DOCSLIB.ORG

O. Medication / Iv Guide

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
O. Medication / Iv Guide O. MEDICATION/IV GUIDE Acetaminophen (Tylenol) .................................................................................................................. O-2 Adenosine (Adenocard) ................................................................................................................... O-3 Afrin ................................................................................................................................................. O-4 Albuterol .......................................................................................................................................... O-5 Amiodarone (Cordarone) .................................................................................................................. O-7 Aspirin (Chewable) ........................................................................................................................... O-8 Atropine ........................................................................................................................................... O-9 Calcium Chloride 10% ................................................................................................................... O-11 Calcium Gluconate 10% .................................................................................................................. O-12 Cyanokit (Hydroxocobalamin) ........................................................................................................ O-13 Dexamethasone (Decadron) ............................................................................................................. O-15 Dextrose 5% (D5W), 10% (D10W), 25% (D25W) and 50% (D50W) ............................................... O-16 Diazepam (Valium) ......................................................................................................................... O-17 Diltiazem (Cardizem) ...................................................................................................................... O-19 Diphenhydramine (Benadryl) ........................................................................................................ O-20 Dopamine ....................................................................................................................................... O-21 Epinephrine (Adrenalin) ................................................................................................................ O-23 Etomidate (Amidate) ....................................................................................................................... O-26 Fentanyl (Sublimaze) ...................................................................................................................... O-27 Glucagon ........................................................................................................................................ O-28 Glucose, Oral ................................................................................................................................. O-29 Ibuprofen .......................................................................................................................................... O-30 Ipratropium Bromide (Atrovent) ..................................................................................................... O-31 Ketamine (Ketalar) ........................................................................................................................... O-32 Lactated Ringer’s (LR) .................................................................................................................... O-33 Lidocaine 2% ................................................................................................................................. O-34 Magnesium Sulfate ........................................................................................................................ O-36 Mark I/DuoDote (NAAK) ............................................................................................................... O-38 Methylprednisolone (Solu-Medrol) ................................................................................................ O-39 Midazolam (Versed) ....................................................................................................................... O-40 Morphine Sulfate ........................................................................................................................... O-42 Naloxone (Narcan) ......................................................................................................................... O-44 Nitroglycerin ................................................................................................................................... O-46 Nitrous Oxide (Nitronox) ................................................................................................................ O-48 