NR 293 QUESTIONS AND ANSWERS LATEST UPDATE

NR 293 QUESTIONS AND ANSWERS LATEST UPDATE Pharmaceutics The dosage form the determines the rate of drug dissolution Pharmacodynamics therapeutic effects /the way the drugs act on the body "what the drug does to the body" Pharmacokinetics what the body does to the drugs ADME ADME absorption distribution metabolism Excretion Absorption being absorbed by the tissue; relates to route of medication fastest to slowest route of medication by mouth sublingual liquid suspension capsule tablet enteric coated tablet extended release tablet bio-availability amount of drug that actually reaches circulation paternal drugs have.... 100% initial bio-availability because they bypass the liver first pass effect initial liver metabolism Oral drugs are metabolized in the liver prior to the blood stream and will NOT have the same bio-availability as IV drugs drugs NOT affected by first pass effect IV, sublingiual, transdermal path, suppository(parenteral) durgs affected by first pass effect Elixir, tablets, capsules (enternal) Half/Life the time it takes for 1/2 the drug to be eliminated in the body Distribution how drugs become available to action site Distribution sites plasma, interstitual fluid, intracellular fluid, transcellular fluid Fast distribution Heart and Liver Slow Distribution Muscle, Fat, Skin Protein binding many drug bind to protein in the blood, if a person has a lower albumin level, free drugs will circulate causing toxicity of the drug, Normal albumin level prescribed more then one medication= decrease in dose to avoid drug toxicity low albumin level = fewer protein binding site which can lead to toxicity commonly used protein bound drugs furosemide aspirin Ibuprofen Lorazepam Erythromycin Diazepam Normal albumin level 3.5-5.5g/dL Metabolism use and transformation of drugs so that they can be excreted from the body Main points of metabolsim kidney and liver Neonates/infants and metabolism have immature liver and kidneys causing them to have decreased or poor metabolism and excretion of drugs Fast acetylators vs slow acetylators genetic condition that affect how the liver metabolizes drugs -slow acetylators=dosage rate lowered because drug is not processed as quickly Excretion(final step) drugs are excreted through liver, kidneys, hair, skin, saliva etc. Major organs in metabolizing and excreting drugs liver and kidneys Excretion is VERY important in who very young (immature kidney/liver) elderly (aging liver/kidney) six rights of medication adminsitration right patient right drug right route right dose right time right documentation Medication error: if part of an order is missing.... always notify the prescriber