Term
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Definition
| Defined by the Food, Drug, and Cosmetic Act as articles intended for use in diagnosis, cure, mitigation, treatment or prevention of disease. |
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Term
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Definition
| Study of drugs and their actions on living systems. |
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Term
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Definition
| Branch of pharmacology concerned ONLY with the use of drugs in the treatment of disease. |
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Term
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Definition
| Study of a drug's actions on the body. |
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Term
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Definition
| Study of the noxious effects of a drug. |
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Term
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Definition
| Describes the drug's structural formula. |
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Term
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Definition
| Official name of a drug as designated by the US Pharmacopeia/National Formulary. |
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Term
| The official name of a drug is often identical to... |
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Definition
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Term
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Definition
| Often an abbrev. of the chemical name, assigned by the lab or company that first develops the drug. |
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Term
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Definition
| Name or brand name assigned by the manufacturer (ex. Tylenol) |
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Term
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Definition
| The changing of an active drug to an inactive chemical thru a series of chemical rxns. |
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Term
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Definition
| % of an administered drug that is available in the blood stream to act on the target tissue. |
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Term
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Definition
| Effective/Lethal dose of a drug that affects 50% of lab animals. |
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Term
| Preventing mislabeling, ending the medicine patent era, and authorizing FDA to enforce standards are roles of the... |
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Definition
| Pure Food and Drug Act of 1906 |
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Term
| Established safety for drugs (prescriptions for unsafe drugs), mandatory show of safety before marketing, and the Truth in Labeling Clause are all parts of the... |
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Definition
| Federal Food, Drug, and Cosmetic Act of 1938 |
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Term
| This act mandated proof of claims and Drug Efficacy Study Implementation. |
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Definition
| Kefauver-Harris Act of 1962 |
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Term
| What does the Drug Efficacy Study Implementation require? |
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Definition
| Proof of claims by drugs made prior to 1962. |
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Term
| This act controls the importation, manufacture, and sale of opium and coca plants and their derivatives. |
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Definition
| Harrison Narcotic Act of 1914 |
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Term
| This act classifies controlled substances into 5 different schedules based on abuse, dependency, etc. |
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Definition
| Controlled Substance Act of 1970 |
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Term
| This agency is responsible for the Controlled Substance Act of 1970. |
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Definition
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Term
| This act established that two peer-reviewed articles may be used in conjunction with research to support safety and efficacy. |
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Definition
| Modernization Act of 1997 |
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Term
| This is a result of the Modernization Act of 1997. |
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Definition
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Term
| This agency is a part of Health and Human Services. |
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Definition
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Term
| This agency is responsible for enforcing the Federal Food, Drug and Cosmetics Act, the Kefauver-Harris Act, and the DESI. |
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Definition
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Term
| This agency is responsible for the safety of foods and cosmetics, and for the safety and efficacy of drugs and medical equipment. |
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Definition
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Term
| This agency is part of the DOJ and is responsible for the regulation and distribution of controlled substances. |
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Definition
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Term
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Definition
| High potential for abuse and no medicinal benefits (e.g. heroin, pot, opiates, hallucinogens) |
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Term
| A Schedule II Drug has... |
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Definition
| High potential for abuse, but some accepted medicinal uses (e.g. coke, amphetamines, morphine) |
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Term
| A Schedule IV Drug has... |
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Definition
| Low potential for abuse, but may cause physical or psychological dependence (ex. diazepam) |
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Term
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Definition
| Failure to exercise the degree of care that another reasonable person would exercise in the same or similar situation in which harm to another person results. |
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Term
| Describe methods to eliminate medication administration errors. |
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Definition
Know your stuff
Follow a national standard of care
Follow local protocols
Stay current
Utilize resources
Focus on the patient |
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Term
| List the four necessary components of a lawsuit. |
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Definition
Duty to Act
Breach of that duty
Harm to someone
Causation |
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Term
| Describe Phase I of research. |
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Definition
