NUR 153pharmacology ATI proctor notes.

Chapter 1: Pharmacokinetics and Routes of Administration • Absorption – how quickly or how well it is absorbed; DEPENDS ON THE ROUTE o Oral – takes a while, must pass through the GI tract ▪ Food can SLOW this down ▪ pH juices play a role ▪ Liquids vs extended release tablets o Sublingual – quick, under the tongue o Intradermal/topical – slow, gradual o Intravenous (IV) – the FASTEST route; immediate absorption • Distribution – requires binding proteins of medication o Albumin is a common binding protein • Metabolism – medication is inactivated o Occurs primarily in the LIVER o Factors that Influence Metabolism: ▪ Age – dysfunction of liver ▪ Children – metabolism is not mature yet First-pass effect – medications are inactivated through their first pass of the liver; THEREFORE, you may need a HIGHER DOSE of the medication to reach therapeutic effects • Excretion – primarily done by the KIDNEYS • Therapeutic Index o HIGH TI = wide safety margin, no need for routine monitoring o LOW TI = small safety margin; NEEDS MONITORING; HIGH risk of toxicity ▪ Ex: vancomycin; need to draw peak/trough blood levels • Half-life – the amount of time it takes for the medication in the body to drop by 50% o Short half-life – leaves the body quickly o Long half-life – lingers in the body for long periods; HIGH risk of toxicity • Agonist – medication designed to produce an action • Antagonist – opposes the action • Nursing Considerations for Routes of Administration o Oral: ▪ May need to mix with apple sauce ▪ Want patient to sit up/Fowler’s position ▪ “Chin to chest” to help with swallowing ▪ REMEMBER! NEVER chew enteric-coated capsules ▪ REMEMBER! Never break/chew extended-release capsules