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What are the two primary phases of drug action?
What are the two primary phases of drug action?
Pharmacokinetics and pharmacodynamics
What are the four main processes involved in pharmacokinetics?
What are the four main processes involved in pharmacokinetics?
What is the primary site of drug metabolism?
What is the primary site of drug metabolism?
Liver
Enteric-coated tablets should always be crushed for faster absorption.
Enteric-coated tablets should always be crushed for faster absorption.
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What is the definition of bioavailability?
What is the definition of bioavailability?
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Which of the following routes of administration has the highest bioavailability?
Which of the following routes of administration has the highest bioavailability?
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What term describes the process of a drug moving from the bloodstream into body tissues?
What term describes the process of a drug moving from the bloodstream into body tissues?
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What is the definition of protein binding?
What is the definition of protein binding?
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What is the definition of half-life?
What is the definition of half-life?
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What is a loading dose?
What is a loading dose?
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What is the definition of steady state?
What is the definition of steady state?
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What is a pro-drug compound?
What is a pro-drug compound?
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What are the primary routes of drug excretion?
What are the primary routes of drug excretion?
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What is the therapeutic index?
What is the therapeutic index?
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What is potency?
What is potency?
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What is maximal efficacy?
What is maximal efficacy?
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What is onset?
What is onset?
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What is duration?
What is duration?
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What is the approximate onset of action for oral medications?
What is the approximate onset of action for oral medications?
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What are peak and trough drug levels?
What are peak and trough drug levels?
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What is the site called where drugs bind to receptors?
What is the site called where drugs bind to receptors?
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What are the possible effects of drugs binding to receptors?
What are the possible effects of drugs binding to receptors?
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What are agonists?
What are agonists?
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What are partial agonists?
What are partial agonists?
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What are non-specific drugs?
What are non-specific drugs?
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What are non-selective drugs?
What are non-selective drugs?
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What are the main mechanisms of drug action?
What are the main mechanisms of drug action?
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What is the definition of a side effect?
What is the definition of a side effect?
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What is an adverse reaction?
What is an adverse reaction?
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What is drug toxicity?
What is drug toxicity?
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What are drug interactions?
What are drug interactions?
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What is an additive drug interaction?
What is an additive drug interaction?
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What is a synergistic drug interaction?
What is a synergistic drug interaction?
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What is an antagonistic drug interaction?
What is an antagonistic drug interaction?
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What is pharmacogenetics?
What is pharmacogenetics?
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What is tachyphylaxis?
What is tachyphylaxis?
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Creatinine clearance is typically decreased in older adults and those with renal dysfunction.
Creatinine clearance is typically decreased in older adults and those with renal dysfunction.
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Which phase of pharmacodynamics would be most influenced by fluid overload and fluid shift, such as in a patient with burns?
Which phase of pharmacodynamics would be most influenced by fluid overload and fluid shift, such as in a patient with burns?
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What nursing action is most important for medications with a narrow therapeutic index?
What nursing action is most important for medications with a narrow therapeutic index?
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What are the three main categories of complementary and alternative medicine (CAM)?
What are the three main categories of complementary and alternative medicine (CAM)?
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What is the definition of botanicals?
What is the definition of botanicals?
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What is the definition of herbs?
What is the definition of herbs?
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What is phytomedicine?
What is phytomedicine?
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According to the Dietary Supplement Health and Education Act (DSHEA), what are the requirements for labeling dietary supplements?
According to the Dietary Supplement Health and Education Act (DSHEA), what are the requirements for labeling dietary supplements?
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What must be included on the label of dietary supplements?
What must be included on the label of dietary supplements?
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What is Current Good Manufacturing Practice (CGMP) for dietary supplements?
What is Current Good Manufacturing Practice (CGMP) for dietary supplements?
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What are some potential hazards associated with the use of herbs?
What are some potential hazards associated with the use of herbs?
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What did the Pediatric Research Equity Act of 2012 mandate?
What did the Pediatric Research Equity Act of 2012 mandate?
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Why is there limited research on pediatric pharmacology?
Why is there limited research on pediatric pharmacology?
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How does drug absorption in children differ from adults?
How does drug absorption in children differ from adults?
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What factors influence drug distribution in children?
What factors influence drug distribution in children?
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How does drug metabolism differ in children compared to adults?
How does drug metabolism differ in children compared to adults?
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How does drug excretion differ in children compared to adults?
How does drug excretion differ in children compared to adults?
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What factors are considered when determining pediatric drug doses?
What factors are considered when determining pediatric drug doses?
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Medication errors are more common in pediatric patients.
Medication errors are more common in pediatric patients.
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What are some reasons why medication errors are more likely to occur in children?
What are some reasons why medication errors are more likely to occur in children?
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When teaching caregivers about drug administration, what information should be emphasized?
When teaching caregivers about drug administration, what information should be emphasized?
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What is the importance of assessing developmental age in addition to chronological age in pediatrics?
What is the importance of assessing developmental age in addition to chronological age in pediatrics?
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How may toddlers react to medication administration?
How may toddlers react to medication administration?
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How may preschool children typically react to medication administration?
How may preschool children typically react to medication administration?
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How may school-age children typically react to medication administration?
How may school-age children typically react to medication administration?
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What is the principle of atraumatic care?
What is the principle of atraumatic care?
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What are the general medication guidelines for neonates?
What are the general medication guidelines for neonates?
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What general medication form is typically preferred for infants?
What general medication form is typically preferred for infants?
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What are the typical medication forms suitable for children aged 2-5 years?
What are the typical medication forms suitable for children aged 2-5 years?
