Prescribing in co-morbidity

Question 1

Examples of co-morbidity that affects absorption

Answer 1

Constipation, gastric surgery

Question 2

Co-morbidity that affects distribution

Answer 2

Blood loss, poor circulation, shock due to decreased blood flow

Question 3

Co-morbidity affecting metabolisation and excretion

Answer 3

Impairment of liver or kidneys, e.g. impaired liver function may cause a patient to not reach therapeutic levels if the liver cannot convert the pro-drug into its active form.

Severely impaired liver function are at risk from toxicity due to raised levels of circulating medications

Question 4

Co-morbidity that can affect excretion?

Answer 4

Anything that reduces renal capacity can expose them to increased risk of toxicity due to an increase in circulating medications.