Pharm Exam 1 Flashcards
What is the first principle of dosage and administration?
1) Read the medication label carefully and compare with MAR at least 3 time.
When removing the drug from the supply drawer/cart
When preparing the drug
Just before administrating the drug to the patient before the container is discarded
What is the second principal of dosage and administration?
Look up information on any drug that you are unfamiliar with.
What are the last 5 principles of dosage and administration?
3) verify drug calculations
4) label all syringes and IV solutions immediately after preparing the ordered dosage. Keep the vial with the syringe
4) NEVER administer a medication prepared by another person.
5) remain with the patient until all medications have been ingested
6) record the administration of each dose on MAR after it has been given.
What is 6 Rights of Medication administration?
Right drug
Right route
Right patient
Right dose
Right time
Right document
What are the pros to oral administration (PO)
Simple, convenient, cheap
Despite its drawbacks, this route is generally preferred
What are the cons of oral administration?
Exact dose received by patient is unknown due to extensive metabolism by liver
Slow onset of action
Some drugs irritate the GI tract
Pros of intravenous (IV)
Rapid drug action
Almost always 100% of dose is received by patient
Large volume of drug can be given via this route
Cons of IV?
Rapid drug action
Drug cannot be retrieved once injected
Higher risk of adverse reactions due to rapid drug action
Phlebitis and thrombosis may occur
Sterile technique required
Define pharmacokinetics
How drugs move throughout the body
ADME
interactions of body and drug
Define pharmacodynamics
What the drug does to the body to cause an effect.
Book***
Effects of the drugs in the body and the mechanisms of their action. As a drug travels through bloodstream, it will exhibit a unique affinity for the drug receptor site.
What is absorption?
Occurs from time drug enters body to the time drug enters bloodstream circulation
Affected by many factors: dosage form and bioavailability….. drug potency…… routes of administration
Define bioavailability
The ability of a drug to be taken up by the body and made available in the tissue where it is needed.
Define potency
The amount of the drug required to produce the desired effect.
Define distribution
Once drug is in the bloodstream, it is carried to sites of action. It’s basically the process of how medication is distributed throughout the body.
How does protein binding effect distribution?
A certain percentage of almost every drug gets bound to plasma protein albumin when it initially enters the bloodstream. The portion of drug that gets protein bound is inactive while it’s bound
How does bioavailability vary?
Dosage form.
IV- practically 100% bioavailable
Oral dosage form- almost always less than 100% bioavailable
What is metabolism
Active drug is changed into inactive metabolites
EXCEPTION: prodrugs such as clopidogrel (plavix)
What are pro drugs?
When you take them they’re in an inactive form and they have to be metabolized to become active.
How are most drugs metabolized by the liver?
First pass effect
Cytochrome P-450 (CYP) enzymes
What is excretion
Elimination of drug from the body
Most drugs are excreted by the kidneys and leave the body via urine and we measure this via creatinine clearance (CrCl) or glomerular filtration rate (GFR)
What are CYP enzymes?
Most drug metabolism that occurs in the liver is done by the cytochrome P450 (CYP) enzyme family
What are the 3 CYP enzymes specifically responsible for drug metabolism?
CYP1– example CYP1A2
CYP2– example CYP2D6
CYP3– example CYP3A4
Which liver enzyme is responsible for most troublesome drug interactions?
CYP3A4
How are CYP enzymes inhibited or induced?
Other drugs, food, drinks, or even genetics
How do CYP enzymes normally work?
Active drugs are metabolized by enzymes and the are ready to be excreted from the body.
What happens when CYP enzymes are inhibited?
The inhibitor inhibits the CYP enzyme from doing what it is supposed to do which is metabolize the drugs. So the drugs start to build up and there is more of it therefore the patient is more at risk of toxicity from the drug.
What happens when CYP enzymes are induced?
The CYP enzymes are working faster than they normally would and the drug is being metabolized faster. The patient is at higher risk for the disease state not being treated adequately because there’s not enough drug in circulation.
What are important ways we measure renal function?
Creatinine clearance (CrCl)
Glomerular filtration rate (GFR)
What is creatinine clearance (CrCl)
We are basically measuring the bodies ability to get rid of drug. And how we do that is by measuring the bodies ability to get rid of creatinine which is a waste product of the body. So when we calculate that and assume that that is about how good the body is at getting rid of drug also.
What is normal CrCl?
120 mL/min for men
95 mL/min for women
CrCl < 30 mL/min is NOT GOOD
