MSN 611 - Pharm Final Exam concepts
latest update
Pharmacokinetics
ADME
1. Absorption: how medication gains access to the body
2. Distribution
3. Metabolism
4. Excretion
1st pass effect
When a drug is metabolized at a specific point in the
body, resulting in a lower concentration of the active
substance.
This phenomenon is termed the first-pass effect and is
most often described in the context of absorption of
chemicals following ingestion. In general, the first-pass
effect after oral absorption is the result of efficient uptake
and metabolism of compounds by the liver.
Generic vs Brand
A medication only has ONE generic name but can have
MULTIPLE brand names (ex: ibuprofen; MOTRIN/ADVIL)
When should a patient be assessed before administering
a medication?
,The patient should be assessed right before
administration of a drug (ex: assess BP prior to
administering a BP med)
What assessment in a patient needs immediate
intervention?
Oliguria or anuria
NSAIDS
Nephrotoxic & Hepatotoxic
COX-1/COX-2 inhibitors with the exception of Celecoxib
#1 Adverse Effect: GI bleeding (fecal occult blood test)
Acetaminophen
Hepatotoxic
Not an antiinflammatory
Corticosteroids
Different routes--> inhaled, intranasal, IM, topical
Major systemic adverse effects: hyperglycemia, HTN,
depressed immune function, decreased bone density (for
these reasons we do NOT like to administer steroids
systemically)
What reasons are steroids used?
Asthma, cancer, nausea, etc.
Serotonin 5-HT Receptor Agonists (-triptans)
Work to treat migraines
, Migraines are most common in females
These medications are TERATOGENIC
Contraindicated in patients with cardiac disease, HTN, or
taking other medications such as SSRIs/SNRIs
Opioids
Patients should not be on more than one opioid
medication
Can cause bradypnea and hypotension
Long-term side effect: constipation
*Naloxone is used to reverse OD
What other uses do opioids have?
Cough (codeine)
Diarrhea
SSRIs
Increase overall serotonin in the body
1st line medication for depression and anxiety
Sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil),
escitalopram (Lexapro), and citalopram (Celexa)
Can increase risk for suicide (black box warning) --> ask
the patient if they have any thoughts of suicide
SE: weight gain and sexual dysfunction
Can cause insomnia so this should be taken in the
morning
latest update
Pharmacokinetics
ADME
1. Absorption: how medication gains access to the body
2. Distribution
3. Metabolism
4. Excretion
1st pass effect
When a drug is metabolized at a specific point in the
body, resulting in a lower concentration of the active
substance.
This phenomenon is termed the first-pass effect and is
most often described in the context of absorption of
chemicals following ingestion. In general, the first-pass
effect after oral absorption is the result of efficient uptake
and metabolism of compounds by the liver.
Generic vs Brand
A medication only has ONE generic name but can have
MULTIPLE brand names (ex: ibuprofen; MOTRIN/ADVIL)
When should a patient be assessed before administering
a medication?
,The patient should be assessed right before
administration of a drug (ex: assess BP prior to
administering a BP med)
What assessment in a patient needs immediate
intervention?
Oliguria or anuria
NSAIDS
Nephrotoxic & Hepatotoxic
COX-1/COX-2 inhibitors with the exception of Celecoxib
#1 Adverse Effect: GI bleeding (fecal occult blood test)
Acetaminophen
Hepatotoxic
Not an antiinflammatory
Corticosteroids
Different routes--> inhaled, intranasal, IM, topical
Major systemic adverse effects: hyperglycemia, HTN,
depressed immune function, decreased bone density (for
these reasons we do NOT like to administer steroids
systemically)
What reasons are steroids used?
Asthma, cancer, nausea, etc.
Serotonin 5-HT Receptor Agonists (-triptans)
Work to treat migraines
, Migraines are most common in females
These medications are TERATOGENIC
Contraindicated in patients with cardiac disease, HTN, or
taking other medications such as SSRIs/SNRIs
Opioids
Patients should not be on more than one opioid
medication
Can cause bradypnea and hypotension
Long-term side effect: constipation
*Naloxone is used to reverse OD
What other uses do opioids have?
Cough (codeine)
Diarrhea
SSRIs
Increase overall serotonin in the body
1st line medication for depression and anxiety
Sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil),
escitalopram (Lexapro), and citalopram (Celexa)
Can increase risk for suicide (black box warning) --> ask
the patient if they have any thoughts of suicide
SE: weight gain and sexual dysfunction
Can cause insomnia so this should be taken in the
morning
