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265 Cards in this Set
- Front
- Back
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What is pharmacology?
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the study of drugs and their interactions with living systems
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Drug
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any chemical that can affect living processes
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Which scientific disciplines does pharmacology draw from?
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anatomy, physiology, chemistry, microbiology, psychology
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Pharmacology
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the study of the physical and chemical properties of drugs as well as their biochemical and physiologic effects
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Clinical pharmacology
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the study of drugs in humans (patients as well as volunteers)
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therapeutics
(aka pharmotherapeutics) |
the use of drugs to diagnose, prevent, or treat disease or to treat pregnancy
(the medical use of drugs) |
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Properties of an ideal drug
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effective, safe, selective
(also reversible, predictable, easy to administer, free from drug interactions, chemically stable, & having a simple generic name) |
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effectiveness
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An effective drug elicits the responses for which it is given (most important property a drug can have).
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safety
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A safe drug cannot produce harmful effects (There is no such thing as a safe drug).
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selectivity
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A selective drug elicits only the response for which it is given--no side effects. (All medications cause side effects.)
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Reversibility
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In most cases, we want drug actions to subside within an appropriate time.
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Predictability
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Since each patient is unique, we cannot know with certainty how a given patient will respond.
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Ease of administration
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An ideal drug should be easy to take (convenient route, low # of daily doses).
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Freedom from Drug Interactions
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An ideal drug would not interact with other drugs.
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The objective of drug therapy
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to provide maximum benefit with minimum harm
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Intensity of response to a drug is determined by...
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the concentration of a drug at its sites of action.
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Pharmacokinetics
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the impact of the body on drugs
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What are the 4 major pharmacokinetic processes?
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1) drug absorption
2) drug distribution 3) drug metabolism 4) drug excretion (ADME) |
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Pharmacodynamics
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the impact of drugs on the body
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Sources of Individual Variation (in a patient's response to a drug)
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drug interactions, physiologic variables (eg age, gender, weight), pathologic variables (esp. diminished function of the kidneys and liver), genetic factors
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Reversibility
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In most cases, we want drug actions to subside within an appropriate time.
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Predictability
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Since each patient is unique, we cannot know with certainty how a given patient will respond.
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Ease of administration
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An ideal drug should be easy to take (convenient route, low # of daily doses).
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Freedom from Drug Interactions
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An ideal drug would not interact with other drugs.
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The objective of drug therapy
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to provide maximum benefit with minimum harm
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Intensity of response to a drug is determined by...
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the concentration of a drug at its sites of action.
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Pharmacokinetics
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the impact of the body on drugs
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What are the 4 major pharmacokinetic processes?
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1) drug absorption
2) drug distribution 3) drug metabolism 4) drug excretion (ADME) |
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Pharmacodynamics
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the impact of drugs on the body
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Sources of Individual Variation (in a patient's response to a drug)
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drug interactions, physiologic variables (eg age, gender, weight), pathologic variables (esp. diminished function of the kidneys and liver), genetic factors
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What are the major organs of drug elimination?
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Kidneys, liver
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Five Rights of Drug Administration
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right drug, right patient, right dose, right route, right time
[also right documentation and right indication (reason)] |
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How to verify "right patient"?
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Name, D.O.B., MA #, check for allergies!
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Why is the nurse's role in drug administration so important?
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The nurse is the patient's last line of defense against medication errors.
(And only link in chain that doesn't have someone after to catch errors) |
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How to identify patients who are at high risk of reacting adversely to drug therapy?
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patient history, physical examination, laboratory data
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basic guidelines to help ensure correct administration
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Read medication order carefully
Verify identity of the patient Verify identity of drug, amount of drug, and suitability of administration route Verify dosage calculation. Don't administer any drug if you don't understand the reason for its route. |
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Tx
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treatment
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Adherence
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the extent to which a patient's behavior coincides with medical advice
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How can patient adherence be promoted?
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by educating patients
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How to reduce the incidence and intensity of adverse drug interactions?
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take a thorough drug history, advise the patient to avoid OTC drugs, monitor for adverse interactions known to occur
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2 things a nurse needs to know when implementing a PRN order
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1. the reason for the drug use
2. the client's medication needs |
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How to minimize a drug's harm?
