Ch. 1, 2 & 4 - Drug Action, Interaction, Regulation Flashcards
Dissolution
Dissolving of smaller particles in GI fluid before absorption
Pharmaceutical Phase
Drug becomes a solution through disintegration & dissolution in order to cross biologic membrane
Disintegration
Breakdown of tablet into smaller particles
Pharmacokinetics
Process of drug movement to achieve drug action
Absorption
Movement of drug particles from GI tract to body fluids
Absorption
Movement of drug particles from GI tract to body fluids…the primary factor affecting drug bioavailability…
Active Absorption
Type of absorption that requires a carrier such as an enzyme or protein to move drug against concentration gradient Requires energy
Pinocytosis
Type of absorption by which cells carry a drug across their membrane by engulfing the drug particles
First Pass Effect
Process by which the drug passes to the liver first AKA Hepatic First Pass
Bioavailability
Subcategory of absorption Percentage of the drug dose that reaches systemic circulation
Protein Binding Effect
A portion of a drug is bound to protein making it inactive & not available to receptors
Distribution
Process by which a drug becomes available to body fluids & tissues…influenced by blood flow, drug’s affinity to tissue & the protein binding effect…many drugs travel in blood stream via proteins (albumin, globulins)
Free Drug
A portion of a drug that remains unbound to protein making it active & able to cause a pharmacological response
Half life
Time is takes for half of the drug concentration to be eliminated
Metabolism
Process by which the body inactivates drugs or biotransforms drugs…liver is primary site for this
Excretion
Process by which the body eliminates drugs Main route is the kidneys (urine)
Pharmacodynamics
The study of the way drugs affect the body
Dose Response
Relationship between minimal versus the maximal amount of drug dose needed to produce result
Maximal Efficacy
Maximum drug effect
Peak of Action
Occurs when drug reaches it’s highest blood or plasma concentration
Onset of Action
Time it takes to reach minimum effective concentration (MEC) after drug is administered…the period of time between drug administration and the first indication the drug was effective
Duration of Action
Length of time the drug has a pharmacological effect
Time Response Curve
Chart that evaluates the 3 parameters of drug action: onset, peak & duration
Receptor Theory
The activity of many drugs is determined by the ability of the drug to bind to a specific receptor The better it fits at the receptor site, the more biologically active the drug is
Kinase-Linked Receptors
Ligand-binding domain for drug binding is on cell surface Drug activates enzyme inside cell
Ligand-Gated Ion Channels
Channel spans the cell membrane & opens allowing for flow of ions (primarily sodium & calcium)
G Protein-Coupled Receptor Systems
Three components: the receptor, G protein that binds with guanosine triphosphate (GTP) & the effector (enzyme or ion channel)
Ligand-Binding Domain
Site on the receptor at which the drug binds
Nuclear Receptors
Receptors found in cell nucleus Activation through transcription factors is prolonged
Agonists
Drugs that produce response
Antagonists
Drugs that block a response
Nonspecific Drugs
Affect various sites
Nonselective Drugs
Affect various receptors
Therapeutic Index
Estimates margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose (ED) in 50% of people and the lethal dose (LD) in 50% of people The closer the ratio is to 1, the greater the danger for toxicity
Drug Actions
Stimulation/Depression Replacement Inhibition/Killing of Organisms Irritation
Therapeutic Range
Therapeutic Window Level of drug between the minimum effective concentration (MEC) in the plasma for obtaining desired drug action & the maximum toxic concentration (toxic effect)
Peak Drug Levels
Highest concentration of a drug in the plasma at a specific time Indicates rate of absorption
Trough Drug Levels
Lowest concentration of drug in the plasma at a specific time Indicates rate of elimination
Loading Dose
Large initial dose given to achieve a rapid MEC when immediate response is desired
Side Effects
Physiological effects not related to desired drug effects
Adverse Reactions
Range of untoward effects of drugs that cause mild to severe side effects More severe than side effects & always undesirable
Toxicity
Toxic effects When drug levels exceed therapeutic range
Pharmacogenetics
Scientific discipline of studying how the effect of drugs actions varies from a predicted drug response due to genetic or hereditary factors
Tachyphylaxis
Rapid decrease in response to the drug “Acute tolerance”
Tolerance
Decreased responsiveness to a drug over the course of therapy
Placebo Effect
Psychological benefit from a compound that may not have the chemical structure of drug effect
U.S. Food & Drug Administration (FDA)
Approves new drugs Develops bio markers & other scientific tools Streamlines clinical trials Ensures product safety
