Nursing Pharmacology

psychological dependence

desire to continue using a drug despite obvious negative economic physical or social consequences

risk-benefit ratio

determination of whether the risks form a drugh outweigh the potential benefits received by taking the medication

attention deficit/hyperactivity disorder (ADHD)

disorder typically diagnosed in childhood characterized by hyperactivity as well as attention, organization, and behavior control issues

blood-brain barrier

Blood vessels (capillaries) that selectively let certain substances enter the brain tissue and keep other substances out

club drug

a diverse group of abused substances taken by people at dance clubs, all night parties and raves

frequency distrubtion curve

a graphic representation of the actual number of patients responding to a particular drug action at different doses

drug allergies

a hyperresponse of body defenses to a particular drug that may result in a diverse range of patient symptoms

delirium tremens

a syndrome of intense agitation confusion terrifying hallucinations uncontrollable tremors panic attacks and paranoia caused by alcohol withdrawl

antagonist

agent that blocks the response of another drug

teratogens

agent that causes birth defects

minimum effective concentration

amount of drug required to produce a therapeutic effect

maintenance doses

amount of drug that keeps the plasma drug concentration in the therapeutic range

adverse drug effect

an undesirable and potentially harmful action caused by the administration of medication

medication error

any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care provider, patient or consumer

assessment

appraisal of a patients condition that involves gathering and interpretubg subjective and objective data

hepatic microsomal enzyme system

as it relates to phamacotherapy, liver enzymes that metabolize drugs as well as nutrients and other endogenous substances, sometimes called the P-450 System

second messenger

cascade of biochemical events taht intitiates a drugs action by either stimulationg or inhibiting a normal activity of the cell

medication error index

categorization of medication errors according to the degree of harm an error can cause

receptor

cellular molecule to which a drug binds to produce its effects

opiods

class of drugs that includes natural substances obtained from the seeds of the poppy plant such as opium morphine and codeine

physical dependence

condition of experiencing unpleasant withdrawal symptoms when a substance is discontinued after repeated use

baseline data

data gathered during the initial assessment that is compared wiht data gathered during later interactions

therapeutic range

dosage that produces the desired effects of a drug

agonist

drug that activates a receptor and produces the same type of response as the endogenous substance

substrate

drug that is metabolized by a CYP enzyme

prodrugs

drugs that become more active after they are metabolized

nursing process

five part decision making system that includes assessment nursing diagnosis planning implementation and evaluation

drug-protein complexes

formed when a drugh that binds reversibly to a plasma protein, particularly albumin, that makes the drug unavailable for distribution to its site of action

Black Box Warning

in some drug inserts, a requirement by the FDA that warns prescribers that the drug carries a risk for serious or fatal adverse effects

controlled substance

in the United States a drug whose use is restricted by the Comprehensive Drug Abuse Prevention and Control Act

scheduled drugs

in the United Statesa a term describing a drug placed into one of five categories based on it potential for misuse or abuse

medication administration record (MAR)

legal documentation of all pharmacotherapies received by the patient

toxic concentration

level of drug that results in serious adverse effects

nursing diagnoses

list of proble.s that address the patients responses to health and life processes

first-pass effect

mechanism whereby drugs are absorbed enter into the hepatic portal circulation and are inactivated by the liver before they reach the general circulation

partial agonist

medication that produces weaker or less efficacious response than an agonist

isozymes

multiple similar forms of an enzyme that perform slightly different metabolic functions

intervention

nursing action that produces an effect or that is intended to alter the course of a disease or condition disigned to move the patient toward the desired goal

drug interaction

occurs when a medication interacts with another substance such as another drug, a dietary supplement, an herbal product, or food that is taken concurrently with the medication, and the drugs actions are affected

planning

phase of nursing process in which appropriate goals and outcomes are developed and nursing interventions that will help the patient them are determined

reticular formation

portion of the brain affecting awareness and wakefulness

therapeutic drug monitoring

practice of monitoring plasma levels of drughs that have low safety profiles and using the data to predict drugh action or toxicity

diffusion

process by which molecules tend to move from an area where they are more concentrated to an area where they are less concentrated

