Term
| A drug taken orally goes through three phases: |
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Definition
1. Pharmaceutic
2. Pharmacokinetic
3. Pharmacodynamic |
|
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Term
| What happens in the pharmaceutic phase? |
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Definition
| The drug becomes a solution so it can cross the biologic membrane |
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Term
| What phase is absent when a drug is administered using the subQ, IM, or IV route? |
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Definition
|
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Term
| What are the four processes of the pharmacokinetic phase? |
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Definition
1. Absorption
2. Distribution
3. Metabolism (biotransformation)
4. Excretion (elimination) |
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Term
| A biologic or physiologic response occurs in which phase of drug action? |
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Definition
|
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Term
| What percentage of drugs are taken by mouth? |
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Definition
|
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Term
| What is another term for the pharmaceutic phase? |
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Definition
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Term
| Drugs in solid form must disintegrate into small particles to dissolve into a liquid. These two processes are known as |
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Definition
1. Disintegration
2. Dissolution |
|
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Term
| What form of drugs are already dissoluted? |
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Definition
|
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Term
| Fillers and inert substances found in tablets are termed: |
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Definition
Excipients.
These allow a drug to take on a particular size and shape, and enhance dissolution |
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Term
| Adding K or Na to sodium enhances its absorption. T/F |
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Definition
| True. Penicillin is poorly absorbed in the GI tract b/c of gastric acid. Adding these substances allows it to be absorbed. |
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Term
| Infants gastric secretions are more acidic, therefore they can absorb more penicillin. T/F |
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Definition
| False. Infants gastric secretions are more alkaline, causing them to absorb more of the penicillin. |
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Term
| The breakdown of a tablet into smaller particles: |
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Definition
|
|
Term
| Dissolving of small particles in the GI fluid before absorption: |
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Definition
|
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Term
| The time it takes the drug to disintegrate and dissolve to become available for the body to absorb it: |
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Definition
|
|
Term
| A lower pH causes a slower disintegration and absorption. T/F |
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Definition
| False. A lower pH will cause drugs to be disintegrated and absorbed faster (in a pH of 1 or 2). The very young and older adults generally have slower rates of disintegration and absorption for drugs that are absorbed primarily in the stomach. |
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Term
| What type of drugs resist disintegration in gastric acid of the stomach? |
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Definition
| Enteric-coated. Disintegration does not occur until the drug reaches the alkaline environment of the small intestine. |
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Term
| The process of drug movement to achieve drug action. |
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Definition
|
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Term
| Movement of drug particles from the GI tract to body fluids. |
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Definition
|
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Term
| What are the three methods of absorption? |
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Definition
|
|
Term
| What happens to protein-based drugs in the small intestine? |
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Definition
| They are DESTROYED by digestive enzymes |
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Term
| Diffusion is an example of |
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Definition
|
|
Term
| Movement by using a carrier such as an enzyme or protein to move a drug against a concentration gradient is |
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Definition
| Active absorption. This requires energy. |
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Term
| Process by which cells carry a drug across their membrane by engulfing the drug particles: |
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Definition
|
|
Term
| The Gi membrane is composed mostly of ____ & ____ |
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Definition
|
|
Term
| Water-soluble drugs pass readily through the lipid bilayer of cell membranes. T/F |
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Definition
| False. Water-soluble drugs need a carrier, such as an enzyme or protein, to pass through the membrane. |
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Term
| What type of particles can pass through the cell membrane? (the answer has to do with electrical charge) |
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Definition
| Nonionized (no positive or negative charge) |
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Term