United States Pharmacopeia National Formulary (USPS-NF)
Current 3 volume authoritative source for drug standards Annual publication with 2 supplements
Controlled Substances
Drugs with potential for abuse Described in 5 schedules
Chemical Name
Drug name that describes it’s chemical structure
Generic Name
Drug’s official, nonproprietary name
Brand Name
Drug name chosen by the drug company that is usually trademarked & owned by that company
Drug Enforcement Agency (DEA)
U.S. sole legal drug enforcement agency that is part of the U.S. Department of Justice
Drug Interactions
Altered or modified action/effect of a drug as a result of interaction with one or multiple other drugs
Over-The-Counter (OTC) Drugs
Obtained without a prescription
Drug Incompatibility
Chemical or physical reaction that occurs among 2 or more drugs in vitro (outside the body)
Pharmacokinetic Interactions
Changes that occur in absorption, distribution, metabolism or excretion of a drug
Therapeutic Drug Monitoring (TDM)
Practice of checking serum drug levels Especially important for drugs with narrow therapeutic range & highly protein bound drugs
Pharmacodynamic Interactions
Interactions that result in additive, synergistic or antagonistic drug effects
Additive Effect
Occurs when 2 drugs with similar actions are administered result in a sum of effects
Synergistic Effect
Occurs when 1 drug has a potentiate effect on another Clinical effect is substantially greater than the combined effect of the 2 drugs
Antagonistic Effect
Occurs when 2 drugs given have opposite effects & cancel each other out
Common symptoms of drug-drug interaction
Nausea, GI upset, headache & dizziness
Drug-Food Interactions
Food can increase, decrease or delay drug absorption Food can bind with drugs causing decreased or slower absorption Food may have impact on absorption of different dosage forms
Drug-Laboratory Interactions
Abnormal plasma/serum electrolyte concentrations can affect certain drug therapies
Drug Induced Photosensitivity
Skin reaction caused by exposure to sunlight EX: sulfa drugs
Elimination
“Excretion”…Process by which the body eliminates drugs…main route is the kidneys (urine)
High Therapeutic Index
A wide margin of safety for drug use
Low Therapeutic Index
A narrow margin of safety for drug use
Pharmacology
The study of the effects of chemical substances on living tissue. They study of drugs, their sources, nature & properties. The study of the body’s reaction to drugs
Drug
Any chemical substance that, when administered, produces a change in function of the body.
Contraindication
A symptom or circumstance that makes treatment with a drug or device unsafe or inappropriate.
Cumulative Effect
A drug effect that is apparent only after several doses have been given. It is caused by excretion or metabolic degradation of only a fraction of each dose given.
Informed Consent
A policy in place for the patient’s protection. It allows the patient to be informed, without coercion, about healthcare procedures.
Physician’s Desk Reference (PDR)
An annual compendium of information concerning drugs, primarily prescription and diagnostic products.
United States Pharmacopeia National Formulary (USP-NF)
A collection of officially recognized drug names. Includes drugs of established usefulness.
Teratogenic
Causing abnormal development of the embryo
Off-Label Uses
Used for something other than what it has been approved for…EX: glucophage for weight loss
Four Sources of Drugs
Plants, Animals, Minerals & Synthetic
1938 Food, Drug & Cosmetic Act
Act that empowered the FDA to monitor & regulate the marketing & manufacturing of drugs
1970 Controlled Substances Act
Act that identified a schedule that showed the potential for abuse of drugs
Nurse Practice Acts
State laws regarding nursing practice
Clinical Pharmacist
A specialist who guides the physician in prescribing drugs (may be stationed on a patient care unit to assist physicians, nurses, and patients.)
Pharmacotherapeutics
The study of of the effects of drugs on the body.
Chronopharmacology
The study of the actions of drugs in relationship to time
Chemotherapy
The study of drugs used to prohibit the growth & production of abnormal cells.
Misfeasance
Giving the wrong drug or drug dose that results in the client’s death
Nonfeasance
Omitting a drug dose that results in the client’s death.
Malfeasance
Giving the correct drug but by the wrong route that results in the client’s death.
Schedule I Drug
A drug with no medical use with very high abuse potential that may lead to severe dependence (EX: heroine, marijuana, LSD, STP, peyote, hashish)
Schedule II Drug
A drug with medical use but with high abuse potential that leads to severe physical or psychological dependence (EX: morphine, opium, methadone, secobarbital, codeine, amphetamines, cocaine, oxycodone)
Schedule III Drug
A drug with medical use with moderate to low physical abuse potential but high psychological abuse potential (EX: Empirin with codiene, Lortab, Fiorinal, Tylenol with codeine)