Clinical pharmacology lecture

Clinically applicable pharmacokinetic parameters, Drugs excreted in breast milk, Treatment, Prevention of potential drug interactions

Dosage use of some antibiotics

Dosage of some antibiotics classified by group name, form, dose, and subject to use.

Drugs excreted in breast milk

Some antihistamines pass into breast milk in large amounts; although the harmful effects are unknown, drug manufacturers recommend not to use; There are reports of children having dizziness and vertigo with clementine.

Drugs that should be avoided or used with caution during pregnancy

Most manufacturers recommend avoiding (or avoiding unless the potential benefit outweighs the risk); Ketorolac is contraindicated during pregnancy, labour, and delivery.

Drugs that should be avoided or used with caution in patients with impaired renal function

Hypokalaemia may precipitate coma (substitute low-potassium diuretics); risk of hypomagnesaemia in patients with alcoholic cirrhosis.

Drugs and degree of renal function decline

Perindopril: Use with caution and monitor reactions; often causes hyperkalaemia and other undesirable effects; Initial dose should be 2mg once daily.

Some comments on drug use in hospitals

The clinically significant propensity to thrombosis is associated with high plasma homocysteine levels, the disulphide oxidation product formed from two homocysteine ​​molecules.

Reactions of some commonly used antibiotics

The ‘*’ before a drug name indicates interactions that should be avoided or where close monitoring is required.

Use of antibiotics to treat some common infections

Always remember that aminoglycoside drugs, amikacin, gentamicin, should not be administered directly intravenously but only intramuscularly and intravenously, the solution for infusion should be evenly dissolved in a large amount of sodium chloride solution.

Prophylactic antibiotics in surgery

Bacterial infections after thoracic surgery are classified as clean surgery. Common bacteria are Staphylococcus aureus, Staphylococcus epidermidis, or less commonly E. coli, Proteus.

Clinical tests and results assessment

Creatinine is a breakdown product of phosphocreatine, an important energy storage substance found in muscle. Creatinine production is relatively constant, depending mainly on the muscle mass of each person.

Using medicine for children

The dose in children, calculated in kilograms of body weight, maybe higher than that in adults, because children have a higher metabolic rate.

Drug use in nursing mothers

Some drugs inhibit the infant's suckling reflex, eg phenobarbital. Certain drugs in breast milk may cause increased sensitization in the infant.

Using drugs for pregnant women

It is recommended to use drugs that have been widely used during pregnancy and are safe and effective. New and untried drugs should not be used.

Medicine use in the elderly

The nervous system of the elderly is often susceptible to damage by commonly used medications such as opioid pain relievers, benzodiazepines, and Parkinson's drugs.

Use of drugs for people with impaired kidney function

The degree of impaired renal function to adjust the dose of the drug. This level depends on the toxicity of the drug and whether the drug is completely excreted by the kidneys or partially metabolized to inactive metabolites.

Pharmacokinetics and clinical importance

Knowledge of pharmacokinetics guides patient drug selection based on the patient's medical condition, e.g. age, renal function

Drug concentration in blood plasma

The plasma drug concentration/area under curve describes a patient's plasma drug concentration at various time points after drug administration.

Therapeutic window

In case of hypersensitivity or synergistic effects with other drugs, the treatment window will be lower, just lower drug concentration can still be effective. 

Pharmacokinetic processes

The drug can be absorbed directly into the bloodstream when administered parenterally, absorbed from the gastrointestinal tract when administered orally or rectally as well as can be absorbed through other routes.

Pharmacokinetic parameters for clinical application

Drug selection should be based on the characteristics of the drug (eg, is the drug well absorbed from the gastrointestinal tract…) and must be based on the specific patient (eg kidney function...).

Nature of drug interactions

Anticholinergics, antihistamines with anticholinergic properties, ganglion blockers, opiates, acetylsalicylic acid slow gastric emptying.

Detect drug interaction management analysis

The nurse must recognize in the patient the clinical signs of one or more adverse effects; ensure that in the infusion solution, in the syringe, the active substances are physicochemically compatible.

Avoid potential drug interactions

Do not combine more than 5 drugs at a time, except in special cases, the doctor's level is not measured according to the length of the prescription

Look up drug interactions

Mims interaction English, Drug interaction facts, David S Tatro, PharmD, 2003, (Incompatex French), Drug interactions and notes, Vietnamese

Clinical drug interactions with food and drink

Alcohol can cause interactions with antidepressants and sleeping pills. Alcohol enhances the ulcerative bleeding effect of non-steroidal anti-inflammatory drugs.