Pharmacokinetics
 It refers to the study of effects of drugs on
 It refers to the study of the absorption,
distribution, metabolism and excretion of
drugs to determine the relationship between
the dose of a drug and the drugs concentration
in biological fluids
ABSORPTION
 Oral preparations such as tablets and capsules
must first disintegrate into smaller particles for
gastric juices to dissolve and prepare the drugs
for absorption in the small intestine
FACTORS AFFECTION ABSORPTION
1. Blood flow to the administration site – a rich
blood supply facilities good absorption, where
a poor blood supply will slow absorption.
2. Solubility of the drug – drugs in liquid from
are easier to absorbed
3. pH of the drug – a drug that is acidic can be
more easily to absorbed in an acidic
environment such as gastric content
4. Ingestion of food before taking oral
medication – some medication interacts with
foods.
DISTRIBUTION
 It refers to the movement of drugs from the
blood into various body fluids and tissues.
FACTORS AFFECTING DISTRIBUTION
1. Blood flow – how fast the drug releases the
orans and tissues depends on the cardiac
output (blood flow) of the person
2. Cell membrane permeability – to be
distributed to the tissue- the drug must cross
the cell membrane; some membrane act as
barrier to distribution of medication.
3. Protein – binding capacity of the medication,
once the drug enters the circulations, it may
become attached top protein mostly albumins,
this protein binding decreases the amount the
free drug available to reach the site of action
METABOLISM
 Known as biotransformation, which refers to
the physical and chemical processing of the
drug.
 Liver is the primary source of
biotransformation
EXCRETION
 Process in which drugs are eliminated from
the body
 Kidney is the organ involved in excretion
PHARMACOLOGY
living organism
MEDICATION MANAGEMENT
1. HALF LIFE – Refers to the time it takes the
body to eliminate half of the blood
concentration level of the original drug dose
2. ONSET OF ACTION – it is the time it takes
the body to responds to a drug after
administration
3. PEAK PLASMA LEVEL – it is the highest
blood concentration of a single drug dose
before the elimination rate equals the rate of
absorption
4. TROUGH – lowest blood serum
concentration of a drug in a person’s system
5. DURATION – is the time a drug remains in
the system in a concentration great enough to
have a therapeutic effect
PREPARATION AND ROUTE
Special consideration regarding administration…
1. Chewable tablets are designed to be
chewed before swallowing because
chewing enhances gastric absorption
2. Buccal and Sublingual medications must
be allowed to dissolve completely before
the client can or drink
3. Suspension and Emulsion should be
administered immediately after shaking
and pouring the bottle
ORAL ROUTE
 Safest
 Most convenient
 Least expensive
 Disadvantage of oral route is slower acting
than another route
 It should be given on client’s under NPO
 Oral drugs should be given with caution to
client who have had CVA (stroke)
BUCCAL
 (cheek) – designed to be place in the buccal
pocket (superior-posterior aspect of the
internal cheek next to the molars) for
absorption by the mucous membrane of the
mouth
SUBLINGUAL
 Medication is designed to dissolve quickly
when placed under the tongue
PARENTAL ROUTE
Introduction of medication by injecting into the body
1. Intradermal (ID) – injection to the
dermis
2. Subcutaneous (SC, SQ) – injection into
the subcutaneous tissues
 3. Intramuscular (IM) – injection into the irritating, no viscous and water-soluble
muscle medications
4. Intravenous (IV) – injection into the vein  Subcutaneous injections place the medication
OTHER ROUTE into the subcutaneous tissues between the
1. Topical – drugs directly apply to the skin and dermis and the muscle
are absorbed into the bloodstream  Common sites: abdomen, lateral and anterior
2. Transdermal patches aspect of the upper arm or thigh, scapular area
3. Suppositories at the back
4. Eye and Nasal Drops INTRAMUSCULAR
5. Inhalation – Nasal inhaler, Metered-dose
 Used to promote rapid drug absorption and to
inhaler
provide an alternate route when the drug is
6. Intraocular
irritating to subcutaneous tissue
RIGHTS IN GIVING MEDICATION
 Sites: ventrogluteal, dorsolateral, vastus
FIVE basic RIGHTS
lateralis, deltoid
1. Right Drug
2. Right Dose  Angle of insertion is 90°
3. Right Client  Placed the patient in the prone position
4. Right Route  Z tract injection (zigzag technique)
5. Right Time INTRAVENOUS
PARTS OF THE DRUGS ORDER  It is the administration of fluids, electrolytes,
1. Name of the client nutrients or medication by the venous routes
2. Date and when the order is written
3. Name of the drug to be administered CENTRAL LINES
4. Dosage  It refers to a venous catheter inserted into the
5. Route by which is to be administered and superior vena cava through the subclavian,
special directives about its administration internal or external jugular vein
SIDE EFFECTS AND ADVERSE REACTION CAPILLARY PUNCTURE
 Adverse reaction – drug effect other than
 A skin puncture performed when small
those that are therapeutically intended and
qualities of capillary blood are needed for
expected; unexpected and potentially
analysis (blood glucose analysis)
hazardous
ARTERIAL BLOOD GAS (ABS)
 Side effects – Nontherapeutic effect maybe
mild and predictable  Revels the ability of the lungs to exchange
gases by measuring the partial pressure of 02
TYPES OF ADVERSE REACTON
(PO2) and carbon dioxide (PCO2) and
1. Drug allergy
evaluates the pH of the arterial blood
2. Drug tolerance
3. Toxic effects BLOOD GASES ARE ORDERED TO
4. Idiosyncratic reaction EVALUATE:
TYPES OF MEDICATION ORDERS 1. Oxygenation
1. STAT Orders 2. Ventilation and the effectiveness of respiratory
2. Single-dose Orders therapy
3. Standing Orders 3. Acid base level of the blood
4. PRN Orders VENIPUNCTURE
INTRADERMAL  Puncturing of a vein with a needle to aspirate
 It is generally used to diagnose tuberculosis blood.
