NUR-641E Advanced Pathophysiology and Pharmacology for the Nurse
Educator
1. Pharmacokinetics: Involves ADME (absorption,
distribution, metabolism and elimination).
Absorption: absorption from the administration site either
directly or indirectly into the blood/plasma.
Distribution: reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or
by other tissues. Elimination: lastly, the drug & its
metabolites are eliminated from the body
2. The route of administration with the highest bio-
availability is: Intravenous; putting entire dose into a
patient's vein and bypassing absorption. Intravenous route
avoids first-pass metabolism in the liver.
3. rectal administration disadvantages: variable and erratic
absorption
4. Steady state (SS): is usually reached within 4-5 half-lives of
a drug
5. The half-life of a drug is defined as: how long it takes
for half the drug to be excreted from the body
6. Half-life of a drug: Determines how frequently the drug
must be administered Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug is
metabolized at a con- stant rate per unit time.
,7. CYP3A4 substrate drugs: May have enhanced activity if
any CYP3A4 inducer drugs are used along with it.
8. Drug development steps (according to the FDA):
Discovery: laboratory re- search to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety
(Phase II)
,Clinical research in humans comparing the new drug to
accepted medications or placebo depending on the study
(Phase III)
FDA review of the results to determine approval
Post-marketing study to identify adverse effects not found in
earlier clinical studies (Phase IV)
9. Medication safety organizations: The Institute for Safe
Medication Practices (ISMP)
The Institute of
Medicine (IOM) The Joint
Commission
The National Coordinating Council for Medication Error
Reporting and Prevention (NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
10.Adverse Drug Reactions (ADRs): Two basic type of
ADRs: pharmacological and idiosyncratic.
85% to 90% of ADRs are pharmacological.
Adverse drug reactions are usually preventable, frequently
occur in a hospital or nursing home setting, and include
medication errors, adverse drug effects, allergic and
idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate
that ADRs be reported.
, Polypharmacy involves using multiple healthcare providers for
care, using multiple medications, and using several
pharmacies for prescription filling.
11. Cardiovascular-Angiotensin converting enzyme
inhibitors (ACEIs):: -
Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of
angiotensin-convert- ing enzyme.
*Important side effects of ACE inhibitors include cough and
angioedema; discon- tinue the ACEI if angioedema occurs.
Educator
1. Pharmacokinetics: Involves ADME (absorption,
distribution, metabolism and elimination).
Absorption: absorption from the administration site either
directly or indirectly into the blood/plasma.
Distribution: reversibly or irreversibly move from the
bloodstream into the interstitial and intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or
by other tissues. Elimination: lastly, the drug & its
metabolites are eliminated from the body
2. The route of administration with the highest bio-
availability is: Intravenous; putting entire dose into a
patient's vein and bypassing absorption. Intravenous route
avoids first-pass metabolism in the liver.
3. rectal administration disadvantages: variable and erratic
absorption
4. Steady state (SS): is usually reached within 4-5 half-lives of
a drug
5. The half-life of a drug is defined as: how long it takes
for half the drug to be excreted from the body
6. Half-life of a drug: Determines how frequently the drug
must be administered Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug is
metabolized at a con- stant rate per unit time.
,7. CYP3A4 substrate drugs: May have enhanced activity if
any CYP3A4 inducer drugs are used along with it.
8. Drug development steps (according to the FDA):
Discovery: laboratory re- search to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety
(Phase II)
,Clinical research in humans comparing the new drug to
accepted medications or placebo depending on the study
(Phase III)
FDA review of the results to determine approval
Post-marketing study to identify adverse effects not found in
earlier clinical studies (Phase IV)
9. Medication safety organizations: The Institute for Safe
Medication Practices (ISMP)
The Institute of
Medicine (IOM) The Joint
Commission
The National Coordinating Council for Medication Error
Reporting and Prevention (NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
10.Adverse Drug Reactions (ADRs): Two basic type of
ADRs: pharmacological and idiosyncratic.
85% to 90% of ADRs are pharmacological.
Adverse drug reactions are usually preventable, frequently
occur in a hospital or nursing home setting, and include
medication errors, adverse drug effects, allergic and
idiosyncratic type reactions.
ADRs are not commonly reported; the FDA does not mandate
that ADRs be reported.
, Polypharmacy involves using multiple healthcare providers for
care, using multiple medications, and using several
pharmacies for prescription filling.
11. Cardiovascular-Angiotensin converting enzyme
inhibitors (ACEIs):: -
Lisinopril, captopril, enalapril, ramipril, benazepril, fosinopril;
*ACEIs reduce blood pressure by suppressing the release of
angiotensin-convert- ing enzyme.
*Important side effects of ACE inhibitors include cough and
angioedema; discon- tinue the ACEI if angioedema occurs.
