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156 Cards in this Set
- Front
- Back
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adverse drug reaction
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an undesirable response to a drug by a patient - may vary in severity from mild to fatal
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agonist
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a drug that brings about a specific action by binding with the appropriate receptor
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compounding
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any manipulation performed to produce a dosage-form drug, other than the manipulations described in the directions for use on the labeling of a drug
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drug
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a substance used to diagnose, prevent, or treat disease
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efficacy
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the extent to which a drug causes the intended effects in a patient
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extralabel use
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the use of a drug that is not specifically listed on the FDA approved label
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half-life
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the amount of time (usually expressed in hours) that it takes for the quantity of a drug in the body to be reduced by 50%
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manufacturing
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the bulk production of drugs for resale outside of the veterinarian-client-patient relationship
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metabolism
(biotransformation) |
the biochemical process that alters a drug from an active form to a form that is inactive or that can be eliminated from the body
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parenteral
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the route of administration of injectable drugs
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prescription drug
(legend drug) |
a drug that is limited to use under the supervision of a veterinarian because of potential danger, difficulty of administration, etc.
"Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian" |
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regimen
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a program for the administration a a drug that includes
-route -dose -frequency -duration |
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residue
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an amount of a drug still present in animal tissue or products (milk, meat, eggs) at a particular point (slaughter or collection)
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veterinarian-client-patient
relationship |
the set of circumstances that must exist between the veterinarian, the client, and the patient before the dispensing of prescription drugs is appropriate
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withdrawal time
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the length of time it takes for a drug to be eliminated from animal tissue or products after it is no longer used
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t 1/2
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abbreviation for half-life
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indications
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reasons for using a drug
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contraindications
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reasons for not using a drug
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pharmacokinetics
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what happens to drugs when they enter the body
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pharmacodynamics
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how drugs exert their effects
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important things techs need to know
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indications
contraindications pharmacokinetics pharmacodynamics toxicity proper labeling client education drug laws |
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toxicity
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how adverse drug reactions manifest themselves
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traditional drug soruces
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plants
minerals animals |
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methods used for drug selection
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diagnostic
empirical symptomatic |
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diagnostic method of drug selection
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involves assessment of a patient (history, PE, lab work, etc)
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empirical method of drug selection
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involves the use of practical experience of the doctor or other professionals to make an educated decision
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symptomatic method of drug selection
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method of choosing drugs based on signs that are presenting in the patient
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components of a regimen
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route
dosage frequency duration |
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components of vet-client-patient relationship
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vet has assumed responsibility, owner has agreed to listen
vet has seen the pet recently and knows enough to make a good diagnosis vet is available for follow-up care |
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over-the-counter drugs
(OTC) |
drugs that have a low potential for toxicity or do not require special administration; can be purchased without a prescription
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controlled substances
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drugs that have the potential for abuse or dependency
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technician responsibilities after a drug is selected
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ensure it is the correct drug
administering by correct route and correct time administering animal's reaction to the drug questioning any unclear orders making and applying labels recording info in record explaining properly to clients |
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five rights of drug administration
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right patient
right drug right dose right route right time |
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steady state
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the point at which drug accumulation rate equals drug elimination rate
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therapeutic drug monitoring
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monitoring drug levels in blood, urine, cerebrospinal fluid, etc. to help a vet monitor for appropriate levels
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factors that influence blood drug concentration levels
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rate of drug absorption
amount of drug absorbed distribution of the drug throughout the body drug metabolism or biotransformation rate and route of excretion |
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factors determining route of drug administration
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available forms of the drug
physical or chemical properties (irritation) of the drug speed of onset restraint / patient behavior considerations nature of the disease / condition |
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routes of administration
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oral
parenteral inhalation topical |
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oral medications
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not the quickest route
stomach has large absorption area and blood supply is affected by many factors NOT FOR ANIMALS WITH VOMITING OR DIARRHEA |