Ondansetron (Zofran) ..................................................................................................................... O-49 Oxygen ........................................................................................................................................... O-50 Pralidoxime Chloride (2-PAM Chloride) ....................................................................................... O-51 Rocuronium (Zemuron) .................................................................................................................. O-52 Sodium Bicarbonate ....................................................................................................................... O-53 Sodium Chloride 0.9% (Normal Saline) (NS) ............................................................................... O-54 Succinylcholine (Anectine) ............................................................................................................ O-55 Vecuronium (Norcuron) .................................................................................................................. O-56 Xylocaine 2% Jelly ........................................................................................................................ O-57 O-1 ACETAMINOPHEN (TYLENOL) CLASSIFICATION 1. Antipyretic. 2. Analgesic. ACTION 1. Inhibits prostaglandin in CNS to reduce fever. 2. Blocks pain impulses. ONSET OF ACTION 1. PO and PR: 10-30 minutes. DURATION OF ACTION 1. PO and PR: 3-4 hours. INDICATION 1. Fever. 2. Pain management. CONTRAINDICATION 1. Hypersensitivity. 2. Severe liver disease. USE WITH CAUTION 1. Anemia. 2. Liver disease. 3. Renal disease. DOSAGE AND ADMINISTRATION 1. Adult: 500-1000 mg orally. 2. Pediatric: 15 mg/kg orally or by rectal suppository. ADVERSE REACTION 1. Nausea, Vomiting, Rash. REFERENCE IN PROTOCOL 1. Medical Emergencies (Febrile pediatric patient). 2. Pain Management. O-2 ADENOSINE (ADENOCARD) CLASSIFICATION 1. Antiarrhythmic. ACTION 1. Acts on AV node to slow conduction. May inhibit reentry pathways. ONSET OF ACTION 1. Immediate. DURATION OF ACTION 1. Less than one minute. INDICATION 1. Conversion of stable narrow complex SVT to sinus rhythm. 2. Conversion of unstable narrow complex reentry tachycardia to sinus rhythm. 3. Regular and monomorphic wide complex tachycardia, thought to be or previously defined to be reentry SVT. CONTRAINDICATION 1. Second and third degree heart blocks, sick sinus syndrome, unless patient has a pacemaker. 2. Hypersensitivity to adenosine. USE WITH CAUTION 1. May produce TRANSIENT first, second, and third degree blocks or asystole for 10-15 seconds. 2. Asystolic pause may be longer in patients taking Tegretol (carbamazepine) or Persantine (dipyridamole). 3. Patients taking theophylline or caffeine may require higher doses. 4. Patients with asthma may experience bronchoconstriction. 5. May be used with wide QRS complex SVT at direction of Base Station. Its use may cause acceleration of the rate. 6. It is ineffective in atrial fibrillation or flutter, and ventricular tachycardia. DOSAGE AND ADMINISTRATION 1. Adult: 6 mg by rapid IV push over 1-3 seconds followed by a rapid NS flush of 20 mL, then elevate extremity. If no response within 1-2 minutes, give 12 mg by same method as before. 2. Pediatric: 0.1 mg/kg up to 6 mg rapid IV push over 1-3 seconds followed by a rapid NS flush of 5-10 mL. If no response within 1-2 minutes, give 0.2 mg/kg up to 12 mg by the same method as before. 3. Place IV in antecubital for best absorption using at least an 18 gauge catheter. ADVERSE REACTION 1. Common but transient: Asystole, Bradycardia (temporary), Hypotension, Chest pain, Flushing, Dyspnea, Apprehension, Back/neck pain, Blurred vision, Burning sensation, Dizziness, Numbness, Tingling in arms, Sweating, Palpitations, Nausea. REFERENCE IN PROTOCOL 1. Cardiac Emergencies (see AHA handbook). 2. Pediatric Cardiac Arrest Guide (Appendix K). O-3 AFRIN CLASSIFICATION 1. Adrenergic sympathomimetic. ACTION 1. Unknown. Causes vasoconstriction of the smaller arterioles in the nasal passages which lasts up to 12 hours. ONSET OF ACTION 1. Less than 5 minutes. DURATION OF ACTION 1. Less than 12 hours. INDICATION 1. Preparation for nasotracheal intubation. 2. Control of epistaxis. CONTRAINDICATION 1. Known hypersensitivity to medication. USE WITH CAUTION 1. Not recommended for children < 6 years old. DOSAGE AND ADMINISTRATION 1. Adult and Pediatric > 6 years old: 2-3 sprays in each nostril. 2. Pediatric < 6 years old: none. ADVERSE REACTION 1. Headache, Drowsiness, Insomnia, Palpitations, Hypertension, Rebound nasal congestion or irritation. 2. Burning, Stinging or
Load more

Recommended publications
  • Onset of Action of Relaxants Francois Donati PH D MD FRCPC
