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158 Cards in this Set

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synergistic effect
a drug interaction that results from combined drug effects that are greater than those that could have been achieved if the drug were gived alone
substrate
a substance on which an eczyme acts
steady state
the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose
side effect
any undesirable effect of a medication that is expected or anticipated to occur in a predictable percentage of pt who recieve a given med
receptor
a molecular structure within or on the outer surface of cells receptors are characterized by the binding of specific substances
prodrug
an inactive drug dosage form that is converted to an active metabolite by various biochemical chemical reactions once inside the body
pharmacogenetics
the study of genetic factors and their influence on drug response
parent drug
the chemical form of a drug that is administered to the body before it is metabolized by the bodys biochemical reactions into its active or inactive metabolites
3 primary protiens that bind to and carry drugs
albumin, alpha-acid glycoprotein, corticosteroid-binding globulin
3 routes of administration
enteral, patenteral, topical
bioequivalent
two meds have the same bioavailability
pharmacodynamic phase
drug receptor interaction
pharmacokinetics
absorption, distribution,metabolism,excretion
pharmaceutical phase
disintegration of dosage form dissolution of drug
pharmaceutics,pharmacokinectics,pharmacodynamics describe what
the relationship between the dose of a drug give to a pt and the effectiveness of the drug in treating the pt's disease
metabolites
a chemical form of a drug that is the product of one or more biochemical metabolic reactions involving the parent drug.
med use process
the administration dispensing monitoring and prescribing of meds
medication misadventure
the broadest term for any undesirable medication related event in patient care that is usually iatrogenic in nature
incompatibility
reaction that occurs when two parenteral drugs or solutions are mixed together resulting in chemical deterioration of at least one of the drugs
idiosyncratic reaction
an abnormal and unexpected susceptibility to a medication other that an allergic reaction that is peculiar to an individual pt
latrogenic hazard
any potential or actual pt harm that is caused by errant actions of health care staff members
cytochrome p-450
general term for a wide variety of tissue enzymes that play a significant role in drug metabolism
contraindication
any condition including any current or recent drug therapy especially related to disease states or other pt characteristics that renders a particular form of treatment improper or undesirable
duration of action
the length of time that a drug concentration in the blood or tissues is suffecient to elicit a therapeutic response
toxicology
the study of poisions and unwanted responses to therapeutic agents
latrogenic response
unintentional adverse effects that are treatment induced
therapeutic index
the ratio between a drug's therapeutic benefit and it's toxic effects
pharmacotherapeutics types of therapy
acute,maintenance,supplemental,palliative,supportive,prophylactic,empiric
3 mechanisms of action in pharmacodynamics
receptor interactions,enzyme interactions,nonspecific interactions
once a drug is at the site of action what does it do
it can modify the rate at which the cells or tissues function
drug effect
the physiologic reaction of the body to the drug
drug action
the cellular processes involved in the drug and cell interaction
duration
the time a drug concentration is sufficient to elicit a therapeutic response
peak
time it takes for a drug to reach its maximum therapeutic response
onset
time it takes for the drug to elicit a therapeutic response
half life
the time it takes for one half of the original amount of a drug in the body to be removed
stimulating drug metabolism causes
diminished pharmocologic effects
delayed drug metabolism results in
accumulation of drugs prolonged action of the drug
factors that increase metabolism
fastacetylator,barbiturate,
rifampin therapy
metabolism is the biologic transformation of a drug into
an inactive metabolite,a more soluable compound, a more potent metabolite
drug metabolism or biotransformation