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parenteral medications
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medications that are injected; can go almost any route
produce most rapid onset of action should be administered slowly, often drugs are irritatiing to tissue oil-based drugs should not be givein this route |
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intramuscular vs intravenous
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parenteral method
one works faster and lasts longer, the other works quickly but lasts for a short duration |
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depot preparation
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when an injectable drug is placed into a substance that delays its absorption
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hypodermoclysis
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another name for subcutaneous
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sloughing of skin
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loss of surface skin; condition that can be caused by giving too much of an injectable drug or a drug outside the vein
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intraperitoneal
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injection of drugs into the abdomen
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intraarticular
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injection of drugs into a joint
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intraccardiac
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injection into the chambers of the heart; used for CPR / euthanasia
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intrathecal
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injection of a drug into the subdural space (cerebrospinal fluid)
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inhalation route
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converting a liquid med to a administration through gas form through a vaporizer or nebulizer
could expose you to drug |
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topical route
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administration by placing the drug on the skin or mucous membranes
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transdermal drug administration
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method of administering drugs through a patch applied to secrete the drug through the skin and into the blood in a slow, continuous manner
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bioavailability
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the degree to which a drug is absorbed and reaches the general circulation
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factors that may affect drug absorption
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*mechanism of absorption
*pH and ionization status of drug *absorptive surface area *blood supply to area *solubility of drug *dosage form *status of the GI tract *interaction with other meds |
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passive transport / absorption
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drug passes across cell membrane by simple diffusion from area of high --> low concentration
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active transport
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drug moves across cell membrane from an area of low --> high concentration
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non-ionized
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not + or - charged molecule
can often easily pass through cell membranes |
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cytochrome P-450 system
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system of enzymes in liver that break down drugs
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alkaline environment
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an environment in which basic drugs are absorbed more readily
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rate of absorption
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increases as the absorptive surface area of drug placement increases
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drug distribution
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the process by which a drug is carried from its site of absorption to its site of action
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path of drug movement
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absorption site
--> plasma in bloodstream --> plasma in insterstitial fluid surrounding cells --> into the cells where it combines with a receptor to create an action |
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concentration gradient
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the difference between the amounts of drug in two compartments
as the gradient increases (difference increases), so dose the tendency of the drug to move from high --> low concentration |
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what occurs to a drug in the plasma
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has a tendency to bind with various proteins (like albumin) or remain free
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drug that is bound to a protein
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is inactive and unavailable for binding with cell receptors or for metabolism
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"storage site" for a drug
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a drug that is bound to a protein, will eventually free itself
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low plasma protein levels
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can be due to malnutrition or disease states and can cause reduced plasma binding of drugs
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barriers
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devices that can exist in particular tissues to retard the movement of all or certain classes of drugs into them
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examples of barriers
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placenta
blood-brain barrier eye barrier |
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things that can interfere with drug distribution
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malnutrition and disease states (lack of plasma proteins)
body barriers (eye, blood-brain, placenta) |
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site of most biotranformation
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the liver, due to action of microsomal enzymes in the liver cells
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metabolite
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what a drug is called once it has been biotransfomed
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factors that can alter drug metabolism
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species
age nutritional status tissue storage health status |
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drug metabolism issues in cats
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animals that have limited ability to metabolize aspirin, narcotics, and barbiturates
due to reduced ability to form glucuronic acid |
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drug metabolism issues in the young
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have a poor ability to biotransform drugs because cytochrome P-450 system is not fully developed
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drug metabolism issues in the old
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have a decreased capacity to biotransform because ability to make liver enzymes needed is impaired
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drugs present in storage compartments (fat or plasma)
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drugs that are not available to be metabolized
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routes of drug excretion
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metabolized by liver and then eliminated by kidneys via urine (most common)
also: - liver (bile) - mammary glands - lungs - intestinal tract - sweat glands - salivary glands - skin |
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example of reduced drug excretion potentially reducing in toxic accumulation
