Ch. 1: Drug Actions and Body Responses Flashcards
a drug effect that is more severe than expected and has the potential to damage tissue or cause serious health problems. it may also be called a toxic effect or toxicity and usually requires intervention by prescriber
adverse effect or adverse drug reactoin
an extrinsic drug that activates the receptor site of a cell and mimics the actions of naturally occuring drugs
agonist
type of andverse effect in which the presence of the drug stimulates the release of histamine and other body chemicals that cause inflammatory reactions. the response may be as mild as a rash or as severe and life threatening as anaphylaxis
allergic response
an extrinsic drug that blocks the receptor site of a cell, preventing the naturally occuring substance from binding to the receptor
antagonist
the percentage of a drug dose that actually reaches the blood
bioavailability
a notice that a drug may produce serious or even life-threatening effect s in some people in addition to its beneficial effects
black box warning
manufacturer owned name of a generic drug; also called “trade name” or “proprietary name”
brand name
drug action that is intended to kill a cell or organism
cytotoxic
the extent that a drug absorbed into the blood stream spreads into the three body water components
distribution
any small molecule that changes any body function by working at the chemical and cell levels
drug
the planned use of a drug to prevent or improve a health problem
drug therapy
the length of time a drug is present in the blood at or above the level needed to produce an effect or response
duration of action
the inactivtion or removal or drugs from the body accomplished by certain body systems
elimination
movement of drugs fromt he outside of the body to the inside using the GI tract
enteral route
drugs that are man made or derived from other species; not made by the human body
extrinsic drugs
rapid activation or elimination of oral drugs as a result of liver metabolism
first pass loss
national and international public drug name created by the US Adoptened Names Council to indicate the usual use of chemical composition of a drug
generic name
time span needed for one half of a drug dose to be eliminated
half life
natural products made from plants that cause a resoponse in the body similar to that of a drug; also called botanical
herbals
drug that has an increased risk of causing patient harm if used in error
high alert drug
desired effect, main effect, of a drug on a specific body tissue or system; therapeutic response
intended action
hormones, enzymes, growth factors, and other chemicals made by the body that change the activity of cells
intrinsic drugs
the first dose of a drug that is larger than all subsequent doses of the same drug; used when it takes more drug to reach steady state than it does to maintain it
loading dose
exactly how, at the cellular level, a drug changes the activity of a cell
mechanism of action
any small molecule that changes any body function by working at the chemical and cell levels
medication
chemical reaction in the body that change sthe chemical shape and content of a drug, preparing the drug for inactivation and eliminatoin
metabolism
the smallest amount of a drug necessary in the blood or target tissue to result in a measurable intended action
minimum effective concentration (MEC)
drugs that are approved for purchase without a prescription
over the counter
movement of a drug from the outside of the body to the inside of the body by injection
parenteral route
maximum blood drug level
peak
movement of drug from the outside of the body to the inside through the skin or mucus membranes
percutaneous route
unexpected adverse effects that are unique to the patient and not related to the mechanism of action of the drug. they are also called idiosyncratic responses
personal responses
ways in which drugs work to change body function
pharmacodynamics
how the body changes drugs; drug metabolism
pharmacokinetics
the science and study of drugs and their actions on living animals
pharmacololgy
the change in body function as an outcome of the mechanism of action of a drug
physiologic effect
the strenght of the intended action produced at a given drug dose
potency
an order written or dictated by a state approved prescriber for specific drug therapy for a specific patient
prescription
the legal status of any drug that is considered unsafe for self medication or has a potential for addiction and is only availably by prescription written by a state approved health care professional
prescription drugs
physical place on or in a cell where a drug can bind and interact
receptor
the trapping of drugs within certain body tissues delaying their elimination and extending their duration of interaction
sequestration
any minor effect of a drug on body cells or tissues that is not the intended action of a drug
side effect
point at which drug elimination is balanced with drug entry, resulting in a constant effective blood level of the drug
steady state
the actual cells or tissue effected by the mechanism of action or intended actions of a specific drug
target tissue
type of percutaneous drug delivery in which the drug is applied to the skin, passes through the skin, and enters the blood stream
transdermal
the lowest or minimum blood drug level
trough level
changes of a drug from a liquid form to a gas that can be absorbed into the body by inhalation
vaporized
PINCH
potassium, insulin, narcotics (opioids), cancer chemotherapy agents, and heparin or any other drug that strongly effects blood clotting - high alert drugs
what does the effectiveness of an agonist drug depend on?
how tightly and how long it binds to its receptor on the cells
what are the symptoms of anaphylaxis?
