Introduction to Pharmacology

***6 rights of med admin

1. drug 2. dose 3. route 4. patient 5. time 6. documentation

A drug that delivers 300 mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after one half-life?

150 mg

The nurse is preparing to five an oral dose of acetaminophen (Tylenol) to a child who weight 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose?

180 mg

The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk with regard to drug therapy? a. immature renal system b. increased peristalsis in the GI tract c. irregular temperature regulation d. smaller circulatory capacity

a

The nurse is teaching a pregnant patient about the effects of medication on fetal development. The nurse understands the greatest risk for medication effects on developing fetuses occurs during which time period? a. First trimester b. Second trimester c. Third trimester d. Birthing process

a

A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation? a. Activity intolerance b. Risk for injury c. Disturbed body image d. Self-care deficit

b

A patient who had a thyroidectomy is now taking levothyroxine, a thyroid hormone, daily. Which term best describes this type of therapy? a. palliative b. maintenance c. supportive d. supplemental

b

An elderly woman told a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction or effect? a. allergic reaction b. idiosyncratic reaction c. mutagenic effect d. synergistic effect

b

In which step of the nursing process does the nurse determine the outcome of medication administration? a. Planning b. Evaluation c. Assessment d. Implementation

b

To achieve the most rapid onset of action, the health care provider will prescribe the medication to be administered by which route? a. Intrathecally b. IV c. IM d. Subcut

b

***absorption

bioavailability first pass effect rate depends on route of administration amount absorbed directly determines intensity of drug action factors that affect it: -stomach acidity -changes in intestine -presence/absence of food -decreased bloodflow to intestine (time of day)

When administering two medications that are highly protein bound, the nurse understands to monitor the patient carefully for which effect? a. A short duration of medication action b. Increase in the risk of drug-drug interactions c. Immediate improvement in the patient's condition d. Hypovolemic shock caused by a low albumin level

b

What things should the nurse check when reviewing a prescription with a patient? (Select all that apply.) a. The patient's home address b. The route of administration c. The age of the patient d. The signature of the prescriber e. The patient's emergency contact

b and d

***considerations for older adult patients: pharmacokinetics

>65 years old high use of medications polypharmacy noncompliance, nonadherence increased incidence of chronic illnesses sensory and motor deficits absorption: gastric pH less acidic gastric emptying slowed movement through GI tract slowed because of decreased muscle tone and activity blood flow to GI tract reduced absorptive surface of GI tract reduced distribution: lower total body water percentages increased fat content decreased production of proteins by the lier, resulting in decreased protein binding of drugs (and increased circulation of free drugs) metabolism: aging liver produces fewer microsomal enzymes, affecting drug metabolism reduced blood flow to the liver excretion: decreased glomerular filtration rate decreased number of nephrons

Describe the phases of pharmacokinetics

A drug moves from the intestinal lumen into the mesenteric blood system A drug binds to the plasma protein albumin and circulates through the body Enzymes in the liver transform the drug into an inactive metabolite Drug metabolites are secreted through passive glomerular filtration into the renal tubules

the nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from IV to PO. The nurse expects the oral dose to be a. higher because of the first-pass effect b. lower because of the first-pass effect c. the same as the IV dose d. unchanged

Correct answer: A Rationale: The first-pass effect is the metabolism of a drug before it becomes systemically available, and it reduces the bioavailability of the drug. Therefore, oral doses need to be higher than IV doses because of the first-pass effect.

Which statement is an example of objective data? (Select all that apply.) a. The patient states that she has a headache. b. The patient has clear urine. c. The patient says that she feels like someone is touching her arm. d. The patient has had a fever for 5 days. e. The patient says that she has felt tired for almost a week.

b and d

A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow the pills. What will the nurse do? a. Crush the tablets and mix them with applesauce or pudding b. Call the pharmacy and ask for the liquid form of the medication c. Call the pharmacy and ask for the IV form of the medication d. Encourage the patient to try to swallow the tablets

Correct answer: B Rationale: The liquid form is appropriate because it is also given via the oral route. Enteric-coated tablets should not be crushed, and the patient should not be forced to take the tablets. This medication does not have an IV form, but even if it did, the routes cannot be changed without a health care provider's order.