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ketamine in cats with urinary obstruction; can cause serious CNS depression because the kidneys excrete the drug
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two principle mechanisms by which kidneys excrete drugs
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glomerular filtration
tubular secretion |
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glomerular filtration
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mechanism by which the kidneys excrete drugs
glomerulus filters metabolites out of the blood into glomerular filtrate which is elimiated as urine |
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components of a nephron
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glomerulus and its corresponding tubule
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tubular secretion
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mechanism in which kidneys eliminate drugs
kidney tubule cells secrete metabolites out of capillaries surrounding the tubule and into the filtrate which comes out as urine |
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tubular resabsorption
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can occur in some cases when drugs are reabsorbed through the glomerular filtrate and back into the blood
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liver excretion of drugs
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concentrates drugs into bile, eliminated by the small intestine (becomes part of feces)
could potentially be reabsorbed in the bloodstream |
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residues
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quantities of drugs that remain in animal products when they are consumed
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why residues are dangerous
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1. People may be allergic
2. Prolonged exposure could result in resistant bacteria 3. May cause cancer in humans |
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drugs that are excreted through the lungs
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convert easily between a gas and a liquid state
move out of the blood and into the alveoli to be expired |
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pharmacodynamics
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the study of the mechanisms by which drugs produce physiologic changes in the body
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lock-and-key model
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model explaining how drugs combine with certain cellular receptors to produce an effect
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affinity
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the tendency of a drug to combine with a receptor
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efficacy
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how well the drug binds with the receptor
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agonist
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a drug with a high level of affinity and efficacy that causes a specific action
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partial agonist
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a drug with low affinity and efficacy
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antagonist
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a drug that blocks another drug from combining with a receptor
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examples of drug effects
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stimulation, depression, irritation, cell death
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dose-response curve
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displays the body's relationship between the dose of a drug and the body's response
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what the dose-response cure shows
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that as a dose increases, an increase in response occurs until a maximum response or plateau is achieved
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potency
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the amount of a drug needed to produce a desired response
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efficacy
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representation of the degree to which a drug produces its desired response in a patient
once this level has been reached, INCREASING DOSE DOES NOT IMPROVE EFFECT |
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theraputic index
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the relationship between a drug's ability to achieve the desired effect and it's tendency to produce toxic effects
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LD 50
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the dose of a drug that is lethal to 50% of the animals in a dose-related trial
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low theraputic index
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drugs with a low margin of safety; must be administered with caution
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high theraputic index
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drugs with a high margin of safety; often can be administered easily
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adverse drug reaction
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undesirable response to a drug that can range from mild to life threatening
can range from mild dermatitis to anaphylactic shock |
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adverse drug reaction factors
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*drug characteristics
*quality or purity of drug *amount of drug used |
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photosensitivity
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result of drugs that cause changes in the skin that can make it very sensitive to light
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idiosyncratic drug reaction
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an unusual or unexpected response to a drug; reportable to the FDA
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drug interaction
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altered pharmacologic response to a drug that is caused by the presence of a second drug
can be beneficial or harmful normal drug response can be increased or decreased |
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components of a drug interaction
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object drug
(one being acted upon) precipitant drug (one that influences the other) |
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TIP
mixing drugs in syringes |
generally should be avoided unless drugs are known to be compatible
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TIP
drugs metabolized by the liver |
when two drugs are given at once, a reaction should be expected
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chemical name
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name that describes the molecular structure of a drug
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code or laboratory name
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name given to a drug by the R&D investigators
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compendial name
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name by which a drug is listed in the USP
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USP
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United States Pharmacopoeia
lists drugs and standards for quality and purity |
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official name
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usually the same as the compendial or generic name
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proprietary or trade name
"brand name" |
name chosen by the manufacturing company
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generic name
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common name chosen by the company, is not the exclusive right of the comany
could be same as official / compendial name drugs with patents that have expired |
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example of name catagories
KETAMINE |
Proprietary: Ketaset, Ketaject, Ketavet, Vetalar