the biologic transformation of a drug into an inactive metabolite , a more soluable compound or a more potent metabolite
areas of rapid distribution
heart,liver,kidneys,brain
drug distribution
the transport of a drug in the body by the bloodstream to its site of action
topical routes
skin,eyes,ears,nose,lungs,vagina
parenteral routes
intravenous,im,subq,id,intrathecal,intraarticular
non first pass routes
aural,buccal,inhalation,intraarterial,im,intranasal,intraocular,intravaginal,intravenous,subq,sublingual,transdermal
first pass routes
hepatic artery,oral,portal vein,rectal
first pass effect
the metabolism of a drug and its passage from the live into the circulation
a drugs route of administration effects
the rate and extent of absorption of that drug
oral meds rely on - to break down drug for absorption
gastric, intestinal enzymes and ph
pharmacokinetics: absorption
the rate at which a drug leaves its site of administration and the extent to which absorption occurs
pharmacognosy
study of natural drug sources
pharmacotherapeutics
the use of drugs and the clinical indications for drugs to prevent and treat diseases
pharmacodynamics
the study of what the drug does to the body
4 phases of pharmacokinetics
absorption,distribution,metabolism,excretion
pharmacokinetics
the study of what the body does to drugs
pharmaceutics
the study of how various drug forms influence pharmacokinetic and pharmacodynamic activities
drug
any chemical that affects the physiologic processes of a living organism
nursing process
assessment dx planning implmentation, evaluation
trade name
drug has a registered trademark
chemical name
describes a drug's chemical composition and molecular structure
generic name
name given to a drug also called nonproprietary name
dissolution
process of how solid forms of drugs disintegrate in the gastrointestinal tract, become soluable and get absorbed into circulation
bioavailability
term used to quantify the extent of drug absorption
antagonist
drug binds to and inhibits the activity of one or more biochemical receptor types in the body resulting in inhibitory or antagonistic drug effects
antagonistic effect
a drug interaction that results in combined drug effects that are less that those that could be achieved if either drug were given alone
agonist
drug that binds to and stumulates the activity of one or more biochemical receptor types in the body resulting in stimulatory or agonstic drug effects
ADE adverse drug event
an injury caused by a medication or failure to administer an intended medication
additive effect
result of a drug interaction that occurs when two drugs with similar actions are given together. also called synergistic effect
med error
any preventable event that may cause or lead to inappropriate medication use or pt harm while the med is in the control of the health care professional pt or consumer
5 rights
rigth drug, right dose, right time, right route, right pt
drug order must contain 6 elements
pt name, date order written, name of med, dosage, route of delivery, signature of prescriber
drug polymorphism
variation in response to drug because of a pt's age, gender, size and body compostion
infusion time
total ml divided by ml/hr =infusion time then mulitply decimal by 60 to get minutes.
1 pt
500 ml
1 tsp
5 ml or zi
30ml
2 T
2 T
30 ml
gri
60/65 mg
gr xv
1g
Hgb
hemoglobin
HCT
hematocrit
BUN
blood, urea, nitrogen
BE
barium enema
T & C
type and crossmatch
N/C
nasal cannula
tid
3 times a day
bid
2 times a day
qid
four times a day
pc
after meals
ac
before meals
BRP
bathroom privilages
excretion of ped pt
kidneys immature affects glomerular filtration rate and tubular secretion decreased perfusion rate of the kidneys.
metabolism in ped pt.
liver immature
distribution in ped pt.
greater TBW means fat is decreased so decreased level of protein binding immature blood-brain barrier
drug
an chemical that affects the physiologic processes of a living organism
considerations in absorption in ped pt.
ph less acidic gastric emptying slow topical absorption faster IM faster and irregular
category x
fetal abnormalities reported and positive evidence of fetal risk in humans is available from studies should not be used in pregnant women
category D
possible fetal risk in humans reported consider benefits VS risk may in some cases warrant use
category C
adverse effects reported on animal fetuses. info on humans not avaioable.