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know the early signs of toxicity and how to manage the toxicity
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What info must you give a pt. when educating about medications?
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drug name & therapeutic category, dosage size, dosage schedule, route & technique of admin., expected therapeutic response & when it should develop, nondrug measures to enhance treatment, duration of treatment, method of drug storage, symptoms of major side effects & how to minimize discomfort & harm, whom to contact if sth. goes wrong
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How to collect data during a preadministration assessment?
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interview pt. & family, observe pt., perform physical exam., laboratory tests, patient's medical & drug histories
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Factors affecting pt.'s capacity for self care
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reduced visual acuity, limited manual dexterity, limited intellectual ability, severe mental illness, cultural attitudes toward drugs, conviction that drug is not needed, lack of $
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Implementation of the care plan in drug therapy
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1 ) drug administration
2) patient education 3) interventions to promote therapeutic effects 4) interventions to minimize adverse effects |
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Goals of preadministration assessment
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1. evaluation of therapeutic and adverse effects
2. identification of high-risk patients 3. assessment of the patient's capacity for self-care |
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Evaluation stage of drug therapy.
What is evaluated? |
1. Therapeutic responses
2. Adverse reactions & interactions 3. Patient adherence 4. Patient satisfaction w/ treatment |
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Federal Pure Food and Drug Act of 1906
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req'd that drugs be free of adulterants
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Food, Drug, and Cosmetic Act (1938)
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req'd that all new drugs undergo testing for toxicity
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Harris-Kefauver Amendments (1962)
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req'd that drugs be proved effective before marketing
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Controlled Substances Act (1970)
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Set rules for drugs that could be abused: 5 categories--Schedules I (no medical use--high abuse potential), II, III, IV, V
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Preclinical Testing
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testing done on animals (this phase takes 1-5 years)
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Duration & Phases of Clinical Testing?
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May take 2-10 years.
4 phases (I-healthy volunteers, II & III-500 to 5000 patients, IV-postmarketing surveillance) |
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Why were women not used for testing of drugs until recently?
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Concern for fetal safety.
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What % of drugs that reach market have serious adverse effects not detected during the testing phases?
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about half
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Why aren't all adverse effects detected before a drug's release?
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1-small sample of patients
2-patients don't represent all types who will take drug 3-trial pt.s take drug for a short time |
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What's a good policy for clinicians who are considering prescribing a new drug?
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Be neither the first to adopt the new nor the last to abandon the old.
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What 3 types of names do drugs have?
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1. chemical
2. generic (nonproprietary) 3. trade (proprietary) |
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What do the final syllables of a drug's generic name typically represent?
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the drug's pharmacologic class (eg "-cillin" endings belong to the penicillin class of antibiotics)
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What are some of the problems that trade names pose?
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1. A single drug can have multiple trade names.
2. OTC products with the same trade name may have diff. ingredients. 3. Can endanger international travelers. |
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Are generic drugs therapeutically equivalent to their brand name counterparts?
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Yes-only concern is with rate and extent of absorption.
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absorption
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the movement of a drug from its site of administration into the blood
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distribution
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drug movement from the blood to the interstitial space of tissues and then into cells
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Metabolism (biotransformation)
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enzymatically mediated alteration of drug structure
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excretion
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the movement of drugs and their metabolites out of the body
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How can one achieve drug concentrations high enough to elicit desired responses while avoiding concentrations that are too high?
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Choose most appropriate route, dosage, and dosing schedule.
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3 ways drugs can cross cell membranes
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1. through channels or pores
2. with the aid of a transport system 3. direct penetration of the membrane itself (MOST common) |
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What does P-glycoprotein do?
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Transports a wide variety of drugs OUT of cells.
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A general rule in chemistry says that LIKE dissolves ____
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LIKE
(Polar compounds don't dissolve in nonpolar solvents) |
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Rate of absorption determines...
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how SOON effects will begin
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Amount of absorption determines...
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how INTENSE effects will be
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Name 5 factors that affect drug absorption.