    $52 REFRESHER COURSE OUTLINE Onset of action of relaxants Francois Donati PH D MD FRCPC Induction of anaesthesia must be performed carefully Cardiac outFur with special attention to the possibility of hypoxia and After intravenous injection, the drug is carried to the aspiration of gastric contents. These problems are largely central circulation where it ruixes with venous blood avoided by the proper placement of a tracheal tube and coming from all organs. Then it enters the ride side of the mechanical ventilation. However, the degree of paralysis heart, goes through the pulmonary circulation and the left required for easy laryngoscopy and tracheal intubation is side of the heart to the aorta. The transition time from not achieved immediately after the injection of the peripheral venous to arterial circulation depends on relaxant drug. The time delay between inducing anaesthe- cardiac output. Not surprisingly, cardiac output has been sia and securing the airway should be considered a danger identified as a major factor affecting succinylcholine period which should be shortened as much as possible. onset time. 13 The onset time of non-depolarizing relax- For the past 35 years, succinylcholine has been the drug ants was found to be shorter in infants, who have a of choice to achieve profound neuromuscular blockade relatively large cardiac output, than in older children. 14' 15 rapidly. Doses of 1- 1.5 mg. kg- i provide excellent intu- Within the adult population, the onset of pancuronium bat[ne conditions in 60 to 90 seconds 1-7 Unfortunately,
    [Show full text]
  • Bioavailability and Bioeqivalence
    UNIT 5 BIOAVAILABILITY AND BIOEQIVALENCE S. SANGEETHA., M.PHARM., (Ph.d) Department of Pharmaceutics SRM College of Pharmacy SRM University BIOAVAILABILITY INTRODUCTION ¾The bioavailability or systemic availability of an orally administered drug depends largely on the absorption and the extent of hepatic metabolism ¾The bioavailability of an oral dosage form is determined by comparing the Area Under Curve (AUC) after oral administration of a single dose with that obtained when given IV Drug bioavailability = AUC (oral) AUC (IV) = Bioavailable dose Administered dose DEFINITION Bioavailability is defined as the rate and the absorption of drug that reaches the biological system in an active form, capable of exerting the desired pharmacological effect, including its onset, intensity and duration of its action. THE NEED FOR BIOAVAILABILITY STUDIES ¾Bioavailability studies provide and estimate of the fraction of the orally administered dose that is absorbed into the systemic circulation when compared to the bioavailability for a solution, suspension, or intravenous dosage form that is completely available. ¾Bioavailability studies provide other useful information that is important to establish dosage regimen and to support drug labeling, such as distribution and elimination characteristics of the drug ¾Bioavailability studies provide information regarding the performance of the formulation TYPES OF BIOAVAILABILITY Absolute bioavailability – Absolute bioavailability of a drug in a formulation administered by an extravascular, including the oral route reaching the systemic circulation is the fraction of the same dose of the drug administered intravenously. Absolute bioavailability= (AUC) abs (AUC) iv Absolute bioavailability = (AUC) abs x Div (AUC) iv x Dabs Where Dabs is the size of the single dose administered via the absorption site And Div is the dose size administered intravenously.
    [Show full text]
  • Professor Jo Klaveness School of Pharmacy University of Oslo
    SUPERVISORS Professor Jo Klaveness School of Pharmacy University of Oslo Associate professor Pål Rongved School of Pharmacy University of Oslo 1 TABLE OF CONTENTS TABLE OF CONTENTS 1 ABBREVIATIONS..........................................................................5 2 ABSTRACT.....................................................................................6 3 INTRODUCTION............................................................................7 3.1 Acetylcholine- a neurotransmitter Synthesis, release and inactivation ... 7 3.1.1 Structure of acetylcholinesterase .................................................................... 8 3.2 Anticholinesterases interfere with acetylcholine activity ........................ 9 3.3 Effects of anticholinesterases................................................................... 9 3.4 Different groups of anticholinesterases.................................................. 10 3.4.1 Short- acting anticholinesterases .................................................................. 10 3.4.2 Medium- duration anticholinesterases .......................................................... 11 3.4.3 Irreversible anticholinesterases..................................................................... 12 3.5 Nerve agents: Irreversible anticholinesterases....................................... 13 3.5.1 The dawn of a deadly weapon ...................................................................... 14 3.5.2 Biochemistry................................................................................................
