Drug excretion is the removal of drugs from the body, mainly through the kidneys, feces, breast milk, sweat, and saliva. The kidneys act as a filter and drugs are removed through urine. As more women breastfeed, medication use during breastfeeding will increase, so it is important to pay attention to which medications transfer least into breast milk and can have the smallest effects on infants. Patient age and any altered drug elimination must also be considered when determining safe medications.
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Pharm Excretion (final)
1.
2. Drug excretion is defined as the removal
of drugs from the body
A healthy kidney is key!
3. Drugs leaving the body can exit in many
different routes
-Kidneys (urine)
-Feces
-Breast milk
-Sweat
-Saliva
4. The most important organ in drug
excretion
-It acts like a filter
-We pee out the drug
5.
6.
7. As health care professionals encourage
more women to breast-feed, medication
use while breast-feeding will increase
Medications will transfer into breast milk;
however, the degree of transfer
depends on several factors
Pay special attention to medications
and encourage medications that have
the least effects on the infant
8. Assess patients for possible altered drug
elimination
Keep in mind the age of the patient
Educate breast feeding mothers, know
which drugs are more likely to transfer to
an infant
9. http://www.forcon.ca/learning/excretion.html
http://www.scribd.com/doc/19341399/Drug-
Excretion
Lynn, S. J. (2012). Adverse drug reactions in the
elderly: Can we stem the tide?. American nurse
today, 7(1),retrieved from
www.americannursetoday.com.
Carrillo Norte, J. A. (2011). Pharmacokinetic process:
does the site of drug action? Excretion of drugs. Rev
Enferm 34:24-31. 2011 retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/22013710.
Lehne, R. (2010). Pharmacology for nursing care (8th
edition). Saint Louis, Missouri: Elsevier
Editor's Notes
So today I’ll be talking with you about how excretion, which like the picture shows excretion is all about how drugs leave the body. In fact, if the door in the picture represented the human body, we’d need to throw a couple more neon red signs in there. That’s a lot of exits.
The kidney is the main organ involved in the process of removing the drug from the body. When the drug reaches the kidneys, the kidneys filter
Excretion through the urine and feces are the most important routes on how drugs leave the body. Sweat is not as important as these two.
As I stated earlier, the kidneys are the most important organ responsible for eliminating drugs from the body. The kidneys act like a filter and in the end most drugs are eliminated from our bodies when we urinate. The blood plus the drug are filtered in route to the kidneys. This creates a liquid, what we call “urine”, which is made of blood’s water and parts of the drug that our body does not need to use. In order for the kidney to eliminate drugs from the body, the drug must somehow be prevented from being reabsorbed from the urine into the bloodstream. The drug must be chemically changed into a compound that is less fat-soluble and therefore less capable of being reabsorbed.
The next two slides will help to demonstrate this filtration process. First, the blood (the red stuff) enters the kidneys (which for the purpose of this metaphor) act much like a coffee filtration device. Once the blood plus the drug enters the kidneys, these organs act like filters, which remove most of the drug from the blood. The blood plus the drug are filtered in route to the kidneys. This creates a liquid, what we call “urine”, which is made of blood’s water and parts of the drug that our body does not need to use. In order for the kidney to eliminate drugs from the body, the drug must somehow be prevented from being reabsorbed from the urine into the bloodstream. The drug must be chemically changed into a compound that is less fat-soluble and therefore less capable of being reabsorbed.
Once the drug has been filtered from the blood, it becomes part of the “urine.” This urine makes it’s way to the bladder, which eventually becomes full to the point that we will need to urinate. During urination, the drug completely exits the body and like the pictures shows ends up in the toilet. And that’s the process of drug excretion via the urine! The blood plus the drug are filtered in route to the kidneys. This creates a liquid, what we call “urine”, which is made of blood’s water and parts of the drug that our body does not need to use. In order for the kidney to eliminate drugs from the body, the drug must somehow be prevented from being reabsorbed from the urine into the bloodstream. The drug must be chemically changed into a compound that is less fat-soluble and therefore less capable of being reabsorbed.
Drugs may transfer into milk if they attain high concentrations in maternal plasma, have a low molecular weight (<500 Da), are low in protein binding, and are lipid soluble. http://www.uspharmacist.com/content/c/10278/?t=women's_healthAs health care professionals encourage more women to breast-feed, the need to educate our nursing mothers and infant caregivers about drug excretion through breast milk will become even more important. Luckily, the degree of transfer or excretion in breast milk is dependent on several factors. Drugs may transfer into milk if they attain high concentrations in maternal plasma, have a low molecular weight, are low in protein binging, and are lipid soluble. In essence, as future nurses, we need to pay special attention to the transfer attributes of medications and encourage use of medications that have the least amount of effects on a breast-feed infant
Need to keep close monitoring on patients who have kidneys problems to make sure drugs are exiting the body at a normal rate. Elderly usually are taking multiple medication and their filtering system is often times impaired or damaged. Children kidneys filter at a faster rate.Also, educate a breast feeding mother on certain drugs that can be excreted through breast milk.