basics of pharm

what is pharmacology

study of drugs and its interactions in the body

what is pharmacokinetics

movement of meds in the body (what the body does to a drug)

4 processes of pharmacokinetics

absorption, distribution, metabolism, excretion

absorption

movement of meds from site of administration to blood

Rate = how soon the effects will begin

Amount = how intense the effects will be

distribution

movement of meds from blood to site of drug action

albumin

abundant protein in the blood and has a high propensity for meds to bind to it

metabolism

chemical breakdown of drugs in the body - primarily by the liver

1st pass effect

when the med goes right to liver before entering the circulatory system - liver takes some of the drug away before it is used by the body (can cause decrease effects)

excretion

elimination of drug from the body - primarily by the kidneys

principle of half life

how long it takes for concentration of medication in the bloodstream to decrease by 50%

steady state

“plasma drug plateau” - occurs after repeated dosage, around 4/5 half lives

routes of administration

oral (PO) - by mouth, slower to onset, cheaper, safer, med must go thru GI tract (causing absorption rate to vary)

sublingual (SL) - under the tongue, patient must let entire med dissolve - quicker absorbed b/c of lots of BV under tongue

rectal/vaginal

inhalation - dependent on paitents ability to inhale

intradermal/topical - @ site of application, use gloves

subcutaneously (SC) / intramuscularly (IM) - highly soluble & absorb quickly

intravenously (IV) - rapid onset, no barriers to absorption - can be dangerous b/c of this

therapeutic range

amount of drug needed in blood stream to be effective

why would a provider order 2 tablets on first day and then one tablet daily after?

b/c large initial dosage can help the body reach optimal levels faster

narrow therapeutic range

have to be very careful, very easy to over/under dose these types of medications. must monitor blood plasma levels to make sure the drug is optimal

what is pharmacodynamics

interactions b/n meds and the cells of the body

agonist

medication that mimics receptor activity in the body

antagonist

medication that blocks receptor activity, causing an opposite reaction

partial agonist antagonist

Nalbuphine - causes analgesia as its agonist effect & prevents respiratory distress as its antagonist effect

what if a patient needs to take meds on an empty stomach?

1 hour before meal or 2 hours after a meal

enteric coded meds

skip thru the GI tract and get released in the small intestine - good for patients with stomach discomfort

what is pharmacogenomics

how a person’s genetic makeup affects the way they responds to medications

naming of medications

generic: official name given to a medication, assigned by regulatory agencies. ex) ibuprofen

trade: trademarked name given by pharmaceutical company that markets the drug. ex) advil, motrin

6 rights of medication administration

right patient

right documentation

right dosage

right time

right medication

right route

complications with IVs

infiltration (IV heplock): when fluid gets into the surrounding tissue, moves out of vein

extravasation: burning of the surrounding tissue, could happen during chemo

hematoma

air embolus from catheter

phlebitis: inflammation of vein, IV in too long starts swelling the vein

cellulitis: inflammation of surrounding cells, bacteria from skin could have got into IV

side effects

central nervous system (CNS): brain fog, dizziness, confusion, headaches

extrapyramidal: tardive dyskinesia

anticholinergic - dry mouth, constipations, blurry vision, urinary retention (can’t eat, can’t shit, can’t see, and can’t pee) - benadril can cause this

cardiac

GI: vommitting

kidney