Term
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Definition
Pharmacokinetics is the study of what the BODY does to the DRUG.
How is the drug absorbed?
How is the drug metabolized and distributed?
How is it excreted? |
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Term
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Definition
| Drug absorption is what happens to a drug from when it enters the body until it reaches circulating tissues. |
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Definition
| One method for a drug to travel through the body to it's target tissue. The drug gets dissolved (depending on whether it is water or lipid soluble) |
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Definition
Diffusion happens when particles in solution travel from a higher concentration to a lower concentration. Drugs that travel by diffusion are distributed in the blood and may work by traveling by diffusion into a cell.
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Term
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Definition
| Active Transport occurs when a drug "hitches a ride" on something else to move across a cell membrane. |
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Term
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Definition
| Pinocytosis is similar to phagacytosis in that a drug would wrap itself around a molecule to move across a cell membrane. |
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Term
| What are the 4 most common processes by which a drug enters the tissue? |
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Definition
-Diffusion
-Active Transport
-Water or lipid transport
-Pinocytosis |
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Term
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Definition
| Dissolution occurs when the disintegrated particles of a solid-form drug become soluble in body fluids such as stomach acid. |
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Term
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Definition
Drugs that are sublingual are placed under the tongue which is extremely vascular and so the drug is quickly introduced into the bloodstream.
Nitroglycerin tablets are an example of a sublingual drug |
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Term
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Definition
| Drug has to be in solution to be absorbed. Drugs are either fat soluble or water soluble. |
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Term
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Definition
| Fat soluble drugs travel most easily through cell membranes (which are made of lipids) including the blood-brain barrier and the placental barrier. |
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Term
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Definition
| Water soluble drugs dissolve well in body fluids. |
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Term
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Definition
a very protective mechanism that protects from infiltration of many drugs like antibiotics.
Allows only some lipid-soluble drugs through:
general anesthesia
barbituates
This makes it difficult to treat diseases of the brain. |
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Term
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Definition
| The placental barrier is not nearly as effective as the blood-brain barrier in filtering out drugs. This makes a fetus very susceptible to a wide range of teratogenic effects from drugs. |
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Term
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Definition
The pH of a drug dictates where it will dissolve.
An acidic drug will dissolve most readily in stomach acid (low pH) and an alkaline drug dissolves most readily in the intestine (higher pH).
Note: a pt. with an antacid or proton pump inhibitor will have a less acidic stomach acid which can interfere with drugs made to dissolve in the stomach. |
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Term
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Definition
First Pass Effect is how much a drug is "chewed up" by the liver before it is distributed to the body.
A drug with a "high first-pass effect" needs a higher dose in order to get the enough drug distributed to the body. |
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Term
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Definition
| The first pass effect is a measurement of how much of a drug will get "chewed up" or processed by the liver before getting circulated to the body tissues. |
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Term
| First Pass Effect - routes that bypass it |
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Definition
Sublingual
transderma
vaginal
Buccal (absorption though the mouth cavity or cheeks)
Intramuscular
intravenous
subcutaneous
intranasal
inhalation
rectal is included on this list, but it does undergo a higher degree of first-pass effect than everything else.
Basically, every drug route except stomach and intestine avoids the first-pass-effect. |
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Term
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Definition
| Drug distribution is how the drug makes its way through the body to it's target tissues. |
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Term
| Drug concentration in body fat |
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Definition
| Drugs that are very fat soluble tend to "hang around" longer in a pt. with higher body fat content. |
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Term
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Definition
Drug circulation is dependent on how permeable the capillaries are and how strong the cardiac output.
A person in shock has very constricted capillaries and low cardiac output so drugs do not circulate well. |
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Term
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Definition
Most drugs will bind to albumin (a protein in the blood.) Drugs bound to albumin do not reach target tissues.
In your book, a drug would be said to be "80% protein bound". |
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Term
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Definition
| A drug that is protein bound is attached to albumin and does not reach it's target tissues. It is called a drug-protein complex. |
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Term
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Definition
| A drug that is protein bound is attached to albumin and does not reach it's target tissues. It is called a drug-protein complex. |
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Term
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Definition
A Drug-Protein Complex is a drug that is bound to albumin in the blood and is therefore not reaching it's target tissues.
Protein-bound drugs act as a drug reservoir. Over time, albumin will release the drug into the system. |
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Term
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Definition
| A low albumin serum level will cause less drug-protein complex and so less of the drug will be protein bound. This means that more of the drug is free in the system and the pt. will effectively get a higher dose of the drug than someone with normal albumin levels. |
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Term
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Definition
lipid soluble drugs often bind to the tissues. This causes the drug to hang around in the body longer.
