Absorption: absorption from the administration site either directly or
indirectly into the blood/plasma.
Distribution: reversibly or irreversibly move from the bloodstream into
the interstitial and intracellular fluid.
Metabolism: bio-transformed via hepatic metabolism or by
other tissues. Elimination: lastly, the drug & its metabolites are
eliminated from the body
,2. The route of administration with the highest bio-availability is:
Intravenous; putting entire dose into a patient's vein and bypassing
absorption. Intravenous route avoids first-pass metabolism in the liver.
3. rectal administration disadvantages: variable and erratic absorption
4. Steady state (SS): is usually reached within 4-5 half-lives of a drug
5. The half-life of a drug is defined as: how long it takes for half the drug
to be excreted from the body
6. Half-life of a drug: Determines how frequently the drug must be
administered
Predicts how long toxic effects can last
Half-life is constant with first-order pharmacokinetics of a drug
Zero-order (nonlinear) pharmacokinetics means a drug is metabolized at
,a constant rate per unit time.
7. CYP3A4 substrate drugs: May have enhanced activity if any CYP3A4
inducer drugs are used along with it.
8. Drug development steps (according to the FDA): Discovery:
laboratory re- search to develop the new drug
Pre-clinical research with animal testing for safety (Phase I)
Clinical research on human subjects for medication safety (Phase II)
Clinical research in humans comparing the new drug to accepted
medications or placebo depending on the study (Phase III)
, FDA review of the results to determine approval
Post-marketing study to identify adverse effects not found in earlier
clinical studies (Phase IV)
9. Medication safety organizations: The Institute for Safe Medication
Practices (ISMP)
The Institute of Medicine
(IOM) The Joint
Commission
The National Coordinating Council for Medication Error Reporting and
Prevention (NCCMERP)
Food and Drug Administration (FDA) Safe Use Initiative
10.Adverse Drug Reactions (ADRs): Two basic type of ADRs:
pharmacological and idiosyncratic.
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