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Flashcards in Chapter 2 Deck (48):
1

Drug

Any chemical that affects the physiologic processes of a living organism

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Pharmacology

Study or science of drugs

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Chemical Name

Describes the drug's chemical composition and molecular structure

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Generic Name

(Non proprietary name)
Name given by the United States Adopted Name Council

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Trade Name

(Proprietary Name)
The drug name has a registered trademark; use of the name is restricted by the drug's patent owner (Usually the manufacturer)

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Pharmaceutics

The study of how various drug forms influence pharmacokinetic and pharmacodynamics activities

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Pharmacokinetics

The study of what the body does to the drug
Absorption
Distribution
Metabolism
Excretion

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Pharmacodynamics

The study of what the drug does to the body
The mechanism of drug actions in living tissues

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Pharmacotherapeutics

The use of drugs and the clinical indications for drugs to prevent and treat diseases

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Pharmacognosy

The study of natural (plant and animal) drug sources

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Drug absorption of various oral preparations
Fastest to slowest

Liquids, elixirs, syrups
Suspension solutions
Powders
Capsules
Tablets
Coated tablets
Enteric-coated tablets

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Pharmacokinetics: Absorption

The rate at which a drug leaves its site of administration, and the extent to which absorption occurs
-Bioavailability
-Bioequivalency

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Factors that affect absorption
Absorption characteristics vary according to the dosage form and route

*Food or fluids administered with the drug
*Dosage formulation
*Status of the absorptive surface
*Rate of blood flow to the small intestine
*Acidity of the stomach
*Status of GI motility

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Routes

A drug's route of administration affects the rate and extent of absorption of that drug
-Enteral (GI tract)
-Parenteral
-Topical

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Enteral Route

The drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine
-Oral
-Sublingual
-Buccal
-Rectal

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First-Pass Effect

The metabolism of a drug and its passage from the liver into the circulation

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A drug given via the oral route may be-

Extensively metabolized by the liver before reaching the systemic circulation (high first-pass effect)

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The same drug given IV-

Bypasses the liver, preventing the first-pass effect from taking place, and more drug reaches the circulation

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Parenteral Route

*Intravenous (fastest delivery into the blood circulation)
*Intramuscular
*Subcutaneous
*Intradermal
*Intraarterial
*Intrathecal
*Intraarticular

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Topical Route

*Skin (including transdermal patches)
*Eyes
*Ears
*Nose
*Lungs (inhalation)
*Rectum
*Vagina

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Distribution

The transport of a drug in the body by the bloodstream to its site of action
*Protein binding
*Water soluble vs. fat soluble
*Blood brain barrier
*Areas of rapid distribution: heart, liver, kidneys, brain
*Areas of slow distribution: muscle, skin, fat

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Metabolism/Biotransformation

The biochemical transformation of a drug into an active metabolite, a more soluble compound, or a more potent metabolite
*Liver (main organ)
*Skeletal muscle
*Kidneys
*Lungs
*Plasma
*Intestinal mucosa

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Biologic transformation of a drug into:

*An inactive metabolite
*A more soluble compound
*A more potent metabolite

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Factors that decrease metabolism

*Cardiovascular dysfunction
*Renal insufficiency
*Starvation
*Obstructive jaundice
*Slow acetylator
*Erythromycin or ketoconazole drug therapy

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Factors that increase metabolism

*Fast acetylator
*Barbiturate therapy
*Rifampin therapy

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Delaying drug metabolism causes:

*Accumulation of drugs
*Prolonged action of the drugs...drug toxicity

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Stimulating drug metabolism causes:

*Diminished pharmacologic effects

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Excretion

The elimination of drugs from the body
*Kidneys
*Liver
*Bowel- biliary excretion-enterohepatic recirculation

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Half Life

*The time it takes for one half of the original amount of a drug to be removed from the body.
*A measure of the rate at which a drug is removed from the body
*Most drugs considered to be effectively removed after about five half-lives
*Steady State

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Onset

The time it takes for the drug to elicit a therapeutic response

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Peak

The time it takes for a drug to reach its maximum therapeutic response

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Duration

The time a drug concentration is sufficient to elicit a therapeutic response

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Peak Level

Highest blood level

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Trough Level (Nadir)

Lowest blood level

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Pharmacodynamics: Mechanism of Action

*Receptor interactions
*Enzyme interactions
*Nonselective interactions

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Agonist

Drug binds to receptor: there is no response

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Partial Agonist

Drug binds to the receptor, the response is diminished compared with that elicited by an agonist

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Antagonist

Drug binds to the receptor: there is no response. Drug prevents binding of agonists

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Competitive Antagonist

Drug competes with the agonist for binding to the receptor. If it binds there is no response

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Noncompetitive Antagonist

Drug combines with different parts of the receptor and inactivates it: agonist then has no effect

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Pharmacotherapeutics: Types of Therapies

*Acute therapy
*Maintenance therapy
*Supplemental/replacement therapy
*Palliative therapy
*Supportive therapy
*Prophylactic therapy
*Empiric therapy

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Contraindications

*Any characteristic of the patient, especially a disease state, that makes the use of a given medication dangerous for the patient
*It is important to assess for contraindications

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Therapeutic Index

Ratio of a drug's toxic level to the level that provides therapeutic benefits

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Tolerance

Decreasing response to repeated drug doses

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Dependence

Physiologic or psychological need for a drug

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Interactions may occur with other drugs or food ***A drug interaction is the alteration of a drug's actions by:

*Other prescribed drugs
*Over-the-counter medications
*Herbal therapies

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Drug Interactions

*Additive
*Synergistic
*Potentiation
*Antagonistic
*Incompatibility

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Drug Sources: Four main sources

1. Plants
2. Animals
3. Minerals
4. Laboratory synthesis