 PPD – purified protein derivatives or PLEBOTOMIST
MANTOUX test  An individual who performs venipuncture
 Identify allergens (ANST) NONINVASIVE PROCEDURES
 Administer local anesthetics  The body is not entered with any type of
instruments; the skin and other body tissues,
 Common site is the inner aspect of the forearm
organs, and cavities remain intact.
 3-4 width below the antecubital space
INVASIVE PROCEDURES
SUBCUTANEOUS
 Means accessing the body’s tissue, organs or
 Commonly used is the administration of small cavity through some type of instrumentation
amount/dose (0.5-1 ml) pf isotonic, non- procedure
TWO MAJOR COMPONENTS OF ROUTINE
ANALYSIS:
1. Random Collection
 Macroscopic Analysis – Includes color,
appearance, odor, specific gravity, pH, protein,
glucose, ketones, blood, bilirubin and
urobilinogen, nitrite and leukocytes.
 Microscopic Analysis – Includes RBC, WBC,
epithelial cells, casts and crystals and other
substance such as bacteria, yeast, mucus
spermatozoa and parasites.
2. Timed Collection
3. Collection from a Closed Drainage
Stool analysis
 It is used to determine the various constituents
of the stool for diagnostic purpose.
OCCULT BLOOD
 It is said to be occult when blood is invisible
on inspection; blood can be detected only
through a microscopic or by chemical means.
Culture and Sensitivity Test (C&S)
 Performed to identify both the mature invading
organism and their susceptibility to commonly
used antibiotics.
PAPANICOLAOU TEST (Pap Smear)
 Done to evaluate the cell maturity, metabolic
activity and morphologic variations of the
cervical tissue.
MAMMOGRAPHY
 A lose dose radiographic study of breast tissue
to reveal congenital abnormalities and lesions.
ANGIOGRAPHY
 Allows visualization of the vascular structure
through the use of fluoroscopy with a contrast
medium into the vessel or vascular system;
also need used in diagnosing aneurism.
ANGIOGRAMS
 Are serial radiographs of blood vessels that are
used to evaluate the size, shape and potency of
the veins.
CARDIAC CATHETERIZATION
 Reveals defects in the heart chambers, valves
and coronary arteries.
ANEURYSM
 Weakness in the wall of a blood vessel
CONTRAST MEDIUM
 Any substance that is used to improve the
visibility of structures during radiography
ULTRASONOGRAPHY
 Ultrasounds (echogram) is a noninvasive study
that uses high frequency sound waves to
visualize deep body structure; doesn't need
contrast medium; the client is instructed to lie
still during the procedure.
ECHOCARDIOGRAMS
 Ultrasonographic procedures used to reveal
abnormal structure of the heart wall.
DOPPLER ULTRASONOGRAPHY
 Doppler (a handled transducer) transmit high
frequency sound waves to the artery or vein
being examined. Doppler ultrasonography
reveals blood clots and peripheral vascular
disease.
ELECTROCARDIOGRAPHY
 An electrocardiogram (ECG, EKG) is a
graphic recording of the heart's electrical
activity.
HOLSTER MONITOR
 A portable cardiac monitor is a device that
records the heart electrical activity.
ENDOSCOPY
 Endoscopy is the visualization cavity through
a scope.
ELECTROENCEPHALOGRAPHY
 Electroencephalography (EEG) is the graphic
recording of the brain’s electrical activity.
ASPIRATIONS and BIOPSY
 Aspiration is performed to withdraw fluid that
has abnormally collected or to obtain a
specimen.
BIOPSY
 Excision of a small amount of tissue.
AMNIOCENTESIS
 It is the withdrawal of amniotic fluids to obtain
a sample for specimen examination
PARACENTESIS
 Aspiration of fluids from the abdominal cavity.
THORACENTESIS
 Is the aspiration of fluids from the pleural
cavity.
PNEUMOTHORAX
 (Collection of air or gas in the pleural space
causing the lungs to collapse.
LUMBAR PUNCTURE (Spinal Tap)
 It is the aspiration of CSF from the
subarachnoid space.