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50 Cards in this Set

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Pharmacokinetic
The study of drug movement throughout the body. (absorption, distribution, metabolism, excretion)
Absorption
the movement of a drug from its site of administration into the blood.
Distribution
The movement of drugs throughout the body
Metabolism
the enzymatic alteration of drug structure (aka biotransformation)
Excretion
the removal of drugs from the body
Pharmacodynamics
what drugs do to the body and how they do it. (the study of biochemical and physiological effects of drugs and the molecular mechanisms by which those effects are produced.)
Pharmacotherapeutics
the use of drugs to treat, prevent or diagnose disease or prevent pregnancy.
Indication
describes a valid reason to use a certain test, medication, procedure, or surgery.
Precaution
can be defined as a pre-existing condition that significantly increases the risk of an adverse reaction to a particular drug, but not to a degree that is life threatening.
Contraindication
pre-existing condition that precludes use of a particular drug under all but the most desperate circumstances.
Selectivity
a drug that elicits only the response for which it is given.
Med error
patient’s last line of defense is the nurse
6 rights of medication
1. Right patient
2. Right medication
3. Right dose
4. Right route
5. Right time
6. Right to refuse
Adverse reaction
(ADR )
is any noxious, unintended, and undesired effect that occurs at normal drug doses.
3 goals of preadministration assessment
i. Collecting base line data needed to evaluate therapeutic and adverse responses.
ii. Identify high risk patients
iii. Assessing patient’s capacity for self care
nursing process (Drugs)
a. preadministration assessment
b. Administer and dosage
c. Evaluate therapeutic response
d. Promote patient adherence
e. Implement nondrug measures
f. Minimize adverse effects
g. Minimize interactions
h. Making PRN decisions
i. Managing toxicity
Administration routes
Intravenous (IV)
Intramuscular (IM)
Subcutaneous (subQ)
Enteral
Oral (PO)
topically
transdermal
rectal
vaginal
direct injection into a specific site
How albumin could effect the level of a medication?
a. Drugs bind to the albumin in the blood stream. Albumin is a large protein and therefore does not leave the bloodstream. Therefore neither do the drugs that are bound to the albumin and the drug cannot reach their site of action. Drugs with the ability to bind to albumin can compete for a binding and as a result one drug can displace another, causing the free concentration of displaced drug to rise.
Half-life
the time required for the amount of drug in the body to decrease by 50%.
Dependence
a state in which the body has adapted to drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued.
Tolerance
decreased responsiveness to a drug as a result of repeated drug administration.
Therapeutic Index
determined using laboratory animals, is defined as the ratio of a drug's LD50 to its ED50. (The LD50, or average lethal dose, is the dose that is lethal to 50% of the animals treated.) A large (or high) therapeutic index indicates that a drug is relatively safe. Conversely, a small (or low) therapeutic index indicates that a drug is relatively unsafe.
Alpha 1 blocker
i. Alpha antagonists lower blood pressure by blocking alpha1 receptors on arterioles and veins, causing vasodilation.
ii. Overdose with an alpha-adrenergic agonist (eg, epinephrine) can produce hypertension secondary to excessive activation of alpha1 receptors on blood vessels. When this occurs, blood pressure can be lowered by reversing the vasoconstriction with an alpha-blocking agent.
Alpha 1 blockers Adverse reactions
1. Orthostatic hypotension
2. Reflex tachycardia
3. Nasal congestion
4. Inhibition of ejaculation
How Alpha 1 blockers work?
1. Relax radial muscle in iris causing pupil constriction
2. Dilation of arterioles in skin, viscera, mucous membranes
3. Dilation of veins
4. Relax prostate capsule
5. Inhibition of ejaculation
6. Contraction of trigone and sphincter of bladder
7. Decrease HTN due to dilation
What happens when Beta1 receptors are activated?
i. Increase HR, force of contraction, and velocity of impulse conduction through AV node
ii. Causes kidney to release renin
What happens when Alpha 1 receptors are activated?
i. Increased pupil size
ii. Constriction of arterioles in skin, viscera, mucous membranes
iii. Constrition of veins
iv. Contraction of prostate capsule
v. Ejaculation
vi. Contraction of trigone and sphincter of bladder
Atropine
Muscarinic antagonist
Prevents receptor activation by endogenous acetychloline
Selective blockade of muscarinic cholinergic receptors
Increases HR
Decreases secretion by exocrine glands (salivary, bronchial, sweat, acid-secreting stomach)
Relaxation of smooth muscle (bronchi, urinary bladder , GI tract
Mydriasis (dilation of pupil)
CNS excitation
What drugs can and cannot be taken with Atropine?
Antihistamines
Phenothiazine antipsychotics,
tricyclic antidepressants
Epinephrine
Principle transmitter released by the adrenal medulla
Prepares body for flight or fight
Only transmitter to activate beta2
Catecholamines
Cannot be taken orally
Have a brief duration of action
Cannot cross the blood brain barrier
Noncatecholamines
Have longer half lives
Can be given orally (do not undergo rapid degradation by MAO and COMT)
Less polar and able to cross blood brain barrier
Cardio selective Beta Blockers
Are preferred to nonselective in pts with diabetes and asthma
Adverse Reactions of Cardio selective Beta Blockers
Bradycardia
Reduced CO
Precipitation of HF
AV heart block
Rebound cardiac excitation
Adverse Reactions of non-selective Beta Blockers
Bronochoconstriction
Inhibition of glycogenolysis
Clonidine: Side effects.
Antihypertensive drug that acts within the CNS.
Drowsiness
Xerostoma
Rebound Hyperension
Avoid in pregnancy
constipation, impotence, gynecomastia, and adverse CNS effects (eg, vivid dreams, nightmares, anxiety, depression)
Sensitization
Exposure to an allergen that results in the development of hypersensitivity.
Idiosyncratic effects
an uncommon drug response resulting from a genetic predisposition.
Terbutaline
Noncatecholamine
Highly selective acting at beta 2 receptors only
High doses will activate beta 1 receptors as well
For: Asthma, delay preterm labor
Adverse: tremors; high doses = tachycardia,
Metoprolol
Cardio selective
Blockade of beta 1 receptor
reduces heart rate
force of contraction
conduction velocity through the AV node.
Metoprolol Adverse Reactions
bradycardia, reduced cardiac output, AV heart block, and rebound cardiac excitation following abrupt withdrawal.
Reserpine: Contraindications
Contradicted for pts with a history of depressive disorder
Metoprolol who should take it?
PTs w/ HTN, angina pectoris and prevention of MI
1906
the first us law passed to protect the public from altered drugs The Pure Food and Drug Act
1938
Mandate for testing of all drugs for harmful effects and accurate labeling.
1952
Clearer definition of prescription drugs, non-prescription, and drugs that cannot be refilled (narcoditics).
1962
Tightened controls over safety issues.
1970
categorized controlled substances on the basis of their relative potential for abuse.
1978
drug investigation process shortened to release drugs sooner to the public.
ALPHA 1 BLOCKERS (ANTAGONISTS) GENERALLY end in... Zosin God (Alpha) is # 1 (Alpha 1) and he hates sin (zosin)
memo