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Name sources of drugs and examples
- Plant - Digoxin, taxol, caffeine, nicotine
- Animal - Hormones
- Mineral - Calcium
- Lab synthesis (genetic engineering) - Procrit, insulin
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Therapeutic classification
- Based on therapeutic use
- Broadly what the drug does
- Examples - antimicrobials kill bugs, antihypertensives lower BP
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Pharmacological classification
Based on the mechanism of action - how the drug works or exerts its activity
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What are the differences between chemical, generic, and brand/trade names of drugs?
- Chemical - Very long, complicated
- Generic - Usually describes the active ingredient
- Brand/Trade - Assigned by pharmaceutical company marketing the drug
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Pharmacokinetics definition
What the body does to the drug
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Pharmacokinetics processes
- Absorption
- Distribution
- Metabolism
- Excretion
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Absorption
- How fast a drug leaves the site of administration
- Oral, topical, IV
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Bioavailability
After a drug goes through the process of absorption, the bioavailability is the amount of the drug left available for the body to use
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Distribution
Movement of drug to site of action
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Metabolism
Drug is altered/transformed
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Hepatic
- Primary site for drug metabolism
- Liver
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Excretion
- Elimination from body
- Renal - primary site
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Rate of excretion
How fast drug excretiates
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Onset
How long a drug takes to start working
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Peak
Drug level at its maximum
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Duration
How long drug lasts
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Half life
How long it takes for drug concentration to decrease to 1/2
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Loading dose
Larger initial dose needed to get drug concentration up
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Maintenance dose
Amount of drug needed to maintain level of concentration
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Serum drug concentration
Amount of drug in body needed to get therapeutic effect
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Pharmacodynamics
What drug does to body
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Dosing
How much drug needed for therapeudic response
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Potency
- How strong drug is
- Strong drug --> need less for effect
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Efficacy
How well drug works
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Lock and key
Drug (key) attaches to cell receptor and opens up cell
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Agonist
Produces response just as body would naturally
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Partial agonist
Not as good as an agonist but produces a similar response
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Antagonist
- Opposite response of agonist
- Lock on and block cell receptor
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Idiosyncratic
Produces unexplained or unexpected response
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Pharmacotherapy
Therapies you can do with drugs
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Acute
Something that comes on abruptly
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Empiric
Make an educated guess and start treatment before it is ordered
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Mintenance
Chronic, ongoing
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Palliative
Provide comfort but not a cure
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Prophylactic
Preventative (vaccine)
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Therapeutic response
Response you wanted for patient
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Side effect
Tolerable effects of drug
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Adverse reaction
- Extended side effect
- Usually intolerable
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Allergic response
Hypersensitivity response of the immune system
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Additive
- Two drugs with similar actions to achieve one goal
- Narcotic and tylenol - both used for pain
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Synergistic
- Two drugs, different pathways, same result
- Hypertensive and diuretic
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Incompatibility
Lethal effects when combined in body
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Iatrogenic
- Response we have caused
- Risk vs. benefit
- The drug may cause damage to body but is needed for the survival of patient
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Teratogenic
Causes fetal defects
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Carcinogenic
Cancer causing agents
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Total parenteral nutrition (TPN)
IV nutrition
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Obstetrics
Pregnant, breast feeding
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Co-morbidities
Patient has multiple diseases
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Pediatric dosing
Weight based
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Polypharmacy
- Multiple drugs --> varying drug levels and interactions
- Requires close monitoring
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