexican-heritage Latinos. Medical Care, 55(7), 654–660. https://doi-org.ncc.idm.oclc.org/10.1097/MLR.0000000000000726

Nikita Murphy posted May 19, 2024 1:59 PM

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I have chosen to discuss five common drugs for my discussion and how the affordable care act has changed the process of prescribing medication.

Drug 1: 

Chemical name- 7-chloro-5-(2-chlorophenyl)-3-hydroxy-1,3-dihydro-1,4-benzodiazepin-2-one (National Center for Biotechnology Information, 2024)

Generic name-lorazepam

Trade name- Ativan

Pharmacologic classification-Benzodiazepine; GABA A-receptor agonist

Therapeutic classification- Sedative-hypnotic; anxiolytic; anesthetic adjunct

(Adams, Holland & Urban, 2020, p. 158)

Drug 2:

Chemical Name- (2-butyl-1-benzofuran-3-yl)-[4-[2-(diethylamino)ethoxy]-3,5-diiodophenyl]methanone (National Center for Biotechnology Information, 2024)

Generic name- Amiodarone

Trade name- Pacerone

Pharmacologic classification-Potassium Channel Blocker

Therapeutic classification- Class III antidysrhythmic

(Adams, Holland & Urban, 2020, p. 425)

Drug 3:

Chemical Name- S-(fluoromethyl)(6S,8S,9R,10S,11S,13S,14S,16R,17R)-6,9-difluoro-11,17-dihydroxy-10,13,16-trimethyl-3-oxo-6,7,8,11,12,14,15,16-octahydrocyclopenta[a]phenanthrene-17-carbothioate (National Center for Biotechnology Information, 2024)

Generic name- Fluticasone

Trade name- Flonase

Pharmacologic classification- Corticosteroid

Therapeutic classification- Drug for allergic Rhinitis, asthma, and skin inflammation

(Adams, Holland & Urban, 2020, p. 607)

Drug 4:

Chemical Name- 

(3-phenoxyphenyl)methyl 3-(2,2-dichloroethenyl)-2,2-dimethylcyclopropane-1-carboxylate (National Center for Biomedical Information, 2024)

Generic name- Permethrin

Trade name- Acticin, Elimite, Nix

Pharmacologic classification- Scabicide; pediculicide

Therapeutic classification- Antiparasitic

(Adams, Holland & Urban, 2020, p. 797)

Drug 5:

Chemical Name- 

Propan-2-yl (Z)-7-[(1R,2R,3R,5S)-3,5-dihydroxy-2-[(3R)-3-hydroxy-5-phenylpentyl]cyclopentyl]hept-5-enoate(NAtional Center for Biomedical Information, 2024)

Generic name- Latanoprost

Trade name- Xalatan

Pharmacologic classification- Prostaglandin analog

Therapeutic classification- Antiglaucoma

(Adams, Holland & Urban, 2020, p. 815)

The Affordable Care Act (ACA), also known as Obamacare, was enacted on March 23, 2010 (Weil, 2020, p. 359). This act had a significant impact on access to medications for millions of Americans. This landmark healthcare legislation aimed to increase the affordability and availability of prescription drugs through various provisions and reforms. The ACA brought about changes in drug pricing, coverage, and access that continue to shape the landscape of medication affordability and availability in the United States. While the aim was to increase medications, for some, the impact of the act was less than significant.

The impact of the ACA was significant for many women of reproductive age. With the cost of medications becoming more affordable, there was an increase in long acting reproductive contraception use (Chuang et al., 2024, p. 13). However, for individuals with chronic conditions requiring expensive medications, the affordability and availability of prescription drugs may still be a challenge. Additionally, the ongoing debate surrounding healthcare reform and drug pricing continues to influence the accessibility of medications for many Americans.

References

Adams, M., Holland, L. N., Jr., & Urban, C. Q. (2020). Pharmacology for nurses: a pathophysiologic approach. Sixth edition. Hoboken, N.J., Pearson.

Chuang, C. H., Weisman, C. S., Liu, G., Horvath, S., Velott, D. L., Zheng, A., & Leslie, D. L. (2024). Impact of the Affordable Care Act on Prescription Contraceptive Use and Costs Among Privately Insured Women, 2006-2020. Women’s Health Issues, 34(1), 7–13. https://doi.org/10.1016/j.whi.2023.08.007

National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 2157, Amiodarone. Retrieved May 18, 2024 from https://pubchem.ncbi.nlm.nih.gov/compound/Amiodarone.

National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 134664, Benzodiazepine. Retrieved May 18, 2024 from https://pubchem.ncbi.nlm.nih.gov/compound/Benzodiazepine.

National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 5311101, Fluticasone. Retrieved May 18, 2024 from https://pubchem.ncbi.nlm.nih.gov/compound/Fluticasone.

National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 5311221, Latanoprost. Retrieved May 18, 2024 from https://pubchem.ncbi.nlm.nih.gov/compound/Latanoprost.

National Center for Biotechnology Information (2024). PubChem Compound Summary for CID 40326, Permethrin. Retrieved May 18, 2024 from https://pubchem.ncbi.nlm