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Study Notes
Pharmacokinetics and Pharmacodynamics
- Two drug phases are pharmacokinetics and pharmacodynamics.
- Pharmacokinetics describes what the body does to a drug. It includes absorption, metabolism, distribution, and excretion.
- Pharmacodynamics describes what a drug does to the body. It includes receptor binding, post-receptor effects, and chemical reactions.
Drug Absorption
- Absorption is the drug's movement from the GI tract into the bloodstream.
- Oral meds use the GI tract. IV meds bypass the GI tract.
- Disintegration is the breakdown of the oral drug into small particles.
- Dissolution is combining small drug particles with liquid to form a solution.
- PO liquids bypass disintegration and dissolution phases.
- Low pH (acidic environment) helps with breakdown, increasing absorption rate.
- Methods of absorption: passive transport, active transport, pinocytosis.
Factors Affecting Drug Absorption
- Blood circulation
- Pain and stress
- Food texture (e.g., fast absorption with acid-rich meals)
- Fat content of food (e.g., milk slows absorption).
- Temperature of food
- Stomach pH
- Route of administration
- Slowed gastric emptying (e.g., after exercise)
- Drug half-life
Drug Distribution
- Drug distribution is the movement of the drug from the bloodstream into body tissues.
- Factors include the drug's ability to bind, vascular permeability, cell membrane permeability, blood flow, tissue perfusion, and lipid solubility.
- Protein binding: a portion of the drug binds to protein, which is inactive.
- Free drug: the portion of the drug not bound to protein.
- Monitor albumin and protein levels to ensure sufficient binding sites for the drug.
- The blood-brain barrier (BBB): water-soluble drugs cannot cross; lipid-soluble drugs with low molecular weights can. The placenta also allows passage of lipid-soluble drugs.
Drug Metabolism (Biotransformation)
- Metabolism chemically changes the drug for excretion.
- Primarily occurs in the liver.
- Bioavailability: percentage of the administered drug usable for activity. IV has 100% bioavailability; PO has less than 100% due to the first-pass effect.
Drug Excretion
- Primarily by kidneys (GFR, creatinine clearance, BUN are indicators of kidney function), liver (bile), feces, lungs (CO2, volatile drugs), saliva, sweat, breast milk.
- The urine pH affects excretion: acidic urine promotes weak base drug excretion; alkaline urine promotes weak acid drug excretion.
Drug Action Effects
- Primary effect: desirable response.
- Secondary effect: desirable or undesirable depending on the context.
Drug Action Mechanisms
- Stimulation: enhancement of existing activity.
- Depression: a decrease in body function.
- Irritation: noxious effect
- Replacement: replacing a missing substance (e.g., insulin).
- Cytotoxic action: invasion and killing of specific cells (e.g., chemotherapy).
- Antimicrobial action: inhibiting/killing/preventing infectious organisms.
- Modification of immune status: altering, enhancing, or depressing the immune system.
Drug Interactions and Effects
- Drug-drug interactions: altered drug effect from interaction with another drug.
- Additive effect: sum of the individual effects (e.g., diuretic and beta-blocker).
- Synergistic effect: effect greater than the sum of individual effects.
- Antagonistic effect: one drug blocks the effect of another (e.g., naloxone for opioid overdose).
- Drug-nutrient interactions (e.g., grapefruit juice, spinach and Coumadin).
- Drug-induced photosensitivity: skin reactions from sunlight exposure.
Drug Half-life, Tolerance, and Toxicity
- Half-life: time for the drug concentration to decrease by half. Prolonged in kidney/liver disease.
- Loading dose: large initial dose to quickly achieve a therapeutic effect, then lower doses afterward.
- Steady state: the plateau when the amount of drug entering the body equals the amount excreted.
- Tolerance: decreased response to a drug.
- Drug toxicity: drug level surpasses the therapeutic range, influenced by age, genetics, disease (e.g., kidney disease).
Pediatric Pharmacology
- Pediatric drug absorption, distribution, metabolism, and excretion differ from adults due to age-related physiological variations.
- Infants, toddlers, preschoolers, and school-age children have different developmental stages that impact how drugs are absorbed, distributed, metabolized, and excreted.
- Dose calculations must consider age and weight to avoid errors, and assessment should consider developmental and/or chronological age when dealing with potential drug reactions or side effects.
- The principles of atraumatic care should be implemented.
- Infants and toddlers may have faster gastric emptying caused by breastfeeding, and children may have altered GI function, pH, and enzyme levels that affect absorption. They may have less fully developed liver/kidney function.
- Monitor I/O and lab values to assess kidney function.
- More drug will cross the BBB than the adult.
Additional Concepts
- Potency: amount of drug needed to elicit a response.
- Maximal efficacy: point where increasing dosage doesn't increase response.
- Onset: time to reach minimum effective concentration.
- Peak: highest drug concentration.
- Duration: length of time for drug to have effect.
- Peak/trough levels: used to monitor drug absorption and elimination rates in patient's blood.
- Complementary and Alternative Medicine (CAM): botanicals, nutrients, herbs.
- DSHEA guidelines for dietary supplements.
- Herbal interactions and hazards.
- Pharmacogenetics: how genetics affect drug response.
- Biologic variations: study of genetic factors influencing drug response.
- Tachyphylaxis: rapid reduction in drug response.
- CAM use can be missed (patients not reporting) and should be considered when working with patients.
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Description
Test your knowledge on pharmacokinetics and pharmacodynamics, the fundamental concepts that explain how drugs interact with the body. This quiz covers drug absorption, factors affecting absorption, and the two phases of drug action. Challenge yourself and enhance your understanding of these critical pharmacological principles.