Article summary and critical discussion questions

¶ … Perioperative pharmacology: pharmacotherapeutics, pharmacokinetics, and pharmacodynamics" denotes some key concerns for perioperative professionals to consider when administering medication for this particular specialty. The article begins with the authors explicating the fact that the vast majority of errors related to issuing medication to patients in this field occurs during the administrative phase due to what is termed "a weakness in the knowledge of the health care provider" (Hernandez et al., 2011, p. 260). As such, the article identifies three key stratifications that health care professionals should consider when issuing perioperative pharmacology: pharmacotherapeutics, pharmacokinetics, and pharmacodynamics. It is worth notin that pharmacokinetics and pharmacodynamics are identified as considerations of pharmacotherapeutics.

Pharmacotherapeutics is best defined as "the use of medications to prevent, treat, cure, or alleviate symptoms of disease" (Hernandez et al., 2011, p.259). A key aspect of this pharmacotherapeutics is pharmacokinetics, a term used to denote just how the body processes medication once the latter has entered the former. Pharmacokinetics has four essential stages that medication must go through in order to produce an efficacious result in a patient; the tending to the administration of such medication must account four all four of these phases which include that related to absorption, distribution, metabolism and excretion. Some of the most salient points in the article regarding the way the body absorbs medication includes the fact that there are several different ways to induce this process "including oral, IV, topical, intramuscular, and subcutaneous" Hernandez et al., 2011, p. 260). How much food is in a person's system has an influence over absorption rates, as does the total area in which the medication is administered and the general solubility of the medication itself.

Distribution is the next phase, and largely refers to the "uptake rate of a medication" (Hernandez et al., 2011, p. 261). Distribution is influenced by factors such as the amount of blood flow, its solubility, and how much of it becomes entrenched in protein. The goal of distributive phase is to get the medication from its route to the area in the body in which it will perform its corrective action. The third pharmacokinetic phase is metabolism in which there is a "changing of a medication from its original form to a water soluble form that can be excreted" (Hernandez et al., 2011, p. 262). There are several factors that affect the rate of a metabolism in patients including genetics, their age, and what sorts of food substances (such as grapefruit juice) (Hernandez et al., 2011, p. 262-263). The final stage is excretion, which is how much and how fast the body is able to eliminate the medication. Elimination routes for excretion include those via the kidneys, sweating, breathing, and others (Hernandez et al., 2011, p. 263).