The day shift charge nurse is making rounds. A patient tells the nurse that the night shift nurse never gave him his medication, which was due at 2100. What will the nurse do first to determine whether the medication was given? a. Call the night nurse at home b. Check the medication administration record c. Call the pharmacy d. Review the nurse's notes

Correct answer: B Rationale: The medication administration record is the legal documentation that the professional nurse uses to sign off medications that are given, so it should be checked first.

When teaching a pregnant woman about the use of drugs during pregnanacy, which statement will the nuse include? a. Exposure of the fetus to drugs is most detrimental during the second trimester of pregnancy b. Pregnant women must never take drugs to control hight blood pressure. c. Drug transfer to a fetus is most likely to occur during the last trimester of pregnancy d. A fetus is at greatest risk for drug-induces developmental defects during the second trimester of pregnancy

Correct answer: C Rationale: Drug transfer to the fetus is most likely to occur during the last trimester of pregnancy. Exposure of a fetus to drugs is most detrimental during the first trimester of pregnancy, and fetuses are at greatest risk for drug-induced developmental defects during the first trimester of pregnancy. Pregnant women need to take medications to control situations such as high blood pressure.

The nurse answers a patient's call light and finds the patient sitting up in bed and requesting pain medication. What will the nurse do first? a. Check the orders and give the patient the requested pain medication b. Provide comfort measure to the patient c. Assess the patient's pain and pain level d. Evaluate the effectiveness of previous pain medications

Correct answer: C Rationale: The nurse should always assess a patient before any intervention. Although the nurse will check the orders and possibly give the medication (and possibly even perform the actions in responses B and D), the first priority is assessment.

A nurse makes an error when administering medications to a patient. Which action by the nurse requires the supervising nurse to intervene? The nurse a. completes an incident report b. informs the prescriber of the error c. documents adverse effects to the medication error d. records completion of an incident report in the medical chart

Correct answer: D Rationale: If there is a medication error, the nurse should complete an incident report with the entire event, surrounding circumstances, therapeutic response, adverse effects, and notification of the prescriber described in detail. However, the nurse should not record completion of an incident report in the medical chart.

What does the nurse identify as a pharmacokinetic change that occurs in older adults? a. Gastic pH is more acidic b. Fat content is decreased because of increased lean body mass c. There is increased production of proteins by the liver d. The number of intact nephrons is decreased

Correct answer: D Rationale: In older adults, the gastric pH is less acidic because of a gradual reduction in the production of hydrochloric acid in the stomach, fat content is increased because of decreased lean body mass, and there is decreased production of proteins by the aging liver and reduced protein intake. It is correct that the number of intact nephrons decreases in older adults.

When administering medications to pediatric patients, the nurse understand that the dosage calculations for pediatric patients are different than for adults because pediatric patients a. are more likely to develop edema b. have more stomach acid c. have skin that is less permeable d. have immature liver and kidney function, resulting in impaired drug metabolism and excretion

Correct answer: D Rationale: In pediatric patients, body temperature is less well regulated, and dehydration occurs easily; pediatric patients lack stomach acid to kill bacteria and have skin that is thinner and more permeable. It is true that pediatric patients have immature liver and kidney function, resulting in impaired drug metabolism and excretion.

A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route? a. IV b. IM c. subcutaneous d. PO

Correct answer: D Rationale: Parenteral routes result in the fastest absorption and therefore also the fastest effects.

The patient's medication administration record lists two anti epileptic medications that are due at 0900, but the patient is NPO for a barium study. The nurse's coworker suggests giving the medications via IV because the patient is NPO. What will the nurse do? a Give the medications PO with a small sip of water b. Give the medications via the IV route because the patient is NPO c. Hold the medications until after the test is completed d. Call the health care provider to clarify the instructions

Correct answer: D Rationale: The dosage for the IV route would not be the same as for the PO route. Holding the medications may cause drug levels to drop and result in seizure activity, and giving the medications PO without consent may alter the test results. The nurse must never assume the route of medication administration and should consult the physician for clarification of the orders.

