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Item #ANM10008 — Source #1
|Medication Distribution - Medical Animation
|MEDICAL ANIMATION TRANSCRIPT: Distribution is the process by which a medication is carried to its target tissue or site of action with the goal of causing a therapeutic response. This process follows medication absorption and precedes medication metabolism. Medication is first carried to highly vascularized tissues including the liver, heart, kidneys, and brain. Then medication is widely circulated within the body, reaching areas of less extensive blood supply such as skin, muscle, and fat. Medication then accumulates in the fat and in poorly vascularized tissues like bone, especially if the medication is lipophilic or strongly attracted to lipids. In the blood, some medication molecules bind to plasma proteins to which they are attracted. In this bound state, medication molecules are unable to produce a pharmacological effect. In bound and unbound form, the medication flows through the arteries and into capillaries. Capillaries carry the medication close to the tissue's cells, where hydrostatic pressure drives molecules between the capillary endothelial cells into the interstitial space. Some protein-bound macromolecules are too large to pass through the vessel walls, so they never reach the target tissue. Unbound or free molecules do reach the target tissue by exiting the bloodstream between the loss junctions in the capillary endothelium into the interstitial space to interact with the tissue cells. Some molecules bind to the cells while others remain in the extracellular fluid. The interaction of the unbound medication with the target tissue results in a therapeutic response. There are many factors that affect distribution. For example, the effect of membrane permeability on distribution can be demonstrated in the brain. The brain's capillaries are impermeable to the majority of medications due to the blood-brain barrier, a membrane that blocks the entrance of both toxic and therapeutic substances into brain tissues. Some medications penetrate the blood-brain barrier based on features like low polarity and high solubility in lipids. Fat-soluble molecules cross cell membranes faster than water-soluble molecules due to the lipophilic nature and phospholipid composition of the cellular membrane. Factors such as body fat percentage and disease also affect medication distribution. Fat deposits retain lipid-soluble unionized medication and release the molecules over time. Thus, obese patients may experience prolonged pharmacologic effects. Inflammation, disease, and injuries such as burns can alter protein levels and thus medication binding, increasing capillary permeability and uptake in cells and tissues. As a complication of kidney disease, albumin cannot bind medications effectively, resulting in a low percentage of protein-bound medication. These shifts result in high levels of free medications circulating throughout the body. [music]|
|What attorneys say about MLA and The Doe Report:
|"It is with great enthusiasm that I recommend Medical Legal Art. We have
used their services for three years and always found their professionalism,
quality of work, and timely attention to detail to exceed our expectations.
We recently settled two complicated catastrophic injury cases. One medical
malpractice case involving a spinal abscess settled for 3.75 million and the
other involving injuries related to a motor vehicle accident settled for 6.9
million. We consider the artwork provided by MLA to have been invaluable in
helping us to successfully conclude these cases.
I highly recommend MLA to anyone seeking high quality, detailed medical
E. Marcus Davis, Esq.
Davis Zipperman, Krischenbaum & Lotito
|"At 3 PM it hit me--I needed exhibits of a tracheostomy, a coronary artery
bypass and a deep vein thrombosis--all in time for a for-trial video
deposition the next day. The Doe Report had each exhibit on line. In
addition, I ran across an exhibit I hadn't even thought of: reduced ejection
fraction after a heart attack. Because this was a video deposition, I could
use the e-mail version of the medical exhibit, print it on my color copier,
and let the camera zoom in. For $400, less than one blow-up by one of The
Doe Report's competitors, I got four first-rate exhibits in less than a day.
The Doe Report saved me time and money."
Tracy Kenyon Lischer
Pulley Watson King & Lischer
|"Thank you for the splendid medical-legal art work you did for us in the
case of a young girl who was blinded by a bb pellet. As a result of your
graphic illustrations of this tragic injury, we were able to persuade the
insurance company to increase their initial offer of $75,000.00 to
$475,000.00, just short of their policy limits.
We simply wanted you to know how pleased we were with your work which, to
repeat, was of superlative character, and to let you know that we would be
more than willing to serve as a reference in case you ever need one. Many
thanks for an extraordinary and dramatic depiction of a very serious injury
which clearly "catapulted" the insurance company's offer to a "full and
fair" amount to settle this case."
Philip C. Coulter
|"I wanted to thank you for the terrific job you did illustrating my client's
injuries. The case was settled at the pre-suit mediation, and I believe a
good part of the success we had was due to the medical legal art you
Your work received the ultimate compliment at the conclusion of the mediation. The hospital risk manager took the exhibit with them at the
conclusion of mediation, and will be using it to train nurses on how to
prevent bed sores..."
Steven G. Koeppel
Troy, Yeslow & Koeppel, P.A.
Fort Myers, FL