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nursing pharm. > LM1 - pharmacokinetics > Flashcards

LM1 - pharmacokinetics Flashcards

1
Q

what is pharmacology?

A

branch of science that studies drugs and their actions on living systems

  • study of drug actions on the body
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2
Q

what is a drug?

A
  • any small molecule that changes a body function (physiological affect) by working at the chemical and cellular levels
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3
Q

what two terms tend to be used interchangeably?

A
  • drug
  • medication (used more for a therapeutic response)
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4
Q

what is pharmacokinetics?

A
  • the process by which a drug enters the body and starts to produce an intended action
  • what body does to the drug

pharma (drug)
kinetics (movement)

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5
Q

what steps does pharmacokinetics include?

A
  • absorption - how it gets in
  • distribution - where it will go
  • metabolism - how it is broken down
  • excretion - how does it leave
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6
Q

what are the routes for absorption of a drug into the bloodstream?

A
  • oral
  • enteral
  • rectal
  • inhalation
  • intramuscular
  • subcutaneous
  • transdermal
  • topical
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7
Q

what is bioavailability?

A
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8
Q

what types of oral medications are there?

A
  • tablets and capsules
  • liquids
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9
Q

what is important to know about tablets/capsules?

A
  • enteric-coated do NOT crush or split (special outering coating)
  • are time release meds -> extended release (ER/XR), sustain release (SR)
  • pay attention whether to be taken WITH meals or WITHOUT meals, or on empty stomach
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10
Q

what is important to know about liquid oral meds?

A
  • absorb more quickly bc not broken down
  • may require refridgeration
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11
Q

what is the first pass effect?

A
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12
Q

what’s important to know about transdermal meds?

A
  • admin. on skin -> absorbed systemically
  • pain patches are used for chronic pain not acute pain
  • remove old patches
  • new patches: date, time and initial
  • wear gloves when applying or removing
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13
Q

what’s important to know about topical meds?

A
  • apply thin layer only to affected area
  • do NOT apply beyond affected area
  • do not double dip when applying
  • use gloves or applicator
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14
Q

what’s important to know about instillations?

A
  • for eyes, ears, nose
  • make sure to wear gloves
  • follow directions
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15
Q

what’s important to know about inhalations?

A
  • nebulizers
  • metered-dose inhalers (MDIs)
  • teach to administer correctly
  • have them demonstrate technique
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16
Q

what’s important about parenteral meds?

A

Intravenous
- systemic effect w/ very rapid onset
- requires IV access, med admin thru here
- may be IV push, piggyback, or continuous infusion
- may use electronic infusion controller
- also, patient-controlled analgesia

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17
Q

parenteral meds: what’s intradermal used for?

A
  • allergy testing
  • testing for TB
18
Q

parenteral meds: what’s subcutaneous used for?

A
  • insulin, heparin
19
Q

parenteral meds: what’s intramuscular used for?

A
  • flu shots, pain shot
20
Q

lifespan considerations for pharmacokinetics- absorption in neonates/pediatrics?

A
  • age 1-2yrs - immature acid-prod. cells (stomach
  • decrease in gastric emptying - slow or irregular peristalsis
  • immature liver decreases first-pass elimination –> results in higher drug levels in blood stream
21
Q

lifespan consideration for pharmacokinetics- absorption in geriatrics?

A
  • decreased BF in FI tract
  • gastric pH changes may alter med absorption of certain meds
  • variations in available plasma proteins
  • decrease cardiac output
  • decrease peripheral circulation
  • decrease body fat- affects transdermal patches
22
Q

what are the route considerations for oral/enteral?

A
  • most convenient and safest

factors affecting rate and extent of absorption
- first-pass effect
- enteric coating
- extended release
- acidity of gastric contents
- gastric emptying rate
- dietary contents
- presence of other drugs

23
Q

what are the route considerations for parenteral?