| Establishes therapeutic uses, initial dosage range and safety issues, and safety of product in animal trials. Tested in small number of humans (20-80). Pharmacodynamics and pharmacokinetics determined. |
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Term
| Describe Phase II of research. |
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Definition
| Establishes safety in 100-300 at dosages and route from Phase I. Protocols are developed, and chronic and accumulative toxicity is tested in animals. |
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Term
| Describe Phase III of research. |
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Definition
| Drug is compared to another product already used for treatment. Establishes effective dosages in 1k-3k pnts. Test the chronic and accumulative toxicity in humans. |
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Term
| After Phase III of research, what can be filed? |
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Definition
| A New Drug Application with the FDA. |
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Term
| What's occurs when a New Drug Application is filed with the FDA? |
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Definition
| All research is submitted, limitations for use are established, and the product is approved/disapproved. |
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Term
| Describe Phase IV of research. |
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Definition
| Continuous investigations after drug is on the market, and the drug is tested for other indications it may have. |
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Term
| What's approved by the FDA (which may contrast manufacturer's recommendation) is included in this section of the drug package insert. |
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Definition
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Term
| This section of the drug package insert informs as to who should not take the product. |
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Definition
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Term
| This type of contraindication may allow use in certain circumstances. |
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Definition
| Relative Contraindications |
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Term
| This type of contraindication should not be ignored, regardless of circumstances. |
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Definition
| Absolute Contraindications |
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Term
| Things like pediatric and pregnancy use, general warnings, etc. are included in this section of a drug package insert. |
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Definition
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Term
| This section of a drug package insert includes signs and symptoms of overdose and related complications. |
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Definition
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Term
| Recommended dosages (as determined in test subjects) are in this section of a drug package insert. |
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Definition
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Term
| How the drug is delivered is contained in this section of the drug package insert (ex. IO, IV, oral, etc.) |
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Definition
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Term
| What are the four sources of medications? |
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Definition
| Plants, Animals, Minerals, and Synthetics |
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Term
| Two examples of plant drug sources. |
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Definition
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Term
| Two examples of animal drug sources. |
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Definition
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Term
| Two examples of mineral drug sources. |
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Definition
| Calcium Chloride, Sodium Bicarbonate |
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Term
| Two examples of synthetic drug sources. |
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Definition
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Term
| The process by which drug molecules are moved from the site of entry into the body into general circulation. |
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Definition
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Term
| A neurotransmitter, widely distributed in body tissues, with the primary function of mediating the synaptic activity of the nervous system. |
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Definition
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Term
| Of or pertaining to the sympathetic nerve fibers of the ANS, which use epi or epi-like substances as neurotransmitters. |
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Definition
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Term
| Drugs that combine with receptors and initiate the expected response. |
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Definition
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Term
| Any one of the postulated adrenergic components of receptor tissues that responds to norepi- and to various blocking agents. |
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Definition
| Alpha-adrenergic receptor |
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Term
| Agents designed to inhibit or counteract the effects of other drugs or undesired effects caused by normal or hyperactive physiological mechanisms. |
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Definition
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Term
| Of or pertaining to the blocking of acetylcholine receptors, resulting in inhibition or transmission of parasympathetic nerve impulses. |
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Definition
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Term
| Any of the postulated adrenergic components of receptor tissues that respond to epi and various blocking agents |
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Definition
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Term
| The time required to metabolize or eliminate half the total amt of a drug in the body |
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Definition
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Term
| The process by which a drug is converted chemically to a metabolite. |
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Definition
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Term
| An anatomical-physiological feature of the brain thought to consist of walls of capillaries in the CNS and surrounding glial membranes. |
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Definition
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Term
| The function of this is to prevent or slow the passage of chemical compounds from the blood into the CNS. |
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Definition
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Term
