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191 Cards in this Set

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A _____ is any substance that alters physiologic function with the potential for affecting health.
drug
A drug is any chemical that can affect _____.
living processes or systems
_____ is a drug administered for its therapeutic effects.
Medication
_____ is the study of chemicals that alter functions of living organisms; the study of the effects of drugs on living organisms; their interactions with living things.
Pharmacology
Drugs that are deemed to be safe to be taken without medical supervision as long as they are taken for the intended purpose and in the correct dose are called _____.
nonprescription
The first step of the drug approval process is _____.
preclinical trials
______ are used in lab animals to see how the drug affects living tissues and get a feel if the drug is effective and safe.
Preclinical trials
Phase ____ studies test a small number of healthy subjects (individuals with the disease are used if the drug is toxic).
1
Phase _____ studies test a small number of individuals with the disease and observe for effectiveness and toxicity. These studies also look at how the drug is absorbed, metabolized, and distributed.
2
Phase _____ studies are larger scale testing. They look at the safety and efficacy of the drug and try to pick up rare but possible side effects.
3
The more people that take a medication the more likely it is that....
a rare or infrequent side effect will manifest itself.
During Phase ____ studies people are given different dosages of the medication to determine which dose is most effective.
2
Phase ____ studies are conducted after the FDA has approved marketing of the drug.
4
Phase ____ studies are referred to as post marketing surveillance. During this phase it is sometimes found that a medication is effective for other medical problems or has adverse effects when combined with different medications.
4
Reasons for mediation use include: _____ treatment, _____ of illness, assist with _____ procedures, to _____ illness, promote _______, and prevent _______.
symptomatic, prevention, diagnostic, cure, health maintenance, and contraception
The ____ name of a drug is based on the chemical structure or make up of the drug.
chemical
The ____ name of a drug is also called the nonproprietary.
generic/official
The _____ name of a drug is assigned by the US Adopted Names Council and is listed in official publications.
generic/official
The _____ name of a drug is also called the proprietary.
trade/brand
The _____ name of a drug is the registered name that is assigned by the manufacturer.
trade/brand
An example of a medication used for symptomatic treatment is _____.
aspirin
An example of a medication used for prevention is _____.
vaccines
An example of medications used in conjunction with diagnostic procedures is ______.
radiopaque dyes
An example of a medication that is used as a curative is _____.
antibiotics
An example of a medication that is used for health maintenance is ______.
insulin
An example of a medication whose use is contraception is ______.
birth control pills
Health maintenance drugs are any drug that is given to help...
the body function normally.
The ____ name of a drug includes the chemical/molecular structure or make up of the drug.
chemical
The ____ name of a drug is also known as the official or nonproprietary name.
generic
Drugs can be classified based on 4 descriptive categories:
-chemical classification
-physiologic classification
-therapeutic classification
-prototype
The chemical classification of a drug describes the ______.
chemical base
The physiologic classification of a drug describes the...
drug's effects on body systems.
The therapeutic classification of a drug describes the...
drug's use in therapy.
The prototype of a drug is...
an individual drug which represents a class of drugs.
A well understood drug model against which other drugs in that class are compared is called a ______.
prototype
Morphine's classifications:
chemical-
physiologic-
therapeutic-
chemical- opiate
physiologic- CNS depressant
therapeutic- narcotic analgesic
Morphine is the prototype for which group of drugs?
narcotic analgesics
Three mechanisms of action for drugs are:
-non-receptor drug actions
-drug-enzyme interaction
-Receptor sites (lock and key)
The drug action that produces a biochemical or physical alteration in the cell's external/internal environment and is a simple physical or chemical reaction is known as _______.
nonreceptor drug actions
The drug action in which a drug interferes with some enzyme that acts as a catalyst for a chemical reaction is known as _______.
drug-enzyme interaction
An example of a drug that uses nonreceptor drug actions is _____.
antacids
The drug action in which a drug attaches to a specific receptor site is known as _____.
receptor sites
When there is a _____ drug action the response results from a biochemical or physiologic interaction between a drug and a receptor site to which it binds.
receptor sites (lock and key)
An example of a drug that has a drug-enzyme interaction is ______.
