This document provides an overview of pharmacokinetics and pharmacodynamics in nursing. It explains the concepts of drug absorption, metabolism, and excretion. It also discusses different routes of drug administration and their effects. Additionally, it includes nursing considerations for various medications.
Contribute Materials
Your contribution can guide someone’s learning journey. Share your
documents today.
1 Table of Contents Answer 1......................................................................................................................................................2 Answer 2......................................................................................................................................................2 Answer 3......................................................................................................................................................3 Answer 4......................................................................................................................................................4 Answer 5......................................................................................................................................................6 Answer 6......................................................................................................................................................8 Case study 1................................................................................................................................................9 Case study 2................................................................................................................................................9 Case study 3..............................................................................................................................................10 References.................................................................................................................................................12
2 Answer 1 a)Pharmacokinetics is the education of drug captivation, absorption, excretion, metabolism, and distribution (Ryman & Meibohm, 2017). b)Pharmacodynamics refers to the learnings of the physiological effects of drugs on the individualandevaluateshowadrugaffectsthecreature(Almazroo,Miah& Venkataramanan, 2017). c)Bioavailability means the degree or rate at which the circulatory system of the body absorbs an administered drug. d)First pass effect also termed as the first-pass metabolism, occurs when a non-intravenous drug enters into the liver and decrease concentration quickly before the drug reaches the target. e)Drug indication means to use a drug to treat the specific disease. For instance, an indication of insulin to treat diabetes. f)Drug contraindication means various health conditions are contraindicated with many drugs which help the physician to prescribe correct pharmaceutical drugs to the patient. g)Adverse drug reaction refers to the injury caused by taking improper or inaccurate medication. h)The therapeutic range is defined as the range of dosage which expected to achieve desirable effects of therapeutic. i)Toxicology is the study of nature and the effects of toxins as well as the treatment of toxins and discipline that includes the study of hostile effects of chemical substances on organisms. Answer 2 a)Three methods of parental administration of drugs are IM (Intramuscular) – Inserted into the muscle SC (Subcutaneous) – Inserted under the skin IV (Intravenous) * It offers 100% bioavailability of a drug – Inserted into the vein (Hörmann & Zimmer, 2016) b)Four aspects that affect the absorption of the drug: Physical forms: Drug exists in the form of liquid, gases, and solid.
3 Molecular size: Absorption of drug is more quickly when the molecular size is small. Liquid water solubility: It means greater liquid water coefficient, higher liquid solubility and thus, greater absorption of the drug (Pridgen, Alexis & Farokhzad, 2015). Particle size: The large size of the particle makes the absorption slow. c)Species and hormones are the two internal factors that affect the metabolism of the drug (Jones et al., 2015). Diet and environment are the two external factors that affect the metabolism of the drug. d)As an individual grows elder, the body organs and tissues start functioning slowly. Due to the decline in the function of body organs, metabolism, drug absorption, excretion, and distribution become worse. The drugs are prolonged, and the activity of drug metabolism decreases in the liver. In an older person, the parenchymal cells reduced that present in the liver and thus, decrease the blood flow in the liver, which makes the liver unable to metabolize drugs (Almazroo, Miah & Venkataramanan, 2017). e)Drugs are excreted by the following four routes such as saliva, kidney, sweat or tears, and lungs. Liver disease, thyroid disease, kidney