| A process that results in the formation of a stable fibrin clot that entraps platelets, blood cells, and plasma. |
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Definition
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Term
| The exact designation of a chemical structure as determined by the rules of chem nomenclature. |
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Definition
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Term
| Of or pertaining to the effects produced by the PNS or drugs that stimulate or antagonize the PNS. |
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Definition
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Term
| Medical or physiological factors that maek it harmful to admininster a medication that would otherwise have a therapeutic effect. |
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Definition
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Term
| Any drug defined in the categories of the Comprehensive Drug Abuse Prevention and Control Act (aka the Controlled Substance Act) of 1970. |
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Definition
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Term
| The effect that occurs when several doses of a drug are administered when absorption occurs more quickly than removal by excretion or metabolism or both. |
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Definition
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Term
| The transport of drugs through the bloodstream to various tissues of the body and ultimately, the site of action. |
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Definition
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Term
| Any substance used to treat or prevent a disease or condition. |
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Definition
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Term
| Modification of the effects of one drug by the previous or concurrent administration of another drug, thereby increasing or diminishing the pharmacological or phsyiological action of one or both drugs. |
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Definition
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Term
| A complex formed by the attachment of a drug to proteins, mainly albumin. |
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Definition
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Term
| Parts of a cell (usually an enzyme or large protein molecule) with which a drug molecule interacts to trigger its desired response or effect |
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Definition
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Term
| A condition characterized by local or diffuse changes in muscle tone, resulting in painful muscle spasms, unusually fixed postures, and strange movement patterns. |
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Definition
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Term
| The amt of drug that produces a therapeutic response in 50% of those who take it. |
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Definition
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Term
| A muscle or gland that responds to nerve impulses from the CNS. |
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Definition
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Term
| Any of several peptides secreted in the brain that have a pain-relieving effect like morphine. |
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Definition
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Term
| The elimination of toxic or inactive metabolites, primarily by the kidneys. |
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Definition
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Term
| The initial biotransformation of a drug that occurs during passage through the liver from the portal vein that occurs before the drug reaches the general circulation. |
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Definition
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Term
| The official, established name of a drug. |
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Definition
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Term
| Arising from an obscure or unknown cause. |
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Definition
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Term
| An abnormal or peculiar response to a drug. |
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Definition
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Term
| A large qty of drug that temporarily exceeds the capacity of the body to excrete the drug (rapid dose to quickly get you to a therapeutic level). |
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Definition
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Term
| Meant to maintain the pt at a therapeutic level. |
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Definition
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Term
| A chemical that is released from one neuron at the presynaptic nerve fiber. |
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Definition
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Term
| Agents that block Beta1 AND Beta2 receptor sites. |
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Definition
| Nonselective beta-blocking agents |
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Term
| Usually the same as the generic name, this drug is denoted in one of the official publications of the US Pharmacopeia or National Formulary. |
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Definition
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Term
| A medication that has been developed specifically to treat a rare medical condition. |
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Definition
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Term
| Of or pertaining to any medication route other than the alimentary canal. |
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Definition
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Term
| The reabsorption fm the renal tubule by passive diffusion. |
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Definition
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Term
| The science of dispensing drugs. |
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Definition
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Term
| The study of how a drug acts on a living organism. |
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Definition
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Term
| The study of how the body handles a drug over a period of time, including the processes of absorption, distribution, biotransformation, and excretion. |
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Definition
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Term
| An inactive or less than effective dose of a harmless drug, usually needed in drug trials. |
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Definition
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Term
| A protective biological membrane that separates the blood vessels of the mother and the fetus. |
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Definition
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Term
