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Absorption
movement of a drug from it's site of administration into the blood stream
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active transport
moving drugs and other substances across membranes using energy to go against a concentration gradient
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additive effects
when two drugs are used together and their response as a group is the same as it would be individually
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adverse reaction
any noxious, unintended and undesired effect that occurs at normal drug doses.
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affinity
strength of the attraction between a drug and it's receptor
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agonist
molecules that activate receptors
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agranulocytosis
dengerous potential side effect of some drugs that suppresses WBC formation in the bone marrow and leads to neutropenia.
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albumin, hypoalbuminemia
many drugs are transported in the blood bound to albumin, the largest protein in blood. When albumin levels are low, perhaps due to malnutrition, drug transport can be affected. More "free drug" is available for use and can lead to toxicity.
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allergy (drug)
exposure to a drug can sometimes stimulate an allergic response involving histamine release. This reaction can result in anything from mild irritation to life threatening anaphylaxis.
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anaphylaxis
a life threatening allergic reaction to a drug that causes severe bronchostriction, edema of the glottis and widespread hypotension.
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antagonist
a molecule that blocks receptors
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area under the curve
represents to bioavailability of a drug when the plasma concentration is plotted over time.
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auto induction
certain drugs can increase the synthesis of drug-metabolizing enzymes in the liver. This can increase the drugs own metabolism as well as that of other drugs in the system. If this occurs, dosages of all drugs affected may need to be increased.
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bioavailablility
the ability of a drug to get from it's site of administration into the blood stream. Usually represented as a percentage of the dose given. IV drugs are 100% because they go directly to the blood stream.
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bioequivelant
when comparing two preparations of a drug, this indicates that the drugs are essentially the same in bioavailability, dose response and time of action.
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biotransformation (metabolism)
the enzymatic alteration of drug structure.
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blood brain barrier
a layer of tightly packed cells that protect the brain and CNS from most drugs and other poisons.
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carcinogenic
any agent that has been known to cause cancer
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clearance
the volume of plasma from which the drug is completely removed per unit time.
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competetive agonist
a drug that competes with endogenous chemicals or other drugs for activation of receptors. Binding is reversible.
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dangerous drug
any drug whose administration has a high likelihood of adverse effects or a narrow therapeutic index. Using these drugs should be administered carefully and the risk/benefits should be considered before administration.
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dependence
- physical - resulting from chronic use of a drug that has produced tolerance and where negative physical symptoms of withdrawal result from abrupt discontinuation or dosage reduction.
- psychological - results from chronic use of a drug that causes psychological symptoms when withdrawn. Also referred to as addiction.
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desensitization
the loss of responsiveness to the continuing or increasing dose of a drug.
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dose response curve and relationship
shows the relationship between the size of an administered dose and the intensity of the response produced. These curve held determine the minimum amt of drug that can be used, the maximum response that can be elicited and how much to increase a dose to achieve the desired response.
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drug-drug interaction
When the action or presense of one drug affects the amount or intensity of response of other drugs. Can be related to protein binding, metabolism, sites of action and elimination.
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drug onset
the time in takes for the drug to reach a level in the blood where a response can be appreciated.
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drug duration
the length of time that a drug maintains sufficient levels in the blood to produce a therapeutic response.
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drug peak-trough cycle
the peak is the time after administration when therapeutic effects and blood levels are highest. The trough is the opposite and is the level at which the therapeutic effect is lowest.
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down-regulation
a decrease in the number of receptors on a cell surface that make the cell less receptive to drugs or hormones.
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ED 50
the amount of a drug needed to produce a defined therapeutic response in 50% of the population.
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efficacy
the ability of a drug to produce the response for which it was intended.
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elimination
the removal of a drug from the body, usually by the kidneys or GI tract
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enteral
introduction of a drug into the GI tract
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enteric coated
covering on a pill or capsule that protects it from being absorbed too early, usually protects the drug until it passes into the small intestine. Often used for drugs that don't work well in acid environments such as the stomach.
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enterohepatic recirculation
drugs are absorbed from the GI tract and are sometimes sent back with bile acids into the GI. Since bile is reabsorbed from the GI tract and "recycled" sometimes drugs are as well. This can increase the time it takes to eliminate a drug from the body.
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facilitated diffusion
the spontaneous passage of molecules or ions across a biological membrane passing through specific transmembrane transport protein.
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first pass effect
when drugs are absorbed from the GI tract they must pass through the liver before reaching systemic circulation. Some drugs undergo a lot of metabolism before they leave the liver. This means that larger doses are needed to produce a response. This can be overcome by administering IM, IV or SQ and bypassing the liver temporarily.
