Render, Pharmacology + Lab values Flashcards
PHARMACOTHERAPEUTICS
The treatment of pathologic conditions through the use of drugs.
PHARMACOKINETICS
Study of what the body does to the drug
PHARMACODYNAMICS
Study of what the drug does to the body
List drug names system
brand name, generic name, chemical name (NCLEX will have just generic)
Classification of drugs
- Its effect on the body
- chemical composition
- Therapeutic action
Drug as an agonist
Activate receptors ( turn on/ promote). This is pharmacodynamics.
Drug as an antagonist
Turn off/block. Inhibit receptors. This is pharmacodynamics.
Receptor Interaction
Pharmacodynamics. To take an effect on the body, the drug and the body’s receptor shape has to match, like a puzzle. Molecular shape matters. A drug-receptor interaction is formed. Result of the interaction depends on whether the drug is an agonist or antagonist.
Affinity
How well a drug and a receptor bind to each other.
List the process of pharmacokinetics
- Absorption
- Distribution
- Metabolism
- Excretion
Absorption,
- Describe
- What drug admin skips this
Movement of a drug from site of administration to blood stream.
-Drugs delivered IV skip this bc delivered straight to the bloodstream.
Factors that affect absorption
- Time of day
- Age of patient
- Drug pH, stomach might break it down to useless form, enteric coated to protect from the stomach’s acidity (take on empty stomach)
- Decreased BV
- Dehydration
- Circulatory issues (Reduced blood flow to an area decreases absorption. e.g. Sepsis and exercise)
- Lipid soluble drugs absorbed faster
- Affected/ swollen area affect drug to bloodstream
Types of drug administration
- Enteral (fast pass effect)
- Sublingual/buccal (nitroglycerin)
- Parenteral (we went over IM, Id, and SUB Q in lab)
- Topical route (eyes, ear, vagina, skin, rectum)
- Transdermal and inhaled)
Topical app produces…
long/short half life?
Topical application
delivers a uniform amount of drug over a longer period, but the effects of the drug are
usually slower in their onset and more prolonged in their duration of action as compared
with oral or parenteral administration. (long half life)
Distribution definition and pathway
-Process of drug travelling to the target site
-Travels first to sites of high blood delivery (brain, kidney, liver), then to less vascularized areas (skin, muscle, fat)
stomach–> SI–>liver
SI to liver thru diffusion
Liver’s effect on drug
Acts as a filter, inactivates meds
deactivate–> removes toxin–>reactivate med (significantly less bioavailable)
Metabolite (toxin) goes to kidney/GI (more polar/water soluble)
What can affect distribution
circulation (low BP)
-most vasc to less vas
Liver enz
AST (aspartate aminotransferase)
-Also found in heart
ALT(alanine aminotransferase)
-liver specific
AST level
-What does high level indicate?
Low okay
- high level indicate liver or heart damage
- Normal level:5 to 40
ALT
7 to 56
Primary site of excretion
kidney
*****teach P to drink water to prevent toxicity
Lab work to check Kidney func
BUN ( blood urea nitrogen)
creatinine
(both invite K+)
creatinine
-normal level
-what does a high level indicate?
what does a low level indicate?
normal: 0.5 to 1.2mg/dL
high level could be impaired kidney function, CHF
shock, or dehydration
Low levels – diet low in protein, severe
liver disease, low muscle mass
K+
3.5 to 5
BUN
10 to 20mg/dL
>50mg/dL=poor liver fnc
When to draw blood to check peak serum level of drug
1 to 1.5hr later
When to draw blood to check trough serum level of drug
30 mins before the next dose
How to check therapeutic levels of a drug
check peak and trough level
*****imp for drugs with low therapeutic index
steady state
This is reached when drug amt eliminated= amt absorbed per dose
achieved after 4/5 half lives
Steven Johnson effect
adverse effect
Drug interaction types
additive: 1+1=2
synergistic: 1+1>2
antagonistic: 1+1<2
Factors affecting drug action
-dev’l consideration—pregnant/fetus
-weight
culture-some won’t take blood infusion
gender
-genetic and cultural factors
psychological factors
env
-pathology
Heparin
- fnc of drug
- How is it monitored
- lab values to expect
blood thinner
-monitor with PTT
normal blood clot when not on med is 25 to 35secs
when on heparin: 46 to 70 secs
If low or normal while on Heparin increase the dose (goal is to prevent blood clot)
protamine
-how is it delivered?
heparin antagonist
-delivered SUB Q IV
Lovenox
- Fnc of drug
- How is it monitored?
blood thinner
monitor with platelet count
platelet values and func
used for blood clotting
150k to 450k/uL
Coumadin
- How is it monitored?
- Fnc
blood thinner
monitor w/PT (prothrombin) and INR
PT
- normal value
- what to do if low or normal
- what does result tell us
Tells us whether normal blood or not
not if to inc/dec coumadin
Normal= 9.5 to 13.5
If it is low or normal while on Coumadin
need to increase the dose
The higher the dose the thinner the blood
INR
- normal
- lab value when on coumadin
- higher #s seen in? what values will be seen?
tells us if to inc/dec coumadin
2-3 when on coumadin
normal: 0.8 to 1.2
3.0-4.5 Seen in clients with Valve replacements
result of hyperkalemia
Metabolic acidosis *Dehydration *Excess potassium intake *Potassium sparing diuretics *Tissue damage-Burns (K+ goes out of cell) *Renal Failure
result of hypokalemia
N/V, loss of KCL, Diuretics
Muscle Cramps, Dysthymias
------------------
Inadequate intake of K+
*ETOH abuse
*CHF/HTN
*GI Loss-V&D
*Renal Loss
*Diuretics-Loop: Furosemide
(Lasix)
Bumetadine (Bumex)Thrombocytopenia
-definition
-lab value
result?
platelet below 150,000
excessive bleeding, bruising
Thrombocytosis
platelet count is above 450,000 Blood too thick
When to hold lovenox
when platelet is less that 200
Normal WBC count
4500 to 11k mm3
Hemoglobin (Hgb
13 to 17g/dL
CAD
Coronary heart disease
CHF
Congestive heart failure
