Pharm 2, 3, 6

drug interaction

-Additive effect -Synergistic effect -Antagonistic effect -Displacement -Interference Incompatibility

liberation

Drug released from dosage form -Drug released from dosage form and is dissolved in body fluid -Process of converting oral drug can be influenced by food and water in the stomach

Antagonist:

Drugs that attach to a receptor but do not stimulate a response

Agonists:

Drugs that interact with a receptor to stimulate a response

Most drug interactions that alter absorption take place in the ___________

GI tract

Duration of action:

How long the drug has a pharmacologic effect

A patient reports postoperative pain, and the nurse administers morphine (a narcotic analgesic) intravenously to ease the pain. Fifteen minutes later, the nurse notes that the patient is very drowsy, respirations are slow and shallow, and oxygen saturation is low. The nurse administers another drug that decreases the action of the morphine. What is this effect called? a) Displacement b) Antagonistic c) Interference d) Synergistic

IDK

what is the fastest absorption route?

IV

gender affects weight therapy

In almost every body system, men and women function differently; experience disease differently

Drug Stages After Administration

LADME: Liberation Absorption Distribution Metabolism Excretion

changes in absorption

Many alterations in absorption can be managed by separating the times of administration

Changes in Distribution

Many interactions that cause a change in distribution usually affect the binding of a drug to an inactive site

allergic reaction:

Occur among patients who have previously been exposed to a drug and whose immune systems have developed antibodies to the drug

illness affect on metabolic rate Patients with _________ failure generally will excrete drugs at a _________ rate

Pathologic conditions may alter rate of absorption, distribution, metabolism, and excretion of drug kidney failure, slower rate

Nocebo effect

Patient's negative expectations can result in a less-than-optimal outcome

placebo effect

Patient's positive expectation can positively affect the outcome

Unbound drugs:

Pharmacologically active portion

drug interactions

Said to occur when the action of one drug is altered or changed by the action of another drug

Drug receptors:

Specific sites where drugs form chemical bonds

Pharmacodynamics:

Study of interactions between drugs and their receptors and the series of events that result in a pharmacologic response

Peak action:

Time at which the drug reaches the highest concentrations on the target receptor sites

Enteral:

Via the gastrointestinal tract by the oral, rectal, or nasogastric routes

Onset of action:

When the concentration of a drug at the site of action is sufficient to start a physiologic response

drug actions

onset of action peak action duration of action

body weight affects drug therapy Considerably ________ patients may require an increase in drug dosage to attain the same therapeutic response

overweight

metabolic rate affect on drug therapy Patients with higher-than-average metabolic rate tend to metabolize drugs more ___________ Chronic _________ enhances metabolism of some drugs

rapidly smoking

Absorption rate depends on ____________, ______________, and _______________

route, blood flow, solubility of the drug

Drugs are "bound" to proteins in the blood during _______________.The more a drug is bound to a protein, the less available it is to the ______________. Some medications can cause binding or unbinding of another medication, increasing or decreasing its effect

transportation, circulation,

A patient is being started on a new drug that has been used safely by many people for years. The patient has no known allergies, and the nurse administers the drug correctly. Suddenly the patient experiences cardiac arrest. What is this type of reaction called? a) Allergic b) Mutagenic c) Idiosyncratic d) Therapeutic

allergic?

Subcutaneous and intramuscular injection absorption is affected by _________________

circulation

changes in excretion Drug interactions that cause a change in excretion usually act in the ________ ________ by changing the ______ to enhance or inhibit excretion

kidney tubules , pH

Organs with ____________ blood supply receive the distributed drug most rapidly

largest

Primary organ of metabolism is the _______; other sites are GI tract and lungs

liver

two ways to elicit drug interactions

-By agents that, when combined, increase the action of one or both drugs -By agents that, when combined, decrease the effectiveness of one or both drugs

Adverse Effects of Drugs

-Desired action -Side effects -Adverse effects (common and serious) - Idiosyncratic reactions: Occur when something unusual/abnormal happens when drug is first administered - Allergic reactions: Occur among patients who have previously been exposed to a drug and whose immune systems have developed antibodies to the drug

half life of drugs

-Factors modifying the quantity of drug reaching a site of action after a single oral dose

Drug Blood Level

-When a drug is circulating in the blood, a blood sample may be drawn and assayed to determine amount of drug present -Important for certain drugs, like anticonvulsants - If drug blood level is low, dosage may be increased; if it is high, dosage must be reduced

All drugs are processed in the body through pharmacokinetics. What is the correct order that drugs pass through the body? a) Liberation, absorption, distribution, metabolism, excretion b) Distribution, metabolism, liberation, absorption, excretion c) Biotransformation, liberation, distribution, absorption, excretion d) Excretion, distribution, liberation, absorption, metabolism

A

Percutaneous:

Absorbed through the skin and mucous membranes - Inhalation, sublingual, or topical

psychology effects on drug therapy

Attitudes and expectations play a major role in a patient's response to therapy; willingness to take medication as prescribed

Parenteral:

Bypasses the GI tract by using subcutaneous, intramuscular, and intravenous injection

When the nurse administers a 50-mg dose of a drug with a half-life of 6 hours, how many milligrams will remain in the body at 24 hours? a) 25 mg b) 12.5 mg ' c) 6.25 mg d) 3.13 mg e) 1.56 mg

D 6.25% remains, so 3.13

excretion

Depends on GI tract and kidneys -Elimination of drug metabolites and some of the active drug from the body - Kidneys are the major organ of excretion; some excreted in feces

distribution

Depends on circulation to be transported throughout body -Drugs are transported throughout the body by body fluids to the sites of action - Protein binding and fat solubility affect distribution - Organs with largest blood supply receive the distributed drug most rapidly - Some drugs cannot pass through the bloodbrain barrier or the placental barrier

metabolism

Depends on enzyme systems T-he process whereby the body inactivates drugs -Primary organ of metabolism is the liver; other sites are GI tract and lungs

absorption

Depends on route of administration -Drug is transferred from entry site into the body's circulating fluids -Absorption rate depends on route, blood flow, and solubility of the drug -Subcutaneous and intramuscular injection absorption is affected by circulation -Intravenous medications are absorbed fastest -Topical medications applied to the skin can be influenced by skin thickness and hydration

Affects on Drug Therapy

age body weight gender metabolic rate illness psychology

drug responses in the body

drug receptors pharmodynamics agonists antagonists

routes of administration

enteral parental percutaneous

Antacids increase the ________________ and can inhibit the dissolution of __________ tablets

gastric ph ketoconazole

age affects drug therapy _______ and the _______ tend to be most sensitive to drug effects Aging process brings about changes in body ________ and organ ________

infants and the very old composition, function

change in metabolism -Drug interactions usually result from a change in metabolism that involves _________ or ___________ the enzymes that metabolize a drug

inhibiting or inducing -Serum drug levels usually increase a result of inhibited metabolism when drugs are given concurrently