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Dose packaging
Medication packages that contain a single dose for a single patient.
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Tachyphylaxis
Rapidly occuring tolerance to a drug. This typically occurs with sympathetic agonists, specifically decongestant and bronchodilation agents.
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Substrates
The chemical or substance on which a drug acts.
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Purple Foxglove
A source of digitalis (a glycoside)
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Deadly Nightshade
A source of atropine (an alkaloid)
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Sources of Drug Information
- United State Pharmacopeia (USP)
- Physician's Desk Reference
- Drug Information
- Montly Prescribing Reference
- AMA Drug Evaluation
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Components of a Drug Profile
- Names
- Classification
- Mechanism of Action
- Indications
- Pharmacokinetics
- Side Effects/Adverse Reactions
- Routes of Administration
- Contraindications
- Dosage
- Special Considerations
- How Supplied
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Schedules of drugs according to the Controlled Substances Act of 1970
- Schedule I - High abuse potential; no medical uses... Heroin, LSD, Mescaline
- Schedule II - High abuse potential; approved medical use.... Opium, Cocaine, Morphine, Codeine, Oxycodone, Methadone, Secobarbital
- Schedule III - Lower abuse potential; Limited opioid amounts or combined with non-controlled substances. Vicodin, Tylenol with Codeine
- Schedule IV - Less abuse potential - Diazepam, Lorazepam, Phenobarbital
- Schedule V - Less abuse potential - Limited amounts of opioids; for cough and diarrhea
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The Pure Food and Drug Act of 1906
Enacted to improve the quality and labeling of drugs, named the United States Pharmacopeia as this country's offical source for drug information.
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Solutions
The most common liquid preparations. Generally water based; some may be oil based.
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Tinctures
Prepared using an alcohol extraction process; some alcohol usally remains in the final drug preparation.
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Suspensions
Preparations in which the solid doesn't not dissolve in the solvent; if left alone, the solid portion will precipitate out.
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Emulsions
Suspensions with an oily substance in the solvent; even when well mixed, globules of oil separate out of the solution.
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Spirits
Solution of a volatile drug in alcohol.
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Elixirs
Alcohol and water solvent, often with flavorings added to improve taste.
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Syrups
Sugar, water, and drug solutions.
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Drug Storage Considerations
- Temperature
- Light
- Moisture
- Shelf Life
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Types of Drug Reactions
- Bind to a receptor site
- Change the physical properties of cells
- Chemically combine with other chemicals
- Altering a normal metabolic pathway
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Drug Dependence
The patient becomes accustomed to the drug's presence in the body and will suffer form withdrawal symptoms upon it's absence. The dependence may be physical or psychological.
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Cumulative Effect
Increased effectiveness when a drug is given in several doses.
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Pharmacodynamics
Effects on the body.
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The greater the affinity the stronger the....
Bond
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Drug Interaction
The effects of one drug alter the response to another drug.
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Drug Antagonism
The effects of one drug block the response to another drug.
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Summation
aka - Additive Effect. 2 drugs that both have the same effect are given together, analogous to 1 + 1=2
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In most cases drugs will either...
Stimulate or inhibit the cell's normal biochemical actions. A drug cannot impart a new function to a cell.
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Example of a partial agonist
Nubain
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Surmountable
A sufficiently large dose of the agonist can overcome the antagonism.
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Pharmacokinetics
How a drug is absorbed, distributed, or metabolized.
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Synergism
2 drugs that both have the same effect are given together and produce a response greater than the sum of their individual responses; analogous to 1 + 1=3
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Potentiation
One drug enhances the effect of another. A common example is Phenergan enhances the effects of Morphine.
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Insurmountable
No amount of agonist can overcome it.
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Pills
Drugs spherically shaped to be easy to swallow.
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Interference
The direct biochemical interaction between 2 drugs; one drug affects the pharmacology of another drug.
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Factors altering drug response
- Age
- Body Mass
- Sex
- Environmental Milieu
- Time of Administration
- Pathological State
- Genetic Factor
- Psychological Factors
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Example of an antagonist
Narcan
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Example of an agonist
Morphine
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Onset of Action
The time from administration until a medication reaches its minimum effective concentration.
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Bioavailability
Amount of a drug that is still active after it reaches its target tissue.
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First Pass Effect
The liver's partial or complete inactivation of a drug before it reaches the systemic circulation.
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Second Messenger
Chemical that participates in complex cascading reactions that eventually cause a drug's desired effects.
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Pro-Drug (Parent Drug)
Medication that is not active when administered but whose biotransformation converts it into active metabolites.
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Drug Names
- Chemical Name: (7-chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benzodiazepin-2-one)
- Generic Name: diazepam
- Official Name: diazepam, USP
- Brand Name (aka trade or proprietary name): Valium
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Types of drug laws and regulations
- Federal laws
- State laws and regulation
- Individual agency regulations
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6 Rights of Medication Administration
- Right medication
- Right dose
- Right time
- Right route
- Right patient
- Right documentation
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Biotransformation
Special name given to the metabolism of drugs.
