Pharmacokinetics and

Pharmacodynamics

Myka Allene A. Catoto, RN

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Objective:
At the end of this lesson, you are expected to:

• Utilize appropriate nursing concepts and actions

holistically and comprehensively in terms of the
pharmacokinetics of drugs.

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 PROCESS PRIMARY SITE OF PROCESS
ABSORPTION Mucosa of the stomach, mouth,
small intestine, or rectum; blood
vessels in the muscles or
subcutaneous tissues or dermal
layers
DISTRIBUTION Circulatory system, through
capillaries and across cell
membranes
METABOLISM Liver, small intestines
EXCRETION Kidneys, sweat glands, lungs or
intestines

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Drug Absorption
• Is the movement of the drug into the
bloodstream after administration.
• The rate and extent of absorption depend on the
environment where the drug is absorbed:
- Chemical characteristics,
- Route of administration

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Factors influencing absorption

• Drug component
• Blood flow, pain, stress, hunger, food and PH
• Route of administration
• Bioavailability

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Drug Distribution
• Distribution is the movement of the drug from
the circulation to body tissues. Drug distribution
is influenced by the rate of blood flow to the
tissues, the drug’s affinity to the tissues, and
protein binding.

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The distribution of a DRUG from the

PLASMA 🡺 🡺 🡺 INTERSTITIUM
depends on:
• Cardiac output
• Local blood flow
• Capillary permeability
• The Tissue volume
• Degree of binding of the drug to plasma and
tissue protein
• Relative lipophilicity of drug
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Distribution into the water
compartments in the body
• Plasma compartment

• Extracellular fluid

• Total Body water

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Metabolism
• Physical and chemical alterations that the
substance undergoes in the body.
Primary site: Liver

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Drug Excretion
• The main route of drug excretion, elimination of
drugs from the body, is through the kidneys. Drugs
are also excreted through:
Bile
Lungs
Saliva
Sweat
Breast milk
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Pharmacodynamics

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Pharmacodynamics
• is the study of the effects of drugs on the body.
• A drug’s primary effect is the desirable response,
and the secondary effect may be desirable or
undesirable.

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Dose-Responses Relationship

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Therapeutic Drug Monitoring

Peak drug level

• Is the highest plasma concentration of drug at a
specific time, and it indicates the rate of drug
absorption. If the peak is too low, effective
concentration has not been reached.
Oral Route
Intravenous
Intramuscular
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Receptor Theory

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Agonist and Antagonist
Agonist: drugs that activate receptors and
produce a desired response.

Antagonist: drugs that prevent receptor activation

and block a response.

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Mechanisms of Drug Action
Mechanism of drug action Drug Action
1. Stimulation Enhances intrinsic activity
1. Depression Decrease neural activity and
bodily functions
1. Irritation Have a noxious effect
1. Replacement Replace essential body
compounds
1. Cytotoxic action Selectively kill invading parasites
or cancer
1. Antimicrobial action Prevent, inhibit, or kill infectious
organisms
1. Modification of immune Modify immune status modify,
status enhances, or depress the
immune system
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Side Effects, Adverse Drug
Reactions, and Drug Toxicity

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Side Effects

• Are secondary effects of drug therapy

• Predictable and range from inconvenient to
severe or life threatening
• Nurses Role: include teaching patients about a
drug’s side effects and encourage them to report
side effects.

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Adverse Drug Reaction

• Unintentional, unexpected reactions to drug

therapy that occur at normal drug dosages
• Undesirable and must be reported and
documented

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Drug Toxicity

• Occurs when drug levels exceed the therapeutic

range; toxicity may occur secondary to overdose
or drug accumulation.

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Drug Interaction
Is defined as an altered or modified action or effect of a drug as a result of
interaction with one or multiple drugs

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Categories:

• Pharmacokinetic Interactions
• Pharmacodynamic Interactions

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Pharmacokinetic Interactions

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Absorption
• when a person takes two drugs at the same
time, the rate of absorption of one or both drugs
can change.
• By increasing or decreasing gastric emptying
• By changing the gastric pH
• By forming drug complexes

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Metabolism
• Increase metabolism of another drug by stimulating
liver enzyme
Enzyme inducers
Enzyme inhibitors
• Use of tobacco and alcohol may have variable effect
on drug metabolism
• Natural or herbal products can also impact drug
metabolism
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Excretion
• Drugs can increase or decrease renal excretion
and can have an effect in the excretion of other
drugs
• Two or more drugs with the same excretion
route, may compete with one another for
elimination from the body
• Changing urine pH affects drug excretion
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Pharmacodynamic Interactions

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Additive Drug Effects

• when two drugs are administered in

combination, and the response is increased
beyond what either could produce alone
• the sum of the effect of the two drugs

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Synergistic Drug Effects and
Potentiation
• the clinical effect of the two drugs given
together is substantially greater than that of
either drug alone

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Antagonistic Drug Effects

• one drug reduces or blocks the effect of the

other

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Drug-Nutrient Interactions

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Drug-Laboratory Interactions

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Drug-Induced Photosensitivity

• Is a skin reaction caused by exposure to sunlight.

It is caused most often by the interaction of a
drug and exposure to ultraviolet A light, which
can cause cellular damage.

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Drugs Legislation, Controlled
Substances, and Over-the-
counter drugs

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Drugs Legislation
• Federal legislation
• Nurse Practice Act
• Canadian Drug Regulation

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Over-the-counter drugs

• Have been found to be safe and appropriate for

use without the direct supervision of a health
care provider
• Available for purchase without prescription in
many retail locations.

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