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1. rate at which drug dissolves 2. Surface area available for absorption 3. Blood flow 4. highly lipid-soluble drugs 5. pH leads to ionizing
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Principal parenteral routes
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intravenous, subcutaneous, intramuscular
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ADME
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absorption
distribution metabolism excretion |
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Absorption is...
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the movement of a drug from its site of administration into the blood
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Distribution is...
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drug movement from the blood to the interstitial space of tissues and from there into cells
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Metabolism (biotransformation) is...
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enzymatically mediated alteration of drug structure
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Excretion is...
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the movement of drugs and their metabolites out of the body
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The intensity of the response to a drug is directly related to...
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the concentration of the drug at its site of action.
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Appropriate drug concentrations are achieved by selecting most appropriate...
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route
dosage dosing schedule |
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3 most important ways by which drugs cross cell membranes
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1) channels or pores
2) aid of a transport system 3) direct penetration of membrane |
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Most common way drugs cross cell membranes
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direct penetration of the membrane
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role of P-glycoprotein
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a transmembrane protein that transports a wide variety of drugs OUT of cells (stopper)
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Organs where P-glycoprotein is found
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liver, kidney, placenta, intestine, capillaries of the brain
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The RATE of absorption determines...
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how SOON effects will begin.
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The AMOUNT of absorption determines...
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how INTENSE effects will be.
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Factors affecting drug absorption (5)
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rate of dissolution
surface area available for absorption blood flow (^) lipid solubility (^) pH partitioning (^ when drug molecules have a greater tendency to be ionized in the plasma) |
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Preferred route of drug admin.
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PO (oral)
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Most drug metabolism takes place here:
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liver
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hepatic microsomal enzyme system
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aka P450 system
Performs most of the drug metabolism in the liver |
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3 cytochrome P450 families that metabolize drugs
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CYP1, CYP2, CYP3
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first-pass effect
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the rapid hepatic inactivation of certain oral drugs
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Most important organ for drug excretion
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the kidney
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Steps in Renal Drug Excretion
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1) glomerular filtration
2) passive tubular reabsorption 3) active tubular secretion |
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Drugs that are lipid soluble undergo passive reabsorption from the renal tubule back into...
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the blood.
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Minimum Effective Concentration
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the plasma drug level below which therapeutic effects will not occur
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Toxic Concentration
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the plasma level at which toxic effects begin
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Therapeutic Range
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the range between MEC and toxic contentration--the objective of drug dosing is to maintain plasma drug levels within the therapeutic range
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drug half-life
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the time required for the amount of drug in the body to decrease by 50%
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When a drug is administered repeatedly in the same dose, plateau will be reached in _____________.
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4 half lives
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Highest level achieved when a drug is administered repeatedly--
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peak concentration
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Lowest level reached when a drug is administered repeatedly--
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trough concentration
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3 techniques to reduce fluctuations in drug levels (btw peaks and troughs)
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1) admin. by continuous infusion
2) admin. a depot preparation 3) reduce of dose and dosing interval (same TOTAL amount, just administered more often) |
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pharmacodynamics
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what drugs do to the body and how they do it
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Goal--to match intensity of drug response to...
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the patient's needs (highest efficacy not always the best)
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maximal efficacy
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the largest effect that a drug can produce (regardless of dose)
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potency
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amount of drug we must give to elicit an effect (rarely an important characteristic)
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receptor
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any functional macromolecule in a cell to which a drug binds to produce its effects
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A drug cannot make the body do anything it is not already capable of doing. It can only...
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alter the rate of preexisting processes.
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Selective drug action is possible because...
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drugs act through specific receptors
(like a lock & key, only those drugs with the proper size, shape, & phys. prop.s can bind to a particular receptor) |
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affinity
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the strength of the attraction between a drug and its receptor
(^ affinity = ^ potency) |
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intrinsic activity
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the ability of a drug to activate a receptor upon binding
(^ intrinsic activity = ^ maximal efficacy) |
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Drugs that mimic the body's own regulatory molecules are called __________.
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agonists (acts like)
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Drugs that block the actions of endogenous regulators are called __________.
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antagonists (block)
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Agonists __________ receptors.
