Lilley Ch 2 (pharmacologic principles) Flashcards by McKenna Michael

drugs with similar actions (1+1=2)

additive effects

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any undesirable occurrence related to administering or failing to administer prescribed medication

adverse drug event

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any unexpected, unintended, undesired or excessive response to a med given at therapeutic doses

adverse drug reaction

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general term for any undesirable effects that are a direct response to one or more drugs

adverse effects

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drug that binds to and stimulates the activity of one or more receptors in the body

agonist

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immunological hypersensitivity reaction resulting from unusual sensitivity of patient to a medication; type of adverse drug event

allergic reaction

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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

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measure of the extent of drug absorption for a given drug and route (from 0% to 100%)

bioavailability

*IV meds have 100% bioavailability

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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

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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

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The name that describes the chemical composition and molecular structure of a drug

chemical name

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any patient condition that makes the use of a medication dangerous.

contraindication

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The general name for a large class of enzymes that plays a significant role in drug metabolism and drug interactions

cytochrome P-450

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A state in which there is a compulsive or chronic need, as for a drug

dependence

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dissolving of solid dosage forms and their absorption

dissolution

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study or science of drugs

pharmacology

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drug name with a registered trademark

trade name

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two types drug classifications

structure

therapeutic use

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first drug in a class of drugs

prototypical drugs

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The study of how various drug forms influence the way in which the drug affects the body

pharmaceutics

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order of dissolution of medications (fastest to slowest)

oral disintegration
liquids
suspension solutions
powders
capsules
tablets
coated tablets
enteric-coated tablets

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absorption of food or drug through the GI tract (Tablets, capsules, suspensions, syrups, suppositories)

enteral route

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drug administration by injection or infusion (Injectable forms of suspensions or solutions)

parental route

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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

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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

1. drug-receptor relationships (drug binds to cell receptor) 2. enzymes (drug can inhibit or enhance enzyme's action) 3. 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