enzyme induction

process by whick a drug increases the activity of the hepatic microsomal enzymes

tolerance

process of adapting to a drug over a period of time and subsequently requiring higher doses to achieve the same effect

enterohepatic recirculation

recycling of drugs and other substances by the circulation of bile through the intestine and liver

loading dose

relatively large dose of a drug given at the beginning of treatment to rapidly obtain a therapeutic response

hallucinogens

seeing hearing or feeling things that are not there

substance abuse

self-administration of a drug that does not conform to the medical or social norms within the patients given culture or society

cross-tolerance

situation in which tolerance to one drug makes the patient tolerant to another drug

fetal-placental barrier

special anatomic barrier that inhibits many chemicals and drugs from entering the fetus

evaluation criteria

specific and measuable achievements that will be used to determine if a particular goal has been met

outcome

statement that includes specific measurable evaluation criteria

pharmacokinetics

study of drug movement throughout the body

pharmacodynamics

study of the mechanisms of drug action and how the body responds to drugs

sedatives

substances that depress the CNS and cause drowsiness or sleep

reboud effects

symptoms of lethargy and fatigue caused by withdrawal of methamphetamine and other stimulants

withdrawl syndrome

symptoms that result when a patient discontinues taking a substance on which he or she was dependent

risk management

system of reducing medication errors by modifying policies and procedures within the institution

evaluation

systematic objective assessment of the effectiveness and impact of interventions

polypharmacy

taking multiple drugs concurrently

intrinsic activity

the ability of a drug to bind to a receptor and produce a strong action

Affinity

the ability of some tissues to attract, accumulate and store drugs in high concentrations relative to other tissues

tetrahydrocannabinol (THC)

the active chemical in marijuana

margin of safety (MOS)

the amount of drug that is lethal to 1% of anmals divided by the amount of drug that produces a therapeutic effect in 99% of the animals

addiction

the continued use of a substance despite serious health and social consequences

median effective dose (ED50)

the dose of a drug required to produce a specific therapeutic response in 50% of a group of patients

median lethal dose (LD50)

the dose of a drug that will kill 50% if a group of animals

median toxicity dose (TD50)

the dose that will produce a given toxicity in 50% of a group of patients

plasma half-life

the length of time required for the plasma concentration of a drug to decrease by one half after administration

efficacy

the maximal response that can be produced from a particular drug

Absorption

the process by which drug molecules move from their site of administration to the blood

medication reconciliation

the process of keeping track of a patients medication as the patients care proceeds from one health care provider to another

excretion

the process of removing substances from the body

metabolism

the process used by the body to chemically change a drug molecule, also called biotransformation

tachyphylaxis

the rapid development of tolerance to any action of a drug either adverse or theapeutic effects

therapeutic index (LI)

the ratio of a drugs LD50 to its ED50

potency

the strength of a drug at a specified concentration or dose

pharmacogenetics

the study of genetic variations that alter patients responses to medications branch of pharmacology that examines the role of genetics in drug response

distribution

the transport of drugs throughout the body after they are absorbed

dose-response relationship

the way a patient responds to varying doses of a drug

additive effect

type of drug interaction in which two agents combine to produce a summation response

synergistic effect

type of drug interaction in which two drugs produce an effect that is much greater than would be expected form simply adding the two individual drugs responses

antagonistic effect

type of drug interactions in which adding a second drug results in a diminished pharmacologic response

anterograde amnesia

type of short term memory loss where the user cannot remember events that occurred while under the influence of a drug

side effect

types of drug effects that are less serious than adverse effects, are predictable and may occur even at therapeutic doses

idiosyncratic response

unpredictable and unexplained drug reaction

idiosyncratic response

unpredictiable and unexplained drug reaction

evidence-based practice

used of research observations nursing practice and clinical judgment to determine care

Adverse Event Reporting System (AERS)

voluntary program that encourages health care providers and consumers to report suspected adverse efects directly to the FDA or the product manufacturer

goal

what the patient should be able to achieve and do based on the problem or nursing diagnosis established from the assessment data

implementation

when the nurse applies the knowledge skills and principles of nursing care to help move the patient toward the desired goal and optimal wellness