Patho + Parm

Pharmakinetics

What the body does to the drug. (Drug movement throughout the body)

Absorption

The process by which a drug enters the bloodstream from its site of administration.

Distribution

The process by which a drug is transported throughout the body after entering the blood stream.

Metabolism

The enzymatic alteration of drug structure. What the body does to alter the drug.

Where are most drugs metabolized?

Liver

How can the body metabolize a drug?

• Inactive metabolite (turn off)

• Less active metabolite (turn down)

• A more soluble compound (easier for liver to excrete)

• More potent (converting an inactive drug to its active form)

Excretion

Removal of drugs from the body.

Bioavailability

The extent of drug absorption. How much of the drug is available to use.

First Pass Effect

Initial metabolism in the liver of a drug absorbed from the GI tract before it reaches systemic circulation in the bloodstream. Less bioavailability.

Enteral Route

The drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine. (goes through GI tract)

Main types of Enteral Routes:

Oral, sublingual, buccal, rectal

What medications should not be crushed?

Enteric coated (EC) tablets, extended release (ER, XR) medications, crush or chew capsules.

What medications can you crush?

Tablets or open capsules

Parenteral Route

Administered with a needle.

Types of parenteral routes:

• Intravenous (IV)

• Intramuscular (IM)

• Subcutaneous (sub-Q)- fatty tissue

• Intradermal- right under skin

• Intraarterial- into arteries

• Intrathecal-Spinal Colum

• Intraarticular- joints

What is the fastest route of medicine administration?

IV. 100% bioavailibility.

Topical Route

Medications absorbed through the SURFACE.

Topical Route Examples

• Skin

• Eyes

• Ears

• Nose

• Lungs (inhilation)

• Rectum (for local effects)

• Vaginal

Blood Brain Barrier

Protects the brain from harmful substances.

Most common form of excretion?

Renal

Important Renal Lab Values

Blood Urea Nitrogen (BUN), creatnine

Half Life

Time required for 50% of a given drug to be removed.

Steady State

Physiologic state in which the amount of drug removed via elimination is equal to amount of drug absorbed with each does.

Peak Level

Highest blood level of a drug (1.5 hours after infusion)

Trough Level

Lower blood level of a drug (30 minutes before next does)

Pharmacodynamics

The study of what drugs do to the body (mechanism of action MOA)

Therapeutic effect

Relationship between size of the dose and intensity of response.

Maximal efficacy

Ideal benefit of the drug.

Potency

How strong the drug is.

What is Mechanism of Action produce by:

Drug receptor relationships.

Receptor

Reactive sit on the surface or inside the cell

Enzyme

Drug chemically binds to an enzyme causing alteration in the enzyme’s interaction with its normal target molecules in the body.

Nonselective interactions

Drug targets cell membranes and various cellular processes causing alteration

Affinity

Attraction between drug and receptors

Intrinsic Activity

how well a drug activates a receptor once it binds to it.

Agonist

Drug that produce the response. The medication itself

Partial Agonist

Creates response; not as definitive or strong

Antagonist

Doesn’t produce a response at all.

Pharmacotherapeutics

Clinical use of drugs to prevent and treat disease.

Acute

Short term or urgent conditions

Maintenance

Long term; trying to help something but can’t fix it.

Supplemental

Replacement for things that are missing. Ex. insulin

Palliative

Comfort. Doesn’t fix problems but make pt feel better

Supportive

Helps maintain body intergity. Usually short term

Prophylatic

Prevention

Embric

Educated guess

Therapeutic Effect

Intended effect of medication

Idiosyncratic Effect

Rare, unpredictable reaction

Carcinogenic effect

Could cause cancer

Teratogenic Effect

Causes harm to fetus

Tolerance

Decreasing response to repeated drug