| What administration methods bypass the GI tract or liver? |
|
Definition
Parenteral drugs
Eyedrops
Eardrops
Nasal sprays
Respiratory inhalants
Transdermal drugs
Sublingual drugs |
|
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Term
| What drugs are absorbed faster than water-soluble and ionized drugs? |
|
Definition
| Lipid soluble and non-ionized drugs. |
|
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Term
| What factors affect drug absorption? |
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Definition
Blood flow,
pain,
stress,
hunger,
fasting,
food,
and pH. |
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Term
| Drugs given IM are absorbed faster in muscles that have more blood vessels such as the _______ than in those that have fewer blood vessels, such as the _____. |
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Definition
|
|
Term
| Subcutaneous tissue has few blood vessels, so absorption is ____. |
|
Definition
|
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Term
| The process in which drugs pass to the liver first |
|
Definition
First-pass effect
or
hepatic first pass |
|
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Term
| If a drug has an extensive first-pass metabolism, what happens to it? |
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Definition
| Most of the dose is destroyed. |
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Term
| The percentage of the administered dose that reaches systemic circulation |
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Definition
|
|
Term
| For the oral route, bioavailability occurs: |
|
Definition
| After absorption and hepatic drug metabolism. |
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Term
| T/F - The bioavailability for the oral route is never 100%. |
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Definition
| True. But for the IV route it IS usually 100%. |
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Term
| To obtain the desired drug effect, the oral dose could be _ to _ times larger than the drug dose for IV use. |
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Definition
3 to 5
This is because oral drugs that have a high first-pass hepatic metabolism may have a bioavailability of only 20-40% upon entering systemic circulation. |
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Term
| Drug form, route, GI mucose and motility, food and other drugs, and changes in liver metabolism are all factors that alter |
|
Definition
|
|
Term
| What happens to a drug that is primarily metabolized by the liver in the presence of a liver disorder? |
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Definition
| Its' bioavailability increases. |
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Term
| The process by which the drug becomes available to body fluids and body tissues |
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Definition
|
|
Term
| Drug distribution is influenced by |
|
Definition
Blood flow
the drug's affinity to the tissue, and
the protein binding effect |
|
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Term
| What are protein-bound drugs primarily bound to? |
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Definition
|
|
Term
| The portion of the drug that is bound to the protein is considered ______, as it is not available to receptors. |
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Definition
|
|
Term
| Only ____ _____ are active and can cause a pharmacologic response. |
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Definition
|
|
Term
| What happens when free drug in circulation decreases? |
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Definition
| More bound drug is released from protein to maintain the balance of free drug. |
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Term
| When two highly protein-bound drugs are given concurrently, what happens? |
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Definition
| They compete for protein-binding sites, causing more free drug to be released into circulation |
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Term
| How is drug dose prescribed? |
|
Definition
| It is prescribed according to the percentage in which the drug binds to protein. |
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Term
| In what form must a drug be metabolized to be excreted by the kidneys? |
|
Definition
|
|
Term
|
Definition
| The time it takes for one half of the drug concentration to be eliminated. |
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Term
| A short half life is considered to be |
|
Definition
|
|
Term
| A long half life is considered to be |
|
Definition
|
|
Term
| What is the main route of drug elimination? |
|
Definition
|
|
Term
| What are routes of drug elimination other than the urine? |
|
Definition
Bile,
feces,
saliva,
lungs,
sweat,
breast milk. |
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Term
| T/F The kidneys filter free unbound drugs, water-soluble drugs, and drugs that are unchanged. |
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Definition
|
|
Term
| T/F Protein-bound drugs can be filtered through the kidneys. |
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Definition
| False. Once the drug is released from the protein, it is a free drug and is eventually excreted in the urine. |
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Term
| With a kidney disease what happens to glomerular filtration rate? |
|
Definition
| It is decreased, and drug excretion is slowed or impaired. |
|
|
Term
| What's the most accurate test to determine renal function? |
|
Definition
| Creatinine clearance (CLcr) |
|
|
Term
|
Definition
| a metabolic byproduct of muscle that is excreted by the kidneys. |
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|
Term
| A _____ in renal GFR results in an increase in serum creatinine levels and decrease in uring creatinine clearance. |
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Definition
|
|
Term
