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the process by which a drug is transferred from its site of entry into the body to the circulating fluids of the body (i.e., blood and lymph) for distribution; the rate at which this occurs depends on the route of administration, the blood flow through the tissue where the drug is administered, and the solubility of the drug
Absorption
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-refers to the ways in which drugs are transported by the circulating body fluids to the sites of action (receptors), metabolism, and excretion.
Distribution
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Organs with the most extensive blood supply that receive the distributing drug most rappidly
heart, liver, kidneys, and brain
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Areas with less blood supply that receive the drugs more slowly
muscle, skin, and fat
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When a drug is circulating in the blood, a may be drawn to determine the amount of the drug present.
Blood Sample
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determines the amount of drug present
blood level
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also call biotransformation is the process by which the body inactivates drugs.
metabolism
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It is important for certain drugs (e.g, and ) to be measured to ensure that the drug blood level is within the therapeutic range.
anticonvulsants and antibiotics
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The enzyme systems of the are the primary site for metabolism of drugs.
liver
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Drugs such as , , and metabolize certain drugs to a minor extent.
WBC's, GI tract and Lungs
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Elimination of drug metabolites and , in some cases, the active drug itself from the body is called
excretion
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The two primary routes of excretion are through the and through the .
GI tract to the feces, and Renal tubules into the urine
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Other routes of excretion include evaporation through the , exhalation from the and secretion into and .
skin, lungs, saliva, and breastmilk
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the amount of time required for 50% of the drug to be eliminated from the body.
half-life
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In patient's who have impaired hepatic or renal function, the half-life may become considerably because of their reduced ability to metabolize or excrete the drug
longer
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this usually occurs when a drug enters a patient and is absorbed and distributed (i.e., expected response)
desired action
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"any noxious, unintended, and undesired effect of a drug, which occurs at doses in humans for prophylaxis, diagnosis, or therapy"
adverse drug reaction
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most commonly seen Adverse drug reactions
rash, nausea, itching, thrombocytopenia, and diarheaa
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the classes of medicine that account for the largest number of Adverse Drug reactions
antibiotics, cardiovascular medicine, cancer chemo agents, and analgesics/ anti-inflammatory agents
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this occurs when something unusual or abnormal happens when a drug is first administered.
idiosyncratic reaction (over response)
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the ability of a drug to induce living cells to mutate and become cancerous
Carcinogenicity
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a drug that induces birth defects
Teratogen
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Most organ systems are formed during what trimester of pregnancy
1st
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occurs when a person begins to require a higher dosage to produce the same effects that lower dosage once provided
tolerance
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also known as addiction or habituation, occurs when a person is unable to control the ingestion of drugs
drug dependence
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Drug dependence that occurs when a person develops withdrawal symptoms for a certain period
Physical dependence
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Drug dependence in which the patient is emotionally attached to the drug
Psychological dependence
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If a patient has a mild reaction, it is understood as a warning NOT to take the medication again. The patient could have an reaction at the next exposure to the drug
Analphylactic
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is said to occur when the action of on drug is altered by the action of another drug.
Drug Interaction
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this happens when two drugs with similar actions are taken for a doubled effect
Additive Effect
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when the combined effect of two drugs is greater than the sum of the effect of each drug given alone
Synergistic Effect
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when one drug interferes with the action of another
Antagonistic Effect
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the displacement of the first drug by a second drug increases the activity of the first drug
Displacement Effect
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when the first drug inhibits the metabolism or excretion of the second drug, causing increased activity of the second drug.
Interference
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when the first drug is chemically incompatible with the second drug, causing deterioration when both drugs are mixed in the same syringe or solution; incompatible drugs should not be mixed together or administered together at the same site; signs of incompatibility are haziness, a precipitate, or a change in color of the solution when the drugs are mixed.
incompatibility
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Via the gastrointestinal tract by oral, rectal, or nasogastric routes
Enteral
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Bypasses the GI tract by using subcutaneous, intramuscular, and intravenous injection
Parenteral
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Absorbed through the skin and mucous membranes
* inhalation, sublingual, or topical
Percutaneous
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What is the correct order in which drugs pass through the body?
- ADME
- 1.Absorption- depends on route of administration
- 2.Distribution- depends on circulation to be transported throughout the body
- 3.Metabolism- depends on enzyme systems
- 4.Excretion- depends on GI tract and kidneys
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Which method of drug administration is absorbed fastest?
Intravenous
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Concentration of a drug is sufficient to start a pharmacologic response
Onset of action
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a drug reaches the highest concentration
Peak action
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How long the drug has a pharmacologic effect
duration of action
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determines the amount of drug present
Drug level
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life threatening reaction that causes respiratory distress and cardiovascular collapse
anaphylactic reaction
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the portion of the drug that is pharmacologically active
unbound drug
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Process of converting oral drug, can be influenced by food and water in the stomach
liberation
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