Term
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Definition
Pharmaceutic
Pharmacokinetic
Pharmacodynamic |
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Term
Pharmaceutic
- definition
- progression |
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Definition
How oral medications become available to the body.
Tablet --- Disintegration --- Dissolution |
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Term
Pharmacokinetic
-definition
- 4 processes |
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Definition
What the BODY does to the drug
Absorption/Distribution/Metabolism/Excretion |
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Term
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Definition
| How the drug gets into the body: primarily through the GI tract, usually the small intestines |
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Term
| 4 factors that affect Absorption |
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Definition
1. Circulation
2. Hunger, fasting, food
3. pH level
4. Exercise |
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Term
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Definition
Quickest - IV
Fast - IM (bypasses GI tract)
Slowest response - Oral |
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Term
| First-Pass Effect (also known as Hepatic First Pass) |
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Definition
Process by which the drug passes to the liver first
Examples: Coumadin, Morphine |
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Term
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Definition
percentage of the drug dose that reaches the systemic circulation...occurs after absorption and hepatic drug metabolism.
Oral meds - less than 100%
IV - usually 100% |
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Term
| Factors that affect Bioavailability |
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Definition
Drug form: tablet, capsule, sustained release
Route: oral, rectal, topical, parenteral
GI: mucosa and motility
Food and other drugs: can assist or prevent absorption
Changes in liver metabolism |
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Term
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Definition
| the process by which the drug becomes available to the body fluids and tissues. |
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Term
| Distribution influenced by: |
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Definition
-Blood flow
- Drug's affinity to the tissue
-Protein-binding effect |
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Term
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Definition
-Some drugs more attracted to protein which leaves less active drug available for system
-Low protein levels decrease the number of protein-binding sites, can cause an increase in the amount of free drug in the plasma - monitor closely for toxicity!
2 highly protein-bound drugs given concurrently compete for protein-binding sites, causing more free drug to be released. BEWARE - toxicity, drug accumulation |
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Term
| Unbound drug VS Bound drug |
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Definition
Unbound drug - ACTIVE drug, free and available for body to use!
Bound drug - Inactivated, not free for the body to use |
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Term
Metabolism
Also known as ?
Mostly occurs where? |
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Definition
Biotransformation
Mostly takes place in the liver via liver enzymes |
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Term
| What do the liver enzymes do? |
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Definition
| Inactivate the drugs and convert them into water-soluble substances for excretion |
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Term
| What should happen to the dose if the patient has hepatitis or cirrhosis thereby causing the drug metabolism rate to decrease? |
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Definition
| Decrease the dose because there won't be as many functional enzymes to break down the medication. |
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Term
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Definition
Time it takes for 1/2 the drug concentration to be eliminated. The longer the half-life, the longer it stays in the body.
Short - 4 to 8 hours
Long - 24 hours or more |
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Term
Excretion/Elimination
Main route
Other routes |
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Definition
Main route - kidneys
Other routes - feces, saliva breast milk, sweat, bile, lungs |
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Term
Creatinine Clearance
Tells us what?
How do we determine this level?
Expected value? |
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Definition
tells us how well the kidneys filtered and cleared creatinine
Higher is better. Determined by a 12 or 24-hr. urine sample.
Expected value: 85-135
Expected value for the elderly: 60 |
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Term
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Definition
What the DRUG does to the body
(*I remember this because drug and dynamic both start with "D") |
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Term
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Definition
| desirable, what we want the drug to do |
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Term
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Definition
may be desirable or undesirable, does things we don't expect.
Ex. Benadryl, Primary purpose to treat the symptoms of allergies. Secondary, causes drowsiness. |
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Term
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Definition
| time it takes for the drug to reach the MEC, minimum effective concentration |
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Term
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Definition
| when the drug reaches its highest blood or plasma concentration |
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Term
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Definition
| length of time the drug has a pharmacologic effect in the body |
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Term
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Definition
the better the drug fits at a receptor site the more biologically active the drug is.
The STRONGER the fit the STRONGER the response |
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Term
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Definition
| drug that produces or causes a response |
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Term
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Definition
drug that blocks a response
e.g. Pepcid blocks histamine |
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Term
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Definition
| certain drugs target more than one body part; they affect various sites because a specific type of receptor may be located in more than one body part. Ex. Bethanechol stimulates the cholinergic receptors in the bladder BUT also those same receptors in the heart, blood vessels, lungs and eyes. |
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Term
| Nonselective Drug Effects |
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Definition
drug targets more than one receptor.