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activate
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Antagonists __________ receptor ______________.
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prevent, activation
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Irreversible binding
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Non-competitive antagonists do this, reducing total # of receptors available for activation by an agonist. (relatively rare)
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Reversible binding
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Competitive antagonists bind at a receptor site
If affinity is =, concentration determines which gets the receptor. |
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When receptors are continually exposed to an agonist, the cell becomes...
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less responsive (desensitized, refractory)
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When receptors are continually exposed to an antagonist, the cell becomes...
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more responsive (hypersensitive)
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Common examples of "receptorless" drugs
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antacids, antiseptics, saline laxitives (work through simple physical or chemical interactions w/ other molecules)
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ED 50
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an abbreviation for average effective dose--dose required to produce a defined therapeutic response in 50% of the population
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Therapeutic Index
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ratio of a drug's LD 50 to its ED 50
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LD 50
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average lethal dose--the dose that is lethal to 50% of the animals treated
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Drug Interactions can be intended and _____ or unintended and _______
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desired
undesired |
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potentiative interaction
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when one drug intensifies the effects of the other (may be beneficial or detrimental)
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inhibitory interaction
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result in reduced drug effects (can be beneficial or detrimental)
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Never combine 2 or more drugs in the same container unless..
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it has been established that a direct interaction will not occur
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2 types of pharmacodynamic interactions
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1) drugs acting at the same receptor (INHIBITORY)
2) drugs acting at separate sites (POTENTIATIVE or INHIBITORY) |
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Rule for drugs with overlapping toxicity
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Do not use together (Tylenol and alcohol, eg)
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polypharmacy
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10 drugs or more being taken concurrently
(^ risk of serious drug interaction) |
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Food frequently ______ the rate of drug absorption, and occasionally ________ the extent of absorption.
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decreases
decreases OR increases |
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High fiber foods--effect on absorption of some drugs
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reduced
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Grapefruit Juice _____ the metabolism of many drugs, thereby _______ the amount available for absorption.
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inhibits/decreases
increasing/raising |
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MAO inhibitors are a family of ____________ that should not be combined with _______________.
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antidepressants
aged cheeses, yeast extracts, Chianti wines |
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"on an empty stomach" means...
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either 1 hour befor a meal or 2 hours after
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St. John's Wort has the _____ effect on drugs as grapefruit juice
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opposite (reduced therapeutic effects)
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ADR
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adverse drug reaction--any noxious, unintended, and undesired effect that occurs at normal drug doses
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Mild ADRs include
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drowsiness, itching, nausea, rash
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Severe ADRs include
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cardiac dysrhythmias, anaphylaxis, and hemorrhage
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Adverse effects are most common in...
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elderly and very young
(severe illness ^ risk) |
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side effect
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a nearly unavoidable secondary drug effect produced at therapeutic doses (anticipated)
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toxicity
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an adverse drug reaction caused by excessive dosing
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allergic reaction
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an immune response--must be prior sensitization of the immune system (mild itching to anaphylaxis)
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anaphylaxis
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a life-threatening response characterized by bronchospasm, laryngeal edema, and a precipitous drop in BP
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idiosyncratic effect
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an uncommon drug response resulting from a genetic predisposition
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iatrogenic disease
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a disease produced by drugs
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physical dependence
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a state in which the body has adapted to drug exposure in such a way that abstinence syndrome will result if drug use is discontinued
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carcinogenic effect
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ability of certain medications and environmental chemicals to cause cancers (including several of the drugs used to TREAT cancer!)
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teratogenic effect
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a drug inducing a birth defect
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Patients taking hepatoxic drugs should
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undergo liver function tests(LFTs) baseline & periodically; watch for jaundice, dark urine, light-colored stools, etc)
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MEDWATCH
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an FDA program that records any new adverse effects of drugs
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MedGuides
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FDA-approved documents to educate patients on minimizing harm from drugs that could be dangerous
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3 most common types of fatal medication errors
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1. overdose
2. wrong drug 3. wrong route |
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medication error
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any preventable event that may cause or lead to inappropriate medication use or patient harm
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boxed warning
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strongest safety warning a drug can carry and still remain on the market
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3 categories that account for 90% of all fatal medication errors
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performance errors (eg wrong route)
knowledge deficits miscalculation of dosage |
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What causes individual variation in drug responses?
