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The process by which drugs are Pharmacokinetics
absorbed, distributed within the body,
metabolized, and excreted.
The study of what the drug does to Pharmacodynamics
the body
Rate of dissolution Factors Affecting Drug Absorption
Surface area
Blood flow
Lipid solubility
pH partitioning
Blood flow to tissues Factors Affecting Drug Distribution
Ability to exit the vascular system
Blood-brain barrier
Protein-binding capacity
substances that are foreign to the Xenobiotics
body, usually synthetic chemical
compounds; medications are a
common example
xenobiotic-metabolizing enzymes Cytochrome P450 (CYP450)
necessary for the production of
cholesterol and steroids and the
detoxification of chemicals and drug
metabolism.
,responsible for phase 1 metabolism in Function of Cytochrome P450 (CYP450)
which drugs are oxidized, reduced, or
hydrolyzed
Oxidation; Reduction; Hydrolysis Phase 1 Metabolism of Drugs via P450
-Drug becomes completely inactive Three possible outcomes of phase 1 drug
metabolism.
-Drug becomes partially inactive but
one or more metabolites remain
active
-Original drug is not
pharmacologically active but one
metabolite remains active
Medications that can increase the rate CYP450 Inducers
of another drug's metabolism by
elevating CYP450 enzyme activity via
increasing enzyme synthesis.
decreasing the concentration of the
"parent drug"
CRAPGPS CYP450 Inducer Medications
Carbamazepine
Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
Medications that inhibit the metabolic CYP450 Inhibitors
activity of one or more of the CYP450
enzymes. Higher risk for toxicity;
prolongs the pharmacological effect
of the "parent drug".
,VISACKGQ CYP450 Inhibitor Medications
Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
-potentially Inappropriate Medication Beers Criteria
(PIM) use in older adults
-potentially Inappropriate Medication
(PIM) use in older adults due to
medication-disease or medication-
syndrome interactions that may
exacerbate the disease or syndrome
-medications to be used cautiously in
older adults
-clinically significant drug interactions
that should be avoided in older adults
-medications to be avoided or dosage
decreased in the presence of
impaired kidney function in older
adults
when one medication systemically Pharmacokinetic Interactions
alters the potency of another
medication.
result of a change due to one Absorption Interaction
medication's effect on another
medication's route of entry into the
body.
caused by the amount of Distribution Interaction
unbound/free medications available at
the various target sites.
, concentration of the medication after Metabolism Interaction
biotransformation into active and
inactive metabolites in higher or lower
than expected.
the body's ability to eliminate Elimination Interaction
medications in pure form or by
altering a metabolite from the body.
does not alter or impact absorption, Pharmacodynamic Interactions
distribution, metabolism, or
elimination because of the one
medication's ability to manipulate the
effect of another medication at its site
of action
refers to the nurse practitioner's ability Practice Authority
to practice without physician
oversight
refers to the nurse practitioner's prescriptive authority
authority to prescribe medications.
Nurse practitioners have the Full-practice scope
autonomy to evaluate patients,
diagnose, order and interpret tests,
initiate and manage treatments and
prescribe medications, including
controlled substances without
physician oversight.
Nurse practitioners are limited in at Reduced-practice scope
least one element of practice. The
state requires a formal collaborative
agreement with an outside health
discipline for the nurse practitioner to
provide patient care.