| Enhancement of the effect of a drug, caused by concurrent administration of two drugs in which one drug increases the effect of the other. |
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Definition
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Term
| Agents that block Beta1 OR Beta2 receptors. |
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Definition
| Selective beta-blocking agents |
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Term
| The combined effects of two drugs that equal the sum of the individual effects of each agent. |
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Definition
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Term
| The combined action of two drugs that is greater than the sum of each agent acting independently. |
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Definition
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Term
| A potentially irreversible neurological disorder characterized by involuntary repetitious movements of the muscles of the face, limbs, and trunk. |
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Definition
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Term
| The desired, intended action of a drug. |
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Definition
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Term
| A measurement of the relative safety of a drug. |
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Definition
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Term
| The range of plasma concentrations that is most likely to produce the desired drug effect with the least likelihood of toxicity. |
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Definition
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Term
| The range between minimal effective concentration and toxic level of a drug. |
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Definition
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Term
| A physiological response that requires that a drug dosage be increased to produce the same effect formerly produced by a smaller dose. |
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Definition
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Term
| The trademark name of a drug, designated by the drug company that sells the medication. |
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Definition
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Term
| Side effects that prove harmful to the patient. |
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Definition
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Term
| Absorption rate: Ingestion (pills) |
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Definition
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Term
| Absorption rate: IV/IO/Inhalation/SL |
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
| What is the max amount of medication that can be administered via IM or SQ route in a single dose. |
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Definition
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Term
| What drugs can be administered via IV and IO? |
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Definition
| All drugs that can be administered IV, can be administered IO. |
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Term
| What are the advantages of enteral drug administration? |
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Definition
| Easy to admin, easy to dose, and it is safe because it can usually be retrieved b/c of slow absorption. |
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Term
| What are the disadvantages of enteral drug admin? |
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Definition
| Absorption is unpredictable, the slow absorption rate means minimal use in the prehospital setting, and it can not be administered to uncooperative patients. |
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Term
| What are the advantages of parenteral drug admin? |
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Definition
| Fast acting, can be used when perfusion is poor,and can be used in patients that refuse/cannot take enteral meds. |
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Term
| What are the disadvantages of parenteral drug admin? |
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Definition
| May be painful, can be costly, and aseptic technique is required. |
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Term
| What are the disadvantages of non-enteral, non-parenteral drug admin? |
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Definition
| May be inadequate with poor perfusion. |
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Term
| This is the study of a drug's movement through the body (i.e. the way chemicals get to the site of action)? |
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Definition
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Term
| Study of a drug's effects on living tissue. |
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Definition
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Term
| In order to circulate in the body, a drug must first dissolve, and then remain... |
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Definition
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Term
| What factors effect/determine movement of fluid and molecules? |
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Definition
| Size, solubility, membrane transport, and carrier transport |
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Term
| How does size effect fluid/molecule movement? |
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Definition
| Larger molecules will have a more difficult time crossing membranes. |
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Term
| Only _________ drugs cross membranes. |
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Definition
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Term
| Refers to increased pH causing increased ionization (charging of molecules) with regards to membrane transport. |
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Definition
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Term
| This refers to a free drug in a solution reaching equilibrium (think membrane transport). |
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Definition
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Term
| Only (ionized/non-ionized) drugs move across membranes. |
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Definition
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Term
| Increased pH causes increased ionization, meaning that _______ drugs will be able to cross membranes. |
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Definition
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Term
| The time a drug takes from administration to therapeutic effects. |
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Definition
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Term
| A specialized cell that only allows certain compounds to bind to its surface (it is a protein). |
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Definition
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Term
| What is the definition of mechanism of action? |