    [Show full text]
  • Pharmacology Part 2: Introduction to Pharmacokinetics
    J of Nuclear Medicine Technology, first published online May 3, 2018 as doi:10.2967/jnmt.117.199638 PHARMACOLOGY PART 2: INTRODUCTION TO PHARMACOKINETICS. Geoffrey M Currie Faculty of Science, Charles Sturt University, Wagga Wagga, Australia. Regis University, Boston, USA. Correspondence: Geoff Currie Faculty of Science Locked Bag 588 Charles Sturt University Wagga Wagga 2678 Australia Telephone: 02 69332822 Facsimile: 02 69332588 Email: [email protected] Foot line: Introduction to Pharmacokinetics 1 Abstract Pharmacology principles provide key understanding that underpins the clinical and research roles of nuclear medicine practitioners. This article is the second in a series of articles that aims to enhance the understanding of pharmacological principles relevant to nuclear medicine. This article will build on the introductory concepts, terminology and principles of pharmacodynamics explored in the first article in the series. Specifically, this article will focus on the basic principles associated with pharmacokinetics. Article 3 will outline pharmacology relevant to pharmaceutical interventions and adjunctive medications employed in general nuclear medicine, the fourth pharmacology relevant to pharmaceutical interventions and adjunctive medications employed in nuclear cardiology, the fifth the pharmacology related to contrast media associated with computed tomography (CT) and magnetic resonance imaging (MRI), and the final article will address drugs in the emergency trolley. 2 Introduction As previously outlined (1), pharmacology is the scientific study of the action and effects of drugs on living systems and the interaction of drugs with living systems (1-7). For general purposes, pharmacology is divided into pharmacodynamics and pharmacokinetics (Figure 1). The principle of pharmacokinetics is captured by philosophy of Paracelsus (medieval alchemist); “only the dose makes a thing not a poison” (1,8,9).
    [Show full text]
  • Efficacy of Trimedoxime in Mice Poisoned with Dichlorvos, Heptenophos Or Monocrotophos
    CORE Metadata, citation and similar papers at core.ac.uk Provided by FarFar - Repository of the Faculty of Pharmacy, University of Belgrade C Basic & Clinical Pharmacology & Toxicology 2005, 96, 111–117. Printed in Denmark . All rights reserved Copyright C ISSN 1742-7835 Efficacy of Trimedoxime in Mice Poisoned with Dichlorvos, Heptenophos or Monocrotophos Biljana Antonijevic´1, Dubravko Bokonjic´2, Milosˇ P. Stojiljkovic´2, Vesna Kilibarda2, Zoran A. Milovanovic´2, Mirjana Nedeljkovic´1 and Matej Maksimovic´1 1Institute of Toxicological Chemistry, School of Pharmacy, University of Belgrade, Vojvode Stepe 450, and 2National Poison Control Centre, Military Medical Academy, Crnotravska 17; 11000 Belgrade, Serbia and Montenegro (Received June 18, 2004; Accepted September 3, 2004) Abstract: The aim of the study was to examine antidotal potency of trimedoxime in mice poisoned with three direct dimethoxy-substituted organophosphorus inhibitors. In order to assess the protective efficacy of trimedoxime against dichlorvos, heptenophos or monocrotophos, median effective doses and efficacy half-times were calculated. Trimedoxime (24 mg/kg intravenously) was injected 5 min. before 1.3 LD50 intravenously of poisons. Activities of brain, diaphragmal and erythrocyte acetylcholinesterase, as well as of plasma carboxylesterases were determined at different time intervals (10, 40 and 60 min.) after administration of the antidotes. Protective effect of trimedoxime decreased according to the following order: monocrotophos Ͼ heptenophos Ͼ dichlorvos. Administration of the oxime produced a significant reacti- vation of central and peripheral acetylcholinesterase inhibited with dichlorvos and heptenophos, with the exception of erythrocyte acetylcholinesterase inhibited by heptenophos. Surprisingly, trimedoxime did not induce reactivation of mon- ocrotophos-inhibited acetylcholinesterase in any of the tissues tested.
