Pharmacology Principles (3) +Hard Note Cards

Phases of Drug Action
1. Pharmaceutical Phase
2. Pharmokinetic Phase
3. Pharmacodynamic Phase

Pharmaceutical Phase
Dissolution/dissolve phase

Pharmacokinetic Phase
(hard notes)
ADME:
-Absorption
-Distribution
-Metabolism
-Excretion

Factors Affecting Rate of Absorption
*All directly related*
-Blood flow
-Lipid solubility
-pH

Intrathecal Injection
Spinal cord injection

Blood Brain Barrier
Drugs must have transport system or HIGH lipid solubility to cross

Factors Decreasing Blood Flow
-Tumors
-Abscesses: removal of puss will improve blood flow

Factors Affecting Distribution: Albumin
Protein-bound drugs require albumin level to be drawn, low albumin requires smaller dose

CYP450
-Group of enzymes that break down certain drugs
-CYP450 inhibitors: slows metabolism, increases buildup/risk for toxicity
-CYP450 inducers: speeds metabolism, less therapeutic effect

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Steady State
-when intake equals metabolism of a drug
-takes 4 to 5 half lives
-requires scheduled ATC

Pharmacodynamic Phase
MOA of drug

Receptorless Drugs
Interact with chemicals instead of receptors for effect

ie. antacids, MgSO4 (retains water in intestine)

High Alert Medications
“Most likely to cause serious harm or death”
-Insulin
-Heparin
-Opioids
-IV KCl
-Neuromuscular blocking agents (anesthetics)
-Chemo

Factors Affecting Drug Action
-Age
-Weight
-Genetics
-Ethnicity
-Gender
-Pathology
-Psychology

Drug Therapy in Children
-Younger than 12 y/o
-Dose by weight
-SDR less defined
-Give PO or thigh muscle for IM

Drug Considerations with Children
-Permeable skin=lower trasderm doses
-Immature BBB=more restrictions
-Altered protein binding until 1y/o=lower doses
-Low GFR=slower excretion
-Low liver metabolism in infants=more free drug
-High liver metabolism in kids=less free drugs
-High risk for drug interactions

Drug Considerations with Elderly
-Slow metabolism
-Decreased absorption
-Impaired circulation
-Low CYP450 enzymes=more free drug
-Impaired excretion

Beers Critera
Drugs that should be avoided with 65+ y/o patients to avoid preventable problems

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Absorption refers to the movement of drug into the bloodstream, with the rate dependent on the physical characteristics of the drug and its formation. Refers to the passage of drug molecules from the site of administration into the circulation. Active …

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absorption The process by which one substance is absorbed, or taken in and incorporated, into another, as when the body converts food or drugs into a form it can use. administer To give a drug directly by injection, by mouth, …

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