Desireable meds
Eesults in therapeutic effects
Undesirable meds
Adverse/ side effects or complications
What is a drug?
Any substance, other than food, used in the ____ disease
Prevention, diagnosis, alleviation, treatment, cure
Factor impacts a drug mechanism of action?
Age
Age
smaller med doses for the elderly
"start low, go slow"
All peds meds are weight-based
Kidney/Liver disease
Causes toxicity
Pharmacogenetics
the study of how a person's genes affect the way he or she responds to drugs
- kidney/liver function
Ethnopharmacology
Meds are absorbed and metabolized differently by people of different groups
- think of enzyme CYP2D6
Agonist
Meds that bind to or mimic the receptor activity that endogenous compounds regulate
ex: morphine sulfate bc activates receptors that produce analgesia, sedation, etc.
Antagonist
Meds that can block the usual receptor activity that endogenous compounds regulate or the receptor activity of other meds
Addiction
A psychological and physical dependence upon a substance beyond normal voluntary control, usually after prolonged use of a substance
Dependence
When a person stops using a drug, their body goes through "withdrawal" : a group of physical and mental symptoms that can range from mild (if the drug is caffeine) to life-threatening ( such as alcohol or opioids)
Tolerance of Drugs
Reduced reaction to drug following its repeated use. Increasing it dosage may re-amplify the drug's effects; however, this may accelerate tolerance, further reducing the drug's effects
Tachyphylaxis
Rapidly diminishing response to successive doses of a drug, rendering it less effective.
Teratogenic Drugs
Drugs that cause developmental abnormalities
X (teratogenic)
Fetal abnormalities reported and positive evidence of fetal risks in humans; use in pregnancy is contraindicated
Teratogenic
C, D, X have significant risk involved
Pharmacokinetics
The activity of drugs in the body over a period of time, including the process by which drugs are absorbed, distributed in the body, localized in the tissues, and excreted
Absorption
movement of the drug from the site of admin to various tissues of body
FIRST PASS EFFECT
FIRST PASS EFFECTS
drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug
Distribution
the blood-brain barrier is a pharmacokinetic property that makes it difficult to treat various disease processes
ex, brain cancer
Metabolism
LIVER LIVER LIVER is responsible for the metabolism of drugs that occur in the body (90%)
What are the 2 lab values we check when we are determining liver function?
ALT, AST
Labs to check if meds is safe for Kidney/ Liver function
ALT/AST and BUN/Creatinine
Liver test
AST/ALT
Kidney test
BUN/Creatinine
Anaphylaxis
severe allergic reaction involving the massive, systemic release of histamine and other chemical mediator of inflammation that can lead to life-threatening shock
FIRST priority is to stop the med
Anaphylaxis
Tips of Herbal Remedies
- DO NOT take if PREGNANT
- DO NOT give to infants or young children
-DO NOT take a large quantity of any herbal preparation
tips for Herbal
high risk of reactions when Rx ( prescription ) or OTC (over the counter) drugs are combined with alternative meds
Rights of Meds/ SAFETY ADMIN
right pt, right med, right dosage, right route, right time, right documentation, right client educ., right to refuse, right to assessment, right to eval
Medication Reconcilation
Done on admission or first visit
-ALL meds
Rx, OTC, Herbals
Medications
Documents immediately after you give the meds
When do we re-evaluate the pt after giving meds?
PO- 1 hr
IM- 30 min
IV - 10 min
AST
0-35 units/L
ALT
4-36 units/L
Creatinine M
0.6-1.2 mg/dL
BUN
10-20 mg/dL
Creatinine F
0.5-1.1 mg/mL