ACE inhibitors
The ACE in ACE inhibitors stands for ______.
angiotensin converting enzyme
The mechanism of action for most drugs is _____.
receptor sites (lock and key)
Drugs that use receptor sites as a mechanism of action can be either _____ or _____.
agonists
antagonists
A drug that attaches to a receptor site and mimics the action of an endogenous substance is known as an _______.
agonist
Something that is already within the body is known as an _____ substance.
endogenous
There are 2 properties of an agonist drug:
affinity and intrinsic activity
Affinity is ______. It refers to the strength of the attraction between the drug and receptor site.
attraction
_____ allows the agonist to bind to the receptor.
Affinity
______ is what allows the agonist to turn on or to activate the receptor.
Intrinsic activity
Intrinsic activity is reflected in _______.
maximal efficacy
Maximal efficacy is the largest...
effect a drug can produce or the maximum degree of relief achieved.
High intrinsic activity = ______ maximum efficacy.
high
______ attach to a receptor site and prevent activation of a receptor by endogenous substances or other drugs.
Antagonists
The _____ inhibits activation of the receptor site.
antagonist
Affinity is reflected in _____.
potency
_____ is the amount of drug that is required to elicit an effect.
Potency
Potency is the _____ of a drug.
strength
The higher the potency of a drug the _____ the necessary dose.
lower
Antagonists have _____ but do not have ______.
affinity
intrinsic activity
Affinity allows the antagonist to ______.
bind to the receptor
Intrinsic activity allows the antagonist to...
turn on or to activate the receptor.
An example of a drug that is an antagonist is ______.
antihistamine
There are 2 types of antagonists:
competitive and non-competitive
Most antagonists are ______.
competitive
_____ antagonists bind reversibly to the receptor site.
Competitive
_____ antagonists bind irreversibly to the receptor site; they can't be knocked off; response is prolonged and you can't reverse effects therefore it isn't usually given.
Non-competitive
Common characteristics of drugs are:
-the do not create responses
-action results from a physiochemical interaction between the drug and a functionally important molecule
-they exert multiple effects on the body
Drugs do not create responses, instead they...
modify existing responses by some physiologic interaction.
Drug action results from a physiochemical interaction between the drug and a functionally important molecule or structure in the body by...
-affecting enzyme interactions
-alter chemical composition
-form chemical bond with specific receptors
We have side effects because drugs exert...
multiple effects on the body.
There are two principles of drug action:
-pharmacodynamics
-pharmacokinetics
_____ is the mechanism of action of a drug. It is how the drug affects the body or works.
Pharmacodynamics
_____ is the effect the body has on the drug; how the body processes the drug.
Pharmacokinetics
The process by which a drug moves through the body and is eliminated is called ______.
pharmacokinetics
Pharmacokinetics looks at 4 processes:
-absorption
-distribution
-metabolism
-excretion
______ is the process by which a medication moves from the site of administration into the bloodstream.
Absorption
Absorption is the primary mechanism of _____.
diffusion
The onset of action is largely determined by the rate of _____.
absorption
______ is the process by which medication is transported from the site of absorption to the site of action.
Distribution
_____ is the physical and chemical processing of a drug.
Metabolism
Metabolism primarily takes place in the ______.
liver
______ is the process of removing the drug or its metabolites from the body.
Excretion
The organ primarily responsible for excretion is ______.
kidneys
Elimination is the combination of _____ and _____.
metabolism and excretion
Factors affecting absorption include:
-route of administration
-solubility
-blood flow to site of administration
-body surface area
-client characteristics
The fastest to slowest routes of administration are:
Fast --------------------------> Slow
IV-----> IM-------> SQ-------> PO
______ is how quickly a medication dissolves into a solution.
Solubility
Two things affect solubility:
-rate of dissolution
-lipid solubility
Fat/lipid soluble drugs cross membranes more quickly because...
our membranes are phospholipid.
____ absorb faster than pills.
Liquids
The higher the blood flow is to the site of administration the more _____ the absorption.
rapid
The larger the absorbing surface are, the _____ the absorption.
greater
An older person has low gastric motility and blood flow which can affect ______.
absorption
Inhaled meds are more quickly absorbed because...
lungs have a large surface area.
4 Factors affecting distribution are:
-circulation
-lipid solubility
-protein binding
-physiologic barriers
Medications are carried to the most _____ organs first.
vascular
The organs that are most vascular are:
liver, spleen, brain and heart.
