Lecture 1 - Intro to Pharmacology Flashcards
non-prescription
FDA says these meds can be safely taken outside of the direction of a professions
NSAIDs, multivitamins
prescription medications
should be taken under the direction of a professional, could have more serious side effects
generic vs trade name
generic is the official name, not capitalized
trade is the brand name, capitalized
acetaminophen vs Tylenol
Parenteral route
Intravenous
subcutaneous
intramuscular
characteristics of the topical or transdermal route
slow onset
long action
locations of topical or transdermal administration
skin, eyes, ears, nose, rectum, vagina, lungs
characteristics of IV administration
immediate onset and shorter action
adverse drug reaction
nontherapeutic, unintended effects of a drug that occurs at therapeutic dose
can be mild or serious
pharmacodynamics
What does the drug do to the body?
How the drugs act on our cells
Pharmacokinetics
processes of drug movement through the body to reach sites of action, metabolism, excretion
ADME
absorption
distribution
metabolism
excretion
agonist
Drug that produces effects similar to those produced naturally
antagonist
Drug that inhibits cell function by occupying receptor sites and prevents natural body substances from occupying the site and activating function
why are enteric coated tablets absorbed fastest?
full dose remains intact until it reaches the small intestine
absorption
Movement of drug from site of administration to bodily tissues
what factors affect absorption?
dose
route
blood flow
GI function
food and other drugs
genetics
oral drug absorption steps
absorbed through intestinal wall
portal vein
liver
circulation
distribution
Movement of drug from blood to various tissues WITHIN the body to site of action
where are drugs distributed most rapidly?
organs that receive large blood supply
ex: heart, liver, kidneys
metabolism
Process by which drugs are inactivated and biotransformed by the body
metabolite
new form of inactivated/biotransformed drug
also called byproduct
how are most drugs metabolized?
CYP enzymes in liver
1st Pass Effect
oral drug passes through GI tract and liver so a little bit is metabolized before it is distributed
this results in smaller amount of the active drug being put back into systemic circulation
rest of drug is metabolized before excretion after circulating in the body
excretion
elimination of a drug from the body
half-life
how long it takes our body to eliminate half of the total amount of the drug that was administered
most common excretion route
kidneys and urine
renal function will affect excretion
peak
when the drug is at its highest level in the body
trough
when drug is at its lowest level
what determines administration timing
peak and trough
next pose should be given after peak but before trough to minimize time below therapeutic range
what considerations should be made for pediatric patients
Absorb, distribute, metabolize and excrete medications differently than adults
immature liver and kidneys
dosages based on weight
body has more water than muscle mass
considerations for geriatric patients
pharmacodynamics and pharmacokinetics are altered - may give smaller dose
polypharmacy - interactions possible when treating multiple co-morbidities
increased fall risk
factors influencing enteral absorption
solubility of med
GI pH
time in GI tract
food
medication form
other meds
why would a medication be sublingual or buccal?
can be absorbed into quickly into highly vascular mucous membranes
swallowing would allow gastric pH to inactivate med
barriers to rectal or vaginal absorption
presence of stool or infectious material
how does solubility affect absorption of SubQ and IM medications?
highly soluble absorbed rapidly, poorly soluble absorbed slowly
how does perfusion affect SubQ and IM absorption?
high perfusion has rapid absorption, low perfusion has slow absorption
What is the absorption pattern for IV meds?
complete dose enters bloodstream directly
how does plasma protein binding affect distribution?
if two drugs compete for binding sites it can cause toxicity
what is the primary protein binding site in the bloodstream?
albumin
why does nutritional status affect medication metabolism?
malnutrition can cause deficiency of factors that produce enzymes for medication metabolism
when should blood sample be obtained for trough levels?
immediately before next dose
partial agonist
acts as an agonist at some receptors and an antagonist at other receptors
contraindications for oral administration
vomiting
decreased GI motility
difficulty swallowing
absent gag reflex
decreased consciousness
what should be performed when applying topical medication to open wounds?
surgical asepsis
what should you do if instilling more than one medication into the same eye?
wait at least 5 minutes between medications
what position should be used for rectal suppositories?
left lateral or sim’s position
what position should be used for vaginal administration?
modified lithotomy or dorsal recumbent
general guidelines for NG and G tube administration
sublingual meds can be administered normally
use liquid or crush meds if appropriate
administer meds separately
do not mix meds with tube feedings
what is the best site for injecting volumes over 2 mL?
ventrogluteal
how much fluid can the deltoid accomodate?
up to 1 mL
what is the best injection site for infants under 1 year?
vastus lateralis
what gauge is appropriate for SubQ injection?
25 - 27 gauge needle
28 - 31 gauge insulin syringe
what length is appropriate for SubQ injection?
3/8 to 5/8 inch
what kind of medications are appropriate for SubQ injection?
nonirritating, water-soluble
what kind of medications are appropriate for IM injection?
irritating meds
solutions in oils
aqueous suspensions
what gauge is appropriate for IM injection?
22 - 25 gauge most usual
18 - 27 gauge possible
what length is appropriate for IM injection?
1 - 1.5 inch
