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Drug
any chemical that can affect living processes TERM 2
pharmacology
DEFINITION 2 study of drugs and their interactions with living systems TERM 3
clinical
pharmacology
DEFINITION 3 study of drugs in humans TERM 4
therapeutics or pharmacotherapeutics
DEFINITION 4 the use of drugs to diagnose, prevent, or treat disease of to prevent pregnancy TERM 5
What are the 3 most important drug
properties?
DEFINITION 5 Effectiveness-elicitsthe responses for which it is givenSafety- cannot produce harmful effects.Selectivity- elicits the response for which it is given
What is the objective of drug therapy?
To provide maximum benefit with minimum harm TERM 7
4 factors that determine the intensity of drug
responses
DEFINITION 7 administrationpharmacokineticspharmacodynamicssources of individual variation TERM 8
6 rights of drug administration
DEFINITION 8 Right drug to the right patient in the right dose through the right route at the right time with the right documentation TERM 9
Nursing responsibilities regarding drugs: what
the nurse must know
DEFINITION 9 more than the 6 rightswhat medications are appropriate for the patientwhat drugs are contraindicated for the patientthe probably consequences of the interaction between drug a patient TERM 10
Preadministration assessment
DEFINITION 10 collecting baseline data (to compare with anticipated therapeutic effects and to evaluate adverse effects)identifying high-risk patientsassessment of patients capacity for self care
making PRN decisions
pro re nataknow the reason for drug usebe able to assess the patient's medication needsevaluate TERM 17
managing toxicity
DEFINITION 17 early identification makes early intervention possibleknow the early signs of toxicityknow the procedure for toxicity management TERM 18
nursing process in drug therapy
DEFINITION 18 preadministration assessmentanalysis and nursing diagnosisplanningimplementationevaluation TERM 19
what is the con of using generic drug names?
DEFINITION 19 more complicated and more difficult to pronounce than trade names TERM 20
cons of using trade names
DEFINITION 20 single drug can have multiple trade names (acetaminophen has around 19)US drugs and drugs outside the country can have the same trade name but have different active ingredientproducts with the same trade name may have different active ingredients
Are generic and trade drugs therapeutically
equivalent
they have the same does of the same ingredient so the only concern would be the non active ingredients and their effects of absorption TERM 22
how much do americans spend annually of
OTC drugs
DEFINITION 22 $20 billion TERM 23
60% of all drugs administered are what?
DEFINITION 23 OTC TERM 24
absorption
DEFINITION 24 the movement of a drug from its site of administration into the blood. TERM 25
rate of
absorption
DEFINITION 25 determines how soon effects will begin
pH partitioning in regards to
absorption
increased ionization in plasma = increased absorption TERM 32
routes of drug administration
DEFINITION 32 IVIM/subQOraltopicaltransdermalinhaledrectalvaginaldirect injection into site of actionsublingual TERM 33
distribution
DEFINITION 33 the movement of drugs throughout the body TERM 34
drug distribution is determined by what 3
factors
DEFINITION 34 blood flow to the tissuesexiting the vascular systementering cells TERM 35
how are drugs carried to tissues and organs of
the body?
DEFINITION 35 by the blood
how to abscesses and tumors complicate
drug distribution?
there is low regional blood flow which impacts therapypus- filled pockets have no internal blood vesselssolid tumors have limited blood supply TERM 37
How do drugs exit the vascular system?