Some drugs bind to bone such as teracycline.
Some drugs bind to muscle. |
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Definition
Biotransformation (or metabolism) is when the drug is broken down or detoxified into other substances.
The main organ of biotransformation is the LIVER |
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Term
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Definition
what a drug becomes after is it metabolized (or has gone through biotransformation)
may be an active metabolite or an inactive metabolite.
active metabolites can cause side effects. |
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Term
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Definition
some drugs are broken down by the liver and become active metabolites that can exert an effect on the body (side effects)
Remember her story about her menopausal drug out-of-body-experience with prometreum. |
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Term
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Definition
| Liver Enzyme Inducers are drugs that can cause a DECREASE in the therapeutic level of another drugs. |
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Term
| What is the main organ of biotransformation? |
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Definition
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Term
| The Kidney's roll in drug excretion |
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Definition
"Polar and peeable"
drugs that break down into polarized molecules can then be excreted by the kidneys. |
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Term
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Definition
Liver enzyme Inhibitors are drugs that can cause an INCREASE in the therapeutic level of other drugs. |
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Term
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Definition
| delayed drug metabolism can result in an accumulation of the drugs (can result in toxicity) or result in a prolonged effect of the drug. |
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Term
| Stimulating Drug metabolism |
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Definition
| Stimulating the metabolism of a drug can cause diminished therapeutic effects. This is because the drug "run through your system" much faster and therefore exerts an effect for less time. |
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Term
| The main organ that eliminates drug from the body? |
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Definition
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Term
| Drug elimination of anesthesia |
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Definition
| anesthesia is eliminated from the body through the lungs. |
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Term
| Drug excretion through the kidneys |
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Definition
The kidneys eliminate most drugs from the body which makes fluid intake VERY IMPORTANT
Bactrim can cause crystals to form is fluid intake is not maintained. |
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Term
| Excretion of chemotherapy drugs |
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Definition
| chemotherapy drugs are mainly excreted through the skin. Skin hygiene becomes very important. |
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Term
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Definition
adequate fluid intake is 50ml per Kilogram per day to allow the body sufficient fluid to easily excrete a drug.
a 100kg person should intake 5000ml - or 5 liters - of liquid a day. |
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Term
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Definition
| Elderly people have a less active thirst drive and so are more prone to under-hydrating. |
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Term
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Definition
| Drug action is how the cell and drug interact - this is the root of HOW the therapeutic effect occurs. |
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Term
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Definition
| The Drug Effect is the body's physiologic reaction to a drug. |
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Term
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Definition
The therapeutic drug effect is the intended effect of the drug.
The reason the drug is prescribed.
examples:
-antihypertensives are meant to lower BP.
-anti-inflammatories are meant to reduce inflammatory response. |
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Term
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Definition
The therapeutic effect
(also called the "margin of safety" or "the margin of specificity")
this is the relationship between:
1. the dose required to induce a therapeutic effect
2. the dose level that causes adverse reactions. |
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Term
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Definition
The margin of safety
(also called the "therapeutic effect" or "the margin of specificity")
this is the relationship between:
1. the dose required to induce a therapeutic effect
2. the dose level that causes adverse reactions. |
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Term
| the Margin of Specificity |
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Definition
The margin of specificity (also called the "margin of safety" or "the therapeutic effect") this is the relationship between:
1. the dose required to induce a therapeutic effect
2. the dose level that causes adverse reactions. |
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Term
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Definition
Example:
If a drug alleviates a symptom with a dose of 50mg
But the drug can cause dangerous side effects at amounts above 70mg, then the therapeutic index is going to be between 50 and 70mg. |
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Term
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Definition
A palliative treatment's goal is to provide the patient comfort, NOT to cure the disease.
A patient who is suffering from advanced cancer might receive palliative morphine. Morphine will not cure the disease, but it will enhance the patient's comfort. |
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Term
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Definition
A curative treatment is a treatment that is mean to resolve the root of the medical problem.
Example
An antibiotic would be taken to cure strep throat. The antibiotic does not alleviate symptoms of an illness, it attacks the CAUSE of an illness |
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Term
| Supportive Therapeutic Response |
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Definition
When the body is not producing enough of a substance to support recovery, some drugs are prescribed to "jump start" recovery by contributing more of what the body already produces.
