Principles of Pharm
&
pharmacokinetics - how the med travels through body
3 absorption - from location of administration to bloodstream
routes
• oral - must absorb through GI tract; quickish depends on pH, emptying, other meds
• sublingual/buccal - must dissolve first; quick systematically
• rectal/vaginal - stool or vag infection; quick local and systematically
• inhalation - inspiratory effort; rapid
• subcutaneous/IM - none; depend on perfusion/solubility
• IV - none; immediate and complete access
pharmadynamics - interactions between meds and target
7
& distribution - transport to target site
• agonist - bind to receptor (morphine)
depends on • antagonist - block receprot (naloxone)
• circulation • partial agonist - act as both
• permeability - fat solubility
> metabolism - active to inactive
liver, kidney, lung, intestine, blood
rate depends on
• age; babies and old decreased liver fxn @ risk for toxicity
• enzymes
• first pass effect - decreased after pass through liver; loading dose, or sublingual, IV
• metabolic pathways > routes
• nutritional status oral (PO)
& excretion - elimination from body • considerations - vomiting, dysphagia,
kidneys, liver, lungs, intestines, exocrine glands confusion (older)
• dysfunction - increased levels and toxicity • w/ food when appropriate
• monitor by BUN, creatinine, urine output • don't crush time release
• safe, cheap, easy
• variable absorption, first pass, must be
Y
therapeutic index (TI) - ideal amount of med in body alert
TI - wide safety margin topical
TI - smaller window • to skin/mucous membrane (with gloves)
• painless, limited effects
considerations:
• inhalation (spacer for pedi)
• route of admin.
- metered-dose (MDI) - shake
• onset
- dry-powder (DPI) - don't shake
• peak
- corticosteriod; rinse for thrush
• plateau parenteral
• duration • intradermal - 10-15·0.1ml
-allergy, cosmetic -
>
-
half-life - time to decrease by 50% • subcutaneous - 45-60 ↑ fat 90 ↳1.5ml
• liver and kidney fxn affects -heparin, insulin
- decreased: meds stay longer
W
• intramuscular - 90 1-3ml
• steady blood concentration - 4 1/2 lives • intravenous - size depends
• inform monitoring in overdose -meds, fluids
&
pharmacokinetics - how the med travels through body
3 absorption - from location of administration to bloodstream
routes
• oral - must absorb through GI tract; quickish depends on pH, emptying, other meds
• sublingual/buccal - must dissolve first; quick systematically
• rectal/vaginal - stool or vag infection; quick local and systematically
• inhalation - inspiratory effort; rapid
• subcutaneous/IM - none; depend on perfusion/solubility
• IV - none; immediate and complete access
pharmadynamics - interactions between meds and target
7
& distribution - transport to target site
• agonist - bind to receptor (morphine)
depends on • antagonist - block receprot (naloxone)
• circulation • partial agonist - act as both
• permeability - fat solubility
> metabolism - active to inactive
liver, kidney, lung, intestine, blood
rate depends on
• age; babies and old decreased liver fxn @ risk for toxicity
• enzymes
• first pass effect - decreased after pass through liver; loading dose, or sublingual, IV
• metabolic pathways > routes
• nutritional status oral (PO)
& excretion - elimination from body • considerations - vomiting, dysphagia,
kidneys, liver, lungs, intestines, exocrine glands confusion (older)
• dysfunction - increased levels and toxicity • w/ food when appropriate
• monitor by BUN, creatinine, urine output • don't crush time release
• safe, cheap, easy
• variable absorption, first pass, must be
Y
therapeutic index (TI) - ideal amount of med in body alert
TI - wide safety margin topical
TI - smaller window • to skin/mucous membrane (with gloves)
• painless, limited effects
considerations:
• inhalation (spacer for pedi)
• route of admin.
- metered-dose (MDI) - shake
• onset
- dry-powder (DPI) - don't shake
• peak
- corticosteriod; rinse for thrush
• plateau parenteral
• duration • intradermal - 10-15·0.1ml
-allergy, cosmetic -
>
-
half-life - time to decrease by 50% • subcutaneous - 45-60 ↑ fat 90 ↳1.5ml
• liver and kidney fxn affects -heparin, insulin
- decreased: meds stay longer
W
• intramuscular - 90 1-3ml
• steady blood concentration - 4 1/2 lives • intravenous - size depends
• inform monitoring in overdose -meds, fluids
