5. No harmful side effects
6. No drug/food interactions
8. Easy to administer
9. Chemically Stable
10. Simple Name
(Currently there are not ideal drugs)
2. Prevent Disease
3. Treat Disease
4. Prevent Pregnancy
2. Knowledge of Patient’s disorders
3. Dosage, administration
5. PRN decisions
Why is this prescribed?
Why am I giving this?
How will this med help my patient?
Onset? Peak? Duration? Interactions?
Does the order sound right? Reasonable?
Have I ensured safety?
2. Side Effects
5. Patient’s account
1. Right Patient
2. Right Drug
3. Right Dosage
4. Right Documentation
5. Right Route
6. Right Time
2. Expected response (& time); possible side effects
3. Dosage and administration schedule
4. Route of administration
5. Duration of drug use
6. Drug storage
7. anything else of importance.
How drugs KIN move
2. Speed of absorption varies with route, blood supply and drug form
3. Route effects onset (oral is the slowest, IV is the fastest)
2. Drug diffuses out of blood to site of action
(Liver and kidney labs are important to determine functioning and prevent toxicity)
2. passage with aid of transport system
3. direct penetration of membrane
2. Amount determines intensity of effects
3. bioavailability – extent of drug absorption
4. How it is dissolved
5. surface area of absorption
6. Blood flow
What % of drug reaches circulation
IV drugs are more bioavailable than PO drugs
Food or fluids taken along with the drug
Some drugs attach to fat, some are stored in fat
Irritante on not black & white every time
-Absorbed through oral or gastric mucosa, small intestine or rectum
-IV, IM, SQ
2. Determined by:
-Blood flow to tissues
-Ability of drug to exit vascular system
-Ability of drug to enter cells
2. What are the benefits? Prevents toxic drugs, bacteria, etc. from hurting the brain
3. What are the disadvantages? Cancer or infection of the brain is difficult to reach because of the BBB.
2. Drugs form reversible bonds with protein
3. Drugs not bound are in a free state
4. As free drug acts on cells, there is a decrease in plasma drug levels
Also if a patient is taking 2 drugs and one takes of most of the protein, then the other drug has a lot of free proteins.
OR, one of the drugs might have more/less affinity for protein binding and therefore there is more/less of the drug free. they compete.
Drug to drug interactions involving P450
-Inhibitor works against enzymes
-Inducer makes more enzymes available
2. Nutritional status (generally protein)
3. Liver disease (liver needs to work)
4. Induction of drug-metabolizing enzymes (P450)
5. First pass effect (not active until hits liver or becomes inactive…may want IV to bypass liver)
2. Primarily through kidneys
– Glomerular filtration
– Passive tubular reabsorption
– Active tubular secretion
3. Other routes
2. protein bound drugs are not filtered
3. Passive reabsorption moves lipid soluble drugs into blood
4. polar and ionized drugs remain in the urine
5. Active transport via tubular pumps for organic acids and bases move drugs from the blood to urine
2. Most drugs eliminated over 4 half-lives
3. Peak effect
2. It’s dynamite what drugs do to the body!
2. Enzyme interaction
3. Nonspecific interations
B. Poor receptor fit, no response likely
C. Some drug-receptor fit. Some response likely.
D. Excellent receptor fit. Good response likely.
2. Enzyme binds to drug instead of normal target cell
Controlled Substances (mostly narcotics – counted)
Drug names (Generic and Brand)
Drug Resources (cell phone, drug book)
3. Family Organization
2. Commonly used herbs:
1. Aloe Vera
3. Dong Quai
5. Garlic (anticoagulant)
7. St. john’s Work (depression, acts like a real drug, anticoagulant)
Awareness of protocols
Communication of data when client receiving study drug