| The CLcr should be determined to establish appropriate drug doses in those with ____. |
|
Definition
|
|
Term
| Normal creatinine clearance is |
|
Definition
|
|
Term
| Older clients may have a CLcr of |
|
Definition
|
|
Term
| The study of drug concentration and its effects on the body |
|
Definition
|
|
Term
| The primary effect of a drug is _____ |
|
Definition
|
|
Term
| The secondary effects of a drug are |
|
Definition
|
|
Term
| The relationship between the minimal versus the maximal amount of drug dose needed to produce the desired drug response |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| the time it takes to reach the minimum effective concentration (MEC) after a drug is administered |
|
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Term
|
Definition
| Occurs when the drug reaches its highest blood or plasma concentration |
|
|
Term
|
Definition
| the length of time the drug has a pharmacologic effect |
|
|
Term
| A time response curve evaluates |
|
Definition
Onset of action
Peak action
and Duration |
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|
Term
| Too high a drug level above the ________ _____ _____________ can result in toxicity. |
|
Definition
| Minimum toxic concentration (MTC) |
|
|
Term
| Where are most receptors found? |
|
Definition
|
|
Term
| What are the 4 receptor families? |
|
Definition
1. Kinase-linked
2. Ligand-gated ion channels
3. G protein-coupled
3. Nuclear |
|
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Term
| Drugs act through receptors by binding to the receptor to ______ a response or to ______ a response. |
|
Definition
Produce (initiate)
Block (prevent) |
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Term
|
Definition
| Drug that produces a response |
|
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Term
|
Definition
| Drug that blocks a response |
|
|
Term
| IC50 is the antagonist drug concentration required to inhibit __% of the maximum biological response. |
|
Definition
|
|
Term
|
Definition
| Various sites and have properties of nonspecifity. |
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|
Term
| Nonselective drugs affect |
|
Definition
|
|
Term
| What are the four categories of drug action? |
|
Definition
1. Stimulation or depression
2. Replacement
3. Inhibition or killing of organisms
4. Irritation |
|
|
Term
| The length of action of a drug depends on |
|
Definition
|
|
Term
| Therapeutic index (TI) estimates |
|
Definition
| the margin of safety of a drug through the use of a ratio that measures the effective dose in 50% of persons or animals, and the lethal dose in 50% of animals. |
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Term
| The closer the therapeutic index is to _, the greater the danger of toxicity. |
|
Definition
|
|
Term
| Drugs with a ___ ______ _____ have a narrow margin of safety. |
|
Definition
|
|
Term
| Drugs with a ___ ______ _____ have a narrow margin of safety. |
|
Definition
|
|
Term
| The therapeutic range (window) of a drug concentration in plasma should be between |
|
Definition
| the minimum effective concentration and minimum toxic concentration. |
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Term
| T/F If the therapeutic range is narrow, the plasma drug level should be monitored periodically to avoid drug toxicity. |
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Definition
| True. Monitoring the theraptutic range is not necessary if the drug is not considered highly toxic |
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Term
|
Definition
| The highest plasma concentration of drug at a specific time. This indicates the rate of absorption. |
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Term
| __ peak time is faster than __ peak time. |
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Definition
|
|
Term
| T/F A urine sample should be evaluated at the proposed peak time, according to the route of administration. |
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Definition
| False. A blood sample should be drawn. |
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Term
| What is the lowest plasma concentration of a drug that measures the rate at which the drug is eliminated? |
|
Definition
|
|
Term
| When are trough levels drawn? |
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Definition
| Immediately before the next dose of drug is given. |
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Term
| Peak levels indicate the rate of _____ and trough levels indicate the rate of _____. |
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Definition
|
|
Term
| What happens if peak is too low? |
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Definition
| No therapeutic effect is achieved. |
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Term
|
Definition
| A large initial dose to initiate an immediate drug response. This achieves a rapid minimum effective concentration in the plasma. |
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Term
|
Definition
| Physiological effects not related to desired drug effects |
|
|
Term
|
Definition
| more severe than side effects. They are unintended and occur at normal doses. They are always undesirable |
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Term
| How can toxicity be identified? |
|
Definition
| By monitoring the plasma (serum) therapeutic range of the drug. |
|
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Term
|
Definition
| Studying how the effect of a drug action varies from a predicted drug response because of genetic factors or hereditary influence. Genetic factors can alter the metabolism of the drug. |
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|
Term
| Decreased responsiveness over the course of therapy |
|
Definition
|
|
Term
|
Definition
| A rapid decrease in response to the drug. An acute tolerance. |
|
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Term
|
Definition
| Psychological benefit from a compound that may not have the chemical structure of a drug effect. |
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