    [Show full text]
  • Anew Drug Design Strategy in the Liht of Molecular Hybridization Concept
    www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 “Drug Design strategy and chemical process maximization in the light of Molecular Hybridization Concept.” Subhasis Basu, Ph D Registration No: VB 1198 of 2018-2019. Department Of Chemistry, Visva-Bharati University A Draft Thesis is submitted for the partial fulfilment of PhD in Chemistry Thesis/Degree proceeding. DECLARATION I Certify that a. The Work contained in this thesis is original and has been done by me under the guidance of my supervisor. b. The work has not been submitted to any other Institute for any degree or diploma. c. I have followed the guidelines provided by the Institute in preparing the thesis. d. I have conformed to the norms and guidelines given in the Ethical Code of Conduct of the Institute. e. Whenever I have used materials (data, theoretical analysis, figures and text) from other sources, I have given due credit to them by citing them in the text of the thesis and giving their details in the references. Further, I have taken permission from the copyright owners of the sources, whenever necessary. IJCRT2012039 International Journal of Creative Research Thoughts (IJCRT) www.ijcrt.org 284 www.ijcrt.org © 2020 IJCRT | Volume 8, Issue 12 December 2020 | ISSN: 2320-2882 f. Whenever I have quoted written materials from other sources I have put them under quotation marks and given due credit to the sources by citing them and giving required details in the references. (Subhasis Basu) ACKNOWLEDGEMENT This preface is to extend an appreciation to all those individuals who with their generous co- operation guided us in every aspect to make this design and drawing successful.
    [Show full text]
  • Comparison of Pharmacokinetics and Efficacy of Oral and Injectable Medicine Outline
    Comparison of pharmacokinetics and efficacy of oral and injectable medicine Outline • Background • Results – Antibiotics – Non steroidal anti-inflammatory drugs (NSAIDs) – Vitamins • Conclusions and recommendations Outline • Background • Results – Antibiotics – Non steroidal anti-inflammatory drugs (NSAIDs) – Vitamins • Conclusions and recommendations Injections given with sterile and reused South America (lower mortality) equipment worldwide Central Europe South America (higher mortality) West Africa Injections given with non-sterile equipment East and Southern Africa Injections given with sterile equipment South East Asia Regions China and Pacific Eastern Europe and Central Asia South Asia Middle East Crescent - 2.0 4.0 6.0 8.0 10.0 12.0 Number of injections per person and per year Injections: A dangerous engine of disease • Hepatitis B – Highly infectious virus – Highest number of infections (21 million annually) – 32% of HBV infections • Hepatitis C – More than 2 million infections each year – More than 40% of HCV infections • HIV – More than 260 000 infections – Approximately 5% of HIV infections Reported common conditions leading to injection prescription • Infections • Asthma – Fever • Other – Upper Respiratory – Malaise Infection/ Ear Infection – Fatigue – Pneumonia – Old Age – Tonsillitis – Pelvic Inflammatory Disease – Skin Infections – Diarrhea – Urinary tract infection Simonsen et al. WHO 1999 Reported injectable medicines commonly used • Antibiotics • Anti-inflammatory agents / Analgesics • Vitamins Simonsen et al. WHO 1999
    [Show full text]
  • Practical Guidelines for Clinicians Who Treat Patients with Amiodarone
    SPECIAL ARTICLE Practical Guidelines for Clinicians Who Treat Patients With Amiodarone Nora Goldschlager, MD; Andrew E. Epstein, MD; Gerald Naccarelli, MD; Brian Olshansky, MD; Braman Singh, MD; for the Practice Guidelines Subcommittee, North American Society of Pacing and Electrophysiology miodarone has become an important drug for the treatment of supraventricular and ventricular arrhythmias, in short-term inpatient and outpatient settings. It may also have a role in affecting outcome in patients at high risk for arrhythmic events and sudden death; its place among available therapies is being established in clinical trials. A Arch Intern Med. 2000;160:1741-1748 Patterns of use of amiodarone are not uni- fibrillation (VF) or ventricular tachycar- form, either in academic or in community dia (VT) with hemodynamic instability. settings; overuse and underuse are likely This indication includes the stipula- real phenomena, although data are sparse tion that the arrhythmias are not respon- and largely anecdotal. Guidelines for phy- sive to other available antiarrhythmic sicians who use amiodarone are unavail- agents or that the patients are intolerant able. Because of the potential for serious of them. toxicity with its use, knowledge of drug dos- It is the consensus of this committee ing, beneficial effects, and adverse effects that amiodarone should be used as the an- is essential for proper patient manage- tiarrhythmic agent of choice, in connec- ment. This guideline was created as an ap- tion with other therapies (eg, b block- proach to the use of amiodarone in clini- ers), in patients with sustained ventricular cal practice. The guideline reviews the tachyarrhythmias who have structural indications for use of amiodarone and meth- heart disease, especially left ventricular ods of initiation of therapy, suggests strat- dysfunction, and who are not candidates egies for the follow-up of patients receiv- for an implantable cardioverter-defibrilla- ing amiodarone, and outlines the adverse tor (ICD).