The nurse is preparing to administer a transdermal patch to a patient and finds that the patient already has a medication patch on his right upper chest. What will the nurse do? a. Remove the old medication patch and notify the health care provider b. Apply the new patch without removing the old one c. Remove the old patch and apply the new patch in the same spot d. Remove the old patch and apply the new patch to a different, clean area

Correct answer: D Rationale: Transdermal drugs should be placed on alternating sites, on a clean and nonirritating area, and only after the previously applied patch has been removed.

The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? (SATA) a. Metformin (Glucophage) 1000 mg PO twice a day b. Sitagliptin (Januvia) 50 mg daily c. Simvastatin (Zocor) 20 mg PO every evening d. Irbesartan (Avapro) 300 mg PO once a day e. Docusate (Colace) as needed for consipation

b and e

The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (SATA) a. explain to the child in advance about the injection b. provide a brief, concrete explanation about the injection c. encourage participation in the procedure d. make use of magical thinking e. provide comfort measures after the injection

b, d, and e

An 86-year-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities? a. The patient and patient's daughter will state the proper way to take the drug. b. The nurse will provide teaching about the drug's adverse effects c. The patient will state all the symptoms of digitalis toxicity d. The patient will call the prescriber if adverse effects occur

a

empiric treatment

based on clinical probability ex. giving broad spectrum antibiotic before receiving culture results

A pregnant patient who is at 32 weeks gestation has a cold and calls the office to ask about taking an over the counter medication that is rated as pregnancy category A. What is the appropriate response by the nurse?

Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it

Knowing that the albumin in neonates and infants has a lower binding capacity for medications, the nurse anticipates the health care provider will perform which action to minimize the risk of toxicity? a. Decrease the amount of drug given. b. Increase the amount of drug given. c. Shorten the time interval between doses. d. Administer the medication intravenously.

a

Patients with renal failure would MOST likely have problems with which pharmacokinetic process? a. Excretion b. Absorption c. Metabolism d. Distribution

a

Chapter 2 key points

The following definitions related to drug therapy are important to remember: pharmacology - the study or science of drugs; pharmacokinetics - the study of drug distribution among various body compartments after a drug has entered the body, including the phases of absorption, distribution, metabolism, and excretion; pharmaceutics - the science of dosage form design The nurse's role in drug therapy and the nursing process is more than just the memorization of the names of drugs, their uses, and associated interventions. It involves a thorough comprehension of all aspects of pharmaceutics, pharmacokinetics, and pharmacodynamics and the sound application of this drug knowledge to a variety of clinical situations Drug actions are related to the pharmacologic, pharmaceutical, pharmacokinetic, and pharmacodynamic properties of a given medication, and each of these has a specific influence on the overall effects produced by the drug in a patient. Selection of the route of administration is based on patient variable and the specific characteristics of a drug. Nursing considerations vary depending on the drug as well as the route of administration.

Chapter 1 key points

The nursing process is an ongoing, constantly changing and evolving framework for professional nursing practice. It may be applied to all facets of nursing care, including medication administration. The five phases of the nursing process include assessment; development of nursing diagnoses; planning with outcome identification; implementation, including patient education; and evaluation. Nursing diagnoses are formulated based on objective and subjective data and help to drive the nursing care plan. Nursing diagnoses have been developed through a formal process conducted by NANDA-1 and are constantly updated and revised. Safe, therapeutic, and effective medication administration is a major responsibility of professional nurses as they apply the nursing process to the care of their patient. Nurses are responsible for safe and prudent decision-making in the nursing care of their patients, including the provision of drug therapy; in accomplishing this task, they attend to the Nine Rights and adhere to legal and ethical standards related to medication administration and documentation. There are additional rights related to drug administration. These rights deserve worthy consideration before initiation of the medication administration process. Observance of all of these rights enhances patient safety and helps avoid medication errors.