Ex. Epinephrine acts on the Alpha-1, Alpha-2, Beta-1, and Beta-2 receptors |
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Term
| 4 Categories of Drug Action |
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Definition
Stimulation or Depression
Replacement - Insulin
Inhibition or killing of organisms - antibiotics
Irritation - laxatives |
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Term
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Definition
| Therapeutic Index - estimates the margin of safety of a drug or how much you can take without a toxic effect |
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Term
TI ratio
Narrow or Low TI
Wide or High TI |
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Definition
Closer it is to 1:Narrow or Low - the greater the danger of toxicity Ex. Vancomycin, Digoxin, Coumadin
Wide or High - carries less risk of drug toxicity |
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Term
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Definition
| should be between the minimum effective concentration (MEC) and the minimum toxic concentration (MTC) |
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Term
| When to draw peak and trough drug levels |
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Definition
Peak - orally, 1-3 hours after giving IV - could be as soon as 10 minutes after giving.
Trough - drawn 1/2 hour before the next dose is due |
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Term
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Definition
| when an immediate drug response is desired, a large initial dose can be given to achieve a rapid MEC |
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Term
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Definition
Two drugs given at the same time, increase the response. They help each other to be more effective.
1+1=2 |
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Term
Synergistic Drug Effect
http://www.indiana.edu/~engs/rbook/drug.html |
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Definition
2 drugs taken together that are similar in action, such as barbiturates and alcohol, create an exaggerated response out of proportion to that of each drug taken separately.
1+1=5 |
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Term
Potentiation Drug Effect
http://www.indiana.edu/~engs/rbook/drug.html |
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Definition
2 drugs taken together and one them intensifies the action of the other. a+b=B
Phenergan, an antihistamine when given with Demerol, intensifies its effect, thereby cutting down on the amount of the narcotic needed. |
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Term
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Definition
1+1=0
Drugs work against each other; overdose of morphine, give Narcan to nullify the effects of the narcotic |
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Term
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Definition
| The drug is doing what it needs to be doing. |
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Term
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Definition
Unintended physiologic effects, not related to the desired drug effects.
These are considered secondary responses; usually not severe enough to stop taking the drug. |
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Term
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Definition
more severe than side effects
generally undesirable
mild to severe
report and document |
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Term
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Definition
| Psychological effect that a drug is working, even if it isn't a drug or it wouldn't be working in such a way as to make a physiological difference. |
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Term
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Definition
Some medications cannot be mixed.
If they become cloudy in the syringe, do not give. |
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Term
| Idiosyncratic Drug Effect |
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Definition
| Unusual reaction; a person may get hyperactive after Benadryl instead of drowsy. |
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Term
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Definition
| Negligence; giving the wrong drug or drug dose that results in the client's death |
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Term
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Definition
| Omission; omitting a drug dose that results in the client's death |
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Term
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Definition
| Giving the correct drug but by the wrong route that results in a client's death |
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Term
Controlled Substances Act
What did it do?
What year?
What schedule drugs may nurses give? |
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Definition
Recognized the potential that some drugs have for abuse and classified these drugs.
1970
Nurses give only Schedule III - V drugs |
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Term
Schedule I
Schedule II
Schedule III
Schedule IV
Schedule V |
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Definition
I - high abuse potential; NO accepted medical use
II - high abuse potential; accepted medical use
III - abuse potential less than I & II, medically accepted drugs
IV - may cause dependence, medically accepted
V- very little potential for dependence, medically accepted |
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Term
HIPPA
What is it?
What year was it adopted? |
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Definition
Health Insurance Portability and Accountability Act
2003 |
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Term
Pregnancy Categories:
A, B, C, D, X |
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Definition
A - no risk to fetus
B - no risk in animal studies; assume little/no risk in women
C- possible risk to fetus; determine risk vs benefit
D - proven risk to fetus; use only in life-threatening situation
X - risk is proven and outweighs benefit. Avoid during pregnancy! |
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Term
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Definition
More than 90% of all illnesses are initially treated with OTC meds.
Almost 60% of clients don't tell MD of OTC med use.
14% reported it wasn't important to tell MD of OTC use. |
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