Example:
With an inflammation of a muscle, a steroid might be prescribed to enhance the steroids that your body already produces to reduce the inflammation. |
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Term
| Substitutive Therapeutic Response. |
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Definition
A substitutive treatment is a treatment that takes the place of a substance that the body does not (or is no longer) producing.
example:
Insulin for diabetics fills in the role of the natural insulin that the body no longer produces. |
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Term
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Definition
| A side effect is a predictable effect of a drug. It can be GOOD or BAD. It results from a therapeutic dose of a drug. Different from an adverse effect. |
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Term
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Definition
An adverse drug reaction happens within the normal therapeutic use of a drug. It is unexpected and undesirable.
This includes:
-Idiosyncratic reactions
-Hypersensitivity reactions
-Drug interactions. |
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Term
| Idosyncratic drug reactions |
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Definition
An idiosyncratic drug reaction is a drug reaction that is different or even opposite to the intended reaction of a drug.
Example:
Some drugs that commonly cause drowsiness can cause hyperactivity in some patients (particularly kids.) |
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Term
| Hypersensitivity drug reactions |
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Definition
| A hypersensitive drug reaction can be a body's over-reaction to a treatment. It is different than an allergy example: penicillin may give some people a mild rash. This is different than an allergic reaction. The drug treats the disease, but is actually hyperactive in it's response. |
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Term
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Definition
| A drug interaction is when two or more drugs interact together to create an unexpected or undesirable response. |
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Term
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Definition
| Also called a "cumulative effect" a toxic drug effect is when the amount of drug in the body is higher than therapeutic treatment and can cause adverse reactions. |
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Term
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Definition
A cumulative Drug effect occurs when the body cannot metabolize and excrete the drug before the next dose is administered.
This may be more common in pt.s with liver disease or kidney failure because they cannot metabolize and excrete a drug as quickly as a healthy patient. |
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Term
| Idiosyncratic Drug reaction |
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Definition
| An idiosyncratic drug reaction is completely different from normal expected side effects. Most often occurs with drugs that have a narrow therapeutic index. |
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Term
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Definition
| An allergic reaction involves a histamine release. It is usually (but not always) a reaction to a drug that happens with the second exposure to a certain drug. vomiting or nausea is NOT an allergic reaction A true allergic reaction must involves a histamine release - hive-like rash, throat swelling, puffy skin. |
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Term
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Definition
Drug dependence is a physical or mental need for a drug.
A body system will adapt to a drug that is continuously in its system and incorporates it. Removal of the drug results in withdrawal.
example: Dependence on a drug such as MDMA (ecstacy) results from MDMA's stimulation of the serotonin system. Repeated use causes the body to stop producing serotonin inducers because the drug is fillign that role. Removal of MDMA from the system can result in extreme anxiety and depression - the opposite of the drug's effects.
Phychological (or mental) need for a drug is not a physical dependence. Example: The need for chocolate is a psychological dependence, not a physical one. |
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Term
| Chain Reaction Drug Responses |
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Definition
When a drug is prescribed to treat a problem, but then causes another problem which is then treated by another drug, and so on and so forth.
Then you end up on five prescriptions which all serve to alleviate the symptoms of another drug.
Common in the elderly. |
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Term
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Definition
| a mutagenic drug effect is basically a drug that causes mutation.. Alterations in the DNA. Usually called carcinogenic. |
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Term
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Definition
Drug tolerance is the body's decreased response to repetitive drug doses.
commonly: tobacco, opioids, alcohol... |
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Term
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Definition
An iatrogenic drug response is an unintentional bad effect of a treatment.
this effect may be:
an actual disease
a skin reaction
hepatic toxicity (killing off of the liver) |
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Term
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Definition
KNOW THIS: Unless you find that two drugs are compatible, consider them INCOMPATIBLE.
this only applies to IV and injectable drugs. (this does not apply to PO meds)
Flush the IV line between two drugs unless you are ABSOLUTELY SURE THAT THE DRUGS ARE COMPATIBLE. |
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Term
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Definition
Onset is the time after administration that it takes for the drug to take action.
This is related by the route of the medication:
IV: really quick
PO & IM: not so quick |
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Term
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Definition
| Peak is when the drug is at it's highest concentration in the body. |
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Term
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Definition
Trough is the opposite of peak. This is when the drug is at it's lowest concentration in the body - usually right before the next dose.
Trough is the better way to measure drug concentration in the body because peak is tough to pinpoint.
