Study Guide 1 Flashcards
scope of practice for APRN prescribing
2 components
- right to prescribe independently
- right to prescribe w/o limitation
med adherence
extent to which pts take their meds as prescribed by LIP and agreed to by pt
medication hx and factors to consider when prescribing
- cost
- disease guidelines
- interactions (drugs and polypharmacy)
- s/e
- allergies
- liver and renal fx
- need for monitoring
- special populations
teratogen
substance which will cause permanent abnormalitiy, growth retardation, or death if fetus exposed
renal function when prescribing
look at creatinine clearnace
e- prescribing
trend bc less likely to have errors
cannot e-prescribe scheduled meds or narcs
pharmacokinetics
study of drug movement throughout the body
first pass effect
o Refers to the rapid heaptic inactivation of certain PO drugs. when drugs are absorbed from the GI tract, they are carried direcly to the liver through the hepatic portal vein before they enter the systemic circulation. If the capacity of the liver to metabolize a drug is extremely high, that drug can be completely inacticated on its first pass through the liver. As a result, no therapeutic effects can occur. To circumvent the first pass effect, a drug that undergoes rapid hepatic metabolism is often administered parenterally.
steady level aka plateau
Administering repeated doses will cause a drug to build up in the body until a plateau (steady level) has been achieved.
time to plateau
approximately 4 half lives with constant dose
decline from plateau
When drug administration id dc’ed, most (94%) of drug in the body will be eliminated over an interval equal to about 4 half lives.
excretion
removal of drugs from the body
most common organ for drug excretion
renal
absorption
movement of drug from site of admin into systemic circulation
factors affecting drug absorption
Rate of dissolution Surface area Blood flow Lipid solubility Ph partitioning