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Definition
| How a drug does what it does. |
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Term
| The maximal effect produced by a drug; more importantly is used comparatively between drugs. |
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Definition
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Term
| A drug's ability to bind with its receptors and the functional relationship between the receptor and effector system. |
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Definition
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Term
| The ability of a drug to work on one isolated receptor. |
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Definition
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Term
| Variation in people due to individual's chemical differences. |
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Definition
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Term
| The process of movement of a drug from a site of application to the extracellular compartments of the body. |
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Definition
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Term
| The four factors of pharmacokinetics. |
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Definition
| Absorption, Distribution, Metabolism, and Elimination |
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Term
| These factors influence absorption. |
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Definition
| Admin site, circulatory status, binding capacity, solubility, body pH, drug concentration, drug interactions, and patient status |
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Term
| Ionized drugs tend to be... |
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Definition
| Electrically charged, lipid insoluble, and water based. |
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Term
| Non-ionized drugs tend to be... |
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Definition
| Uncharged, lipid soluble, and acidic in nature. |
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Term
| Which type of solution will bind more quickly, water or oil? |
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Definition
| Water, as oil solutions tend to bind to adipose tissue. |
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Term
| Why does admin site affect absorption? |
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Definition
| The number of biological membranes the drug must pass through is relative to admin site. |
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Term
| This is the process whereby a drug is transported from the site of absorption to the site of action. |
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Definition
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Term
| What two factors effect drug distribution within the body? |
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Definition
| Circulatory status and binding ratios |
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Term
| Why do binding ratios effect drug distribution in the body? |
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Definition
| Plasma proteins bind to drugs, which makes the drug inactive. These drugs remain as a reservoir in the blood until they become unbound. Med conditions that affect pH or the liver can alter %'s. |
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Term
| Is the placenta an effective barrier? |
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Definition
| No, anything momma gets, baby gets. |
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Term
| Biotransformation is synonymous with... |
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Definition
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Term
| This refers to the chemical alteration of a drug, usually from an active form to and inactive form. |
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Definition
| Biotransformation (metabolism) |
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Term
| Most drugs are administered _______ , and must be __________ to be removed from the body. |
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Definition
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Term
| Drugs must usually be _______-soluble to be metabolized. |
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Definition
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Term
| What are the four methods of biotransformation? |
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Definition
| Oxidation, reduction, hydrolysis, and conjugation |
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Term
| This is biotransformation via an addition of an oxygen molecule. |
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Definition
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Term
| This is the biotransformation of a drug via the removal of a hydrogen ion. |
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Definition
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Term
| This is the biotransformation of a drug via the addition of a water molecule. |
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Definition
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Term
| This is the biotransformation of a drug via the addition of another molecule meant to make the medication water soluble. |
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Definition
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Term
| This organ causes a parent drug to become less lipid-soluble, so it becomes more water soluble and can be excreted. |
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Definition
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Term
| What cells of the liver do the work of metabolism? |
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Definition
| Hepatic (sp. microsomes in the hepatic cells) |
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Term
| T or F, microsomes in hepatic cells increase in number and efficiency with each exposure to a drug. |
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Definition
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Term
| The elimination of metabolites from the body. |
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Definition
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Term
| This organ is the primary location of elimination. |
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Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
| Besides the kidneys, how else can metabolites be eliminated from the body? |
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Definition
| Exhalation of volatile products through the lungs, and via perspiration of the skin. |
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Term
| What are the four ways in which medications act in the body? |
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Definition
| Replacement, Chemical Antagonism, Alteration of Phsyiochemical Environment, or Drug/Receptor Interaction |
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Term
| Drugs replacing an essential, but missing, natural (endogenous) substance normally found in the body, refers to... |
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Definition
