PMHNP Module 3 passed 100%
What routes of med admin are parenteral - All Injections ( IM Sub Q IV, Intrathecal), AND Inhaled , transdermal (patches) , transmucosal (sublingual, nasal, rectal) . All PO meds = enteral; Topical is all ointments placed on the skin PO meds absorption pattern - Varies greatly due to: »»Stability and solubility of the medication »»Gastrointestinal pH and emptying time »»Presence of food in the stomach or intestines »»Other medications currently being administered »»Forms of medications (enteric-coated pills, liquids) Rectal medication admin is? - Unreliable/ inconsistent absorption/ good for unconscious, vomiting pts or small children parenteral = - any route of administration other than oral or rectal ; injections, irrigation solutions, dialysis solutions Pharmacokinetics - What the body does to drug/ how it processes it. The process by which drugs are absorbed, distributed within the body, metabolized, and excreted. factors that impact drug absorption - Body Factors: Area of absorptive surface i.e. in GI the microfolds increase surface area, gut pH level, GI motility, presence of other substances. other diseases; In elderly less acidic stomach ph and less blood flow to GI. Drug Factors: Formulation , molecular size , lipid water solubility, concentration etc. Pharmacodynamics - = study of what a drug does to body relationship between drug concentration @ site of action and resulting effect, including time course and intensity of therapWhat is a decreased effects of the same dose of a drug over time - Tolerance ( mostly patients taking benzo, pain rx etc) Your client Sam is being treated for panic disorder with agorophobia. He is currently prescribed Paroxitine (Paxil CR 37.5, qd) and Clonazepam (Klonopin 0.5 mgqd prn. He has been on Clonazepam for 2 years and admits needing 4 pills to achieve the same effect that 1 pill initially produced What is an electrical stimulus for bipolar which leads to seizure - kindling from Prozac to MAOI, how long to wait - 5-6 weeks due to prozac have a long half-life What is combining an MAOI with a serotonergic agent is contraindicated because this may cause what - Serotonin Syndrome (PB pg 156) What causes Serotonin Syndrome - drugs combination: 1)SSRIs and MAOIs 2)Drug and herbal interactions 3)SSRI and St. John's wort What are symptoms of serotonin syndrome - -Autonomic Instability -Altered Sensorium -Restlessness -agitation -myoclonus -hyperreflexia -hyperthermia -diaphoresis -tremors eutic and adverse effects. The effect of a drug present at site of action is determined by that drug's binding with a
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