Measuring trough levels (right before the next dose is scheduled) can tell you if the peak is high. If the trough is high, then the peak levels are "stupid high". This would mean that you must time subsequent doses further apart so that you don't make the patient toxic. |
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Term
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Definition
The duration of action is the time the drug is present in the body causing a therapeutic response.
Benzodiazapenes hang out in the body for a long time. Fat soluable, long duration of action. |
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Term
| Therapeutic Level/Plateau |
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Definition
A therapeutic drug level is the goal with some drugs: to keep the drug at constant levels in the body.
The therapeutic level or drug plateau can be explained as the desired concentration of a drug after repeated fixed doses. |
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Term
| The term for reaching a fixed concentration of drug in the body - usually after repeated fixed doses: |
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Definition
| Therapeutic Drug levels or Drug level Plateau. |
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Term
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Definition
Half-life is the time it takes for the drug to be reduced by 1/2 the original amount. There are two types:
-Elimination half-life
-Distribution half-life |
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Term
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Definition
Also called "Elimination Half-life" this is when the drug in the body is 1/2 of it's original amount.
This is dependent on the drug, but also the patient.
A patient with a compromised liver or kidneys will have longer drug half-lives. |
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Term
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Definition
| Elimination half life is the same as "Half life'. This is a measure of the rate at which drugs are removed from the body. |
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Term
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Definition
Distribution Half-Life is the time it takes for the drug levels to reach 1/2 there original amount IN THE BLOOD.
This is when 1/2 of the drug has migrated into the tissues. |
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Term
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Definition
When a drug reaches Elimination Half Life, optimally, the next dose would be given in order to reach Steady State.
Steady State is when "drug in" equals "drug out"
Steady State is most often achieved after 4 half-lives. |
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Term
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Definition
Cumulation is when the drug surpasses Steady State and "drug in" is MORE than "drug out"
Can result in toxicity. |
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Term
| Minimum Inhibitory Concentration |
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Definition
Minimum Inhibitory Concentration is the lowest concentration of an antibiotic which inhibits bacteria.
This ONLY applies to antibiotic drugs. |
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Term
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Definition
Minimum Inhibitory Concentration - this is the lowest concentration of an antibiotic which inhibits bacteria.
The lower the MIC, the better, because you can give less drug to kill the bacteria. |
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Term
| Minimum Inhibitory Concentration |
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Definition
| Measurement of how much antibiotic is needed to inhibit a bacteria. Measured in exponential concentration levels 0, 2, 4, 6, 8 or simply as "S-I-R" (sensitive - intermediate - resistant) |
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Term
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Definition
This is the Minimum Inhibitory Concentration of an antibiotic needed to inhibit a bacteria. Sometimes measured in levels 0,2,4,8,16 (as above) or simply denoted by "S" "I" "R" (Suceptible, Inhibited, or Resistant)
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Term
| How does age affect a body's response to a drug? |
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Definition
Kids and Elderly have:
differences in liver and kidney function
differences in body fat: kids have more, the elderly may have less.
differences in metabolic rate
differences in immune systems activity |
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Term
| How does body mass affect a drug action on the body? |
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Definition
| The more body mass, the more diluted the drug concentration will because of simple volume of a body system. |
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Term
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Definition
| Drug Dose Response Curve - the relationship between the dose of a drug and the response of a drug.
[image]
When the curve plateaus, all the receptors for the drug are filled up. More drug at this point will cause increased adverse reactions (or even toxicity) but cannot have an increased therapeutic effect. |
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Term
| Synergistic Drug interaction |
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Definition
| When two drugs are given together to enhance the positive effect of both drugs drug. |
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Term
| Some developmental considerations for drugs administered to infants. |
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Definition
When giving drugs to infants, it is important to remember that:
- infants have immature liver and kidneys.
- They have less total body fat, which effects absorption and distribution.
- Infants need lower drug dosages and longer drug dosing intervals.
- In infants, drug half-life is 2-5 times longer.
- Infants have lower BP so there blood flow patterns are different.
- Infants bodies contain more water so water-soluble drugs will exert a stronger effect.
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Term
| Some considerations in drug administration for children. |
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Definition
- Children's drugs are weight based.
- Dosages calculated individually for each child.
- Lower dosages will be needed The half-life of drugs may be shorter in kids than adults.
- Kids are more pron to adverse affects.
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Term
| Some consideration in drug administration to the elderly |
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Definition
The elderly have decreased kidney and GI function.
The elderly have decreased plasma proteins in their serum.
The elderly have increased ratio of body fat to lean muscle
They are more prone to polypharmacy issues so drug interactions are more of an issue. |
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