Answers|Latest Update
Prescriptive authority
legal authority granted to advanced practice nurses to prescribe medication; DETERMINED BY STATE
LAW
Rational Drug Selection
based on individual patient and addresses disease specific information: ONLY A GUIDELINE
Drug Selection
includes analysis of cost, guidelines, avaibalbility, interactions, side effects, allergies, hepatic and renal
function, need for monitoring, special precautions i.e elderly
medication education basic components
medication name
purpose
dosing regimen
administration
adverse effects
any storage needs
associated labs testing
food & drug interactions
duration of therapy
medication adherence
barriers to adherence=
forgetfulness
lack of planning
cost
dissatisfaction
altered dosing
Phamacokinetics
study of drug movement throughout body
principles of pharmacokinetics
absorption
distribution
metabolism
excretion
Passage of drugs across membranes
- channels and pores
- transport systems (P-glycoprotein)
- direct penetration of the membrane
Absorption of drugs
, Transfer of drugs from site of administration across cell membrane into the blood stream
factors that affect absorption of drugs
rate of dissolution- how easy dissolves
surface area- >surface area moves faster
blood flow- >blood flow moves faster
lipid solubility - lipid easily cross membrane
ph partitioning -
Distribution of drugs
movement of drugs from systemic circulation to site of drug action
factors that determine drug flow
blood flow to tissues
ability to exit vascular system
ability to enter cell
Drug ability to exit vascular system
capillary bed- typical
blood brain barreier
placenta drug transfer
protein binding - albumin
drug ability to enter cell
binds with receptors on external surface of cell membrane
drug metabolism
the enzymatic biotransformation of a drug structure
most occur in liver by P450 system
first pass effect
rapid hepatic inactivation of drug on its first pass through liver
drug excretion
elimination of a drug from the body
Drug Excretion Routes
renal
breast milk
bile
lungs
sweat
saliva
therapeutic drug range
range of drug between minimum effective dose and toxic dose. larger index - safer dose smaller
index- harmful dose