category B
studies indicate no risk to animal fetus info on humans unavailable
category A
studies indicate no risk to human fetus
which stage of pregnancy is the greatest danger for drug induced development defects
first trimester
synergistic effect
a drug interaction that results from combined drug effects that could have been achieved if the drugs where given alone
substrate
a substance on which an enzyme acts
steady state
a physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose
expediteted drug approval
a hastening the usual IND approval process in response to public health threat
durham-humphrey amendment
the act of 1951 differentiated between prescription and otc drugs also which drugs could be refilled without a prescription
federal food and drug act
first fed law that attempted to protect the public from danger 1906
federal food, drug and cosmetic act
1938 act required drug manufactures to apply for an IND exemption for a safety review before marketing new drugs
harrison narcotic act
1914 established the legal term narcotic
sherley amendment
1912 prohibited labeling of med with false therapeutic claims intending to defraud the purchaser
kefauver-harris amendment
1962 required drug to be proved safe and effective before being approved
controlled substance act
1970 promotes research on drug abuse prevention education treatment rehabilitation and enhancement of law enforcement
orphaned drug act
1983 aid in the development of drugs for treatment of rare diseases
autonomy
self determination and ability to act on one's own
investigational new drug
drug not approved by the FDA but available for use in experiments to determine its safety and effects
2 types of ADR's
allergic and idiosyncratic
veracity
duty to tell the truth
nonmaleficence
the duty to do no harm to a client
justice
being fair or equal in one's actions
confidentiality
duty to respect privileged information about a pt. implications include not talking about a pt in public or outside the context of the health care setting
beneficence
the doing or active promotion of good implications include how the patient is best served
use of otc's may
delay effective treatment of more chronic disease states, delay treatment of serious life threating disorders, may relieve symptoms of a disorder but not the cause
stages of development
infant 0-1yr, toddler 1-3yr, preschooler 3-6yr, school age 6-12yr, adolescent 12-18yr, young adult 18-45yr, middle aged 45-65yr, older adult 65 and up
opioid drug withdrawl
peak period 1-3 days /duration 5-7days
opioids produce
analgesia, drowsiness, euphoria, tranquility, other mood alterations
commonly abused substances
opioids stimulants depressants alcohol nicotine
drug used for withdrawl of opioid
clondine, methadone
amphetamines, cocaine, methylphenidate are what
stimulants
effects that lead to abuse of stimulants
elevation of mood, reduction of fatigue, sense of incresed alertness, invigoration alertness
methylenedioxyamphetamine
love drug
methylendioxymethamphetamine
ecstasy
stimulant withdrawl
peak 1-3 days
duration 5*7days
signs of stimulant withdrawl
social withdrawl, psycomotor retardation, hypersomnia, hyperphagia
signs of symtoms withdrawl from stimulants
depression, suicidal thoughts and behaviors, paranoid delusions
depressants
drugs that relieve anxiety, irrability,tension
opioid signs of withdrawl
drug seeking, mydriasis, diaphoresis, rhinoorrhea, lacrimation diarrhea bp and pulse up
benzodiazepine and barbiturates are
depressants
flunitrazepam (rohypol)
roofies date rape drug used to enhance a herion high or to ease the coming down from a cocaine high
depressant withdrawl
peak period short acting agent 2-4 days.long acting agent 4-7 days
alcohol (ethanol)
CNS depression
flumazenil ( romazicon)
may be used to reverse the acute sedative effects of benzodiazepines
3 ethano withdrawl treatment durgs
diazepam ( valium ), lopazepam ( ativan ), disulfiram ( antabuse ).
releases epinephrine that creates physiologic stress rather that relaxation
nicotin
drug aids in cessation of smoking
bupropion ( zyban)
commission E monographs
comprehensive published herbal recommendations from the german equibalent of the us fda
legend drugs
meds not legally available without a prescription
phytochemical
the pharmacologically active ingredient in an herbal remedy
dietary supplement and health education act
1994 defines dietary supplements and provide the regulatory framwork for their sale.
opioid analgesic
synthetic pain-relieving substance that originated from the opium plant.
narcotic
any agent that produces insensibility or stupor
roofies
pills that are classified as benzodiazepines
amphetamines
drugs that stimulate the CNS
how opioids work
they block receptors in the cns blocking pain
stimulants work by
releasing biogenic amines form their storage sites in the nerve terminals main one is norepinephrine
how do benzodiazepines and barbiturates work
they increase the action of gamma-aminobutyric acid
drug order must contain 6 elements
pt name, date order written , name of med, dosage size frequency and doses, route of delivery, signature of prescriber