disease, and chronic obstructive pulmonary disease are four chronic diseases that may affect the elimination of drugs (Kawase, Yamamoto, Egashira & Iwaki, 2016). f)Polypharmacy refers to the concurrent use of various medicines by an individual patient (Noale et al., 2016). It is most commonly found in elder persons. Polypharmacy happens due to multiple pathologies, lack of knowledge about aging, use of repeat prescriptions, and poor communication between healthcare providers and patient. Answer 3 a) FormulationDescription Waferorally disintegrating tablet containing medication (Califf, McCall & Mark, 2017) Lotionmedication dissolved in a water or alcohol base for topical application – lower viscosity than creams Dropsmedication dissolved in sterile liquid for topical application Tableta drug mixed with a base compound and compressed into a variety
Paraphrase This Document
Need a fresh take? Get an instant paraphrase of this document with our AI Paraphraser
4 of shapes Creamemulsion of oil and water for topical application Emulsionthe mixture of oil and water containing a drug Patchdelivers the drug through the skin at a steady concentration Injectionsterile aqueous or oily suspensions containing a drug delivered parenterally Syrupconcentrated sugar solution containing a drug Suppositorysolid preparation containing a drug which dissolves when administered rectally Suspensionthe liquid in which insoluble particles of the drug are dispersed GelSemi-solid emulsion in an alcohol base for topical application. Capsulegelatin container enclosing a drug in liquid Inhalantfinely powdered or liquid drugs administered into the respiratory system b)Slow release drug is defined as a drug that released into the body of the living being slowly over a long period. Sustained release is defined as a design to release the drug slowly into the body over a prolonged time (Liu, Yang, Gao, Li & Wan, 2017). Slow release prevents regular medication of the patient and releases a reliable amount of drugs over an extensive period. Answer 4 Medication Group/Classification Common medication useGeneric medication example AnaestheticsSedationPropofol AnalgesiaNeuralgia*Hydrocodone Antacids*Milk of magnesiaAluminum hydroxide
6 disorder *AntimineralocorticoidMenopauseEstrogen and Progesterone Hypnotics, sedativesSedative*Melatonin Hypoglycaemics*MetforminGlucagon Insulin*AcarboseInsulin *Beta blockersHypertensionPropranolol *BronchodilatorsAsthmaSalbutamol Electrolyte solutionsRehydration*Plasmalyte A Laxatives/aperientsConstipation*Lactulose Ophthalmic, otic*DexamethasoneAcetazolamide Nasal medications*Nasal sprayPhenylephedrine *TeratogenicPregnancy preventionEstrogen and Progesterone CorticosteroidsInflammation*Methylprednisolone Aceponate *DiureticPulmonary edemaFrusemide Narcotic analgesiaSevere pain*Fentanyl NeurolepticsMood stabilizer*Cariprazine *Vitamin KBleeding disordersPhytonadione Answer 5 DrugMajor drug group/class Common routes for administratio n Mode of action Adverse Reactions Describe at least 3Nursing Considerations for each of the below
Secure Best Marks with AI Grader
Need help grading? Try our AI Grader for instant feedback on your assignments.
7 medications Glyceryl Trinitrat e VasodilatorsOral route or sublingual route It works into the body after being converted into chemical and helps the heart to pump blood around the body (Little et al., 2018) Dizziness, fainting, headache, and decreased heart rate The nurse should monitor blood pressure and heart rate consistently and keep the patient on a cardiac monitor Do not mix the drug with another drug infusion Must use non-PVC fluid bags for administratio n WarfarinAnticoagulan t Oral routeThis drug blocks the vitamin K to make clotting factors which reduce the number of factors in the blood Bleeding, vomiting, flatulence, nausea, and hemorrhag e The nurse should know the way of managing bleeding linked with warfarin The nurse needs to consider the dosing adjustments or use of optional agents when combining the drug with other medication A periodic blood testing is required to do for assessing the prothrombin
8 time of the patients Actrapid Insulin HormonesIt is administered by using the injection, and subcutaneous insulin is the standard route for administration (Jacob, Taylor, Tomlins & Sahota, 2016). The bottle requires to be observed before administering insulin for changes like precipitation or clumping It helps glucose to enter into the cells and control blood glucose which reduce the complication s of diabetes Headache, weight gain or loss, swelling, anxiety, and low blood sugar Be specific to provide the correct type of insulin Never use a regular syringe for insulin and know the effects of insulin The nurse should undertake a training course for the safe use of insulin Answer 6 Six actions essential to do after a medication error are: Inform the patients about the medication error Report or inform the rest of the care team Report the documented error to the safety committee of the hospital for avoiding any further complications (Dahlin, Chuang & Roulet, 2018) Inform the medication error to the doctor who is treating the patients Internal notification of the medication error Report to the unit manager or supervisor Case study 1 1.Anaphylaxis is one of the serious allergic reaction that may cause the death of a person and should be treated as an emergency (Grabenhenrich et al., 2016). It arises when an