Chapter 3 key points

There are many age-related pharmacokinetic effects that lead to dramatic differences in drug absorption, distribution, metabolism, and excretion in the young and the older adult. At one end of the lifespan is the pediatric patient, and at the other end is the older adult patient, both of whom are very sensitive to the effects of drugs Most common dosage calculations use the milligrams per kilogram formula related to age. Organ maturity may also be considered. It is important for the nurse to know that many elements besides the mathematical calculation itself contribute to safe dosage calculations. Safety must remain the first priority and concern with consideration of the nine rights of medication administration The percentage of the population older than 65 years of age continues to grow, and polypharmacy remains a concern with the increasing number of older adult patients. A current list of all medications and drug allergies must be on their person or with their family/caregiver at all times Your responsibility is to act as a patient advocate as well as to be informed about growth and developmental principles and the effects of various drugs during the lifespan and in various phases of illness

A drug given by which route is altered by the first-pass effect? a. Oral b. Sublingual c. Intravenous (IV) d. Subcutaneous (subcut)

a

The nurse plans care for a male patient who is 80 years old. The nursing diagnosis is noncompliance with the medication regimen related to living alone, as evidenced by uncontrolled blood pressure. What should the nurse do next? a. Enlist the help of a home care nurse for pharmacotherapy. b. Examine the results of nursing help with the medications. c. Collaborate with the provider on a new medication regimen. d. Assess the impact of home self-management of medications.

a

Which nursing action will increase the absorption of a medication administered intramuscularly (IM)? a. Massage the site after injection. b. Apply ice packs to the injection site. c. Lower the extremity below the level of the heart. d. Administer the medication via the Z-track method.

a

tolerance

a decreasing response to repeated drug doses

adverse effects

a general term for any undesirable effects that are a direct response to one or more drugs

The nurse is reviewing the various forms of topical medications. Which of these are considered topical medications? (SATA) a. rectal ointment for hemorrhoids b. eye drops for inflammation c. sublingual tablet for chest pain d. inhaled medications for asthma e. intradermal injection for TB testing

a, b, and d

The nurse understands that drugs exert their actions on the body by what process? (Select all that apply.) a. Interacting with receptors b. Altering metabolic chemical processes c. Making the cell perform a new function d. Inhibiting the action of a specific enzyme

a, b, and d

The nurse is reviewing data collected from a medication history. Which of these data are considered objective data? (SATA) a. White blood cell count 22,000 mm3 b. Blood pressure 150/94 mmHg c. Patient rates pain as an 8 on a 10-point scale d. Patient's wife reports that the patient has been very sleepy during the day e. Patient weighs 68 kg

a, b, and e

The nurse knows that which factors will affect the absorption of orally administered medications? (Select all that apply.) a. Time of day b. pH of the stomach c. Form of drug preparation d. Patient in high-Fowler's position e. Presence of food in the stomach

a, b, c, and e

What information should the nurse chart when documenting medication administration? (Select all that apply.) a. The time of administration b. Information about an "incident report" in the patient's chart c. The patient's age d. The route of administration e. The dosage of medication administered

a, d, and e

***neonatal and pediatric considerations: pharmacokinetics

absorption: gastric pH less acidic until 1-2 years of age gastric emptying slowed intramuscular absorption faster and irregular distribution: greater total body water means lower fat content decreased level of protein binding immature blood-brain barrier means more drugs enter the brain metabolism: liver immature; does not produce enough microsomal enzymes older children may have increased metabolism, requiring higher doses than infants other factors excretion: kidney immaturity affects glomerular filtration rate and tubular secretion decreased perfusion rate of the kidneys may reduce excretion of drugs

***metabolism

also referred to as biotransformation liver is most responsible biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite (as in the conversion of an inactive prodrug to its active form), or a less active metabolite cytochrome p-450 enzymes, also known as microsomal enzymes help break down lipophilic, hydrophilic, and enzymes blocked by grapefruit (take care with immunosuppressants and statin drugs)

***steady state

amount of drug absorbed equals amount of drug removed

The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. What is the correct order of the steps of the nursing process?

