Chapter 28 Outline - Pharmaco-therapeutics achievement of...

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Pharmaco-therapeutics- achievement of the desired therapeutic goal of drug therapy. The clinical purpose for administering a drug (indication) Pharmacokinetics- the effect of the body on the drug, once the drug enters the body; movement of drug molecules in the body in reaction to absorption distribution metabolism and excretion. Pharmacodynamics- drugs alter cell physiology and affect the body Absorption - drug is transferred from site of entry to the blood stream. Efficacy – refers to how well the drug exerts therapeutic effectiveness. Potency – how much of the drug is required to get the desired therapeutic effects. Loading dose- larger than normal dose is given when patient is in acute distress and maximum therapeutic effect is desired asap; Toxicity can be detected quickly and treated in hospital environment, (when therapy is initiated) Maintenance dose- usual or daily dosage (keep patient at therapeutic level) Distribution- movement of medication through the bloodstream to the cells Metabolism - Conversion of the drug by the liver Excretion- Removal of drug by the kidneys or lungs (inhalation anesthetics); drug is inactive in this process . Blood brain barrier- tightly packed capillary walls that supply blood to the brain. Drug cellular interaction- drug interacts with one or more cellular structures to alter cell function. Synergism - Drug interaction that increases the drugs affect Histocompatibility antigens - genetically determined markers for self-cell identification.
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Drug Names i. Chemical Names- main chemical in drug (something can’t pronounce ii. Generic Name- drugs active ingredient (acetaminophen) assigned by manufacturer (used to order meds) iii. Brand name- Tylenol Drug Preparations i. Capsule (oral) a. Can’t be divided equally and should not be crushed ii. Elixir a. Contains alcohol and should always be clear iii. Enteric coated a. Dissolves in small intestine; coated to prevent stomach irritation b. Resistant to the digestive action of the stomach iv. Syrup a. Contains sugar and particulates may form v. Suspension a. Must be shaken well Pharmacokinetics Absorption (enters blood stream) is influenced by…. o Rate Orally take longest to absorb Injected absorbed more rapidly than oral IV placed directly in blood stream; are not absorbed; immediate effect. o Routes of administration Enteral – GI tract Fowlers position helps minimize gastric reflux 2
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Avoid crushing sustained release pellets for tube fed clients. Oral Sublingual –under tongue Buccal- in cheek or under top lip Nasogastric Check tube placement before med administration gastronomy o Parenteral- avoids GI tract (injections) Intra…. Subcutaneously o Topical- Applied to skin or mucosa membranes Lipid solubility o More lipid soluble drug can be absorbed easily and pass more easily through the cell membrane Absorption is increased with increased blood flow o Patients with impaired circulatory function absorb drugs slower than patients with normal circulatory function.
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