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half-life
the amount of time it takes for half of a dose to leave the body. Five half-lifes are required to reach a steady state of drug level. Drugs with short half-lifes have to be administered more frequently to maintain blood levels but are eliminated much faster when stopped.
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hypersensitivity reactions
several different types of reactions, all essentially allergies to medications. If the med is essential and the reaction is mild, the drug can be administered with a dose of an antihistamine to reduce the hypersensitivity reaction symptoms.
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hemolysis
breakdown or destruction of red blood cells
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iatrogenic
adverse affects or illnesses caused by the administration of medications
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idiosyncratic reaction
adverse effect of a drug that in unpredictable and unusual. Occurs often with new drugs that haven't been used in a certain population very much.
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inhibition, inhibitor
drug or substance that can inhibit the P450 system and slow down metabolism of itself and/or other drugs in the body. Dosages may need to be adjusted down to prevent toxicity.
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intrinsic activity
the ability of a drug to activate a receptor upon binding
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ionized
drugs that carry a charge are ionized. This is an imporant property to know because ionization makes it harder for a drug to cross membranes which can alter absorption but also protects the brain and fetus.
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LD50
the dose which is lethal for 50% of the population
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legend drug
any drug that requires a prescription
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lipid solubility
The ability of a drug to cross cell membranes is determined by its lipid solubility (lipophilic). Drugs that are ionized are not lipophobic.
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margin of safety
Drugs have have a narrow margin of safety are drugs that have a narrow therapeutic index. Meaning, what would be a therapeutic dose in one patient would be a lethal dose in another. Safe drugs are ones for which the lethal dose is much higher than the effective dose.
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maximal efficacy
the largest effect that a drug can produce
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minimum effective concentration
The minimum serum drug concentration necessary to produce a desired pharmacologic effect in most pts.
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minimum toxic concentration
the minimum dosage that will produce toxic effects
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mutagenic
a drug that can change DNA
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nephrotoxic
a drug that can be damaging to the kidneys
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noncompetetive
a drug that binds irreversibly to a receptor
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off-label
using a drug for a purpose that has not officially been approved by the FDA
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OTC
over-the-counter, drugs that can be purchased without a prescription.
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ototoxic
drugs that can damage hearing
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partial agonist
a drug that has only moderate intrinsic activity
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passive diffusion
most drugs move by passive diffusion down a concentration gradient to cross membranes in the body.
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pH
the measure of how basic or acidic a substance is.
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pharmacoDynamics
what drugs can do to the body
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pharmacoKinetics
what the body does to a drug
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pharmacogenetics
the study of how genetics affects drug metabolism and actions
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pharmacotherapeutics
the use of drugs to diagnose, prevent or treat illness or prevent pregnancy
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placebo
a preparation that is devoid of intrinsic pharmacologic activity
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plasma concentration
the amount of a drug that has reached systemic circulation
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polypharmacy
the use of more than one drug in a patient
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potentcy
the amount of a drug that must be given to elicit an effect. A potent drug is one that can produce maximal effects with a small dose.
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potentiation
when two drugs are given together and the effects of one are enhanced by giving the other.
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protein binding
the ability of a drug to bind to protein in the blood. drugs that are highly protein bound don't have much free drug available to reach sites of action.
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relative potency
the potency of a drug in comparison to others like it.
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selectivity
the ability of a drug to bind to specific receptors and produce targeted responses. The more selective the drug, the fewer adverse effects will be experienced.
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serum sickeness
an immune system reaction to certain medications, injected proteins used to treat immune conditions, or antiserum
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side effect
a nearly unavoidable secondary drug effect produced at therapeutic levels. more common with non-selective drugs.
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spectrum of activity
the range of illness or diseases a drug can treat
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subtherapeutic
the level of a drug that dose not produce a therapeutic response
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synergism
when the response of two drugs given together is greater than the response of either drug taken alone.
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tachyphylaxis
a rapid decrease in the response to a drug after repeated doses over a short period of time
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teratogenic
a drug that is toxic to a fetus
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therapeutic index
the range of dosages of a drug that can produce a therapeutic response in patients. the wider the index, the safer the drug
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tolerance
when taken chronically, the body can build a tolerance to a drug and require a higher dosage to obtain the same response.
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toxicology
the study of symptoms, mechanisms, treatments and detection of poisoning of patients
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volume of distribution
the distribution of a medication between the plasma and the rest of the body
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zero order kinetics
drug elimination is independent of the drug's concentration
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