assessment diagnoses planning implementation evaluation

effect of drug on elderly pt

at risk for prolonged drug effect and toxicity less lean muscle, more fat means the drug keeps redistributing instead of metabolizing

A patient asks the nurse why a lower dose of IV pain medication is being given than the previous oral dose. What is the nurse's best response to the patient? a. "Medications given orally bypass the portal circulatory system." b. "Medications given intravenously are not affected by the first-pass effect." c. "Drugs administered intravenously enter the portal system before systemic distribution." d. "A large percentage of an intravenously administered drug is metabolized into inactive metabolites in the liver."

b

A 77-year-old man who has been diagnoses with an upper respiratory tract infection tells the nurse that the is allergic to penicillin. Which is the most appropriate response by the nurse? a. Many people are allergic to penicillin b. This allergy is not of major concern because the drug is given so often c. What type of reaction did you have when you took penicillin? d. Drug allergies don't usually occur in older individuals due to built-up resistance to allergic reaction

c

An 82 year old patient is admitted to the hospital after an episode of confusion at home. The nurse is assessing the current medications he is taking at home. Which method is the best way to assess him home medications? a. ask the patient what medications he takes at home b. ask the patient's wife what medications he takes at home c. ak the patient's wife to bring his medications to the hospital in their original containers d. contact the patient's pharmacy for a list of the patient's current medications

c

Drug half-life is defined as the amount of time required for 50% of a drug to: a. be absorbed by the body. b. exert a response. c. be eliminated by the body. d. reach a therapeutic level.

c

The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient? a. Do you depend on sleeping pills to get to sleep? b. Do you have a family history of heart disease? c. When you have pain, what do you do to relieve it? d. What childhood diseases did you have?

c

What is the ratio between a drug's therapeutic effects and toxic effects called? a. Affinity b. Tolerance c. Therapeutic index d. Cumulative effect

c

What is the study of physiochemical properties of drugs and how they influence the body called? a. Pharmacology b. Pharmacokinetics c. Pharmacodynamics d. Pharmacotherapeutics

c

When calculating pediatric dosages, the nurse understands which method is MOST accurate for dosing calculations? a. Use of drug reference recommendations based on mg/kg of body weight. b. Calculated doses based on body weight need to be increased by 10% because of immature renal and hepatic function c. Dosage calculation by body surface area because it takes into account the difference in size for children and neonates d. Medication dosing calculated according to body weight because it is based on maturational growth and development

c

While caring for a patient with cirrhosis or hepatitis, the nurse nows that abnormalities in which phase of pharmacokinetics may occur? a. absorption b. distribution c. metabolism d. excretion

c

While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the older adult patient because of which alterations in pharmacokinetics? a. increased renal excretion of protein bound drugs b. more alkaline gastric pH, resulting in more adverse effects c. decreased blood flow to the liver, resulting in altered metabolism d. less adipose tissue to store fat-soluble drugs

c

3 types of drug names

chemical generic trade/proprietary

A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement? a. Take the tablet with 2-3 oz of orange juice b. Avoid taking all other medications with any enteric-coated tablet c. Crush the tablet before swallowing if you have problems with swallowing d. Be sure to swallow the tablet whole without chewing it.

d

A patient's chart includes an oder that reads as follows: "Atenolol 25mg once daily at 0900." Which action by the nurse is correct? a. The nurse gives the drug via the transdermal route b. The nurse gives the drug orally c. The nurse gives the drug intravenously d. The nurse contacts the prescriber to clarify the dosage route

d

The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. What patient function does the nurse recognize as the most influential when deciding to use the intravenous route of drug administrations? a. altered biliary function b. increased glomerular filtration d. reduced liver metabolism d. diminished circulation

d

The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have a. increased protein in circulation b. fat composition lower than 0.001% c. more muscular body composition d. water composition of approximately 75%

d

What is another term for biotransformation of a drug? a. Dilution b. Excretion c. Absorption d. Metabolism