9 individual is exposed to an allergen to which he is allergic.At the cellular level, the antibodies travel to the mast cells and release chemicals that cause symptoms of anaphylaxis. It is beneficial to know the signs as well as symptoms of anaphylaxis for the person to avoid the allergic reaction. Food, medicines, latex, insect stings, and exercise are the five common agents that may trigger anaphylaxis. In the given case, Mr. Brown is suggested to take adrenaline, which quickly reverses the effects of the anaphylactic reaction. 2.The mechanism of action of adrenaline drug: It acts on alpha as well as a beta-adrenergic receptor. It decreases vasodilation and raises vascular permeability through its action on receptors. It also relaxes the smooth muscle of bronchial that helps in alleviating wheezing and bronchospasm that occur during anaphylaxis (Chen & Wang, 2017). It is administered through auto-injector and reverses the symptoms of anaphylaxis by acting on both the beta and alpha adrenergic receptors in the body. It prevents the blood pressure to fall by redirecting the blood to essential organs. It is given by intramuscular injection to ensure that the drug is injected into the musclebecause absorption is more rapid and reliable through the intramuscular site. 3.As an EN, I will provide emergency care to Mr. Brown, remove the allergen, lay the patient flat, inject Epinephrine, and provide oxygen.Yes, it is within my scope of practice to supply oxygen to the patient because any delay in administering oxygen can lead to the death of the patient.I will communicate with the patient to assess the knowledge of Mr. Brown regarding the previous allergic reactions and assess the patient for all kinds of allergies. I would consult with the staff of the emergency department and the doctor who used to treat Mr. Brown. As an EN, it is required to document the allergy status of Mr. Brown on the medication chart and respiratory rate. Case study 2 1.Mrs. Jones is having a low level of hemoglobin, and surgery will take place on Monday morning.For doingsurgery, sherequirestoadministera bloodtransfusion.Low hemoglobin occurs due to anemia, chronic kidney disease, and thalassemia (Rodrigo et al., 2018). 2.A mild or severe complication can occur during blood transfusion such as blood-borne infections, acute immune hemolytic reaction, and affect the bone marrow (Tan et al.,
Paraphrase This Document
Need a fresh take? Get an instant paraphrase of this document with our AI Paraphraser
10 2017).The other complications of blood transfusion that a person needs to be aware of are acute kidney failure, lung problems, anemia and shock. If a patient experienced delayed potential reaction, then the nurse should stop the transfusion and replace the donor blood with the normal saline. Blood-borneinfections:Blood-borneinfectionscausedbybacteriaorviruses transmitted to the body of a person while transmitting blood. It may also happen if the blood infections are not tested by the physicians before blood transfusion. Acute immune hemolytic reaction:It occurs within 24 hours of the blood transfusion due to the rapid destruction of red blood cells of the donor by host antibodies (IgG). The reaction is associated with hemolysis and occurs after transfusing a few millilitres of blood. Acute kidney failure: It happens when the kidneys of the person lose the ability to remove waste materials from the blood. Blood transfusion reaction creates clotting of blood within the blood vessels of the kidney that cause kidney failure. Lung problems: It happens when the body struggles to get enough oxygen and have shortness of breath. It refers to the situation in which lungs fill with more fluid at the time of blood transfusion. 3.I will explain the signs and symptoms of blood transfusion reaction like back pain, fever, chills, skin flushing, fainting, itching, flank pain, dizziness, shortness of breath, or dark urineto Mrs. Jones so that she would be aware of the reactions and take immediate precautions.Sheshouldbeawareofreceivingtoomuchblood,whichcausesa transfusion reaction. 4.Blood and blood products are to be transported under the same temperature as when stored, and the temperature can be maintained by using frozen or chilled packs (Hong et al., 2016). Minimal physical handling of all the blood components needs to be practised while handling the products of blood.Blood products are transported under the same temperature condition as when they are stored which is maintained by using cardboard boxes with inserted thermal insulation and several configurations of chilled coolant packs.The laboratories and hospitals also use the shippers of blood service to transport blood products.The blood components need to be handled by ensuring that the products are not exposed to an outside temperature for more than 30 minutes and the packaging of
