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Figure 5.1 The four processes of pharmacokinetics: absorption, distribution, metabolism, excretion. Pharmacology for Nurses A Pathophysiologic Approach Second Edition Michael Patrick Adams Leland Norman Holland, Jr. Paula Manuel Bostwick Chapter 5 Pharmacokinetics Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 5.2 Effect of pH on drug absorption: (a) a weak acid such as aspirin (ASA) is in a nonionized form in the acidic environment and absorption occurs; (b) in a basic environment, aspirin is mostly in an ionized form and the absorption is prevented. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 5.4 First-pass effect: (a) drugs are absorbed; (b) drugs enter hepatic portal circulation and go directly to liver; (c) hepatic microsomal enzymes metabolize drugs to inactive forms; (d) drug conjugates, leaving liver; (e) drug is distributed to general circulation. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 5.3 Plasma protein binding and drug availability: (a) drug exists in a free state or bound to plasma protein; (b) drug-protein complexes are too large to cross membranes. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 5.5 Enterohepatic recirculation. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 1 Figure 5.6 Single-dose drug administration: pharmacokinetic values for this drug are as follows: onset of action = 2 hours; duration of action = 6 hours; termination of action= 8 hours after administration; peak plasma concentration = 10mcg/ml; time to peak drug effect = 5 hours; t ½ = 4 hours Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Figure 5.7 Multi-dose drug administration: drug A (---) and drug B (---) are administered every 12 hours; drug B reaches the therapeutic range faster, because the first does is a loading dose. Pharmacology for Nurses: A Pathophysiologic Approach 2nd Ed. Michael Patrick Adams, Leland Norman Holland, Jr., and Paula Manuel Bostwick Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. 2