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Term
| What are some examples of drugs that act via replacement? |
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Definition
| Dextrose, O2, electrolytes, glucose, insulin |
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Term
| When a drug acts via this mechanism, a chemical binds to a site that either causes a totally opposite response, or ties up the receptor site allowing no response. |
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Definition
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Term
| What are two examples of drugs that act via chemical antagonism? |
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Definition
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Term
| This occurs when a drug acts by changing concentration gradients. |
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Definition
| Alteration of physiochemical environment |
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Term
| What are two examples of drugs that act via alteration of physiochemical environment |
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Definition
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Term
| This is the most common way that a drug acts on the body, examples include SSRI and beta blockers. |
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Definition
| Drug/Receptor Interaction |
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Term
| What are the four characteristics of a receptor site? |
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Definition
| Selectivity (one drug for one receptor), reversibility (drug can readily attach and detach), specificity (chem config of a drug is specific to a receptor), and quantity (drug must reach receptor in enough concentration to trigger a rxn) |
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Term
| What are the four variability issues associated with drug action on the body? |
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Definition
| Prescribed dose, administered dose, concentration and site of action, and intensity of effect variability issues |
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Term
| Patient compliance,and errors in med admin are variability issues associated with... |
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Definition
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Term
| Rate/extend of absorption, body size/composition, distribution of body fluids, protein and tissue binding and rate of elimination are variability issues of... |
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Definition
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Term
| Pathological factors, genetic factors, drug interactions, and tolerance development are variability issues of... |
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Definition
| Concentration and Site of Action |
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Term
| Drug-receptor interaction, functional state (health of individual) and the placebo effect are variability issues of ... |
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Definition
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Term
| Discuss pediatric age and drug interactions. |
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Definition
| Speed of medication metabolization is dependent on the liver development. Will be able to metabolize some drugs more rapidly/easily, and not others. |
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Term
| Discuss geriatric age and drug interactions. |
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Definition
Lose ability to metabolize drugs as quickly, due to:
Decreased CO (circulation)
Decreased renal function (elimination)
Decreased body water (solubility)
Decreased body fat (drug binding)
Decreased serum/albumen (drug binding)
Decreased respiratory capacity |
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Term
| Discuss obstetrics and drug interactions. |
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Definition
| Placenta barrier and physiological changes in the mother impact the metabolism and excretion of medications. |
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Term
| Formula to calculate drug dosages |
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Definition
Volume to be administered=
(D)esired dose x Total (V)olume of drug / Total (Q)uantity of drug (so...DV/Q) |
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Term
| Formula for calculating maintenance drips |
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Definition
Vol to be admin'd =
V x D X (A)dmin set/ Q
(VDA/Q) |
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Term
| Calculating fluid admin dosages |
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Definition
VA=RT
V-olume to be infused
A-dmin set (gtts/ml)
R-ate of infusion (gtts/min)
T-ime of infusion (MINUTES ONLY) |
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Term
|
Definition
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Term
| Mental math formula for converting pounds to kg |
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Definition
Weight in pds divided by two, then subtract 10% of result from the answer.
ex. 220 lbs to kg
220/2=110-(10% of 110=11)=100 kg |
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Term
| Convert inches to centimeters |
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Definition
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|
Term
| This is a disease of hyperglycemia resulting from an absolute lack of insulin. |
|
Definition
| Type I DM (diabetes mellitus) |
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Term
|
Definition
| Viral infection that attacks the beta-cells of the pancreas, or an auto-immune disease that affects the pancreas. |
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|
Term
| This type of DM is hyperglycemia secondary to a cellular insensitivity to insulin. |
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Definition
|
|
Term
| What are the three types of insulins? |
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Definition
| Basal, Mealtime, and Neutral Protamine Hagedorn (NPH, aka insulin zinc suspension) |
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Term
|
Definition
| Used in conjunction with mealtime insulin, or oral hypoglcymics, basal insulins provide a slow, steady release of insulin that controls the blood sugar when no food is digested. |
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Term
| Describe mealtime insulin |
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Definition
| Consists of fact-acting and ultra-fast acting insulins that are taken before, during or after food ingestion to control sugar regulation associated with meals. |
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Term
| Describe insulin zinc suspensions (NPHs) |
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Definition
| Intermediate-acting insulins made by mixing regular insulin and protamine (which helps prolong duration) |
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|
Term
| This is a substance isolated from rainbow trout sperm, but is now made synthetically that prolongs insulin duration. |
|
Definition
|
|
Term
| What are the two subclasses of mealtime insulins? |
|
Definition