    [Show full text]
  • Drugs Which Can Affect Near Vision: a Useful List
    Drugs Which Can Affect Near Vision: A Useful List Joanne L. Smith B.Sc., Ph.Phm.* J. Raymond Buncic, M.D., F.R.C.S.(C)t ABSTRACT This paper documents a list of drugs that cause problems with near vision, by virtue of effects on accommodation, occasionally refractive error and diplopia. It is meant as a reference aid to the clinician when confronted with problems of focusing on near objects or print. There are many drugs that have been reported to interfere with near or reading vision, producing blurring, decreased accommodation and diplopia. This paper lists the drugs that have been reported in the literature to produce symptoms which interfere with near vision. Case reports for the listed drugs vary greatly from many to few. The drugs have been divided into the following categories: those causing (A) blurring at near, (B) diplopia and (C) induced myopia. Those drugs which only rarely cause these symptoms have been omitted. From the Departments of Pharmacy* and Ophthalmologyt, The Hospital For Sick Children, Toronto, Ontario, Canada Requests for reprints should be addressed to: Dr. J. Raymond Buncic, Department of Ophthalmology, The Hospital For Sick Children, 555 University Ave., Toronto, Ontario, Canada M5G lX8 TABLE 1 DRUGS COMMONLY CAUSING DIFFICULTY WITH FOCUSING AT NEAR OR BLURRED VISION. DRUG INCIDENCE REFERENCE Antipsychotics Chlorpromazine 14-23 8 Clozapine 5 8,14 Fluphenazine 1.2-4.3 8 Haloperidol 6.8-16 8 Loxapine 12,14 Perphenazine 7.4-17.8 8 Pimozide 20 8 Risperidone 1-2%, >/= 10% 11 Thioridazine 0.6-18 8 Thiothixene 20 8
    [Show full text]
  • Adult Intravenous Medications
    Revised 9/08 ADULT INTRAVENOUS MEDICATIONS STANDARD AND MAXIMUM ALLOWABLE CONCENTRATIONS, GUIDELINES FOR CONTINUOUS OR TITRATED INFUSIONS MEDICATION STANDARD MAXIMUM CONC./ DOSING MONITORING/COMMENTS ADMIXTURE INFUSION INSTRUCTIONS Adenosine 6 mg/2 mL vial Give undiluted directly into 6 mg initially. If SVT not ECG, heart rate, blood pressure (Adenocard®) (3 mg/mL) given undiluted vein over 1-2 seconds. resolved in 1-2 minutes, may Administer as proximal as follow with 12 mg dose. If Extremely short half life: possible to trunk (i.e., not in not resolved in 1-2 minutes, < 10 seconds Slows conduction time through the AV node, interrupting the re-entry lower arm, hand, lower leg, may follow with an Not effective for converting A. pathways through the AV node, or foot). If administered additional 12 mg dose. flutter, A. fib, or ventricular restoring normal sinus rhythm. through IV line, administer tachycardia. as close to pts heart as Contraindicated if symptomatic Onset of action: immediate Duration: seconds possible. NS flush must be bradycardia, sick sinus given rapidly, immediately syndrome, 2nd or 3rd degree AV following injection of block (unless pt. has functioning adenosine pacemaker) Amiodarone Load: Dilute 150 mg (3mL) in Peripheral line: Up to 2 Load: 150 mg/100 mL over Telemetry monitoring, BP (Cordarone®) 100 mL D5W (1.5 mg/mL) mg/mL 10 minutes. (hypotension occurs frequently (PVC bag suitable for loading (Not to eXceed 30 mg/mL) with initial rates), HR Antiarrhythmic agent that dose) (Concentrations over 2 (arrhythmias: AV block, depresses conduction velocity, mg/mL administered for THEN bradycardia, VT/VF, torsades de slows AV node conduction, raises Maintenance infusion: longer than 1 hour must be pointes), electrolytes the threshold for VF, and eXhibits Dilute 900 mg (18 mL) in infused via central line) Infusion: 1 mg/min for 6 some α and β blockade activity.
