Chapter 3 Vocab

Question 1

Four Phases of Pharmacokinetic phase.

Answer 1

-absorption
-distribution
-metabolism (biotransformation)
-excretion (elimination)

Question 1

Pharmacokinetic phase

Answer 1

What the body does to the drug

Question 2

Absorption-

Answer 2

the movement of medications from the location of administration (gastrointestinal tract, muscle skin, mucous membranes, or subcutaneous tissue} to the bloodstream.

The most common routes are enteral (by mouth through the GI tract) and parenteral (by injection).

Question 3

Distribution-

Answer 3

The transportation of medication to sites of action by bodily fluids. (Movement of the drug from the circulation to body tissues)

Question 4

Metabolism (biotransformation)

Answer 4

-The process by which the body chemically changes drugs into a form that can be excreted.

-Changes medications into less active or inactive forms by the action of enzymes. This occurs primarily in the liver, but also takes place in the kidneys, lungs, intestines, and blood.

Question 5

Excretion-

Answer 5

-the elimination of medications from the body primarily through the kidneys. Elimination also takes place through the liver(bile), lungs, saliva, sweat, intestines, and exocrine glands (such as breast milk)

-Kidney dysfunction can lead to an increase in the duration and intensity of a medication’s response, so it is important to monitor blood urea nitrogen (BUN) and creatinine levels.

Question 6

addictive effect

Answer 6

When two drugs are administered in combination and the response is increased beyond what either could produce alone, the drug interaction. It is the sum effect of two drugs. can be desirable or undesirable.

Question 7

Synergistic effect

Answer 7

When two or more drugs are given together, one can have a synergistic effect on the other. In other words, the clinical effect of the two drugs given together is substantially greater than that of either drug alone.

Question 8

Absorption across the mucosal lining of the small intestines occurs through passive transport 9diffusion and facilitated diffusion), active transport, and pinocytosis.

Answer 8

Passive transport-Does not require energy to move drugs across the cell membrane.
-Has two processes:

diffusion-drugs move across the cell membrane from one area of higher concentration to one of lower concentration.

facilitated diffusion-relies on a carrier protein to move the drug from one area of higher concentration to one of lower concentration.

Active transport-requires a carrier, such as enzyme or protein, to move the drug against a concentration gradient. Energy is required for active absorption.

Pinocytosis-the process by which cells carry a drug across their membranes by engulfing the drug particles in a vesicle.

Question 9

Bioavailability-

Answer 9

The percentage of the administered drug available for activity.

Question 10

Medication reconciliation

Answer 10

An accurate list of medication

Question 11

First pass effect- (First pass metabolism)

Answer 11

After absorption of oral drugs from the GI tract, they pass from the intestinal lumen to the liver via the portal vein. In the liver some drugs are metabolized to an inactive form and are excreted, thus reducing the amount of active drug available to exert a pharmacologic effect.

Question 12

Free drugs

Answer 12

Drugs that are able to exit blood vessels and reach their site of action, causing a pharmacological response.

Question 13

Blood-brain barrier (BBB)

Answer 13

Blood vessels in the brain have special endothelial lining where the cells are pressed tightly together (tight junctions). The BBB protects the brain from foreign substances. which includes about 98% of drugs on the market.

Question 14

Prodrug-

Answer 14

a compound that is metabolized into an active pharmacologic substance.

-designed to improve bioavailability
-instead of administering a drug directly a prodrug might be used instead to to improve pharmacokinetics (absorption, distribution, metabolism, excretion), decrease toxicity, or target a specific site of action.

Question 15

half-life

Answer 15

The time it takes for the amount of a drug in the body to be reduced by half.

Question 16

steady state

Answer 16

-A plateau drug level
-occurs when the amount of drug being administered is the same as the amount of drug being eliminated.

Question 17

loading dose

Answer 17

A large initial dose of medication that is significantly higher than the dose needed to obtain therapeutic effects of the drug while the steady state is reached.

-a loading dose will produce toxic side effects if given in repeated doses.