d

When the nurse is reviewing a list of medications taken by an 88-yea-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted a time or two in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? a. NSAIDs b. Cardiac glycosides c. anticoagulants d. antihypertensives

d

Which statement best describes pharmacokinetics? a. Adverse effects and toxic reactions to medications b. Physiologic interaction between a drug and body cells c. Converts medication into its active chemical substance d. What the body does to the drug after it is administered

d

***bioavailability

determined by drug properties and route of administration

patient condition

disease of any kind can alter a patient's therapeutic response, as can stress, depression, and anxiety

maintenance treatment

doesn't eradicate preexisting condition ex. birth control used to prevent disease progression

drug concentration

dosage adjustments should be made in the patients who are liver or kidney compromised (or immature, like neonates) to appropriately accommodate their impaired metabolism and excretion

***excretion

elimination of drugs from the body renal excretion kidney is most responsible some drugs reach the kidneys in their original form, but most get there in the water soluble form biliary excretion - done by intestine and bowel

palliative treatment

goal is to provide relief from symptoms and maintain quality of life usually end of life; not always

prophylactic treatment

goal of preventing illness ex. vaccine

***peak level

highest blood level of a drug

***parenteral route

intravenous (fastest delivery into the blood circulation) intramuscular subcutaneous intradermal intraarterial intrathecal intraarticular

***trough level

lowest blood level of a drug

supportive treatment

maintains integrity of the body during recovery ex. oxygen

***medication errors

may or may not cause harm remember 6 rights and 3 checks procuring prescribing transcribing dispensing monitoring use of abbreviation usually dosing is the issue and in elderly insulin and morphine factual documentation only medication reconciliation

therapeutic drug monitoring

measurement of specific drugs at timed intervals in order to maintain a relatively constant concentration of the medication in the bloodstream Monitored drugs tend to have a narrow "therapeutic index," a ratio between the toxic and therapeutic doses of medications For some drugs, maintaining this steady state is not as simple as giving a standard dose of medication. Each person will absorb, metabolize, utilize, and eliminate drugs at different rates based upon their age, general state of health, genetic makeup, and the interference of other medications that they are taking. These rates may change over time and vary from day to day. Changes in the rate may also occur in various disease states or through interaction with other medications.

dependence

need for a drug that can be: physical - physiologic need for a drug to avoid physical withdrawal symptoms psychological - also known as addiction and is the obsessive desire for the euphoric effects of a drug

toxicity

occurs if the peak blood level of the drug is too high

***first-pass effect

oral drugs metabolize in the liver before getting into the blood stream and are therefore less effective than when given IV/IM at the same dose this means that PO dose of the same drug will be higher than its IV/IM dose

effect of drug on pt with liver dysfunction

over exaggerated drug effect related to decreased blood volume and decreased excretion be sure to consider liver toxicity when prescribing/administering for these patients

***topical route

skin (not including transdermal patches) eyes ears nose lungs (inhalation) rectum vagina

toxic effects

the conditions of producing adverse bodily effects due to poisonous qualities

therapeutic action

the desired or intended effect of a particular medication

***enteral route

the drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine oral sublingual buccal rectal (can also be topical)

therapeutic index

the ratio between the toxic and therapeutic concentrations of a drug large = safer compares amount needed to achieve therapeutic action vs amount to reach toxicity

polypharmacy

the simultaneous use of multiple drugs to treat a single ailment or condition.

***pharmacokinetics

the study of what the body does to the drug absorption distribution metabolism excretion

effect of drug on burned, malnourished, and elderly pt

these patients lack albumin levels and therefore have more free drug

***half-life

time required for half of a given drug to be removed from the body trough level, peak level check with vancomycin and antibiotics

***distribution

transport of a drug by the bloodstream to its site of action albumin is the most common blood protein and carries the majority of protein-bound drug molecules

drug interactions

two drugs competing for binding sites leading to more free/unbound drug. this may result in unexpected drug reactions additive synergistic antagonistic incompatibility

supplemental treatment

used to provide a substance to the body to maintain normal function ex. iron

acute treatment

usually more intense ex. chemotherapy to sustain life or treat disease