    [Show full text]
  • Methadone Maintenance
    Methadone Maintenance Judith Martin, MD Medical Director BAART Turk Street Clinic San Francisco, CA Dr. Martin, Disclosures • No conflict of interest to disclose. • No discussion of off-label use. • Special thanks to Dr. Thomas Payte for allowing me to use some of his great slides. Physicians Working in MMT Will Know: • How to safely induce patients to MMT. • How to adjust methadone dosing for maximum effectiveness. • How to detect and manage MMT side effects and medication interactions. • How to work within legal/regulatory framework of 42 CFR part 8. Safety Considerations in MMT: • Avoid sedation and respiratory depression (stay within tolerance) • Minimize side effects of constipation, sweating, hypogonadism • Alertness to potential medication interactions, QT/cardiac risk • Minimize diversion, accidental ingestion or dosing errors Safe Induction: “Start Low go Slow” • Methadone-related deaths during MMT occur during the first 10 days of treatment and are more common with higher induction doses. • There is no way of directly measuring tolerance to methadone. Estimate of opioid tolerance is based on history and physical, supported by toxicology tests. Methadone Deaths in Treatment • Induction risk 7 times greater than active heroin use. Methadone induces its own metabolic rate over time. Eventual dose needed will be usually much higher than initial tolerance. • Most deaths also show benzodiazepines on toxicology. This is true of most unintentional opiate poisonings. Methadone is an Unusual Opioid: • Slow onset of action: patient starts to ‘feel’ the swallowed dose 30-45 minutes later. • Delayed peak action: greatest effect from single dose is 2-4 hours post ingestion. • Tissue stores: methadone deposited in tissue over 3-7 days to reach steady state.
    [Show full text]
  • Pharmacokinetics: the Absorption, Distribution, and Excretion of Drugs
    Chapter 3 Pharmacokinetics: % C The Absorption, . 789—. Distribution, and 4 5 6 X Excretion of Drugs 1 2 3 – 0 • = + OBJECTIVES After studying this chapter, the reader should be able to: • Explain the meaning of the terms absorption, distribu- tion, metabolism, and excretion. • List two physiologic factors that can alter each of the KEY TERMS processes of absorption, distribution, and excretion. • achlorhydria • adipose • Explain how bioavailability can impact drug response • albumin and product selection. • aqueous • Compare the roles of passive diffusion and carrier-medi- • bioavailability ated transport in drug absorption. • bioequivalent • biotransformation • Describe two types of drug interaction and explain how • blood-brain barrier they might affect drug response and safety. • capillary permeability • cardiac decompen- sation • carrier-mediated transport • catalyze • concentration gradient • dissolution • distribution • epithelium • equilibrium • excretion 27 28 Practical Pharmacology for the Pharmacy Technician • extracellular • lipids • prodrug • first-pass effect • metabolism • saturable process • hydrophilic • metabolite • steady state • interstitial • passive diffusion • volume of distribution • intracellular distribution The process by Safe and effective drug treatment is not only a function of the physical and chemical prop- which a drug is carried to erties of drugs, but also a function of how the human body responds to the administration sites of action throughout of medication. The study of the bodily processes that affect the movement of a drug in the the body by the blood- body is referred to as pharmacokinetics. To understand the pharmacology of drugs, the stream. pharmacy technician must also understand the four fundamental pathways of drug move- ment and modification in the body (Fig. 3.1). First, drug absorption from the site of admin- metabolism The total of all istration permits entry of the compound into the blood stream.
    [Show full text]