Question 18

pharmacodynamics-

Answer 18

the study on the affects of the drugs on the body. (what the drugs do to the body)

Question 19

Dose-response relationship

Answer 19

The body’s physiologic response to changes in drug concentration at the site of action.

Potency-The amount of drug needed to elicit a specific physiologic response to a drug.

maximum efficacy- The point at which increasing a drug’s dosage no longer increases the desired therapeutic response.

Therapeutic index(TI)-describes the relationship between the therapeutic dose of a drug (ED) and the toxic dose of a drug(TD)

Therapeutic range-(therapeutic window)-a range of doses that produces a therapeutic response without causing significant adverse effect in patients.

Question 20

Onset-

Answer 20

The time it takes for a drug to reach the minimum effective concentration (MEC) after administration.

Question 21

Peak

Answer 21

A drug’s peak occurs when a drug reaches its highest concentration in the blood.

Question 22

Duration of action-

Answer 22

The length of time the drug exerts a therapeutic effect.

Question 23

Peak drug level-

Answer 23

-The highest plasma concentration of a drug at a specific time, and it indicates the rate of absorption. If the peak is too low, effective concentration os too low.

-If the peak drug level is ordered, a blood sample should be drawn at the appropriate peak time based on the route of medication.

Question 24

Trough drug level

Answer 24

The lowest plasma concentration of a drug and it measures the rate in which the drug is administered.

-The trough levels are drawn just before the next dose of drug regardless of route of administration.

Question 25

receptors

Answer 25

proteins found on cell surface membranes or within the cell itself.

Drug binding sites are primarily on proteins, glycoproteins, proteolipids, and enzymes. pg. 25

Question 26

ligand-binding domain

Answer 26

the site on the receptor at which drugs bind.

Question 27

agonists-

Answer 27

Drugs that activate receptors and produce a desired response.

Question 28

Partial agonists-

Answer 28

drugs that elicit only moderate activity when binding to receptors; partial agonists also prevent receptor activation by other drugs.

Question 29

antagonists-

Answer 29

Drugs that prevent receptor activation and block a response.

Question 30

Nonspecific drugs-

Answer 30

A drug that stimulates or blocks the cholinergic receptors affects all anatomic sites.

Drugs that effect multiple receptor SITES are considered NON-SPECIFIC DRUGS.

Question 31

Nonselective drugs-

Answer 31

Drugs that affect multiple receptors.

Question 32

Side affects-

Answer 32

Expected secondary effects of drug therapy.

Question 33

Adverse drug reactions-

Answer 33

Unexpected, unintentional, reactions to drug therapy that occur at normal drug dosages.

Question 34

Drug toxicity-

Answer 34

-Occurs when drug levels exceed the therapeutic range;

-may occur secondary to overdose(unintentional or intentional) or drug accumulation.

Factors that increase toxicity: age, genetics, disease.

Question 35

tachyphylaxis

Answer 35

an acute, rapid decrease in response to a drug. It may occur after the first dose or several doses.

Question 36

Placebo effect-

Answer 36

A psychological drug response not attributed to the chemical properties of a drug.

Question 37

drug interaction-

Answer 37

an altered or modified action or effect of a drug as a result of interaction with one or multiple drugs.

Question 38

Therapeutic drug monitoring (TDM)-

Answer 38

• Checking serum drug levels used for all drugs but especially for drugs that have a narrow therapeutic range and are highly protein bound.

Ex) Digoxin and phenytoin are two drugs that require TDM.

Question 39

antagonistic effect-

Answer 39

-When drugs with antagonistic effects are administered together, one drug reduces or blocks the effect of the other.

Question 40

photosensitivity-

Answer 40

reaction to the skin caused by exposure to sunlight.

-photoallergic reaction-when a drug goes through activation in the skin by the ultraviolet light to a compound that is more allergenic than the parent compound.

-phototoxic reaction- a photosensitive drug undergoes photochemical reactions within the skin to cause damage.