tightness in the chest, difficulty breathing, low blood pressure, hives on the skin, swelling of the face, mouth and throat, weak, thready pulse, a sense that something bad is happening
if the entire drug dose enters the blood stream what is the bioavailability of that drug? what if only part of the drug entered the blood stream?
if the entire drug entered the blood stream, bioavailability is at 100%, if only part of the drug entered, it is less than 100%
which drug entrance route has 100% bioavailability
parenteral
which drug route has the least predictable absorption pattern
oral drugs
which drugs usually require higher doses?
those given by mouth because absorption is effected by anything occuring in the stomach or intestines
which route has the most rapid drug entry?
intraarterial and intravenous
do most drugs exert their mechanism of action while in the blood stream?
no, the blood stream is just the road way for the drug to make it to its target cell
what are the three compartements that drugs are distributed into?
blood stream (first drug compartment), interstitial space (second drug compartment), and intracellular space (third drug compartment
drug distribution and activity are reduced in which body state? why?
dehydration - most drugs do not act in the blood stream and a decrease in blood volume or pressure slows the speed in which they can reach the tissues they need to get to
what does metabolism do for drugs?
it changes the chemical structure. it can activate them, inactivate them, or prepare them for elimination
why are loading doses used for drugs that have a longer half-life?
because it is used to get the blood level up to the MEC as fast as possible and once the MEC is achieved, all other doses can be smaller and still maintain it because the drug has a long half-life and is eliminated slowly
which age groups have higher rates of metabolism than adults?
toddlers, preschool children, school-age children, and adolescents
what is the BUN (blood urea nitrogen) level
10-20 mg
creatinine levels
males - 0.6-1.3 mg
females - 0.5-1 mg
what should be known before giving a drug?
the renal status of any person
why do infants need a higher dose in terms of milligrams per kilogram than a toddler or older child would?
because they have more total body water than older children and adults and this means that drugs that easily dissolve in water spread through more water and are lost by the kidney more rapidly (they are more dilute)
drugs that can cause birth defects
teratogenic or teratogens
when is the risk for drugs to cause birth defects the highest?
from the third week to the eighth week of pregnancy
adequate well-controlled research studies that have included pregnant women have not shown the drug to have an increased risk for birth defects or problems with the fetus
pregnancy category A
a drug is placed in this category if: ther have been no adequate or well-controlled studies in pregnant women, but animal studies have been done and do not show the drug to have an increased risk to the fetus or animal studies do show an increased risk for problems in the fetus but adequate well-controlled studies that have included pregnant women have shown no increased risk to the fetus
pregnancy category B
drug that has had no adequate or well-controlled studies in pregnant women, but animal studies have been done and show it to have an increased risk for problems or no animal studies have been done and there are no well-controlled studies testing this drug that have included pregnant women
pregnancy category C
drugs that have had adequate well-controlled or observational studies in pregnant women that have an increased risk to the fetus shown
pregnancy category D
drugs that have had well-controlled or observational studies in pregnant women or in animals and have a greatly increased risk of fetal abnormalities. these drugs should not be given to women who are pregnant or may become pregnant
pregnancy category X
what are the most important organs for drug metabolism and elimination
liver and kidneys
what drug does cimetidine (Tagamet) enhance the action of and, in turn, increase the risk for adverse effects?
quinidine (Quinadure, Quinidex)
what affect does ciprofloxacin (Cipro) have when taken with warfarin (Coumadin)
it increases the blood concentration of warfarin, increasing the risk for bleeding
ibuprofen (Advil) and naproxen (Aleve) reduce the effectiveness of which drugs?
angiotensin-converting enzyme inhibitor antihypertensives such as captopril (Capoten)
Grapefruit juice greatly increases the activity of many drugs including…
felodipine (Plendil), midazolam (Versed), and lovastatin (Mevacor)
St John’s wort can reduce the effectiveness of many drugs. what are three?
digoxin (Lanoxin), warfarin (Coumadin), and oral contraceptives (birth control pills)
movement of a drug from the outside of the body into the bloodstream
absorption
what are the normal levels of albumin in the blood?
3.5-5 g/dL - decreased values indicate possible kidney disease
what are normal levels of alanine aminotransferase (ALT)?
3-35 iu/L or 8-20 units/L - increased values indicate possible liver disease
what are the normal levels of ammonia in the blood?
15-110 mg/dL - increased levels may indicated possible liver disease
what are normal BUN levels?
10-20 mg/dL
what are normal creatinine levels for males and for females?
males - 0.6-1.3 mg/dL
females - 0.5-1 mg/dL
