Chapter 1 pharmacology
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The study of how various drug forms influence pharmacokinetic and pharmacodynamic activities.
Only happens when taken by mouth. (Disintegration and Dissolution)
the study of what the body does to the drug. (Absorption, Distribution, Metabolism,Excretion)
How the drug gets into the body.
Where the drug travels in the body.
How the body alters the drug to a more H20 soluble form
HOw the drug leaves the body, which is usually through the kidneys (urine)
When Drugs are Protein Bound
They are inactive
- they study of what the drug does to the body:
- The mechanism of drug actions in living tissue.
the use of drugs and the clinical indications for drugs to prevent and treat diseases.
the time it takes
- Give tablets 1st
- capsules 2nd
The very young and very old have more alkaline ph, so pills break down more slowly.
- Liver is most responsible for metabolism.
- *Pregnant women metabolize more quickly.
- *Elderly-metabolizes more slowly.
- (t1/2)- How frequent a drug is administered.
- The longer the half life- the less the drug is given.
Kidneys are the main route of
elimination of drugs.
#1 most effective way to see how kidneys are functioning.
Two lab tests for the Liver to check liver function are
LAT and AST
To test the function of the kidneys, you would check
BUN and Creatine Clearance and you would know age, gender and race.
At Peak(most effective)
is when another dose should be given.
highest level in blood. half bound and half free.
- Onset of action is the time it takes to reach the minimum effective concentration (MEC) after a drug is administered.
- About one hour until you feel change.
- with a gel cap about 30 minutes.
Duration of Action
How long drug works
fight or flight
Drugs that produce a response.(stimulates)
drugs that block a response.( blocks pain as an example).
The 4 categories of drug action include:
- 1. stimulation or depression
- 2.replacement (endocrine or nutritional)
- 3.inhibition or killing of organisms
The therapeutic index (TI)
estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic or concentration) dose (ED) .
Peak drug level
is the highest plasma concentration of drug at a specific time. Peak drug levels indicate the rate of absorption. If the drug is given orally, the peak time may take 1-3 hours after drug administration.. If the drug is given IV, the peak time might occur in 10 minutes. A blood sample should be drawn at proposed peak time, according to the route of administration.
THe trough drug level
is the lowest plasma concentration of a drug, and it measures the rate at which the drug is being eliminated. Trough levels are drawn immediately before the next dose of drug is given, regardless of the route of administration.Peak levels indicate the rate of absorption of the drug and trough levels indicate the rate of elimination of the drug.
Peak and trough levels are requested for drugs that
have a narrow therapeutic index and are considered toxic, such as aminoglycoside antibiotics. If either the peak or trough level is too high, toxicity can occur. If the peak is too low, no therapeutic effect is achieved.
large initial dose, then drop it down.
refers to a rapid decrease in response to the drug. In essence, tachyphlaxis is an "acute tolerance".
The Nursing Process
- Nursing Diagnosis
- Planning(goal and the outcome (short term)
- Evaluation- always ongoing, how close the individual has come to the goal.
Judgement or conclusion about the risk for or actual need/problem of the patient.
- * Subjective Data
- ****Current health history
- ****Client symptoms
- ****Current Medication
- ****Past health history
- **** Clent's enviroment
- **** Primary language and communication needs.
- *Objective Data
- **Physical assessment
- Laboratory tests and Diagnostic tests
characterized by goal setting
NUrsing Actions necessary to accomplish the goals
- *Client teaching
- Side effects
- Cultural Considerations
5 plus rights of Drug Administration
- Right Client
- Right drug
- Right dose
- Right time
- Right route
Five plus "rights" of Drug Administration
(These are considered the 6th Right.)
- RIght documentation-if it is not documented then it was not done.
- Right Assessment
- Right to Education
- Right evaluation
- Right to refuse
- Read the name band
- make sure you have the right patient
- right dose
Factors Modifying the Drug Response
- Body weight
Forms and Routes
IV, IM, SQ, ID
Enteral-functional Gi tract
- Nasogastric and gastrostomy tubes- also falls into enternal routes.
- *Topical ointments
- or patches, make sure you wear gloves
-Infuencing factors****child's age, health status, underlying disease, hydratio, route of administration.
**Route of administration
****Gastric acidity,emptying,motility, surface area, enzyme leveld, intestinal flora
- **Peripheral perfusion
- **Effectiveness of circulation
- **Children's skin is thin and porous.
- -Influencing factors
- *maturational level of child
- *first pass effect
- *higher metabolic rate.
- -Areas of occurence
- ----Infants have decreased renal blood flow, Glomerular filtration rate, renal tubular function
- *Intestines, salivary glands
- *sweat glands and mammary glands
- Fish or poultry
- Vegetable sources such as beans, nuts, and whole grains
- eat soy in moderation
- lower cholesterol; slow hot flashes; prevent breast and prostate cancers; aid in weight loss; and ward off ostroporosis
- Adults should get 20-35 grams of dietary fiber per day.
- Fiber intake for children >2 is the child's age+5 grams
THe best sources are fresh fruits and vegetables. nuts and legumes, and whole grain foods.
- A mineral that aids in blood clotting and transmission of nerve impulses and regulates the hearts rhythm.
- *99% us stored in bones and teeth
- *Remaining 1% is found in blood and other tissue.
Vitamins A,D,E and K.
Water- Soluble Vitamins
- Vitamin B complex and C
- Vitamin B1-thiamine
- Vitamin B2-riboflavin
- Vitamin B3-Niacin
- Vitamin B6-pyridoxine
- Vitamin B12-cobalamin
- Vitamin C-ascorbic acid
Antidote for oral anticoagulant overdose
- Vitamin C
- Folic acid when deficient in pregnancy
- Vitamin B12
- Foods rich in iron
- iron deficiency anemia
- bidy storage of iron
- **Iron toxicity
- **** Adverse effects:hemorrhage and shock.
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