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.
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
What is pharmacotherapeutics?
Study of therapeutic uses and effects of drugs
What is pharmacology?
Branch of medicine concerned with the uses, effects, and modes of actions of drugs
What is pharmacodynamics?
Study of drugs & their actions on living organisms
What is unwanted response to a therapeutic drug?
Adverse drug effects (ADE)
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
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
What agency enforces the Harrison Narcotic Law of 19414?
Drug Enforcement Agency
What is schedule I drug?
High abuse potential. Severe dependence liability classification
II also has high abuse potential & dependence liability as well
i.e: heroin, hashish, LSD, GHB
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
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
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
What are some core patient variables?
- Health status
- Life span & gender
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
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
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.
alteration of a substance (such as a drug) within the body
What is a drug half-life?
How long a drug takes for half of it to be eliminated from the blood stream
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
These are the smaller doses given after a loadig dose to maintain an accumulation of medication in the pt for therapeutic relief
Plateau or steady state
When the same amt of drug going in is the same amt of drug being taken out (METABOLIZED)
The extent, quality or degree of being poisonous
An action or effect of a drug other than that desired
Causing abnormal development of the embroy
Any injury or illness that occurs as a result of medical care
i.e: foley cath & UTI
What is drug tolerance?
Progressive decreases in the effectiveness of drug
Drug doses must be increased to achieve the same effectiveness
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?
5%. Free (active) = produce effects
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
How is therapeutic index calculated?
What does it mean when the TI is narrow?
It means drug will produce unwanted effect
Drugs that mimic the body's own regulatory function
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
What is drug clearance?
The rate drug leaves body
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.
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
When should pharmacotherapeutic response of a drug be measured?
When drug has achieved steady state
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
What is potency?
The amount of a drug that must be given in order to produce a PARTICULAR RESPONSE
In what condition are loading dose given?
Patient’s medical condition may warrant immediate and full drug effect
What is synergistic effect?
When 2 or more “UNLIKE” drugs are used together to produce a combined effect
What is an additive effect?
When 2 or more “LIKE” drugs are combined.
What is nonreceptor responses
Drugs exert their effect by reacting physically or chemically w/ other molecules in the body
What is Minimum Effective Concentration (MEC)?
The level of drug needed in the body to produce an effect
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