Lilley Ch 2 (pharmacologic principles) Flashcards
drugs with similar actions (1+1=2)
additive effects
any undesirable occurrence related to administering or failing to administer prescribed medication
adverse drug event
any unexpected, unintended, undesired or excessive response to a med given at therapeutic doses
adverse drug reaction
general term for any undesirable effects that are a direct response to one or more drugs
adverse effects
drug that binds to and stimulates the activity of one or more receptors in the body
agonist
immunological hypersensitivity reaction resulting from unusual sensitivity of patient to a medication; type of adverse drug event
allergic reaction
combination of the 2 drugs results in drug effects that are less than the sum of each drug given alone (1+1= <2)
antagonistic effect
measure of the extent of drug absorption for a given drug and route (from 0% to 100%)
bioavailability
*IV meds have 100% bioavailability
One or more biochemical reactions involving a parent drug; occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as metabolism
biotransformation
The barrier system that restricts the passage of various chemicals and microscopic entities (e.g., bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen
blood-brain barrier
The name that describes the chemical composition and molecular structure of a drug
chemical name
any patient condition that makes the use of a medication dangerous.
contraindication
The general name for a large class of enzymes that plays a significant role in drug metabolism and drug interactions
cytochrome P-450
A state in which there is a compulsive or chronic need, as for a drug
dependence
dissolving of solid dosage forms and their absorption
dissolution
study or science of drugs
pharmacology
drug name with a registered trademark
trade name
two types drug classifications
structure
therapeutic use
first drug in a class of drugs
prototypical drugs
The study of how various drug forms influence the way in which the drug affects the body
pharmaceutics
order of dissolution of medications (fastest to slowest)
- oral disintegration
- liquids
- suspension solutions
- powders
- capsules
- tablets
- coated tablets
- enteric-coated tablets
absorption of food or drug through the GI tract (Tablets, capsules, suspensions, syrups, suppositories)
enteral route
drug administration by injection or infusion (Injectable forms of suspensions or solutions)
parental route
Drugs applied to the skin (Aerosols, ointments, creams, powders, foams, gels, transdermal patches, inhalers, rectal & vaginal suppositories)
topical route
*all topical routes avoid first pass effect except rectal
examples of parenteral route
- IV
- injection: SubQ, IM, ID, intraarterial, intradermal, intrathecal, intraarticular
transport of a drug by the bloodstream to its site of action; The study of what the BODY does to the DRUG
pharmacokinetics
movement of a drug from its site of administration into the bloodstream
absorption
when A drug absorbed in the intestine must first pass through the liver before it reaches the bloodstream
first pass effect
* PO meds have high first pass effect
what big organs are drugs first delivered to
heart
kidneys
liver
brain
why would unbound drugs be a problem
drugs need to bind to albumin
unbound drugs are free floating in bloodstream and can cause drug-to-drug interactions
what four things can metabolism alter a drug into
- inactive metabolite
- more soluble compound
- more potent active metabolite
- less active metabolite
what organ is most responsible for metabolism of drugs
liver
enzymes that target lipid-soluble drugs that are more difficult to eliminate
cytochrome P-450 enzymes
“fat loving” dissolve in fat or oil (cross cell membrane easily/ last longer)
lipophilic
“water loving” dissolve in water (need help to cross cell membrane/ act faster & are eliminated faster)
hydrophilic
the elimination of drugs from the body.
excretion
primary organ responsible for excretion
kidneys
time required for half (50%) of a given drug to be removed from the body
half life
*after 5 half lives, drug is out of system
Physiologic state in which the amount of drug removed via elimination is equal to amount of drug absorbed with each dose.
steady state
highest blood level of drug
peak level
lowest blood level of drug
trough level
the time required for the drug to elicit a therapeutic response
onset of action
length of time that the drug concentration is sufficient to elicit a therapeutic response
duration of action
occurs if the peak blood level of the drug is too high
toxicity
study of what the DRUG does to the BODY
pharmacodynamics
3 mechanisms of action in pharmacodynamics
- drug-receptor relationships (drug binds to cell receptor)
- enzymes (drug can inhibit or enhance enzyme’s action)
- nonselective interactions (drug’s target is cell membrane or cellular processes)
The clinical use of drugs to prevent and treat diseases
pharmacotherapeutics
when prescriber uses the drug for non-FDA –approved indications
off-label prescribing
type of therapy prevents progression of a disease or condition (ex: birth control)
maintenance therapy
type of therapy supplies the body with a substance needed to maintain normal function (ex: insulin for diabetes and iron for anemia)
supplemental (or replacement) therapy
type of therapy provides relief of symptoms with a goal of improving quality of life (ex: high-dose opioids in end stages of cancer)
palliative therapy
type of therapy maintains the integrity of body functions while the patient recovers from illness or trauma (ex: blood products to patient who lost blood during surgery)
supportive therapy
type of therapy prevents illness or undesirable outcomes.
prophylactic therapy
type of therapy based on clinical probabilities
empiric therapy
poisonous or harmful effects
toxic effects
the ratio of a drug’s toxic level to the level that provides therapeutic benefits
therapeutic index
decreasing response to repeated drug doses
tolerance
physiologic or psychological need for a drug
dependence
physiologic need for a drug to avoid physical withdrawal symptoms
physical dependence
also known as addiction and is the obsessive desire for the euphoric effects of a drug
psychological dependence
2 drugs interact in such a way that their combined effects are greater than the sum of the effects for each given alone (1+1= >2)
synergistic effect
2 parenteral drugs or medications are mixed together and the result is a chemical deterioration of one or both (precipitate, color change, or haziness).
incompatability
type of adverse drug reaction in which there is an extension of the drug’s normal effects (lower BP)
pharmacologic reaction
type adverse drug reaction: immune system response to neutralize substance
hypersensitivity (allergic) reaction
type adverse drug reaction: occurs unexpectedly in a particular patient
idiosyncratic reaction
type adverse drug reaction: unwanted effects of 2 drugs given together
drug interaction
adverse drug effect: drugs that are damaging to fetus
teratogenic
adverse drug effect: permanent changes in the genetic composition of living organisms
mutagenic
adverse drug effect: cancer causing agents
carcinogenic
The study of natural (versus synthetic- lab created) drug sources (i.e., plant, animals, minerals)
pharmacognosy
Study of the economic factors influencing the cost of drug therapy
pharmacoeconomics
Science of adverse effects of chemicals on living organisms
toxicology
The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose.
steady state
what are the four first pass routes
hepatic arterial
rectal
portal venous
oral
what drug type has response because drug binds to receptor
agonist
what drug type has diminished response compared to agonist, but drug still binds to receptor
partial agonist
what drug type has no response when drug binds to receptor and prevents binding of agonists
antagonist
what drug type competes with agonist for binding to receptor, but if it binds, there is no response
competitive antagonist
what drug type causes the agonist to have no effect because the drug combines with different parts of receptor and inactivates it
noncompetitive antagonist