11 the products should be checked or examined before sending to other health practitioners. The blood can be disposed of by tie a knot in the tubing above the needle and drain the blood. Being an EN, an individual would require to check the type of the blood of both donor and the receiver to avoid transfusion reaction because every person has different blood types. EN could check blood types by testing the blood in the laboratory of the hospital and labelled the blood bag with the blood type. It is also necessary to test the donated blood carefully to find out the blood type and any other infections in the blood. Case study 3 1.Jack has been prescribed to take IV fluids because he is in a state of depleted water and normal saline (Baddour et al., 2015). He has low blood volume or if he may be dehydrated due to cholecystitis. He may be prescribed to take D5W (means 5% Dextrose in water) IV fluid as it contains hypotonic sugar water. 2.The nurse needs to record the fluid volume, the body weight of the patient, and urinary output. 3.Several complications included in the IV therapy, which are as follows: Infiltration: It mainly occurs when there is IV fluid leak into the tissues. Hematoma: It occurs due to leakage of blood from the blood vessel into the tissues. Air embolism: It takes place when a bulk of air enters into the vein of the patient through the set of IV administration. Phlebitis: It is the swelling of a vein that occurs as a result of a pH agent entered during IV administration (Ramsay et al., 2018). Extravasation: It refers to the leaky of vesicant drugs into the adjoining tissues and causes severe damage to the local tissues. Hypersensitivity:Itcanbelife-threateningandshouldberecognizedandtreated immediately. 4.The most common electrolyte imbalance identified is potassium (K) that help to conduct muscle contraction, keep blood pressure and regulate the flow of fluids (Giordano et al., 2016). Changes in the diet are given to treat potassium electrolyte. It is to be monitored by doing a potassium blood test to check the increase or decrease in the amount of potassium in blood.
12 5.As a nurse,I will educate Jack by saying or explaining the benefit of administering IV fluids and assure him of no risks during the treatment. I will kindly tell him that IV fluids are must to give him for controlling the heartbeat. I would report this to the doctor to talk to him in getting the IV fluid.
Secure Best Marks with AI Grader
Need help grading? Try our AI Grader for instant feedback on your assignments.
13 References Almazroo, O. A., Miah, M. K., & Venkataramanan, R. (2017). Drug metabolism in the liver.Clinics in liver disease,21(1), 1-20. Baddour, L. M., Wilson, W. R., Bayer, A. S., Fowler Jr, V. G., Tleyjeh, I. M., Rybak, M. J., ... & Bolger, A. F. (2015). Infective endocarditis in adults: diagnosis, antimicrobial therapy, and management of complications: a scientific statement for healthcare professionals from the American Heart Association.Circulation,132(15), 1435-1486. Califf, R. M., McCall, J., & Mark, D. B. (2017). Cosmetics, regulations, and the public health: understanding the safety of medical and other products.JAMA internal medicine,177(8), 1080-1082. Chen,D.,&Wang,Z.(2017).AdrenalineinhibitsosteogenesisviarepressingmiR‐21 expression.Cell biology international,41(1), 8-15. Dahlin, K. B., Chuang, Y. T., & Roulet, T. J. (2018). Opportunity, motivation, and ability to learn from failures and errors: review, synthesis, and ways to move forward.Academy of Management Annals,12(1), 252-277. Giordano, M., Ciarambino, T., Castellino, P., Malatino, L., Di Somma, S., Biolo, G., ... & Adinolfi, L. E. (2016). Diseases associated with electrolyte imbalance in the ED: age- related differences.The American journal of emergency medicine,34(10), 1923-1926. Grabenhenrich, L. B., Dölle, S., Moneret-Vautrin, A., Köhli, A., Lange, L., Spindler, T., ... & Scherer, K. (2016). Anaphylaxis in children and adolescents: the European Anaphylaxis Registry.Journal of allergy and clinical immunology,137(4), 1128-1137. Hong, H., Xiao, W., Lazarus, H. M., Good, C. E., Maitta, R. W., & Jacobs, M. R. (2016). Detection of septic transfusion reactions to platelet transfusions by active and passive surveillance.Blood,127(4), 496-502. Hörmann, K., & Zimmer, A. (2016). Drug delivery and drug targeting with parenteral lipid nanoemulsions—A review.Journal of Controlled Release,223, 85-98.
