medication

Pharmacodynamics: The study of how a drug interacts with the cells of the body to produce a desired effect.
Metabolism: The process whereby the body breaks down a drug into metabolites.
- Main Site: Primarily occurs in the liver.
- Metabolite: A product generated from the metabolism of a drug.
- Many drugs possess what are called first-pass effects, where the initial passage through the liver reduces the concentration of the drug before it enters systemic circulation.
- Example: If a patient takes a 500 mg pill, the amount ultimately utilized by the body may be less due to metabolism.
Secretion: The process through which the body eliminates drugs.
- Main organ for secretion: Kidneys, but drugs can also be excreted in feces via the GI tract.

Therapeutic Dose: The dose of the drug that achieves the desired outcome.
- For example, if the therapeutic range is 50 mg/kg/day and a calculated dose is 45 mg/kg/day, it may not harm the patient, but it may not be effective.
Safe Dose: This refers to the maximum amount that can be administered without causing harm.
- Example: If the maximum safe dosage is 50 mg/kg/day, administering this amount is considered safe. Any excess is unsafe.

Minimal Dose: The smallest amount of drug that can produce a therapeutic effect.
Maximal Dose: The highest amount of drug that can be safely administered.
Toxic Dose: The amount that leads to adverse effects or signs of toxicity.

STAT: A medication order that needs to be administered immediately, usually in emergency situations. It has the highest priority.
PRN: An order that means medication should be administered as needed.

Unit Dose Systems: Utilized in long-term care facilities where medication is individually packaged for each day or dose.
- Normally these are organized in blister packs or similar forms that allow for easy dispensing (e.g., one pack per day).
How to Handle Medications:
- Always use appropriate containers, such as souffle cups, to dispense medications without direct hand contact.
- For liquid medications, ensure a graduated measuring device is used and pour at eye level on a flat surface.

Inhalers: Devices that administer medications, often bronchodilators or corticosteroids, via inhalation.
- Importance of timing: If patients are using two different inhalers, ensure bronchodilators are administered first before corticosteroids to maximize therapeutic effect.
- New trends in inhalers are allowing combinations of medications to improve patient adherence by requiring only one inhaler instead of two.

Enemas:
- Administration involves positioning the patient correctly and ensuring the lubricated tip is aimed towards the patient’s belly button during insertion.
Eye Drops: Procedure involves applying pressure to the inner canthus post-administration to prevent systemic absorption, especially relevant with beta-blocker eye drops (e.g., Timolol).
Ointments: Administered carefully with gloves to prevent systemic absorption through the skin.

Syringes: Different syringes (unit vs. ml) must be used correctly according to the dosage prescribed.
- A unit syringe is used specifically for insulin, while a ml syringe is used for other medications.
- Dosing must be precise; incorrect vial retrieval could lead to severe overdose.

Definition: Parenteral nutrition involves providing nutrients directly into the bloodstream via an IV due to inability to ingest food orally.
- Nutrition provided includes fats, lipids, vitamins, and other necessary substances tailored specifically for the individual patient.
- TPN solutions are prepared according to each patient's specific needs by pharmacists and are not reused between patients.
Ethics of Medication Administration: Balancing patient safety with necessary medical interventions, underscoring the need for understanding harm versus benefit in treatment procedures.