Multiprofessional Critical Care Review: Pediatric 2024 (MCCRCP24ON)-Pharmacology- Five Things You Need to Know

Pharmacology- Five Things You Need to Know

Pdf Summary

The presentation by Tom Moran, PharmD, MS, BCPS, FCCM, titled "Pharmacology: Things You Need To Know," covers several key principles in pharmacology and pharmacokinetics, especially as they pertain to differing ages and conditions of critical illness. The primary objectives of the presentation are to discuss medication pharmacokinetic properties (ADME: Absorption, Distribution, Metabolism, and Excretion), delve into pharmacokinetics and ontogeny, and differentiate between first-order and zero-order kinetics.<br /><br />Key definitions provided include:<br />- <strong>Pharmacology:</strong> Concerns the science of drugs, including their origin, composition, pharmacokinetics, therapeutic use, and toxicology.<br />- <strong>Pharmacokinetics:</strong> Studies the time course of a drug and its metabolites in the body.<br />- <strong>Pharmacodynamics:</strong> Investigates the reactions between drugs and living systems.<br />- <strong>Pharmacogenomics:</strong> Explores how genetics influences pharmacology.<br /><br />Important principles discussed:<br />1. <strong>Absorption and Bioavailability:</strong> Absorption refers to how a drug moves from the administration site into circulation, while bioavailability means the fraction of the administered dose that reaches systemic circulation unchanged. Various drug-specific (e.g., particle size, solubility) and patient-specific factors (e.g., gastric pH, age) affect these processes.<br /><br />2. <strong>Distribution:</strong> This involves the movement of the drug through the body and is influenced by factors like cardiac output and lipid solubility. The concept of Volume of Distribution (Vd) is critical in understanding how drugs spread within the body.<br /><br />3. <strong>Metabolism:</strong> Primarily occurring in the liver, this involves biotransformation through Phase I (e.g., hydrolysis, oxidation) and Phase II (e.g., conjugation) processes, converting drugs into more water-soluble compounds for elimination.<br /><br />4. <strong>Elimination:</strong> Encompasses excretion of drugs primarily through hepatic (biliary) and renal pathways. Key concepts include glomerular filtration and the influence of various therapies on drug clearance.<br /><br />5. <strong>Pharmacokinetic Elimination:</strong> This includes zero-order kinetics, where the elimination rate is constant, and first-order kinetics, where a constant percentage of the drug is eliminated over time.<br /><br />6. <strong>Half-Life and Steady State:</strong> Half-life is the time for the plasma concentration of a drug to decrease by half, helping determine dosing intervals. It takes about five half-lives to achieve a steady state in drug concentration.<br /><br />By understanding these principles, clinicians can better manage medication therapy, accounting for critical variables and personalizing treatment to achieve optimal therapeutic effects and reduce toxicity.

Keywords

Pharmacology

Pharmacokinetics

Pharmacodynamics

Pharmacogenomics

Absorption

Bioavailability

Metabolism

Elimination

Half-Life

Steady State

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