PHARM: Detoxification

Define Detoxification

1. removal of toxic substances to promote homeostasis.

attributes of detoxification

1. Hepatic

2. Renal

Which organ is responsible for the metabolism of drugs?

1. liver

Excretion can happen through which organs

1. lungs

2. kidneys

impaired detoxification can lead to what…

1. waste accumulation

Detoxification relies on which organs?

1. liver and kidneys

Liver failure leads to…

1. accumulation of ammonia (not converted to urea)

Nursing consideration of Detoxification in Infants

1. may notice jaundice.

2. infants/ babies have larger liver.

3. some meds must be avoided

4. dosing of medication based on weight.

5. infants kidneys: inability to concentrate urine.

Nursing consideration of Detoxification in older adults

1. organ function begins to decline

2. increase risk of hepatotoxicity

3. increase risk of nephrotoxicity

4. must drink less when older.

Example of a liver disease?

1. cirrhosis

what is cirrhosis?

1. scarring of the liver tissue due to ongoing inflammation of liver (hepatitis)

what is hepatitis?

1. inflammation of the liver.

Example of a kidney disease?

1. chronic kidney disease

What chronic conditions can damage the kidney/liver?

1. diabetes - directly affect renal capillaries, affect kdineys

2. heart failure - heart can’t pump enough blood to kidney to function

3. chronic alcohol use

4. medication use

Why is ammonia more toxic than urea>

1. Easy to cross blood brain barrier

2. affects neurological system so it can cause change in mood, increase irritability

3. increase incoherence, confusion, and disorientation.

4. risk of asterixis

early signs of ureamia?

1. nausea

2. apathy

3. weakness

4. fatigue

5. mental status change

Functions of the liver

1. break down medications

2. metabolizes food

3. energy storage

4. helps store fat solubles like vitamin A, K, D, E, and (WATER SOLUBLE B12) helps absorb these vitamins

5. helps with production of clotting

6. bile secretion

Functions of the kidneys?

1. eliminate urine

2. balance electrolytes

3. balance acid base

if patient has kidney failure, what is restricted of them?

1. Potassium

2. phosphorus

3. protein intake

Primary prevention of detoxification

1. increase water intake

2. increase fiber intake

3. encourage regular toileting practice ( avoid delaying, going when you need to go).

4. avoid Smoking

5. avoid Contaminated food/fluids

6. decrease intake of Caffeine

7. Avoid straining

s/s of liver disease

1. jaundice

2. clay color stool

3. ascites (big belly).