Term
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Definition
| amount of time it takes for drug to be reduced by 50% in the blood |
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Term
|
Definition
| percentage of the drug that reaches the systemic circulation |
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Term
|
Definition
| oral drugs that enter the system and undergo rapid inactivation of the drug-leads to less drug in the system |
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Term
| Hepatic first pass: Elderly |
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Definition
| diminished due to decreased liver function; increased risk of higher than therapeutic dose |
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Term
| Hepatic first pass: Women |
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Definition
| Oral estragen undergoes extensive first pass; patches, vag rings and tablets are more affective |
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Term
|
Definition
| drugs used for other reasons than FDA approved or not in the population it was studied for |
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Term
|
Definition
| increases the amount of enzymes to metabolize drugs; decreases the concentration and pharmacodynamic effects of the drug |
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Term
| CYP 450 inhibitors: competitive inhibitors |
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Definition
| when two drugs are administered concurrently and are metabolized by the same isoenzyme |
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Term
| CYP 450 inhibitors: non-competitive inhibitors |
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Definition
| when two drugs compete for the same biding site but only one is metabolized by the isoenzyme |
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Term
|
Definition
| both competitive and non-competitive, the drug with the greatest affinity for the isoenzyme receptor is the inhibiting drug; causes the other drug to not be metabolized |
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Term
|
Definition
| level of drug in the blood stream to obtain therapuetic response |
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Term
|
Definition
| drugs that bind to receptors and produce a therapeutic effect |
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Term
|
Definition
| drugs that bind to receptors and block actions; prevent cells from doing something specific |
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Term
|
Definition
| "ties up" a drug; makes it unavailable to tx the body; most common is albumin |
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Term
| protein binding: increase in circulation |
|
Definition
| causes an increase in binding which causes a decreased pharmacological effect |
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Term
| protein binding: decrease in circulation |
|
Definition
| causes more free circulating drug which causes an increased pharmacological effect |
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Term
| Protein binding: clinical pearl |
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Definition
| if pt with liver disease has elevated LFTs, the liver may not metabolize properly which increase the risk of toxic drug levels:give reduced dose of drug or hold |
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Term
|
Definition
| bc cells have high lipid concentrations; drugs that are fat soluble pass through the cells easier |
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Term
|
Definition
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|
Term
| Idiosyncratic Drug reaction |
|
Definition
| unusual or unexpected reaction |
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Term
|
Definition
| severe allergic drug reaction |
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Term
| Assessment necessary to choose the correct drug: 8 questions |
|
Definition
| Goal of therapy, related drug classes, mechanism of action, distinguishing features, how does the drug enter the body, how does the drug leave the body, safety profile of chosen drug |
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Term
|
Definition
| Medication reconcilliation, contraindications, any medical conditions, presence of kidney or liver disease |
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Term
|
Definition
| common practice; use with precaution |
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Term
| Issues to consider when prescribing generic versus proprietary drugs |
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Definition
| bioequivalence and therapeutic efficacy may not be the same; difference in bioavailabilty could make the generic drug less effective |
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Term
| What are some unbiased sources for prescribing information |
|
Definition
| Mosby's GenRX, American Hospital Formulary, Tarascan, Sanford Guide,and ePocrates |
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Term
| To prevent prescribing errors |
|
Definition
| always include DOB, list quantity needed for the full course of tx, and know Joint Commission's "do not use" list |
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Term
|
Definition
| high risk for adverse reactions due to organ immaturity; underdeveloped blood brain barrier which cause drugs to pass more readily into the CNS |
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Term
| Pharmacokinetics: Children |
|
Definition
| higher rate of metabolism than adults; drugs less protein bound;distributed affected by a higher concentration of water in client |
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Term
| Pharmacokinetics: Elderly |
|
Definition
| decreased organ fx leads to decreased liver metabolism and decreased excretion by the kidneys |
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Term
|
Definition
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Term
|
Definition
| animal or human studies show no risk or animal studies show risk but not in human studies |
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Term
|
Definition
| animal studies have shown adverse effects; no human studies completed; or no human or animal studies available |
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Term
|
Definition
| Positive evidence of human fetal risk |
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Term
|
Definition
| Fetal abnormalities seen in humans and in animal studies. Contraindicated in pregnancy |
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Term
| Elements necessary for accurate RX |
|
Definition
| Name, address, DOB, license number, DEA number, name of collaborating MD, Date of issuance, name;strength;dosage; and quantity of drug, directions for usage, refills authorized, and prescriber's signature |
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Term
|
Definition
Azole Antifungals: precipitant drug
-itraconazole
-ketoconazole
-posaconazole
-voriconazole
-fluconazole |
|
|
Term
| Effects of simvastatin/lovastation with antifungals |
|
Definition
| risk of myopathy and rhabdomyolysis; caused by inhibition of sim/lov metabolism by CYP3A4 |
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|
Term
| Antifungal Agents: Terbinafine(lamisil) |
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Definition
|
|
Term
| Antifungal Agents: Ciclopirox nail lacquer (Penlac) |
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Definition
|
|
Term
| Statins: Atorvastatin (Lipitor) |
|
Definition
| less metabolism of CYP3A4 but cases of myopathy with CYP3A4 reportedd |
|
|
Term
| Which statins are not metabolized by CYP3A4? |
|
Definition
Fluvastatin(lescol)
Rosuvastatin(Crestor)
Paravastatin (Pravachol) |
|
|
Term
| Use of simvastatin and Amiodarone(cordarone) increases the risk of |
|
Definition
| myopathy and rhabdomyolysis |
|
|
Term
| List the predisposing risk factors for for rhabdomyolysis |
|
Definition
| over 65ys of age,, uncontrolled hypothyroidism, and renal impairment |
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|
Term
| Simvastatin dose should not exceed____ in combination with__________ |
|
Definition
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|
Term
| When used with certain Statins, this drug may cause an increase in bleeding |
|
Definition
|
|
Term
| The mechanism that causes increased bleeding with usage of coumadin and certain statins is |
|
Definition
| the inhibition of warfarin metabolism by CYP2C9 |
|
|
Term
| List the statins that should not be given with Warfarin |
|
Definition
Fluvastatin (lescol)
Lovastatin (mevacor)
Rosuvstatin (crestor)
Simvstatin (zocor) |
|
|
Term
| List the two statins not known to interact with warfarin |
|
Definition
Atorvastatin (lipitor)
Pravastatin (pravachol) |
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|
Term
| A teratogen is a subtance that causes |
|
Definition
| malformations in fetal growth, structure, or development |
|
|
Term
| Characteristic set of malformations, acts during a specfic window of vulnerability, and incidence of malformation increase with increasing dosage during exposure all all criteria of a |
|
Definition
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