NURSING 101 Pharmacology Proctored ATI Study Guide. Exam (elaborations)

NURSING 101 Pharmacology Proctored ATI Study Guide. Exam (elaborations) Pharmacology Proctored ATI Study Guide Chapter 1: Pharmacokinetics and Routes of Administration • Absorption ▪ Route of admin affects the rate and amount of absorption o Oral: ▪ GI pH and emptying time ▪ Presence of food in the stomach or intestines ▪ Form of meds (liquid/XR) o Sublingual/buccal ▪ Quick absorption systemically through highly vascular mucous membranes o Inhalation via mouth/nose ▪ Rapid absorption through alveolar capillary networks o Intradermal, topical ▪ Slow, gradual absorption o SQ/IM ▪ Highly soluble meds have rapid absorption (10-30min), poorly soluble have slower absorption ▪ Blood perfusion at site of injection affect absorption o IV ▪ Immediate and complete • Distribution o Transportation of meds to sites of action by body fluids o Plasma binding protein: meds compete for protein binding sites within bloodstream, primarily albumin. The ability of med to bind to protein can affect how much med will leave and travel to target tissues. • Metabolism o Primarily occurs in the liver but can take place in the kidney o Factors that influence metabolism: ▪ Age (infants/older adults require smaller doses) ▪ First pass effect: liver inactivates some meds on first pass through and thus require sublingual or IV route (may need higher dose) • Excretion: o Eliminated through the kidneys. o Kidney dysfunction can result in elevated levels of medications. • Med Response o Maintain plasma levels between minimum effective concentration and the toxic concentration: • Therapeutic index (TI) o High TI has a wide safety margin. o Low TI requires monitoring of serum levels. o Tough levels: obtain immediately before next dose.