DEFINITION 37 capillary beds- typically passing between capillary cells rather than through them.BBBPlacenta drug transfer TERM 38
BBB (blood brain barrier)
DEFINITION 38 tight junctions between the cells that compose the walls of most capillaries in the CNSMust be able to pass through the cells of the capillary wall TERM 39
What drugs can cross the BBB
DEFINITION 39 lipid soluble drugs or drugs that have their own transport system TERM 40
placenta drug transfer and the risks
DEFINITION 40 membranes of the placenta do NOT constitute an absolute barrier to the passage of drugsrisks: birth defects such as mental retardation, gross malformations, low-birth weight, if the mom uses opioids- drug dependent baby
Infants and elderly drug metabolism
liver metabolism is decreased TERM 47
first pass effect
DEFINITION 47 hepatic inactivation of oral drugs- concentration is greatly reduced before hitting systemic circulation TERM 48
nutritional status impact on drug metabolism
DEFINITION 48 lack of cofactors (like vitamins) may decrease metabolism TERM 49
drug excretion
DEFINITION 49 removal of drugs from the body TERM 50
drugs and their metabolites can exit the body
through:
DEFINITION 50 urine, sweat, saliva, breast milk, or expired air
steps in renal drug excretion
glomerular filtrationpassive tubular reabsorptionactive tubular secretion TERM 52
factors that modify renal drug
excretion
DEFINITION 52 pH-dependent ionizationcompetition for active tubular transportage TERM 53
decreased renal function leads to
DEFINITION 53 increased duration and or intensity of drugs TERM 54
enterohepatic recirculation leads to what
route of excretion
DEFINITION 54 bile (feces) TERM 55
clinical significance of plasma drug levels
DEFINITION 55 direct correlation between therapeutic and toxic drug responses and the amount of drug present in the plasma
time to decline from
plateau
usually about 4 half lives TERM 62
3 techniques for reducing fluctuations in drug
levels
DEFINITION 62 continuous infusiondepot administrationreduce dose and dosing interval TERM 63
pharmacodynamics
DEFINITION 63 the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are producedin other wordsthe study of what drugs do to the body and how they do it TERM 64
dose response relationship
DEFINITION 64 relationship between size of administered dose and intensity of the response it produces. TERM 65
what does the dose response relationship
determine
DEFINITION 65 the minimum amount of drug we can usethe maximum response a drug can elicithow much we need to increase the dosage until desired intensity of response is achieved
maximal efficacy
largest effect that a drug can producematch intensity of response with the patients needvery high maximal efficacy is not always more desirable.(most important) TERM 67
relative
potency
DEFINITION 67 the amount of drug we must give to elicit an effect TERM 68
drug receptors
DEFINITION 68 any macromolecule in a call to which a drug binds to produce its effectsbody's receptors:hormonesneurotransmitters TERM 69
receptor binding
DEFINITION 69 binding of a drug to its receptor is reversiblereceptor activity is regulated by endogenous compoundswhen a drug binds to a receptor, it will either mimic or block the action of the endogenous regulatory molecules and increase or decrease the rate of physiologic activity normally controlled by that receptor TERM 70
important properties of receptors
DEFINITION 70 receptors are normal points of control of physiologic processesreceptor function is regulated by molecules supplied by the bodydrugs can only mimic or block the body's own regulatory moleculesdrugs cannot gives cells new functionsdrugs produce their therapeutic effects by helping the body use prexisiting capabilitiesin theory, possible to synthesize drugs to alter any biologic process for which receptors exist
competitive
antagonists
compete with agonists for receptor bindingbind reversibly to receptorsequal affinity TERM 77
partial agonists
DEFINITION 77 only moderate intrinsic activitythe maximal effect that they can produce is less than that of a full agonistcan act as antagonists TERM 78
continuous exposure to agonist leads to
DEFINITION 78 desensitized or refractory(down-regulation) TERM 79
continuous exposure to an antagonist can
lead to
DEFINITION 79 hypersensitivity TERM 80
drugs that don't involve
receptors
DEFINITION 80 simple physical or chemical interactions with small moleculesantacids, antiseptics, saline laxatives, chelating agents
The ED
dose producing therapeutic response in 50% of population (standard dose)nurses can adjust based off of the ED TERM 82
the larger the therapeutic
index:
DEFINITION 82 the safer the drug TERM 83
drug drug interactions
DEFINITION 83 can occur whenever a patient takes more than one drugpatients frequently take more than one drug (polypharmacy) TERM 84
consequences of drug drug effects
DEFINITION 84 increased therapeutic effectsincreased adverse effectsreduction of effects therapeutic or adversecreation of a unique response TERM 85
4 basic mechanisms that drugs interact
through
DEFINITION 85 direct chemical or physical interactionspharmacokinetic interactionpharmacodynamic interactioncombined toxicity
pharmacodynamic interactions that occur at
separate sites may be:
potentiativeorinhibitory TERM 92
the risk for serious drug interaction is directly
proportional to:
DEFINITION 92 significantly impact the outcome of therapy TERM 93
grapefruit juice effect
DEFINITION 93 inhibits the metabolism of certain drugs using CYP3A isoenzymesRaises the drugs' blood levels