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Efficacy
A drug's ability to cause the expected response.
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Receptor
Specialized protein that combines with a drug resulting in a biochemical.
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Plasma-Level Profile
Describes the length of onset, duration, and termination of action, as well as the drugs minimum effective concentration and toxic levels.
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Pharmacodynamics
How a drug interacts with the body to cause it's effects.
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Minimum Effective Concentration
Minimum level of drug needed to cause a given effect.
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Down regulation
Binding of a drug or hormone to a target cell receptor that causes the number of preceptors to decrease.
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Free drug availability
Proportion of a drug available in the body to cause either desired or undesired effects.
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Parenteral route
Delivery of a medication outside of the gastrointestinal tract, typically using needles to inject medications into the circulatory system or tissues.
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Biologic half-life
Time the body takes to clear one half of a drug.
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Hydrolysis
The breakage of a chemical bond by adding water, or by incorporating a hydroxyl (OH-) group into one fragment and a hydrogen ion (H+) into the other.
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Drug
Chemical used to diagnose, treat, or prevent disease.
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Enteral route
Delivery of a medication through the gastrointestinal tract.
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Agonist
Drug that binds to a receptor and causes it to initiate the expected response.
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Oxidation
The loss of hydrogen atoms or the acceptance of an oxygen atom. This increases the positive charge (or lessens the negative charge).
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Antagonist
Drug that binds to a receptor but does not cause it to initiate the expected response.
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Teratogenic drug
Medication that may deform or kill the fetus.
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Capsules
Gelatin containers filled with powders or tiny pills, the gelatin dissolves, releasing the drug into the GI tract.
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Assay
Test that determines the amount and purity of a given chemical in a preparation in the laboratory.
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Placental barrier
Biochemical barrier at the maternal/fetal interface that restricts certain molecules.
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Metabolism
The body's breaking down chemicals into different chemicals.
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Bioassay
Test to ascertain a drug's availability in a biological model.
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Bioequivalence
Relative therapeutic effectiveness of chemically equivalent drugs.
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Osmosis
Movement of a solvent in a solution from an area of lower solute concentration to an area of higher solute concentration.
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Blood brain barrier
Tight junctions of the capillary endothelial cells in the CNS vasculature through which only non-protein bound, highly lipid-soluble drugs can pass.
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Powders
Not as popular as the once were, some are still in use. (granulated)
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Tablets
Powders compressed into a disklike form.
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Suppositories
Drugs mixed with waxlike base that melts at body temperature allowing absorption by rectal or vaginal tissue.
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Forms of Parenteral Routes
- IV - Intravenous
- ET - Endotracheal
- IO - Intraosseous
- Umbilical
- IM - Intramuscular
- SQ - Subcutaneous
- Inhalation/Nebulized
- Topical
- Transdermal
- Intradermal
- Nasal
- Instillation
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Forms of Enteral Routes
- PO - Oral
- OG/NG - Orogastric/Nasogastric
- SL - Sublingual
- Buccal (between cheek and gum)
- PR - Rectal
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Up regulation
A drug causes the formation of more receptors than normal.
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Pharmacology
The study of drugs and their interactions with the body.
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Non-competitive antagonism
The binding of a an antagonist causes a deformity of the binding site that prevents an agonist from fitting and binding.
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Competitive antagonism
One drug binds to a receptor and causes the expected effect while also blocking another drug from triggering the same receptor.
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Ionize
To become electronically charged or polar.
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Irreversible antagonism
A competitive antagonist permanently binds with a receptor site.
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Side effect
Unintended response to a drug.
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Drug response relationship
Correlation of different amounts of a drug to clinical response.
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Agonist-antagonist (partial agonist)
Drug that binds to a receptor and stimulates some of its effects but blocks others.
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Affinity
Force of attractions between a drug and a receptor.
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Termination of action
Time from when the drug's level drops below its minimum effective concentration until its eliminated from the body.
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Duration of action
Length of time the amount of drug remains above its minimum effective concentration.
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Therapeutic Index
Ratio of a drug's lethal dose for 50 percent of the population to effective dose for 50 percent of the population.
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Diffusion
Movement of a solute in a solution from an area of higher concentration to an area of lower concentration.
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Filtration
Movement of molecules across a membrane from an area of higher pressure to an area of lower pressure.
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Drug catergories harmful to a fetus
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Active transport
Require the use of energy to move a substance.
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Carrier
Mediated diffusion or facilitated diffusion - process in which carrier proteins transport large molecules across the cell membrane.
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Passive transport
Movement of a substance without the use of energy.
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Allergic reaction
aka Hypersensitivity. This effect occurs as the drug is antigenic and activates the immune system, causing effects that are normally more profound than seen in the general population.
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Idiosyncrasy
A drug effect that is unique to the individual; different than seen or expected in the population in general.
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Tolerance
Decreased response to the same amount of a drug after repeated administrations.
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Cross-tolerance
Tolerance for a drug that develops after adminstration of a different drug. Morphine and other opioid agents are common examples. Tolerance for 1 agent implies tolerance for others as well.
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