14 Jacob, D., Taylor, M. J., Tomlins, P., & Sahota, T. S. (2016). Synthesis and identification of FITC-insulinconjugatesproducedusinghumaninsulinandinsulinanaloguesfor biomedical applications.Journal of fluorescence,26(2), 617-629. Jones, H. M., Chen, Y., Gibson, C., Heimbach, T., Parrott, N., Peters, S. A., ... & Hall, S. D. (2015).Physiologicallybasedpharmacokineticmodelingindrugdiscoveryand development:apharmaceuticalindustryperspective.ClinicalPharmacology& Therapeutics,97(3), 247-262. Kawase, A., Yamamoto, T., Egashira, S., & Iwaki, M. (2016). Stereoselective inhibition of methotrexate excretion by glucuronides of nonsteroidal anti-inflammatory drugs via multidrug resistance proteins 2 and 4.Journal of Pharmacology and Experimental Therapeutics,356(2), 366-374. Little, M. W., Macdonald, A. C., Boardman, P., Bratby, M. J., Anthony, S., Hadi, M., & Tapping, C. R. (2018). Effects of sublingual glyceryl trinitrate administration on the qualityofpreprocedureCTangiographyperformedtoplanprostateartery embolization.Journal of Vascular and Interventional Radiology,29(2), 225-228. Liu, X., Yang, Y., Gao, B., Li, Y., & Wan, Y. (2017). Environmentally friendly slow-release urea fertilizers based on waste frying oil for sustained nutrient release.ACS Sustainable Chemistry & Engineering,5(7), 6036-6045. Noale, M., Veronese, N., Perin, P. C., Pilotto, A., Tiengo, A., Crepaldi, G., & Maggi, S. (2016). Polypharmacyinelderlypatientswithtype2diabetesreceivingoralantidiabetic treatment.Acta diabetologica,53(2), 323-330. Pridgen, E. M., Alexis, F., & Farokhzad, O. C. (2015). Polymeric nanoparticle drug delivery technologies for oral delivery applications.Expert opinion on drug delivery,12(9), 1459- 1473. Ramsay, G., Baggaley, A., Shaw, P. V., Soltanmohammadi, E., Ventham, N., Shi, N. G., ... & Kilkenny, J. (2018). Variability in the prescribing of intravenous fluids: A cross sectional multicentre analysis of clinical practice.International Journal of Surgery,51, 199-204.
15 Rodrigo,R.,Allen,A.,Manampreri,A.,Perera,L.,Fisher,C.A.,Allen,S.,...& Premawardhena, A. (2018). Haemoglobin variants, iron status and anaemia in Sri Lankan adolescents with low red cell indices: A cross sectional survey.Blood Cells, Molecules, and Diseases,71, 11-15. Ryman, J. T., & Meibohm, B. (2017). Pharmacokinetics of monoclonal antibodies.CPT: pharmacometrics & systems pharmacology,6(9), 576-588. Tan, A. J. Q., Lee, C. C. S., Lin, P. Y., Cooper, S., Lau, L. S. T., Chua, W. L., & Liaw, S. Y. (2017).Designingandevaluatingtheeffectivenessofaseriousgameforsafe administration of blood transfusion: A randomized controlled trial.Nurse education today,55, 38-44.