Exam 1 (Chapters 1-6) Flashcards
First 5 “Rights”
- Right patient
- Right drug
- Right dose
- Right route
- Right time
Last 5 “Rights”
- Right reason
- Right documentation
- Right education
- Right evaluation
- Right to refuse
High alert medications (acronym and meaning)
PINCH
Potassium Insulin Narcotics Chemo Heparin
Define pharmacokinetics
a drug’s movement through the body, and the way the body uses and changes the drug (absorption, distribution, metabolism, elimination)
Stages of pharmacokinetics (4)
- Absorption
- Distribution
- Metabolism
- Elimination
Absorption: three drug entry routes
- Percutaneous (skin or mucous membranes)
- Enteral (through GI tract)
- Parenteral (injection or IV)
Factors that affect absorption (5)
- Route (percutaneous, enteral, parenteral)
- Dosage form (pill, liquid)
- Blood flow at administration site
- GI function
- Presence of food or other drugs
Factors that affect distribution (5)
- Adequacy of blood circulation - is it being moved
- Protein binding - what proteins it binds to
- Muscle or fat - where it is stored in the body
- Blood-brain barrier - does it cross or not
- Pregnancy/lactation - does it affect fetus or come out in breast milk
Factors that affect metabolism (3)
- Enzyme induction (accelerates metabolism)
- Enzyme inhibition (slows metabolism)
- First pass effect
Define drug metabolism and list where it occurs
The method by which drugs are inactivated or biotransformed by the body
Occurs in liver, kidneys, lungs, red blood cells GI tract
Define drug distribution
Where the drug is carried within the body (via blood and tissue fluids)
Define drug absorption
Movement of the drug from outside of the body into the blood stream
Advantages (2) and disadvantages (1) of percutaneous route
Advantages:
- Bi-passes the GI tract (important if drug broken down by GI tract)
- Rapid absorption
Disadvantages:
- Absorption dependent on circulation
Advantages (2) and disadvantages (3) of enteral route
Advantages:
- High patient acceptance
- Convenient
Disadvantages:
- Least predictable
- Not all of the med gets absorbed (first pass loss)
- Absorption dependent on motility
Advantages (3) and disadvantages (2) of parenteral route
Advantages:
- Goes directly into blood stream
- 100% bioavailable
- Quickest absorption
Disadvantages:
- More dangerous
- Invasive
Define drug elimination and where it occurs
What happens if drug elimination is impaired
Elimination of the drug from the body
Occurs in intestinal tract, kidneys, lungs, and skin
If drug elimination is impaired it can lead to accumulation and toxicity
Define serum drug level
The amount of drug in the blood at a particular time
What is the MEC
Minimum effective concentration
The lowest serum level of a drug needed to intended action/effect
Define duration of action
How long a drug remains at the MEC or higher (minimum effective concentration)
Define steady state
The balance between drug entry and drug elimination
When the quantity of drug eliminated equals the quantity of the drug that reaches the systemic circulation in a given unit of time
With regards to serum drug levels, define:
Half-life, peak, trough, toxic concentration
Half-life: time-span needed for half of the drug to be eliminated
Peak: the maximum blood level
Trough: the minimum blood level
Toxic concentration: excessive levels that may cause damage
Define pharmacodynamics and mechanism of action
Pharmacodynamics: what a drug does to the body
Mechanism of action: exactly how a drug changes the activity of a cell
Explain receptor theory
Drugs control the activity of a cell by acting on receptors
Define agonists and antagonists
Agonists: drugs that bind to cell receptors and “turns on” intrinsic cell response
Antagonists: drugs that block receptors in the cell, preventing intrinsic cell response (may slightly bind but won’t activate)
