The physician ordered 2/3 strength Ensure 6 oz PO q4h for 24 hrs. What is the total volume in mL you would administer in 24 hrs?

A) Gastric emptying time:
Gastric emptying time plays a significant role in drug absorption. The faster the stomach empties its contents into the small intestine, the quicker the drug can be absorbed. If gastric emptying is delayed, such as with certain diseases, medications, or conditions (like gastroparesis), drug absorption may be slowed. Conversely, rapid gastric emptying can lead to quicker absorption, potentially reducing the time the drug has to exert its effects.

B) Capillary walls with large spaces between cells:
Capillary permeability influences how easily a drug can pass from the bloodstream into tissues. If the capillary walls have large gaps, such as in certain areas of the body (e.g., in the liver or spleen), drugs can more easily move across the capillary membrane and be absorbed into the system.

C) Stability and solubility of the medication:
For a drug to be absorbed effectively, it must be stable in the body and soluble in bodily fluids. Drugs that are poorly soluble or unstable in the stomach may not be absorbed efficiently. For instance, medications that are lipophilic (fat-soluble) may require a carrier or special formulation (e.g., emulsions or nanoparticles) to aid in absorption, whereas hydrophilic drugs may face challenges crossing cell membranes without assistance.

D) Inspiratory effort:
Inspiratory effort does not directly affect the absorption of drugs. Inspiratory effort refers to the act of inhaling, which is more relevant to drugs administered via inhalation (e.g., inhalers or nebulizers). It affects how well the drug is delivered to the lungs but does not influence absorption in the gastrointestinal tract or other routes of administration.

E) Presence of food in the stomach or intestines:
Food in the stomach or intestines can either speed up or slow down drug absorption. Some drugs are absorbed better on an empty stomach because food can slow gastric emptying and alter the drug's solubility. On the other hand, certain medications (e.g., fat-soluble drugs) may require food for optimal absorption.

Given:

Volume of fluid: 1000 mL

Infusion time: 8 hours

Drop factor: 15 gtt/mL

Formula:

Flow rate (gtt/min) = (Volume (mL) / Time (hr)) x Drop factor (gtt/mL) / 60 min/hr

Step 1: Calculate the infusion rate in mL/hr:

Infusion rate (mL/hr) = Volume (mL) / Time (hr)

Infusion rate (mL/hr) = 1000 mL / 8 hr

Infusion rate (mL/hr) = 125 mL/hr

Step 2: Calculate the flow rate in gtt/min:

Flow rate (gtt/min) = (Infusion rate (mL/hr) x Drop factor (gtt/mL)) / 60 min/hr

Flow rate (gtt/min) = (125 mL/hr x 15 gtt/mL) / 60 min/hr

Flow rate (gtt/min) = 1875 gtt/hr / 60 min/hr

Flow rate (gtt/min) = 31.25 gtt/min

Step 3: Round to the nearest whole number:

Flow rate (gtt/min) ≈ 31 gtt/min