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body weight/size/composition, age, pathophysiology (esp. kidney, liver, electrolyte status), tolerance, genetics, gender, race, drug interactions, diet, lack of adherence
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Effects of kidney disease on drugs
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reduced drug excretion, increased drug accumulation in body
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Effects of liver disease on drugs
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increased drug accumulation in body
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Pharmacodynamic Tolerance
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tolerance resulting from adaptive processes that occur in response to chronic receptor occupation
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Metabolic Tolerance
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results from accelerated drug metabolism
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Elderly patients have a _____ rate of drug absorption, so drug responses may be ______________
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slower
delayed |
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4 major factors altering drug distribution in the elderly.
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1. increased body fat
2. decreased lean body mass 3. decreased body water 4. reduced serum albumin |
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Hepatic drug metabolism in elderly
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decreased, longer drug half-lives, prolonged effects
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excretion in elderly
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renal function declines --> DRUG ACCUMULATION--most important cause of adverse drug reactions in the elderly
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Factors leading to poor adherence in the elderly
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*conviction that drug isn't really necessary
*multiple chronic disorders & prescriptions & doses *difficult packaging *living alone, *$, *side effects |
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chemotherapy
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the use of chemicals against invading organisms (in treatment of cancer or infection)
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anitibiotic
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a chemical that is produced by one microbe and has the ability to harm another microbe
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antimicrobial drug
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any agent, natural or synthetic, that has the ability to kill or suppress microorganisms
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selective toxicity
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the ability of a drug to injure a target cell or target organism without injuring other cells or organisms that are in intimate contact with the target
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How is selective toxicity achieved against bacterial pathogens?
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1. disruption of bacterial cell wall (weaken rigid cell wall, promoting lysis)
2. inhibition of an enzyme unique to bacteria (eg folic acid producing enzyme) 3. disruption of bacterial protein synthesis |
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narrow spectrum antibiotics
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active against only a few species of microorganisms
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broad spectrum antibiotics
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active against a wide variety of microbes
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3 major groups of antimicrobial drugs
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antibacterial, antifungal, antiviral
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4 ways microbes resist drugs
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1. decrease concentration of drug at site of action
2. alter structure of drug target molecules 3. produce a drug antagonist 4. cause drug inactivation (drug-metabolizing enzymes) |
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Microbes acquire restistance via...
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spontaneous mutation OR conjugation
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conjugation
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a process by which extrachromosomal DNA is transferred from one bacterium to another (thus conferring resistance)
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How does antibiotic use promote emergence of drug-resistant microbes?
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Makes conditions favorable for overgrowth of microbes that have acquired mechanisms for resistance
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Which antibiotics promote drug resistance?
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Broad-spectrum drugs do the most to facilitate emergence of resistance
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Nosocomial infection is the ___ leading cause of death in the US
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6th
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Suprainfection
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a NEW ifection that appears during the course of treatment for a primary infection (normal flora eliminated, allowing new infection to flourish)
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12 steps to prevent antimicrobial resistance among hospitalized adults
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1. vaccinate, 2. get the catheters out, 3. target the pathogen,
4. access the experts, 5. antimicrobial control, 6. use local data, 7. treat infection, not contamination, 8. treat infection, not colonization, 9. say "no" to vanco, 10. stop treatment when cured, 11. isolate the pathogen, 12. break the contagion chain |
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Vaccination prevents _________
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infection
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Catheters/invasive devices are the leading exogenous causes of ___________
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nosocomial infections
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Contamination of culture samples leads to
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false positive results on bacteriological tests
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When to use vancomycin
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only when clearly necessary (in order to delay emergence of vanco resistant organisms)
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3 factors to consider when choosing an antibiotic.
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1. identity of infecting organism
2. drug sensitivity of infecting organism 3. host factors (site of infection, status of host defenses) |
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First rule of antimicrobial therapy
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Match the drug with the bug
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Do drugs cure infection on their own?
