1. AFAMS Basic Pharmacokinetic Concepts (Dari) EO 003.01 Part 15

2. AFAMS Importance of Lesson (Dari) Pharmacy technicians are required to have a basic understanding of what the body does to drugs in order to understand the factors that affect the dosing of medications. AFAMS Insert Dari

3. AFAMS Overview of Lesson (Dari) Definitions Absorption Distribution Metabolism Excretion Factors that influence drug dosage and action In-class Assignment AFAMS Insert Dari

4. AFAMS Definitions (Insert Dari) Pharmacokinetics – what the body does to the drug. Includes the following four stages: (1) Absorption of drug (2) Distribution of the drug (3) Metabolism of the drug (4) Excretion of the drug Pharmacodynamics – what the drug does to the body (will be covered in future lectures). Insert Dari

5. AFAMS Insert Dari

6. AFAMS Routes of Administration (Insert Dari) This will be covered in more detail during EO 003.02 Insert Dari Topical (Insert Dari) Oral (Insert Dari) Intravenous (Insert Dari) Transdermal (Insert Dari) Subcutaneous (Insert Dari)

7. AFAMS Absorption (Insert Dari) The process by which the drug enters the body through the bloodstream. Some substances work outside the body but most must enter the body in order to work. Most drugs will undergo intestinal absorption through the GI tract. Drugs that are administered intravenously are an exception as they are directly administered to the bloodstream and do not undergo absorption. Insert Dari

8. AFAMS Absorption: Oral vs Intravenous Administration RouteBenefitsDisadvantages Oral Safe Convenient No need for sterile equipment Variable absorption – only a percentage of the drug ingested is absorbed Gastric irritation may cause vomiting (not useful if patient is vomiting) Requires cooperation of patient Onset of effect is slow Intravenous Extremely rapid effect Initial absorption step is by- passed (immediately enters the bloodstream) Drug levels are more accurately controlled Most dangerous route Drug must be in aqueous solution Must be performed slowly Once injected, drug cannot be removed

9. AFAMS (Insert Dari)

10. AFAMS Distribution (Insert Dari) The movement of the drug from the blood to the body tissue. Factors that effect drug movement in body tissues include blood flow to the tissue (i.e. organs = fast, muscle = slow) as well as characteristics of the drug. Some characteristics include: - Size of the drug - Water solubility - Lipid solubility Insert Dari

11. AFAMS Water-soluable vs Lipid soluable Medications (Insert Dari) Lipid soluble – the drug mixes well with fats. If a drug is lipid soluble that means that it can easily pass through the outer membrane of a cell (which is composed of lipids). It also means that the drug will distribute well into the fat tissue = accumulation of drug in the body. Water soluble – the drug mixes well with water and as a general rule does not mix well with fats. Insert Dari

12. AFAMS Metabolism (Insert Dari) Metabolism- the modification of the chemical structure of a drug by the body. There are MANY steps to this process. Metabolite – drug product that results from metabolism, may be more active or less active than the original/parent drug. The majority of drug metabolism occurs in the liver. There are variations among individuals as to how they metabolize medications and how quickly they do so. Insert Dari

13. AFAMS Elimination (Insert Dari) Removal of the drug from the body. Main route for this to occur is through the kidneys and excretion in the urine. Some drugs may be reabsorbed via the kidneys and will require multiple metabolism steps before they can be excreted from the body. Insert Dari

14. AFAMS Dosing of medications (Insert Dari) Dose = the amount of medication being administered. Effective dose = dose of medication required to achieve the desired therapeutic effect. Lethal dose = dose of medication that will cause death. If a effective dose and lethal dose do not have much difference between them that drug has a narrow therapeutic range. Insert Dari

15. AFAMS Factors Influencing Drug Dosage فکتورهایکه مقدار ادویه توصیه شده را متاثرمیسازد Age Weight Gender Physical Health سن وزن جنس صحت فزیکی

16. AFAMS Age سن Infants: –Immature body systems –Not fully developed kidney and liver functions Children: –Different physiologic profile and body mass distribution –Dose per kilogram Older adults: –Depressed liver and kidney systems. –Higher ratio of fat tissue to muscle tissue –Increased risk for drug interactions شیر خوار: - طفل نابالغ - سیستم کلیوی و کبد بشکل ممکن انکشاف ننموده است اطفال: - از نگاه فزیکی مختلف و دارای یک شکل برجسته و با حجم خوبتر میباشد - دوز ادویه بر کیلوگرام جوان بزرک سال: - افسردگی کبد و سیستم کلیوی - افزائش تناسب مقدار انساج شهمی به انساج عضلی - افزائش خطر مداخله ادویه

