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75 Cards in this Set
- Front
- Back
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What is Pharmacokinetics?
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What drugs do to the body
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Where are most drugs absorbed?
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In the small intestine
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First Pass Effect (hepatic)=Bioavailability
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Losing a lot of the medications effect the 1st time you take it.
Avoid this by taking: SL, Buccal, rectal, vaginal, topical, IM, SC, IV |
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Dissolution
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How much of the drug is available and how quickly
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The bulk of most tablets can be made of :
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Starches (as fillers)
Adhesive Binders Lubricants Disintergrators |
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GI tract:
What influences absorption? |
Gastric Emptying (times vary)
Amount of acid in stomach (varies by person) Time of day |
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GI Tract:
What drug is partly destroyed by acid? |
PCN
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GI tract:
Less acid in stomach means.... |
there's more drug available to be absorbed.
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GI tract:
Food can do what to absorption? |
Can slow or block absorption of meds.
Some absorbed best w/ food. EC tab dissolve in alkaline states |
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Tetracycline is best when given..?
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on an empty stomach
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Asprin does what to the stomach?
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Can cause an upper GI bleed in stomach. EC tablets help bypass the stomach where it is dissolved in the small intestines.
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Hepatic 1st pass Effect:
Morphine Orally is __ ___ __ __ ___. |
Rapidly metabolized by the liver.
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How much Morphine do you have to give orally than IM to achieve the same effect?
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6 x the amount
-varies depending on the drug |
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How much more Codeine do you have to give orally to achieve the same level of pain relief?
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2x's the amount of Codeine orally to achieve the same effect.
-varies by drug |
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What are the routes of Administration?
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1) Enteral (po, sm intes, rectum)
2) Parenteral **FASTEST** IV, IM 3)Topical (skin, eyes, ears, lungs) 4) Transdermal (nitro patch, estrogen) |
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Elimination of meds is usually by?
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Kidney (Primary) or Liver/Bowel=Biliary excretion
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Most drugs need to ______.
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Bind with blood proteins.
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What is the most common blood protein binder?
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Most common is Albumin
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What happens to drugs that are bound in the blood stream?
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They stay in the system longer b/c they do not diffuse easily through the capillary walls.
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Free drugs diffuses into tissues which..
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Interact w/ receptors and produce a biologic effect
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Older people might need (what kind of dose of medicine?)
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A smaller dose b/c their bodies react more easily to it.
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net effect of binding=
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create reservoir of drug released or replenish free drug
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Not bound to albumin=
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shorter time in the body
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bound to albumin=
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longer duration
Warfarin is strongly bound and in the body for 3 days. |
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What is a drug receptor?
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A molecule that a drug binds to, to initiate effects.
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Affinity
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Degree to which drugs attracts and binds with receptor.
Will elicit an agonist or antagonist effect. |
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Agonist
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produces the response we want
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Antagonist
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Blocks or inhibits a response we want.
Aceinhibitors- inhibits renin, treats BP |
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Efficacy
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Capability of stimulating the receptor to some action.
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What do drugs do to the body?
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They do NOT create functions but MODIFY existing functions in the body.
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What is a side effect?
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An action that is expected to occur
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Are drug errors preventable?
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Yes drug errors are preventable
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What are adverse drug reactions?
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Inherent, non predictable event w/ normal therapeutic use
(usually dose related) |
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What is a drug-drug interaction?
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any modification of the action of one drug by another drug
May Increase or decrease action of drug may be part of therapeutic program |
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What happens when hydralazine and nitroglycerin are taken?
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They both dilate BV so a severe hypotensive response could occur.
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MOAIs diminish ability to metabolize catecholamines and related compounds as tyramine-(found in cheese and wine.)
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can cause a hypertensive crisis
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What causes coumadin to lose its effectiveness?
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eating too many leafy green veggies (vitamin K causes blood to clot.)
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Drug allergies:
Type 1 Drugs: PCN, cephalosporins, iodides |
-Occur soon after exposure
-urticaria (hives) and itching Not usually serious but an acute reac. can cause anaphlaxix or shock. |
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Drug allergies:
Type 2 |
Autoimmune response
-lysis of certain blood cells -delayed ex)hemolytic anemia w/ methydopa |
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Drug Allergies:
Type 3 Drugs: PCN, iodides,sulfonamides and phenytoin(anti-sz drug) |
Doesn't occur 1st time taken.
Body builds up antibodies serum sickness-delayed hives, pain, fever, swollen lymphnodes |
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Drug allergies:
Type 4 |
Contact dermatitis
Caused by topical application of drugs doesn't occur 1st time body builds up anitbodies |
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What is therapeutic index?
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relative safety of drug (safe level)
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What is narrow therapeutic index?
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means close to toxic levels
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What is half life?
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time for 1/2 of the drug to be removed from the body
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What is steady state?
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Blood level in which amount of drug removed is equal to the amount absorbed
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What is peak?
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highest concentration of drug, usually specimen collected 15-30 min after IV administration
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What is therapeutic index?
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relative safety of drug (safe level)
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What is narrow therapeutic index?
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means close to toxic levels
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What is half life?
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time for 1/2 of the drug to be removed from the body
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What is steady state?
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Blood level in which amount of drug removed is equal to the amount absorbed
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What is peak?
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highest concentration of drug, usually specimen collected 15-30 min after IV administration
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What is peak?
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peak is the highest concentration of drug, usually specimen collected 15-30 min. after IV administration
(assures toxic level not achieved) |
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What is Trough?
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Therapeutic range in blood maintained
(specimen taken just prior to next dose due) |
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Onset
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time to illicit drug therapeutic response
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Peak
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reaches maximum effect
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duration
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time drug able to continue to exert therapeutic effect
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Therapeutic effect
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improves condition
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prophylactic effect
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prevents condition
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What are desired outcomes when giving medication?
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-Cure
-no pre-existing symptom or diminishes it -limits disease/prevents disease -improves quality of life (vaccines) |
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What is meant by tolerance?
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decreased response to repetitive drug doses ex) morphine
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What is meant by a drug dependance?
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physiological or psychological need for a drug
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What is physical dependence?
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Physical need for drug
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What is psychologic dependence?
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desire for euphoric effects of drugs
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Additive effect
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2 drugs similar actions given together
-usually to decrease doses of each drug to avoid toxic effects |
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Synergistic effect
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combined drug effects
2 drugs work together to achieve an effect |
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Ca causes....
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contractility of the the heart
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Teratogenic
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causes structural defects in the fetus
-most vulnerable w/in the 1st trimester |
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3 major categories of Teratogens
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1) viral diseases
2) radiation 3) drug or chemicals |
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Mutagenic
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changes in genetic composition (change in DNA can go either way. can be abnormal and stay or go back to normal)
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Carcinogenic
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causes cancer
-some antneoplastic agents (chemo) -usually lengthy exposure and long latent period before cancer develops. |
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8 rights of medication administration
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drug dose route
time patient refuse documentation equipment |
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pruitis
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itching
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angiodema
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edema due to increased pereability of the blood capillaries
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rhinitis
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runny nose (excessive)
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lacrimal tearing
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excessive tearing
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