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No, they work in concert with host defense systems to subdue infection.
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Do antimicrobial drugs pose a threat to the fetus?
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Yes, they can cross the placenta and do harm.
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What level of drug concentration is desirable?
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Equal to or greater than the MIC (often 4 to 8 times MIC is best)
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Why shouldn't you discontinue antibiotics prematurely?
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Recurrent infection, with relapse of more drug resistant organisms.
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additive antibiotic response
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combined effect = sum of separate effects
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potentiative antibiotic response
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combined effect is greater than sum of separate effects
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antagonistic antibiotic response
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combined effect is less than sum of separate effects
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indications for prophylactic use of antimicrobial drugs
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surgery (certain kinds/given beforehand), bacterial endocarditis (prosthetic heart valves), neutropenia, recurrent UTIs
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Misuses of antimicrobial drugs
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Attempted treatment of untreatable infection (eg viral), treatment of FUO, improper dosage, treatment w/o proper bacteriological info, omission of surgical drainage
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Insulin aspart
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an analog of human insulin with rapid onset (10-20 min) and short duration (3-5 hr), Rx only
Given 5-10 min a.c. Route: subQ (injection or infusion), IV (emergencies only) Appearance: clear |
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Insuline glargine
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delayed onset (70 min)
prolonged duration (at least 24 hrs) given once daily (same time) modified human insulin (HA) Route: subQ only Rx, clear appearance not to be combined with other insulins |
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Insuline NPH
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a human insulin with protamine (a protein that retards absorption)
delayed onset (60-120 min) extended duration (16-24 hr) given 2ce daily (gently agitate before use) only insulin that may be mixed with shorter-acting insulins Route: subQ Appearance: cloudy |
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regular insulin (aka "natural" or "native" insulin)
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the form of insulin made by the human pancreas (human insulin)
Absorption is slower acting (onset 30-60 min) w/ duration of 5-10 hrs. Appearance--clear Available OTC (U-100) Route: subQ (injection or infusion), IM (rare), oral inhalation (not currently used), IV (off-label, emergencies only) |
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Site of normal insulin synthesis
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Pancreas (by Beta cells within the islets of Langerhans)
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Why is insulin released?
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Due to a rise in blood glucose (eg after a meal)
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What does insulin do?
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anabolic--promotes conservation of energy and buildup of energy stores (glycogen--liver's way of storing for later use) Promotes cellular uptake of glucose
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Why are short duration (rapid acting) insulins given?
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In association with meals to control the postprandial rise in blood glucose.
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How are short duration insulins administered?
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sub-Q (or IV)
clear solution |
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What administration method is acceptable for all forms of insulin?
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subQ (the usual route)
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Who uses insulin?
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People with diabetes mellitus.
All type 1 patients. 40% of type 2 patients. |
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Can one overdose with insulin?
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Yes, this can cause severe hypoglycemia.
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How should severe hypoglycemia be treated?
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Preferred-IV glucose
Otherwise-glucagon |
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glucagon
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a polypeptide hormone of the pancreas that has the opposite effects of insulin on carb. metabolism (promotes breakdown of glycogen to glucose, raising blood glucose levels)
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How is glucagon administered?
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parenterally -- IM, SubQ, IV
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Penicillin G
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first penicillin available, active against gram-positive bacteria (most gram-neg bac are resistant)
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Penicillin G is the drug of first choice for which infections?
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Pneumonia, meningitis (et alli)
(sensitive to gram-positive cocci) |
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Penicillin G is a ________-spectrum agent.
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narrow
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Penicillin G is available in 3 ____ and is usually administered __________.
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salts; IM
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Which form of penicillin G may be given IV?
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Potassium penicillin
(large doses administered IV can result in hyperkalemia & possible dysrythmias or cardiac arrest) |
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Toxicity level of Penicillin G?
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It is the least toxic of all antibiotics.
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Penicillin as an allergen?
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Penicillins are the most common cause of drug allergy.
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How to treat anaphylaxis?
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epinephrine (+ respiratory support)
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Penicillins should not be co-administered with ___________.