Generic: Ketamine Compendial: Ketamine Chemical: 2-(o-chlorophenyl)-2-methyl-aminocyclohexanone Code/lab: CI-581 CI-369 |
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CVM
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Center for Veterinary Medicine
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CVM of FDA drug container label requirements
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1. Drug names (generic / trade)
2. Drug concentration / quantity 3. Name and addy of manuf. 4. Controlled substance status 5. Manuf. control / lot no. 6. Expiration date also instructions of use and side effects |
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Comprehensive Drug Abuse Prevention and Control Act of 1970
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act that allowed DEA to place drugs into categories or schedules according to their potential for abues
label must have a "C" followed by roman numeral of appropriate schedule, on upper R of label |
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NDC number
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not required by law but is a 10-digit number that identifies the manufacturer / distributor, drug formulation, and package size
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withdrawal time
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must be listed on drug label of drugs intended for animals that may be consumed by humans
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FDA
EPA USDA |
three agencies that regulate animal health products
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FARAD
(Food Animal Residue Avoidance Databank) |
project from USDA that is in charge of avoiding drug residues in food animals
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Animal Medicinal Drug Use Clarification Act (1994)
(AMDUCA) |
gave veterinarians ability to use drugs extralabel
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Veterinary Feed Directive (VFD)
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allows the FDA CVM greater control over feed additives
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Minor Use in Minor Species Animal Health Act (MUMS)
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act that allowed vets to use FDA approved drugs for less common species or indications
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why pharmacokinetics is important
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data received during testing helps determine dosage and frequency
tells what the fate of the drug is in the body |
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why dosage recommendations exist
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the drug needs to be at a required concentration, and over time less and less of the drug is available
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loading dose
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a large amount of drug initially administered to get the appropriate blood level of the drug reached quickly
subsequent doses will be lower |
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factors that influence blood concentration of a drug
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*rate of absorption
*amount absorbed *body distribution (where it ultimately goes) *biotransformation *route of excretion |
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what will occur if a drug is administered IM or SQ
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plasma concentration will rise during initial absorption then decreases as absorption is completed
eventually equilibrium will occur between plasma and peripheral components |
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when concentration of the drug decreases
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when elimination begins
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bioavailability
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the degree to which a drug is absorbed and reaches general circulation
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passive transport of drugs
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drugs go through pores in the cell membrane; involves no energy expenditure
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active transport of drugs
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drugs go through cell membranes using energy
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pinocytosis
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drug is engulfed by the cells
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factors of drug absorption
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size of drug
(most drugs relatively small) solubility (drugs stay in water phase or go to fatty areas) distribution |
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water soluble drugs
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drugs in which passive transport depends on the size of the drug molecule
most drugs are either lipid soluble or too large for this method of passage exceptions are caffeine and furosemide |
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lipid soluble drugs
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drugs in which passive transport is achieved by permeability within the lipid layer of the cell membrane
size is not usually a restrictive factor unless it is very large |
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nonionized =
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absorption =
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barriers to absorption
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blood-brain barrier
CSF barrier GI mucosa |
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area of the brain that does not have tight junctions
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area postrema
(vomiting center) if tight junctions were found here it would make monitoring difficult |
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components of total body water
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intracellular component
extracellular component (plasma and interstitial fluid) |
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ethyl alcohol
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commonly consumed drug that fully equilibrates with total body water
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mannitol
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drug that has huge molecules that does not enter cells and stays in the extracellular fluid
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what the distribution of drugs depends on
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what blood components the molecule attaches to
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albumin
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plasma protein that drugs are commonly bound to
only unbound drugs are diffused through capillary walls and used diminishes maximum intensity of the drug but increased duration of action |
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factors that affect protein binding
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*patient age
*temperature *pH of drug *amount of binding sites on protein itself |
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site of free drug elimination
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kidneys (free)
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protein bound drugs (elimination)
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can not pass through the glomerulus or tubules
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sites of biotransformation
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*liver
*pulmonary macrophages *plasma and blood cells (blood enzymes) *GI epithelium *kidneys |
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three consequences of biotransformation in the liver
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activation
maintenance of activity inactivation results in making the drug more water soluble than it was to start with |
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first pass effect
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phenomenon that occurs when some drugs taken orally begin biotransformation in the GI lumen
drug will enter portal circulation and go through the liver before it reaches general circulation diminishes effect of the drug |
