Pharmacology and Toxicology Principles of Pharmacology II PDF

PHARMACOLOGY AND TOXICOLOGY PRINCIPLES OF PHARMACOLOGY- II WO N G C H U N K E U N G 9 SEP 2024 1 DIFFERENT ROUTES OF DRUG ADMINISTRATION Enteral Route of Medication A Rectal route of medication – Rapid and effective absorption of medications...

PHARMACOLOGY AND TOXICOLOGY PRINCIPLES OF PHARMACOLOGY- II WO N G C H U N K E U N G 9 SEP 2024 1 DIFFERENT ROUTES OF DRUG ADMINISTRATION Enteral Route of Medication A Rectal route of medication – Rapid and effective absorption of medications ii – Absorption via highly vascularized rectal mucosa – Medications undergo passive diffusion – Partially bypass the first-pass metabolism Parenteral Route of Medication Intravenous injection * AK 3II – Most common parental route of medication administration, bypass liver’s first-pass metabolism – Provide easy access to the circulatory system https://www.pharmacyteach.com/2022/09/different-routes-of-drug- B administration.html – Upper extremity is commonly the preferred site for https://www.ncbi.nlm.nih.gov/books/NBK568677/ intravenous medication EAK- – Lower incidence of thrombophlebitis and thrombosis than the lower limbs 8 DIFFERENT ROUTES OF DRUG ADMINISTRATION Parenteral Route of Medication Intramuscular injection – Administered in different body muscles patpat – The buttock's upper outer quadrant is chosen traditionally for intramuscular injections Subcutaneous injection – Administered to the layer of skin just below the dermis and epidermis layers – Subcutaneous tissue has few blood vessels https://www.pharmacyteach.com/2022/09/different-routes-of-drug- administration.html – Absorption at a slow, sustained rate https://www.ncbi.nlm.nih.gov/books/NBK568677/ – Administered to various sites, including the upper arm's outer area and abdomen A 9 DRUG CALCULATIONS Three primary methods for calculation of medication dosages Ratio and Proportion Method Desired Over Have or Formula Method Dimensional Analysis Method https://clipart-library.com/calculator-cliparts.html 17  RATIO AND PROPORTION METHOD Example One: A consultant orders 4 mg intravenous (IV) of a drug On hand, a clinician has 2 mg/mL vials How many milliliters are required to carry out the ordered dose? 19  DESIRED OVER HAVE OR FORMULA METHOD Example Three: A SMO orders lorazepam 4 mg IV for a patient in severe alcohol withdrawal On hand, a Medical Officer has 2 mg/mL vials How many milliliters should they draw up in a syringe to deliver the desired dose? 24 WHAT IS LORAZEPAM? - Used to relieve anxiety, and to treat insomnia caused by anxiety In a class of medications called benzodiazepines Commonly used to treat alcoholism and alcohol withdrawal symptoms In a tablet form as well as in liquid form for injection Help to decrease withdrawal symptoms https://family-intervention.com/wp-content/uploads/2016/05/Alcohol- Addiction-Treatment.jpg and reduce any cravings to drink 25 DIMENSIONAL ANALYSIS METHOD Uses a series of conversion factors of equivalency No need memorizing specific formulas Start with unit of measure Build the equation with available information – Place information with the same unit of measure as the preceding denominator in the numerator – So that unwanted labels will cancel out – Repeat until all units of measure not needed in the answer are cancelled out – Determine the numeric answer with correctly unit of measure 30  DIMENSIONAL ANALYSIS METHOD Example Five: A Resident Specialist need to administer digoxin 0.5 mg IV daily for a patient with heart failure  Drug concentration available from the pharmacy is digoxin 0.25 mg/mL How many milliliters will she need to administer to deliver the desired dose? https://www.nursingcenter.com/ncblog/august-2021/dimensional-analysis 31  DIMENSIONAL ANALYSIS METHOD Answer to Example Five Step 1: Place the unit of measure needed on the left side of the equation Step 2: On the right side, place the information given with mL in the numerator. In this example, the drug concentration available is 0.25 mg/mL. Place mL in the numerator and 0.25 mg in the denominator https://www.nursingcenter.com/ncblog/august-2021/dimensional-analysis 32  DIMENSIONAL ANALYSIS METHOD Answer to Example Five Step 3: The desired dose is 0.5 mg. Place information to the equation in the numerator to cancel out the unwanted labels Step 4: Multiply numbers across the numerator, and similarly across the denominator. Divide the numerator by the denominator for the final answer Answer: Administer 2 mL of digoxin daily https://www.nursingcenter.com/ncblog/august-2021/dimensional-analysis 33 COMMON PHARMACY ABBREVIATIONS https://images.squarespace-cdn.com/content/v1/5e48489da899cd09424943db/1628797586063- 68JF1Y1T4G1UTY6RBSQS/medical+abbreviation+list+acronyms+terms+common+nursing+cna+pharmacy 35 STEP 3: CLINICAL RESEARCH (CLINICAL RESEARCH PHASE STUDIES - PHASE 3) Study Participants: 300 to 3,000 volunteers who have the disease/condition Purpose: Efficacy and monitoring of adverse reactions Length of Study: 1 to 4 years (Approximately 25-30% of drugs move to the next phase) Demonstrate whether or not the drugs offer a treatment benefit to a specific population Involve 300 to 3,000 participants Provide most of the safety data While in previous studies less common side effects may be undetected Larger and longer studies can show long-term or rare side effects https://www.fda.gov/patients/learn-about-drug-and-device-approvals/drug-development-process 48 STEP 3: CLINICAL RESEARCH (CLINICAL RESEARCH PHASE STUDIES - PHASE 4) Study Participants: Several thousand volunteers who have the disease/condition Purpose: Safety and efficacy https://www.fda.gov/patients/learn-about-drug-and-device-approvals/drug-development-process 49 STEP 3: CLINICAL RESEARCH (CLINICAL RESEARCH PHASE STUDIES DETAILS) FDA IND Review Team Consists of a group of specialists in difference areas: Project Manager: Coordinates the team’s activities Medical Officer: Reviews all clinical study information and data before, during, and after the trial Pharmacologist: Reviews the preclinical studies Pharmakineticist: Focuses on the drug’s absorption, distribution, metabolism and excretion processes. Interprets the blood-level data Chemist: Evaluates a drug’s chemical compounds, how it is made, its stability, quality control and the presence of impurities Microbiologist: Reviews the data if the product is an antimicrobial product Statistician: Interprets clinical trial designs and data, evaluate protocols, safety and efficacy data https://www.fda.gov/patients/learn-about-drug-and-device-approvals/drug-development-process 52