Low circulation leads to ____ distribution.
low
Lipid soluble drugs have affinity for ______ tissue.
subcutaneous
Drugs generally move attached to a ______.
protein
As long as a drug is bound to a protein it has no _____ affect.
physiologic
Drugs that are bound to proteins more tightly, release _____ and therefore have an _____ duration of action.
slowly
extended
The protein that drugs usually bind to is ______.
albumin
A drug that is more than ____% bound is highly bound. A drug that is less than ____% bound is more loosely bound and therefore is given more often.
80
30
_____ barriers are a selective mechanism opposing the passage of certain substances from the blood into the brain.
Physiologic
A physiologic barrier is the _____.
blood brain barrier
Drugs that can enter the brain are ______ or have some type of ______ that allows it to cross the blood brain barrier.
highly lipid soluble
special transport mechanism
Most medications are absorbed in the ____.
small intestine
Most ____ won't cross the blood brain barrier.
antibiotics
Metabolism is also called ____.
biotransformation
Metabolism primarily occurs in the _____ where enzymes are.
liver
The consequences of metabolism include:
-accelerated renal excretion
-drug activation- inactivation
-increased therapeutic action
Accelerated renal function is a consequence of metabolism that converts a drug into ______ that can be eliminated by the _____.
water soluble form
kidneys
Drug ______, a consequence of metabolism, can convert a drug or compound into a less active or inactive form therefore decreasing the toxicity.
inactivation
Drug activation is a consequence of metabolism that occurs with _____.
prodrugs
A ______ is a drug with no pharmacologic activity until it is metabolized into an active form.
prodrug
Increased therapeutic action is a consequence of metabolism that may...
convert or increase the action of a drug.
During metabolism, some drugs are inactivated in the liver. The _____ avoids this inactivation by giving the drug via another route or in increased PO dosages.
first-pass effect
Some factors that affect metabolism include:
-liver dysfunction and age
The _____ are primarily responsible for excretion.
kidneys
2 ways that drugs are excreted are:
glomerular filtration and active tubular secretion
Factors that affect kidney excretion are:
-kidney function
-age
-acidity of urine (certain drugs are excreted more effectively at particular pH levels.
If a person has problems with metabolism and excretion, the duration of action will be _____.
longer
_____ is the medical use of drugs.
Pharmacotherapeutics
Pharmacotherapeutics is the use of drugs for _____, _____, ____, and _____ illness and disease or to prevent _____.
preventing, diagnosing, managing, and curing

pregnancy
The reason we give a drug is called it's _____.
therapeutic effect
The level or amount of drug needed to cause a therapeutic effect is called the ______.
critical concentration
If a drug level falls below the critical concentration, the drug will have ______.
no effect.
The _____ of a drug is the range between the minimum effective and minimum toxic concentrations.
therapeutic range
The ____ the therapeutic range of a drug the safer the drug is to administer.
wider
The ____ is the minimum plasma/concentration level of a drug required to elicit a pharmacologic response.
minimum effective concentration
The _____ is the plasma level at which toxic effects are observed.
minimum toxic concentration
The ____ measures the drugs margins of safety.
therapeutic index
The _____ is the time after administration of a drug that we see a therapeutic effect or a therapeutic action begins.
onset of action
The time the drug remains in the body in concentrations high enough to have a therapeutic effect is called the ______.
duration of action
The _____ is the highest plasma level achieved by a SINGLE dose of the drug.
peak plasma level
The peak plasma level is primarily affected by the _____.
rae of absorption.
The ratio that represents the therapeutic index is
lethal dose/effective dose
The closer the therapeutic index is to 1, the more ____ the margin of safety.
narrow
The peak plasma level for ____ occurs immediately.
IV
The lowest level or concentration of a drug in an individual system is called the _____. To determine this the blood should be drawn right before the next dose is given.
trough
The time required for the elimination process to reduce the concentration of the drug by half of the original dose is called the ______.
half-life
Knowing the half-life of a drug is important because it is used to estimate how long it would take for a drug to get to a _____.
steady state
A plateau is also called the _____.
steady state
Once there is a maintained concentration of the drug in the plasma during a series of scheduled doses, it is said that a ____ has been reached.
plateau/steady state
A steady state occurs when the drug's rate of ____ is equal to the drug's rate of _____.
absorption
elimination
Half-life is affected by ______ and ________.
metabolism and excretion
The goal of administering medications is for the steady state to be higher than the _____ but lower than the ______.
minimum effective concentration
minimum toxic concentration
It takes ____ half-lives for a drug to reach a steady state and this many more for it to leave the body.
