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50 Cards in this Set
- Front
- Back
Pharmacokinetic
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The study of drug movement throughout the body. (absorption, distribution, metabolism, excretion)
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Absorption
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the movement of a drug from its site of administration into the blood.
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Distribution
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The movement of drugs throughout the body
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Metabolism
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the enzymatic alteration of drug structure (aka biotransformation)
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Excretion
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the removal of drugs from the body
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Pharmacodynamics
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what drugs do to the body and how they do it. (the study of biochemical and physiological effects of drugs and the molecular mechanisms by which those effects are produced.)
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Pharmacotherapeutics
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the use of drugs to treat, prevent or diagnose disease or prevent pregnancy.
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Indication
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describes a valid reason to use a certain test, medication, procedure, or surgery.
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Precaution
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can be defined as a pre-existing condition that significantly increases the risk of an adverse reaction to a particular drug, but not to a degree that is life threatening.
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Contraindication
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pre-existing condition that precludes use of a particular drug under all but the most desperate circumstances.
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Selectivity
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a drug that elicits only the response for which it is given.
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Med error
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patient’s last line of defense is the nurse
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6 rights of medication
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1. Right patient
2. Right medication 3. Right dose 4. Right route 5. Right time 6. Right to refuse |
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Adverse reaction
(ADR ) |
is any noxious, unintended, and undesired effect that occurs at normal drug doses.
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3 goals of preadministration assessment
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i. Collecting base line data needed to evaluate therapeutic and adverse responses.
ii. Identify high risk patients iii. Assessing patient’s capacity for self care |
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nursing process (Drugs)
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a. preadministration assessment
b. Administer and dosage c. Evaluate therapeutic response d. Promote patient adherence e. Implement nondrug measures f. Minimize adverse effects g. Minimize interactions h. Making PRN decisions i. Managing toxicity |
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Administration routes
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Intravenous (IV)
Intramuscular (IM) Subcutaneous (subQ) Enteral Oral (PO) topically transdermal rectal vaginal direct injection into a specific site |
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How albumin could effect the level of a medication?
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a. Drugs bind to the albumin in the blood stream. Albumin is a large protein and therefore does not leave the bloodstream. Therefore neither do the drugs that are bound to the albumin and the drug cannot reach their site of action. Drugs with the ability to bind to albumin can compete for a binding and as a result one drug can displace another, causing the free concentration of displaced drug to rise.
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Half-life
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the time required for the amount of drug in the body to decrease by 50%.
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Dependence
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a state in which the body has adapted to drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued.
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Tolerance
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decreased responsiveness to a drug as a result of repeated drug administration.
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Therapeutic Index
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determined using laboratory animals, is defined as the ratio of a drug's LD50 to its ED50. (The LD50, or average lethal dose, is the dose that is lethal to 50% of the animals treated.) A large (or high) therapeutic index indicates that a drug is relatively safe. Conversely, a small (or low) therapeutic index indicates that a drug is relatively unsafe.
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Alpha 1 blocker
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i. Alpha antagonists lower blood pressure by blocking alpha1 receptors on arterioles and veins, causing vasodilation.
ii. Overdose with an alpha-adrenergic agonist (eg, epinephrine) can produce hypertension secondary to excessive activation of alpha1 receptors on blood vessels. When this occurs, blood pressure can be lowered by reversing the vasoconstriction with an alpha-blocking agent. |
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Alpha 1 blockers Adverse reactions
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1. Orthostatic hypotension
2. Reflex tachycardia 3. Nasal congestion 4. Inhibition of ejaculation |
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How Alpha 1 blockers work?
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1. Relax radial muscle in iris causing pupil constriction
2. Dilation of arterioles in skin, viscera, mucous membranes 3. Dilation of veins 4. Relax prostate capsule 5. Inhibition of ejaculation 6. Contraction of trigone and sphincter of bladder 7. Decrease HTN due to dilation |
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What happens when Beta1 receptors are activated?
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i. Increase HR, force of contraction, and velocity of impulse conduction through AV node
ii. Causes kidney to release renin |
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What happens when Alpha 1 receptors are activated?
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i. Increased pupil size
ii. Constriction of arterioles in skin, viscera, mucous membranes iii. Constrition of veins iv. Contraction of prostate capsule v. Ejaculation vi. Contraction of trigone and sphincter of bladder |
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Atropine
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Muscarinic antagonist
Prevents receptor activation by endogenous acetychloline Selective blockade of muscarinic cholinergic receptors Increases HR Decreases secretion by exocrine glands (salivary, bronchial, sweat, acid-secreting stomach) Relaxation of smooth muscle (bronchi, urinary bladder , GI tract Mydriasis (dilation of pupil) CNS excitation |
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What drugs can and cannot be taken with Atropine?
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Antihistamines
Phenothiazine antipsychotics, tricyclic antidepressants |
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Epinephrine
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Principle transmitter released by the adrenal medulla
Prepares body for flight or fight Only transmitter to activate beta2 |
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Catecholamines
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Cannot be taken orally
Have a brief duration of action Cannot cross the blood brain barrier |
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Noncatecholamines
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Have longer half lives
Can be given orally (do not undergo rapid degradation by MAO and COMT) Less polar and able to cross blood brain barrier |
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Cardio selective Beta Blockers
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Are preferred to nonselective in pts with diabetes and asthma
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Adverse Reactions of Cardio selective Beta Blockers
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Bradycardia
Reduced CO Precipitation of HF AV heart block Rebound cardiac excitation |
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Adverse Reactions of non-selective Beta Blockers
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Bronochoconstriction
Inhibition of glycogenolysis |
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Clonidine: Side effects.
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Antihypertensive drug that acts within the CNS.
Drowsiness Xerostoma Rebound Hyperension Avoid in pregnancy constipation, impotence, gynecomastia, and adverse CNS effects (eg, vivid dreams, nightmares, anxiety, depression) |
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Sensitization
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Exposure to an allergen that results in the development of hypersensitivity.
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Idiosyncratic effects
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an uncommon drug response resulting from a genetic predisposition.
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Terbutaline
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Noncatecholamine
Highly selective acting at beta 2 receptors only High doses will activate beta 1 receptors as well For: Asthma, delay preterm labor Adverse: tremors; high doses = tachycardia, |
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Metoprolol
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Cardio selective
Blockade of beta 1 receptor reduces heart rate force of contraction conduction velocity through the AV node. |
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Metoprolol Adverse Reactions
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bradycardia, reduced cardiac output, AV heart block, and rebound cardiac excitation following abrupt withdrawal.
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Reserpine: Contraindications
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Contradicted for pts with a history of depressive disorder
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Metoprolol who should take it?
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PTs w/ HTN, angina pectoris and prevention of MI
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1906
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the first us law passed to protect the public from altered drugs The Pure Food and Drug Act
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1938
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Mandate for testing of all drugs for harmful effects and accurate labeling.
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1952
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Clearer definition of prescription drugs, non-prescription, and drugs that cannot be refilled (narcoditics).
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1962
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Tightened controls over safety issues.
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1970
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categorized controlled substances on the basis of their relative potential for abuse.
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1978
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drug investigation process shortened to release drugs sooner to the public.
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ALPHA 1 BLOCKERS (ANTAGONISTS) GENERALLY end in... Zosin God (Alpha) is # 1 (Alpha 1) and he hates sin (zosin)
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memo
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