A
  • SQ, IM, painful, infection potential, localized side effects, costly, difficult for those self-admin.

intravenous:
- immediate effect, increase, in toxicity if overdose, compatibility in 2 drugs being given at the same time
- requires IV access
-painful, infection risk

24
Q

route considerations for inhalation meds?

A
  • rapid absorption of drugs
  • depends of size pf drug particles entering in pulmonary tree to reach the alveoli
  • must be able to effectively inhale drugs
25
route considerations for topical/ transdermal?
- topical creams, lotions, ointments - local effects - transdermal patch formulated for systemic effect - absorption affected by blood flow to skin - sublingual and buccal may be rapid
26
about pharmacokinetics-distribution: what factors impact it?
- blood flow –hypovolemia, blocked vessels, constricted vessels, weak pumping heart - plasma protein binding-drug is bound to protein (ex.albumin), inactive to be slowly released and prolong actions - lipid solubility- can pass through plasma membrane - blood-brain barrier-tightly woven mesh of capillaries that protect the brain from potentially dangerous substances (poisons, viruses). Meds made of lipids (fat) or have a “carrier” can get through - placental barrier-placenta permeable to some medication that can harm fetus - caution in medication usage - capillary permeability-permeability of capillaries is dependent on the tissue of the organ - volume of distribution-bioavailability of medication - half-life
27
lifespan considerations for pharmacokinetics distribution for neonates/pediatrics?
- decreased fat, greater total body water - decrease protein binding (immature liver) - increase drug to brain, blood-brain barrier not fully developed
28
lifespan considerations in pharmacokinetics distribution for geriatrics?
- decrease in total body water, muscle mass., and body fat -> which potentially could increase longer duration of action for many medications - decrease in serum albumin (protein binding),, more active free drug--- prescribed lower levels of medication
29
what is metabolism in pharmacokinetics?
- chemical reaction in the body that changes the chemical shape and content of the drug to be easily excreted (biotransformation)
30
what organs are involved in the metabolism part of pharmacokinetics?
- liver** - kidneys** - lungs - white blood cells (WBCs)
31
what are prodrugs?
- drugs in the inactive form when take and will become an active form when metabolized by enzymes in the liver (ex. aspirin)
32
lifespan considerations for pharmacokinetics metabolism for neonate/pediatrics?
- underdeveloped liver, decrease liver enzymes to break down drugs - older children may result in increase metabolism, fully developed liver, may require higher dosage
33
lifespan considerations for pharmacokinetics metabolism for geriatrics?
- aging process - decrease in liver enzymes and “First Pass Effect, higher “free“ circulating drug concentration which is higher risk for side effects and drug toxicity - drug dosages should be based on liver function test
34
what affects the metabolism of all drugs in pharmacokinetics?
grapefruit juice - effects the metabolizing rate of some medications - lowering levels of drug metabolizing enzyme CYP3A4 in enzyme - seville (sour) orange juice affects the liver's ability to metabolize using enzymes, not regular OJ
35
what does excretion mean in pharmacokinetics?
- process in which drugs have been metabolized and are now at the end stage of being eliminated from the body
36
what organs are responsible for pharmacokinetics excretion?
- kidneys - liver - intestinal and lungs other routes: - sweat, tears, reproductive fluids (seminal fluid), breast milk
37
what factors affect kidney excretion during pharmacokinetics?
rate of secretion affected by factors like: - age - weight - biological sex - kidney functions
38
what labs to do for excretion through the kidneys in pharmacokinetics?
- serum creatinine (bloodwork) - glomerular filtration rate (nephron - filtering system) - creatinine clearance (urine work
39
lifespan considerations for pharmacokinetics excretion for neonate/pediatrics?
- immature kidneys with decrease glomerulus filtration, reabsorption, and tubular secretion. - do not clear medications as efficiently from body - dosage base on kilogram and small dosage - frequent assessments must be done
40
lifespan considerations for pharmacokinetics excretion for geriatrics?
- kidney and liver function decreases with age - decrease in excretion - prolonged half-life - greater risk for toxicity (higher circulating drug levels)

nursing pharm. (6 decks)

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