CH 2
rate
Absorption _____ depends on route, blood flow, and solubility of the drug
pharmacokinetics
All drugs are processed in the body through
condition
clinical reasearch phase II invovles patients who have the _____ they are trying to treat
2-10 yrs (average 5 yrs)
clinical research for a new drug could last for ____ years
20-100
clinical research phase I include _____ subjects tested on for 4 to 6 wks
dosing
clinical research phase III provide info on proper
Excretion
depends on GI tract and kidneys
Distribution
depends on circulation to be transported throughout body
Metabolism
depends on enzyme systems
Absorption
depends on route of administration
drug blood level
for certain drugs this is important to measure to make sure the drug is within therapeutic range
interference
probenecid & ampicilin are to drugs that cause
half-life
refers to the amount of time required for 50% of the drug to be eliminated from the body.
antagonistic effect
tetracycline + antacid = decreased absorption of tetracycline
Interference
the first drug inhibits the metabolism or excretion of the 2nd drug, therby increased activity of the 2nd drug
Duration of action
How long the drug has a pharmacologic effect
times
Many alterations in absorption can be managed by separating the ____ of administration
GI tract
Most drug interactions that alter absorption take place in the
2 months to 7 years
NDA reveiw for a new drug takes up to ___ months- ____ years
metabolism
The process whereby the body inactivates drugs
Absorption, distribution, metabolism, excretion (ADME)
What is the correct order that drugs pass through the body?
3.13 mg
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?
Displacement
_______ by a second drug could cause the first drug's activity to increase b/c of more unbound drug is available
Additive effect
two drugs with similar actions or taken for an increased effect
Adverse effects
undesired effect of a drug that which can be less serve and less common then a side effect.
displacement
warfarin + valproic acid = increase anticoagulant effect
drug presents
when a drug is circulating in the blood a sample may be drawn to determine
toxicity
when an adverse effect becomes serve
distribution
when drugs are transported throughout the body by body fluids to the sites of action
agonist
when it comes to drugs, the better the "fit," the better the response, this is called
Antagonistic effect
when one drug interferes with the action of another; the second drug is s/t conseidered the antidote to the 1st
Synergistic effect
when the combined effect of two drugs r greater than the sum of the effect of each drug given together
Heat and massage
will increase absorption.
30
within ____ days the FDA must make a decision on the basis safety and whether to allow clinical research for a drug
liver
primary organ of metabolism ; other sites are GI tract and lungs
Peak action
A drug reaches the highest concentration
absorption
A nurse can administer oral drugs with a glass of water to help with
idiosyncratic effect
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 a cardiac arrest. What is this type of reaction called?
antagonistic 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?
Percutaneous
Absorbed through the skin and mucus membranes thru Inhalation, sublingual, or topical
drugs
Some _____cannot pass through the blood-brain barrier or the placental barrier; effective for meningitis
Parenteral
Bypasses the GI tract by using subcutaneous, intramuscular, and intravenous injection
Onset of action
Concentration of a drug is sufficient to start a pharmacologic response-feel releives
Drug level
Determines the amount of drug present
absorption
Drug is transferred from entry site into the body's circulating fluids for
Liberation
Drug released from dosage form and is dissolved in body fluid
unbound drugs
Drugs are bound to proteins in the blood during transportation
antagonists
Drugs that attach but do not elicit a response, called
excretion
Elimination of drug and metabolites some of the active drug from the body
blood supply
Organs with largest ______ receive the distributed drug most rapidly
food & water in the stomach
Process of converting oral drug can be influenced by
circulation
Subcutaneous and intramuscular injection absorption is affected by
circulation
The more a drug is "bound" to a protein, the less available it is to the
thickness & hydration
Topical medications applied to the skin can be influenced by skin thickness and hydration
Enteral
Via the gastrointestinal tract by the oral, rectal, or nasogastric routes
15.6
a patent receiving 1000 mg of a medication that has a half-life of 4 hours would have ____mg left after 24 hours.
increased
a patient wih poor kidney function will have _______ action & duration of a drug
Drugs
act by forming a chemical bond with specific receptor sites, similar to a key and lock.
Protein binding & fat solubility
affects distribution in the body
incompatibility
ampicilin + gentamicin = ampicilin inactivities gentamicin
absorption
antacids increase the gastric pH and can inhibit the dissolution of ketoconazole tablets is an example of alterations in
Carcinogen
any substance directly involved with causing cancer
Drug interactions
are caused by an alteration in metabolism, by inhibiting or stimulating the enzymes that metabolize a drug
Kidneys
are the major organ of excretion; some excreted in feces
synergistic effect
aspirin + codeine=
3%-6%
drug interactions represent _____% of preventable in-hospital adverse drug reation cases
increase, decrease
drug interactions, when combined will either _______ or _______ their action
partial agonists
drugs that attach and elicit a small response, but also block other responses, called
Teratogen
drugs that can effect prenatal development
Incompatibility
haziness, formation of precipitate (crystals), or change in color of the drug solution mix is signs of
addictive effect
hydrocodone + acetaminophen=
phase 4
includes refinig doses & potential drug interaction
the nurse
is expected to know the desired effect, side effects, adverse effects and allergic reactions of drugs
drug interactions
major component of the # of hospital emergency department visits & admission
intravenous
medications that are absorbed fastest
Allergic reactions
occurs b/c of previous exposure to an antigen (drug) that results in the development of antibodies agaisnt the drug
Idiosyncratic effects
occurs when s/t unusual happens when a drug is first administered
1-3 ( average 18 mon)
preclinical research & development of a drug, include animal testing and could last for ____yr