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aminoglycosides
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ampicillin
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the first broad-spectrum penicillin in clinical use; has an increased ability to penetrate the gram-negative cell envelope (broad spectrum)
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How is ampicillin to be administered?
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oral or IV
(for oral amoxicillin is preferred--more acid stable) |
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sulbactam
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a beta-lactamase inhibitor (extends the antimicrobial spectrum of a penicillinase-sensitive penicillin)
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Unasyn
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Ampicillin/sulbactam
administered IV (a broad-spectrum penicillin) |
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Penicillin and high-risk patients
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Patients with a history of SEVERE allergic reactions to penicillin should receive penicillin with EXTREME CAUTIION, if at all
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Doses for penicillin G are given in...
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units (1 unit = 0.6 mg)
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Doses for all penicillins other than penicillin G are prescribed in...
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mL
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During IM injection, aspirate to avoid...
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injection into an artery
(Take care to avoid injection into a nerve) |
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Whenever a parenteral penicillin is used, keep the patient under observation for
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at least 30 minutes.
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If, in the rare case, a pt w/ penicillin allergy requires penicillin,
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it should be given acc. to a desensitization schedule
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High doses of IV potassium penicillin G may cause
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hyperkalemia
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Penicillins can accumulate to harmful levels if...
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renal function is severely impaired.
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What is the only longer acting insulin that may be mixed with short-acting insulins?
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NPH
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When mixing insulins, which should be drawn into syringe first?
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short-acting insulin
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MIC
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Minimum Inhibatory Concentration--the lowest concentration needed to completely supress bacterial growth
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MBC
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Minimum Bactericidal Concentration--the concentration that decreases the # of bacterial colonies by 99.9%
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Clinical Manifestations of Diabetes
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polyuria, polydipsia, polyphagia, weight loss
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Usual sites of subQ insulin injection
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abdomen, upper arm, thigh
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Store unopened vials of insulin in ____________
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the refrigerator.
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Opened vials can be stored at room temp for ____________
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1 month (no direct sunlight or extreme heat)
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Dosing goal of insulin
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Maintain blood glucose levels within an acceptable range
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When should a typical diabetic measure blood glucose?
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Before meals and at bedtime
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potential causes of hypoglycemia
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insulin overdose, reduced food intake, vomiting, diarrhea, excessive alcohol intake, unaccustomed excercise, termination of pregnancy
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Early signs & symptoms of hypoglycemia
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tachycardia, palpitations, sweating, nervousness, headache, confusion, drowsiness, fatigue
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penicillins are active ONLY against bacteria that are...
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undergrowing growth and division
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PBPs
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penicillin binding proteins
(a bacterial defense mechanism) |
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Ampicillin is useful against which infections?
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Enterococcus faecalis, Proteus mirabilis, E. coli, Salmonella spp., Shigella organisms, and H. influenzae
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Most common side effects of ampicillin
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rash & diarrhea
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Diabetes is primarily a disorder of __________ metabolism
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carbohydrate
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Over time, hyperglycemia can lead to:
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hypertension, heart disease, renal failure, blindness, neuropathy, amputations, stroke
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The onset of symptoms is usually abrupt in Type __ Diabetes.
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Type 1
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In type 1 diabetes, which cells are destroyed?
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pancreatic beta cells
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When hyperglycemia becomes severe and is allowed to persist, what condition develops?
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ketoacidosis
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What symptom is diagnostic of diabetes?
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excessive plasma glucose
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What plasma glucose level suggests diabetes?
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200 mg/dL or higher
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Levels of A1c reflect...
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average blood glucose levels over the previous 2 to 3 months
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People with "prediabetes" are at risk for developing...
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type 2 diabetes and CVD
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standard method for day-to-day monitoring of glucose levels
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SMBG (self-measurement of blood glucose)
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tight glucose control
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maintaining glucose levels within normal range around the clock (difficult to achieve, but greatly reduces morbidity and mortality)
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Responsibility for managing diabetes rests with...
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the patient.
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If hypoglycemia is allowed to persist,
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irreversible brain damage or even death may result.
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embolism
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blood vessel blockage at a site distant from the point of (IV) administration
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