Facts for exam

ADME

Absorption → Distribution → Metabolism → Excretion

Pharmacokinetics

what the body does to the drug

Pharmacodynamics

what the drug does to the body

Liver

major site of metabolism

Kidneys

major route of excretion

First-pass effect

occurs primarily with oral medications

Bypass

IV administration bypasses absorption and has essentially complete bioavailability

Narrow therapy index

small safety margin → close monitoring

Long half-life

drugs stays in blood longer

Agonist

activates a receptor

Antagonist

blocks or inhibits a receptor

Medication reconciliation

Medication reconciliation prevents discrepancies at transitions of care

If medication error occurs

asses the client FIRST

What to do when med error occurs

never hide the error, always report as soon as possible

NSAIDs

GI bleeding + renal concerns

Prednisone

infection, hyperglycemia, osteoporosis; don't abruptly discontinue after prolonged use

Methotrexate

monitor CBC/liver function; avoid alcohol

Biologic "mab" drugs

infection risk

Allopurinol prevents what? and doesn't help what?

prevents gout; does NOT provide immediate relief of an acute attack

Alendronate

empty stomach + ≥8 oz water + remain upright ≥30 min

Raloxifene

thromboembolism risk

Calcium

hypercalcemia, kidney stones, constipation; interacts with many medications

Ondansetron

QT prolongation/torsades + serotonin syndrome are serious concerns

Psyllium

ALWAYS take with ≥8 oz fluid

Iron

constipation + dark stools; empty stomach improves absorption but food may improve tolerance