| Regular and Ultra-fast Acting |
|
|
Term
| Why is regular insulin named "regular" insulin? |
|
Definition
| Most closely resembles natural insulin in its actions and duration. |
|
|
Term
| This mealtime insulin is an ultra-short acting form of regular insulin that has a very short absorption time, reaches peak levels quickly, but doesn't last as long as regular insulin. |
|
Definition
| Ultra-fast acting insulin |
|
|
Term
| What are the oral hypoglycemic medications? |
|
Definition
| Sulfonylureas, biguanides, alpha-glucosidase inhibitors, and Thiazolidinedione Derivatives (TZDs) |
|
|
Term
| What are the effects of sulfonylureas? |
|
Definition
-Stimulate beta cells in pancreas to release insulin
-decrease amount of serum glucagon
-decrease glucose formation in the liver |
|
|
Term
| This is a hint for recognizing sulfonylureas oral hypoglycemics. |
|
Definition
| Tend to end in -ide or -ase |
|
|
Term
| Biguanides, aka "anti-hyperglycemics", have what effect? |
|
Definition
-Decrease hepatic glucose formation
-Increase glucose transport into the cell
-Decrease glucose absorption in GI tract |
|
|
Term
| What are the effects of alpha-glucosidase inhibitors? |
|
Definition
| Relatively new class of meds recently approved by the FDA, work by blocking enzymes req'd for the digestion of most carbs. |
|
|
Term
| Describe the effects of TZDs (thiazolidinedione derivatives). |
|
Definition
Seem to potentiate actions of insulin on target tissues. Work by:
-increasing the effects of circulating insulins
-decreasing insulin resistance
-improving insulin sensitivity
-reducing fasting plasma glucose, insulin and free fatty acids |
|
|
Term
| Describe the actions/uses of glucagon. |
|
Definition
| Synthesized in the alpha cells of the pancreas, glucagon causes a breakdown of stored glycogen to glucose, has a positive inotropic and chronotropic effect on the heart via heart glucagon receptors, and in large doses relaxes smooth muscle of the GI tract and esophagus. |
|
|
Term
| Mechanism of action of Glucagon |
|
Definition
| Causes the breakdown of glycogen to glucose at alpha cells of the pancreas |
|
|
Term
| Indications for glucagon admin. |
|
Definition
-Hypoglycemia
-Beta blocker overdose
-Calcium channel overdose
-Esophageal spasm |
|
|
Term
| Contraindications for glucagon use. |
|
Definition
-Hypersensitivity
-Pheochromocytoma (tumor of the adrenal glands) |
|
|
Term
|
Definition
-Converts glycogen to glucose
-Positive chronotrope/inotrope of heart
-Decreases renal vascular resistance
-Relaxes GI tract muscle |
|
|
Term
| In a pt using beta-blockers, this can be used to speed up the heart. |
|
Definition
| Glucagon (administered in large doses) |
|
|
Term
| What is the adult dose of glucagon for diabetic treatment? |
|
Definition
| 0.5-1 mg, which can be repeated one time @ 15 min |
|
|
Term
| What is the adult dose of glucagon for non-diabetic treatments? |
|
Definition
|
|
Term
| What is the pediatric dose of glucagon? |
|
Definition
| 0.5 mg, but not usually recommended |
|
|
Term
| What are the side effects of glucagon administration? |
|
Definition
| Allergic rxns and can make the patient hypotensive |
|
|
Term
| How does glucagon come prepared? |
|
Definition
| Comes in one unit of powder with 1 mL of diluting solution that must be reconstituted. |
|
|
Term
| As it relates to drug admin, the definition of % is... |
|
Definition
some gram of 100 mL
x/100 mL |
|
|
Term
|
Definition
| Dextrose prompts the pancreas to release insulin, which drives glucose and K+ into cells. |
|
|
Term
| Indications for dextrose admin. |
|
Definition
-Documented hypoglycemia
-Hyperkalemia |
|
|
Term
| Give hypoglycemic levels for adults, pediatrics, and neonates. |
|
Definition
-Adults, less than 80 mg/dL
-Peds, less than 60 mg/dL
-Neos, less than 40 mg/dL |
|
|
Term
| Contraindications of dextrose admin. |
|
Definition
-Suspected CVA (brain bleed)
-TBI
-Delirium tremors |
|
|
Term
|
Definition
| Raises blood glucose levels and lowers serum K+ levels. |
|
|
Term
|
Definition
12.5-25 g (normal field dose)
0.5-1 g/kg (textbook) |
|
|
Term
|
Definition
0.5 g/kg
-Greater than 15 kg, use D25 or D50
-Less than 15 kg, use D10 or D25 |
|
|
Term
|
Definition
|
|
Term
| What are the side effects of dextrose admin? |
|
Definition
|
|
Term
| What are the preparations of dextrose? |
|
Definition
D50--25 g/50 mL
D25--2.5 g/10 mL
D10--25 g/250 mL |
|
|
Term
| Convert D50 to D10, D12.5, and D25. |
|
Definition
|
|
Term
| Visceral afferent nerve fibers |
|
Definition
| Carry signals from internal organs to the CNS |
|
|
Term
| Visceral efferent nerve fibers |
|
Definition
| Send signals from the CNS to internal organs |
|
|
Term
| Somatic afferent nerve fibers |
|
Definition
| Sensory, send signals from the muscles to the CNS |
|
|
Term
| Somatic efferent nerve fibers |
|
Definition
| Motor, send signals from the CNS to muscles |
|
|
Term
| These are autonomic nerves that reside in the CNS and terminate before the synaptic cleft. |
|
Definition
|
|
Term
| These nerves originate after the synaptic cleft and terminate at the target organ. |
|
Definition
|
|
Term
| The two types of sympathetic ganglia. |
|
Definition
| Chain ganglia and collateral ganglia |
|
|
Term
| These ganglia extend to target organs and stimulate sweat glands, constrict skin blood vessels, increase blood flow to skeletal muscle, act as positive inotrope/chronotrope, cause bronchodilation, and stimulate energy production. |
|
Definition
| Sympathetic Chain Ganglia |
|
|
Term
| These sympathetic ganglia are located in the abdominal cavity. |
|
Definition
|
|
Term
| Collateral ganglia are responsible for... |
|
Definition
-Reducing blood flow to abdominal organs
-Decreasing peristalsis
-Relaxing urinary bladder smooth muscle
-Releasing glucose stores in the liver |
|
|
Term
| Parasympathetic ganglia stimulation results in... |
|
Definition
-Pupillary constriction
-Increased peristalsis
-Digestive enzyme secretion
-Bronchoconstriction
-Negative inotrope/chronotrope |
|
|
Term
| Adrenergic receptors are part of what nervouse system? |
|
Definition
|
|
Term
| List the adrenergic receptors. |
|
Definition
| Alpha-adrenergic (A1, A2) and Beta-adrenergic (B1, B2) |
|
|
Term
| Alpha-adrenergic receptors are (inhibitory/excitatory). |
|
Definition
|
|
Term
| Beta-adrenergic receptors are (inhibitory/excitatory). |
|
Definition
|
|
Term
| These neuroreceptors are found in the smooth muscle of blood vessels and the GI tract, constrict blood vessels and stimulate glucose production. |
|
Definition
|
|
Term
| These neuroreceptors cause vasoconstriction, and inhibit renin release, platelet aggregation, and insulin secretion. |
|
Definition
|
|
Term
| These neuroreceptors are primarily located in the SA node and left ventricle, and have a stimulatory effect. |
|
Definition
|
|
Term
| These neuroreceptors are located in the smooth muscle of the lungs and blood vessels, the uterus and the cerebellum. Cause relaxation. |
|
Definition
|
|
Term
| The PNS utilizes what kind of receptors? |
|
Definition
|
|
Term
| What are the two types of cholinergic receptors? |
|
Definition
|
|
Term
| This type of neuroreceptor is found at the NMJ of cardiac and smooth muscle, in some glands of the SNS, and acts excitatory in the GI tract and inhibitory in the heart. |
|
Definition
|
|
Term
| This type of neuroreceptor is found at the NMJ of skeletal muscles and are purely excitatory. |
