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What are contraindications & precautions?
C: Symptom of circumstance that makes treatment with a drug or a device unsafe or inappropriate. P: An action taken in advance to protect against danger, harm, or possible failure.
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What is pharmacokinetics?
Study of metabolism & action of drugs with particular emhphasis on the time required for absorption,duration of action, distribution in the body & method of excretion
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What is pharmacotherapeutics?
Study of therapeutic uses and effects of drugs
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What is pharmacology?
Branch of medicine concerned with the uses, effects, and modes of actions of drugs
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What is pharmacodynamics?
Study of drugs & their actions on living organisms
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What is unwanted response to a therapeutic drug?
Adverse drug effects (ADE)
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What were the major provisions of the Kefauver-Harris Act on 1962? (4)
- 1. Adverse rxns & contraindications must be cited & included in the literature
- 2. Evaluation of testing methods used by manufactureres
- 3. Specified the process for withdrawal of approved drugs when safety & effectiveness were in doubt
- 4. Mandated the establishment of clinical efficacy of new drugs before marketing
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What is the Harrison Narcotic Law of 1914?
It is an act that sets rules for the manufacture & use of drugs with potential for abuse
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What agency enforces the Harrison Narcotic Law of 19414?
Drug Enforcement Agency
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What is schedule I drug?
Examples
High abuse potential. Severe dependence liability classification
II also has high abuse potential & dependence liability as well
i.e: heroin, hashish, LSD, GHB
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Examples of Schedule II, III, IV, V drugs
- II: morphine
- III: moderate moderate: codeine
- IV: pentazocine (agonist-antagonist)
- V: limited abused potential, lowest dependence: loperamide
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Why is IV one of the most dangerous route?
Once it is given it cannot be retrieved nor its distribution throughout the body be slowed or stopped
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Gastric acids and enzymes destroy many drugs
Food may interfere with the dissolution & absorption of certain drugs
These are examples of core ____ ______
Core drug knowledge
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What are some core patient variables?
- Health status
- Life span & gender
- Environment
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Are these actions to minimize adverse effects or maximmize therapeutic effects?
1. Drugs that have enteric coating & drugs in sustained-release form should never be chewed, crushed, or broken.
2. NG & G tubes need to be flushed after administration of meds
3. Shake liquid med immediately before administration of the medication
4. Med may be mixed w/ food or fluids
5. Nurse must follow closely the cardinal rules of drug administration (6 Rights)
6. Drugs administered thru an NG or G tube are instilled slowly
7. Repeated doses of sucrose-containing syrups may increase the risk of gingivitis or dental caries
8. Assess for proper placement before administering drugs
- 1. Minimizing
- 2. Maximizing - so pt gets all the meds
- 3. Maximizing - to distribute meds evenly so pt gets the right dose
- 4. Maximizing - to encourage pt. to take all meds prescribed
- 5. Minimizing - to eliminate med errors
- 6. Maximizing
- 7. Mimizing
- 8. Mimizing
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Adrenergic (adrenaline) or cholinergic (NT-acetylcholine)
In cell biology a structure in cell membrane or within a cell that combines with a drug hormonee, chemical mediator, or infectious agent to alter an aspect of the function of the cell.
AKA sensory nerve ending
Receptors
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special characteristics of the capillary walls of the brain that prevent potentially harmful substances including many med from moving out of the bloodstream into the brain or cerebrospinal fluid.
blood-brain barrier
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AKA metabolism
alteration of a substance (such as a drug) within the body
biotransformation
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What is a drug half-life?
How long a drug takes for half of it to be eliminated from the blood stream
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To achieve a therapeutic amt in the body more rapidly than would occur only by accumulation of the repeated smaller doses
Larger than normal dose administered as the first in a series of doses, the others of which are smaller than the loading dose but equal to each other
Loading dose
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These are the smaller doses given after a loadig dose to maintain an accumulation of medication in the pt for therapeutic relief
Maintenance dose
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Plateau or steady state
When the same amt of drug going in is the same amt of drug being taken out (METABOLIZED)
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The extent, quality or degree of being poisonous
toxicity
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Side effect
An action or effect of a drug other than that desired
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Causing abnormal development of the embroy
Teratogenic effect
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Any injury or illness that occurs as a result of medical care
i.e: foley cath & UTI
Iatrogenic
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What is drug tolerance?
Progressive decreases in the effectiveness of drug
Drug doses must be increased to achieve the same effectiveness
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The amount of drug bound to the protein determines how effective the drug is in the body.
If 95% bound to protein, how many % cause pharmacological effect on the body?
Protein binding
5%. Free (active) = produce effects
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Determined either by measurement of concentration of drug in body fluids or by magnitude of pharmacologic response
Rate & extent to which an active drug or metabolite enters the general circulation, permitting access to the site of action
Bioavailibity
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How is therapeutic index calculated?
What does it mean when the TI is narrow?
ED50/LD50
It means drug will produce unwanted effect
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Drugs that mimic the body's own regulatory function
Agonists
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When both a full agonist & partial agonist are present, how does the partial agonist react to the agonist?
What is an example of agonist-antagonist narcotic?
Partial agonist will actually compete against the agonist for receptor occupancy, therefore producing a net decrease in receptor activation observed with the full agonist alone
i.e: pentazocine
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What is drug clearance?
The rate drug leaves body
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What is Single-occupancy theory?
The intensity of the body’s response to the drug isdirectly r/t the # of receptors occupied by the drug
The maximum response occurs when all of the receptors have drug molecules attached.
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Can drug create new responses in the body?
No! They can only turn on, turn off, promote, or block a response that the body is inherently capable of producing
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When should pharmacotherapeutic response of a drug be measured?
When drug has achieved steady state
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What is modified occupancy theory?
Different drugs have different strengths of attractions, or affinity, for receptor sites. Once a drug is attached to a receptor, it has different abilities to stimulate the receptor
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What is potency?
The amount of a drug that must be given in order to produce a PARTICULAR RESPONSE
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In what condition are loading dose given?
Patient’s medical condition may warrant immediate and full drug effect
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What is synergistic effect?
When 2 or more “UNLIKE” drugs are used together to produce a combined effect
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What is an additive effect?
When 2 or more “LIKE” drugs are combined.
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What is nonreceptor responses
Drugs exert their effect by reacting physically or chemically w/ other molecules in the body
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What is Minimum Effective Concentration (MEC)?
The level of drug needed in the body to produce an effect
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What is potentiation?
An INTERACTION in which the effect of only ONE of the TWO drugs is increasedDrug that has mild effect enhances the effect of a second drug
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