17. AFAMS Weight وزن Children: –Body surface area, height and weight are important factors in determining drug dosages –Calculated by milligrams of drug per kilogram of body weight Adults: –Overweight and underweight adults –Average adult dose is based on a drug quantity that will produce a particular effect in 50% of the population between 18 and 65 years of age and approximately 150 pounds in weight. –Dosage may need to be adjusted for those who are extremely underweight or overweight. اطفال: - قسمت سطحی وجود، طول و وزن از جمله فکتور های مهم در تعین ادویه میباشد - ملی گرام ادویه بر گیلوگرام وزن مریض محاسبه میگردد کاهلان: - کاهلان با وزن زیاد یا کم - دوز ادویه در سنین کاهلان متوسط براساس مقدار ادویه بوده که 50 فیصد تاثیرات خاص را دربین سنین 18 الی 65 تولید خواهد کرد و تقریفاً دارای وزن 150 پاند باشد. Insert Dari

18. AFAMS Gender ارثیت Women higher percentage of body fat Men higher percentage of body fluid Drugs fat soluble, thus women may accumulate more of these drugs in their body Pregnancy Drugs pass through the placenta and breast milk. Very important to confirm if a patient is pregnant and to make sure drugs are dosed properly to prevent harm to the developing baby or newborn. فیصدی شهم در نزد زن ها بیشتر میباشد فیصدی مایعات وجود در نزد مرد ها بیشتر است ادویه منحل در شهم بدین معنی است که زن ها مقدار بیشتراین ادویه را در وجود دارند Insert Dari ادویه از طریق پلاسنتا و شیر ثدیه انتقال مینماید Insert Dari

19. AFAMS Physical health صحت فزیکی Disease processes alter dosage requirements, particularly in clients with kidney, liver, digestive and cardiovascular problems. عبارت ازیک پروسه مرض بوده که نیازمندی های مقدار ادویه توصیه شده را مخصوصاً در مریضانیکه مشکلات کلیه، کبد، قلبی وعائی و سیستم هضمی داشته باشند تغیرمیدهد،

20. AFAMS Questions? (Insert Dari)

21. AFAMS In-Class Assignment (Insert Dari)

22. AFAMS 1. Put the following pharmacokinetic steps in the order in which they generally occur: (Insert Dari) A)Metabolism B)Elimination C)Distribution D)Absorption Insert Dari

23. AFAMS 1. Put the following pharmacokinetic steps in the order in which they generally occur: (Insert Dari) D) Absorption C) Distribution A)Metabolism B)Elimination Insert Dari

24. AFAMS 2. Answer: Which of the following is NOT true regarding intravenous and oral administration? (Insert Dari) A)Intravenous administration achieves a faster onset of action when compared to oral. B)If a person is vomiting oral administration of medication is preferred. C)Oral administration is convenient for the patient. D)Intravenous administration skips the absorption step as the drug is administered directly into the blood stream. Insert Dari

25. AFAMS 3. Fill in the blanks: The majority of drug metabolism occurs in the ______ and the majority of drugs are eliminated via the _______. (Insert Dari)

26. AFAMS 3. Answer: Fill in the blanks: The majority of drug metabolism occurs in the liver and the majority of drugs are eliminated via the kidneys. (Insert Dari)

27. AFAMS 4. Which of the following is best defined as the dose which achieves a desired therapeutic effect? (Insert Dari) A)Minimal dose B)Maximal dose C)Lethal dose D)Effective dose Insert Dari

28. AFAMS 4. Which of the following is best defined as the dose which achieves a desired therapeutic effect? (Insert Dari) A)Minimal dose B)Maximal dose C)Lethal dose D)Effective dose Insert Dari

29. AFAMS 5. Which of the following influences the dosing of a drug? (Insert Dari) A)Gender B)Weight C)Age D)All of the above Insert Dari

30. AFAMS 5. Answer: Which of the following influences the dosing of a drug? (Insert Dari) A)Gender B)Weight C)Age D)All of the above Insert Dari