|
Definition
|
|
Term
| The primary neurotransmitter of the PNS |
|
Definition
|
|
Term
|
Definition
| Terminal end of the pre-synaptic neuron |
|
|
Term
|
Definition
-At all pre-ganglionic neurons (both PNS and SNS)
-At all PNS post-ganglionic neurons
-At some SNS post-ganglionic neurons |
|
|
Term
| Which sympathetic post-ganglionic neurons use ACh? |
|
Definition
| Sweat glands, erector pili, and skeletal muscle blood vessels |
|
|
Term
| The primary SNS neurotransmitter. |
|
Definition
|
|
Term
| Where is NE formed and used? |
|
Definition
| Formed in the terminal end of the post-synaptic neuron, used at most SNS post-ganglionic neurons |
|
|
Term
| Describe the enzymatic destruction of ACh. |
|
Definition
| Broken down by acetylcholinesterase in the synaptic cleft quickly after release, or rapidly reabsorbed back into the presynaptic cleft. |
|
|
Term
| Describe the enzymatic destruction of NE. |
|
Definition
| Broken down more slowly than ACh, NE is reabsorbed back into the presynaptic vesicle, and the remainder is broken down by monoamine oxidase (MAO) and COMT). This plays an important role as it relates to psychotropic meds. |
|
|
Term
| Identify the precursors to NE |
|
Definition
| Formed in the terminal end of post-synaptic neurons from the amino acid tyrosine-->dopa-->dopamine-->NE-->Epi |
|
|
Term
| What are the NE receptors? |
|
Definition
|
|
Term
| Which NE receptor causes constriction of blood vessels and stimulates glucose production? |
|
Definition
|
|
Term
| Dopamine acts on these receptors to cause peripheral vasoconstriction. |
|
Definition
|
|
Term
| Which NE receptor causes constriction; and inhibits renin, platelet aggregation, and insulin secretion? |
|
Definition
|
|
Term
| What are the epinephrine receptors? |
|
Definition
|
|
Term
| These epi receptors are positive chronotropes and inotropes, and are located in the SA node and left ventricle. |
|
Definition
|
|
Term
| These epi receptors cause smooth muscle dilation, and are located in the lungs and uterus. |
|
Definition
|
|
Term
| These epi receptors are located in fat, cause fat breakdown and stimulate temperature increase. |
|
Definition
|
|
Term
| These receptors are located in the visceral blood vessels and terminal nerve endings of the pre-synaptic axons. |
|
Definition
|
|
Term
| These receptors dilate mesentry, and act on specific beta receptors in the heart. |
|
Definition
|
|
Term
| What is special about the cardiac effects of dopaminergic receptors? |
|
Definition
| Increase inotropy without increasing chronotropy. |
|
|
Term
| Mimics the PNS, stimulates the PNS. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Mimics the SNS, stimulates the SNS. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the three groups of anti-cholinergic blockers? |
|
Definition
| Muscarinic, Ganglionic and Neuromuscular Junction Blockers |
|
|
Term
| Describe muscarinic blockers. |
|
Definition
| Block muscarinic receptors at the effector organ. |
|
|
Term
| Describe ganglionic blockers. |
|
Definition
| Used surgically to produce hypotension. |
|
|
Term
| Describe neuromuscular junction blockers. |
|
Definition
| Block nicotinic receptors at the NMJ (these are paralytics). |
|
|
Term
| What are the two types of NMJ blockers? |
|
Definition
| Non-depolarizing blocking agents and depolarizing blocking agents |
|
|
Term
| These NMJ blockers act by competitively block ACh to its receptors, have a quick onset and short to medium duration. |
|
Definition
| Non-depolarizing blocking agents |
|
|
Term
| These NMJ blockers depolarize the plasma membrane of skeletal muscle fiber, which makes the muscle fiber insensitive to further stimulation by ACh (very short duration). |
|
Definition
| Depolarizing blocking agents |
|
|
Term
| Discuss the role of benzodiazepines. |
|
Definition
| Most common antiepileptic meds in the EMS environ, also used for sedation, chem restraint, muscle relaxant, anxiolytic, and sleep disorders. Works by stimulating the release of GABA. |
|
|
Term
| Benzos are highly protein bound, what is a possible danger of this? |
|
Definition
| Sudden Hx change can cause a massive dump of benzos in the body. |
|
|
Term
| Are benzos a good preventative seizure med? |
|
Definition
|
|
Term
|
Definition
| Gamma-aminobutyric acid, an inhibitory neurotransmitter which provides a sedative effect over the surrounding area, desensitizing local receptor sites. |
|
|
Term
| What is the treatment for benzo OD? |
|
Definition
|
|
Term
|
Definition
| Mainstay of anticonvulsant therapy when benzos do not suffice. Stabilize neuronal membranes by decreasing Na+ and Ca++ influx, limiting depolarization. |
|
|
Term
| What is the issue with hydantoins? |
|
Definition
| Have significant cardiovascular and pediatric side effects, and can cause birth defects. |
|
|
Term
|
Definition
| The last resort treatment for generalized seizures, barbs inhibit the release of the excitatory neurotransmitter glutamate. Side effects include respiratory depression, hypotension, bradycardia and pediatric hypersactivity. |
|
|
Term
| This is a CNS depressant agent that results in a calming effect secondary to a small med dose. |
|
Definition
|
|
Term
| This is a CNS depressant agent that results in sleeping due to a higher dose of med. |
|
Definition
|
|
Term
| This is a side-effect of some meds that promotes antegrade memory loss. |
|
Definition
|
|
Term
| These are used for their anti-inflammatory properties in treatment of cerebral edema and spinal cord injury. |
|
Definition
|
|
Term
| The type of side effects most commonly seen with tricyclic antidepressants. |
|
Definition
| Anticholinergic (dry mouth, blurred vision, urinary retention, etc.) |
|
|
Term
| This is a serious side effect of TCAs, usually seen in high dosages. |
|
Definition
| Anticholinergic delirium; presents with confusion, agitation, and psychotic symptoms (hallucinations) |
|
|
Term
| What cardiovascular effects can TCAs have? |
|
Definition
| Hypotension, tachycardia and dysrhythmia. But of greater concern are quindine-like effects on the heart. |
|
|
Term
| What are quindine-like cardiac effects. |
|
Definition
| Decreased K+ movement within myocardial cells results in prolonged QT interval, widened QRS compelex, prolonged refractory period, and decreased conduction. |
|
|
Term
| What kind of negative side-effects are commonly seen in antipsychotic med pts? |
|
Definition
|
|
Term
| What causes extrapyramidal reactions? |
|
Definition
| Development of supersensitivity of dopamine receptors. |
|
|
Term
| What types of effects fall under the extrapyramidal umbrella? |
|
Definition
| Parkinson-like movement disorder (rigidity, shuffling gate, tremor), restlessness, muscle spasms, and malignant syndrome (catatonia, stupor, unstable BP, fever). |
|
|
Term
| The most serious extrapyramidal side effects are known as... |
|
Definition
|
|
Term
| What are acute dystonic rxns? |
|
Definition
| Usually occur in muscles of the head and neck, ex's incl. fixed gaze, lock jaw, spasms of the laryngeal and tardive dyskinesia. |
|
|
Term
| What is tardive dyskinesia? |
|
Definition
| A serious acute dystonic reaction involving involuntary repetitious movements of the mouth, tongue, face, limbs, and trunk. Very serious as it may be permanent and there is no effective treatment. |
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