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BasicPharm

Basic Pharmacologic Principles& Key Points

QuestionAnswer
PHARMACOKINETICS... movement of med molecules in the body; absorption, distribution, metabolism, excretion
ABSORPTION... movement of med from admin site to blood stream
most common routes of admin enteral (GI tract) and parenteral (inj)
ABSORPTION: RATE... AMOUNT... ROUTE... -determines how soon the med will take effect -determines its intensity -affects the rate/amnt of absorption
ORAL: ABSORPTION PATTERN varies greatly: stability/solubility of med, gastric intestinal pH/emptying time, presence of food, other meds, forms of med (entericCoated, liquid)
IM/SC: ABSORPTION PATTERN rapid or slow: water solubility of med (>soluble absorbed in 10-30min; <soluble slower); inj site (>blood flow=rapid; <blood flow=slower)
IV: ABSORPTION PATTERN instantaneous-direct into blood; complete-all reach blood
ORAL:ADVANTAGES&DISADVANTAGES -safe, inexpensive, easy/convenient ->variable absorption, inactivation by GI tract/ first pass effect, pt must be cooperative/conscious, contra-NV
FIRST PASS EFFECT... .
IM: ADVANTAGES&DISADVANTAGES -used for poorly soluble med, appropriate for preapring meds absorbed slowly for extended period of time/depot preparations -inconvenient, >cost, pain with RF infection and local tissue/nerve damage
DEPOT PREPARATIONS... .
IV: ADVANTAGES&DISADVANTAGES -rapid onset, can control precise amnt, allows admin of large vol of fluid, irritating meds given free-flowing IV, immediate absorption/response -potentially dangerous of admin of wrong med, >>cost/inconvenient, RF infection/embolism
DISTRIBUTION... transportation of med to its site of action by body fluids; influenced by circulation, plasma protein binding, barriers
CIRCULATION... delayed if pt has peripheral vascular or cardiac disease
PLASMA PROTEIN BINDING... meds compete for protein binding sites; one displaces another med from protein binding site=cause free concentration of that med to rise; eg sulfonamide abx displaces warfarin= >free concentration, >RF bleeding
BARRIERS... only meds that have transport system or lipid-soluble able to cross the blood-brain barrier; neonates= <dose of med that have actions in brain (immature blood-brain barrier)
METABOLISM... occurs primarily in liver; liver dysfunction= <ability to metabolize, RF accumulation/toxicity
THERAPEUTIC CONSEQUENCES OF METABOLISM >renal excretion, inactivation of med, >therapeutic action, activation of pro-med into active forms, <toxicity when active forms converted to inactive, >toxicity when inactive converted to active
FACTORS INFLUENCING RATE OF MED METABOLISM age, med-metabolizing enzymes, first-pass effect, 2 or more med, nutritional status
AGE... very young=hepatic immaturity; very old/aging=declining hepatic med metabolism =prolonged med effects
MED-METABOLIZING ENZYMES... .
FIRST PASS EFFECT... meds are inactivated on their first pass through the liver *impt to know w/c meds must be given nonenteral route bc of high first pass effect
METABOLISM OF 2 OR MORE MEDS WHEN GIVEN CONCURRENTLY... rate of metabolism is affected=med accumulation *impt observe > or < levels of meds when given together
NUTRITIONAL STATUS... malnourished pt may be deficient in factors necessary to produce med-metabolism enzymes = impaired med metabolism
EXCRETION... elimination of med from body primarily through kidneys *impt monitor pt with renal dysfunction for > duration/intensity of med responses
half-life (t1/2) affected by liver/kidney function; takes 4half-lives to achieve steady state of serum concentration (drug intake = drug metabolism/excretion)
short half-life med leaves body quickly 4-8hr; short-dosing interval or minimum effective concentration (MEC) will drop between doses
long half-life med leaves body more slowly 24+hr, >RF med accumulation/Toxicity; med given at longer intervals w/o loss of therapeutic effects, take longer time to reach steady state
PHARMACODYNAMICS... mechanism of action; interaction between meds and target cells, body system, organs to produce effects
UNCONTROLLED SUBSTANCES... require monitoring by primary care provider, but no risk of abuse and/or addiction; eg Abx
CONTROLLED SUBSTANCES... meds that have potential for abuse and dependence, categorized into schedules; SCHEDULE I-IV
SCHED? .
FDA PREGNANCY RISK CATEGORY... .
SEVERAL FACTORS INFLUENCE INDIVIDUAL DIFFERENCES IN MED RESPONSE... body wt, age, gender, genetics, biorhythmic cycles, tolerance, accumulation, psychological factors, med conditions, allergy?
PEAK & TROUGH LEVELS... peak blood draw depends on route of admin, oral take longer to peak than IV trough blood levels done immediately before next dose
EXTRAPYRAMIDAL SYMPTOMS (EPS) abnormal body movements; involuntary fine motor tremors, rigidity, uncontrollable restlessness, acute dystonias (spastic movements, muscle rigidity affecting head, neck, eyes, facial area, limbs)
NURS RESPONSIBILITY WHEN PT REFUSES TO TAKE MED determine the reason for refusal, provide information risk of refusal, notify MD, document refusal and actions taken
LACTATION giving the med immediately after breastfeeding will minimize med concentration in the next feeding
Created by: sarahjqs
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