4-5
The intensification/potentiation of drug effects is known as ______.
synergism
_____ occurs when 2 drugs produce a combined effect greater than that of either drug alone or one drug potentiates the other.
synergism
When one drug potentiates another it means that it causes the other drug to...
last longer and have greater effects.
The reduction/inhibition of drug effects is known as _____.
antagonism
_____ is when you give a medication to inhibit or prevent the effect of another. It can decrease the effect or reverse it completely.
antagonism
Mechanisms of drug interactions can be by
-direct physical/chemical interactions
-pharmacokinetic interactions
-pharmacodynamic interactions
You should never combine 2 drugs in the same cup of syringe unless you know they are compatible because they can inactivate one another. This would be a ______ interaction.
direct physical
When one drug affects the absorption, distribution, or excretion of another drug it is called a ______ interaction.
pharmacokinetic
Pharmacodynamic interactions are related to...
antagonists and agonists competing for receptor sites.
Certain drugs can affect the absorption of _____.
nutrients
Some foods can affect the absorption of _____.
drugs
An example of a food that affects the absorption of a drug is...
leafy greens and coumadin
An example of a drug that affects the absorption of nutrients is...
diuretics and potassium
Always check a patient's _____ level before administering a diuretic.
potassium
Any noxious, unintended and undesired effect that occurs at normal drug doses is called ______.
adverse effect
A minor and expected adverse effect is a _____.
side effect
_____ are immunologic responses.
Allergic reactions
When the body forms antibodies after the first exposure to some medication or food, on the second exposure a _____ will occur.
allergic reaction
A severe life threatening allergic reaction is called _____.
anaphylaxis
_____ is when a client develops a decreased response to a drug therefore a higher dose or frequency is required in order to achieve the same therapeutic effect.
Tolerance
A highly unpredictable, uncommon response to a drug that is believed to have a genetic predisposition and therefore is very specific to an individual is called an ______ reaction.
idiosyncratic
The accumulation of a drug int he body that can lead to toxic levels and toxic effects is called _____.
cumulation
_____ means a drug can cause cancer.
Carcinogenicity
_____ means a drug is known to cause birth defects.
Teratogenicity
Certain organ systems that may experience adverse effects are:
-CNS
-GI
-Hematologic (blood)
-Hepatotoxicity (liver)
-Nephrotoxicity (kidneys)
4 ways to maximize therapeutic effects are:
-evaluate therapeutic response
-make good PRN decisions
-take supportive measures
-patient teaching
Examples of PRN decisions that maximize therapeutic effects are:
-giving pain meds around the clock for first 24-48 hrs
-administering pain meds before mobilizing patient
Non-drug measures that can help to maximize the effects of a drug are called ______.
supportive measures
3 ways to minimize the adverse effects of a drug are:
-knowledge about major adverse effects, time to occur, early signs and interventions
-supportive measures
-patient education
An example of supportive measures that can minimize adverse effects of a drug are:
when giving medications that irritate the GI tract, administer them with food or milk.
In order to minimize the adverse effects/interactions of a drug you should have knowledge of...
-major adverse effects
-time these effects will occur
-early signs
-interventions
Factors that can affect medication action include:
-age (developmental)
-gender
-weight
-Basal metabolic rate
-diet
-environment
-psychologic factors
-illness and disease
-time of administration
-culture (genetics)
_____ may not have all enzymes present to metabolize all drugs because the kidney and liver functions are insufficient for metabolism and excretion.
Infants
_____ people have decreased liver and kidney function, poor circulation, decreased gastric motility and gastric acid secretion, all of which can affect medication action.
Elderly
Medications for children are based on their _____.
weight
The client's expectation about what a drug will do is referred to as the ______.
placebo effect
A psychologic factor that affects medication action is the _____.
placebo effect
If a drug is to be give on an empty stomach, it should be administered ____ before a meal of _____ after a meal.
1 hour

2 hours