\u0e50 Because of this competition there is more free unbound drug this can lead to

๐ because of this competition there is more free

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Because of this competition, there is more free, unbound drug; this can lead to and unpredictable response called a drug-drug interaction Blood-Brain Barrier: The barrier system that restricts the passage of various chemicals and microscopic entities (bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen Metabolism: o Process by which the body changes a drug from its original form to a form that is pharmacologically inactive and can be readily eliminated or excreted o Also called Biotransformation o Biochemical alteration of a drug into: Inactive metabolite More soluble compound More potent metabolite o The organ most responsible for metabolism is the LIVER Other metabolic tissues include: Skeletal muscle Kidneys Lungs Plasma Intestinal mucosa o Factors that affects metabolism: Decrease metabolism: Cardiovascular dysfunction Renal insufficiency Starvation Obstructive jaundice Slow acetylator Increase metabolism: Fast acetylator Barbiturates
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Rifampin therapy o Effects of metabolism: Delayed drug metabolism results in: Accumulation of drug Prolonged action Stimulating drug metabolism results in: Diminished pharmacologic effects Excretion: o Process where all drugs and/or their metabolites are eliminated from the body o Primary organ responsible for excretion is the kidneys Liver and the bowel/intestines also play a role in excretion Special Patient Populations o Consider pathophysiologic processes in patients such as renal or hepatic dysfunction Example: If a patients liver functions are elevated, and doctor orders Tylenol you will not give it to them because it is toxic to the liver, which will be an issue if liver enzymes are already elevated o Consider developmental and maturational changes in organ systems o Consider the effects of disease (s) on drug disposition Pharmacodynamics: What the drug does to the body: “The study of the biochemical and physiological effects of drugs and the study of mechanisms of drug actions in living organisms” o Not the same as pharmacokinetics; which is what the body does to the drug Action/ Mechanism of Action: o Once the drug is at the site of action it can: Modify (increase or decrease) the rate at which the cell or tissue functions Modify the strength of function of that cell or tissue o What a drug CAN’T do is cause a cell or tissue to perform a function that is not part of its natural physiology Reactions to drugs: o Therapeutic Effect: Expected or predictable response This is the end goal of giving a medication o Side Effects: Unintended effects If a patient is having side effects, you treat the symptom (ex: nausea) o Adverse Effects: Severe responses to medication If patient is having an adverse effect, the nurse: DISCONTIUES the drug ASAP Monitor patient to see if they are okay Contact HCP Fill out incident report o Toxic Effects:
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