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Absorption
Movement of drug from administration site into bloodstream
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Distribution
Movement of drug through the bloodstream to tissues and cells
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Metabolism
Conversion of the drug into another substances
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Excretion
Removal of the drug or substance it became from the body
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Clearance (or clearance rate)
The rate at which drug molecules disappear from the circulatory system, primarily through hepatic (liver) metabolism and renal excretion
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Protein binding
Process during distribution in which a portion of drug is attracted to and binds to protein, such as albumin in blood, preventing it from passing through capillary walls; therefore this portion is inactive and cannot achieve therapeutic effect
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Free drug
The portion of being distributed in the body that is not bound to protein & therefore is active & can achieve therapeutic effect
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Agonist
Drug molecules that attach to receptors on cells to stimulate the cell to act; they promote function
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Antagonists or blockers
Drug molecules that attach to receptors & prevent something else from attaching ( block the receptor) and causing an effect
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Half-life
The amount of time that is required to remove half or 50% of blood concentration of a drug
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Steady-state
The point at which the amount of drug that is administered and the amount that is being eliminated from the body balance off. The balance creates a stable level of drug in the blood
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Clearance
The rate at which drug molecule disappear from the circulatory system, primarily through hepatic metabolism and renal excretion
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Biotransformation
Another term for metabolism of drugs. When drugs are changed from their original form to a new form in the body
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Metabolites
Product of metabolism, a drug that is metabolize is generally changed into an inactive form on its way to excretion . Occasionally a drug be metabolized in active metabolites substance that can achieve an independent effect that can be either therapeutic
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First pass effect
The rate of metabolism of a drug varies as it is circulated through the bloodstream, to the portal circulation, and through the liver. The percentage of the drug metabolites on the first circulation or pass through the liver is high then the drug loses effectiveness during this first pass before reaches the general circulation. Loss of effectiveness in the first pass
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P-450 System
A system of liver enzyme families three of which are involved in drug metabolism. drugs can either induce or inhibit P-450 system altering metabolism of other drugs
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Potency
A drug's relative pharmacologic activity. The amount of drug that must be given in order to produce a particular response. Highly potent drugs often have a higher affinity for the receptor site on the cell so little is needed to produce its effects
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Efficacy
How well a drug produces its desired effect. Is relative to the intrinsic activity. The higher the activity the greater the efficacy
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ED50
Effect dose 50. The dose of a drug that is required to produce a therapeutic effect in 50% of the population. Often considered the standard or typical dose and is chosen when the drug therapy is initiated
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LD50
Lethal dose 50 The point at which the dose of a drug would be fatal in 50% of the population
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Maintenance dose
I drug dose that is administered consistently over time, such as every day. Often achieved after 4-5 half-lives.
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Loading dose
A higher dose of a drug given initially at the start of drug therapy when the drug has a longer half-life and needs to achieve steady-state in the shortened time frame due to the patient's medical condition requiring immediate steady-state for effective treatment
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Therapeutic index
Ratio comparison used to determine the safety of a drug. The ED 50 is divided by the LD50 in ratio form and if there is little difference between the two the drug has a narrow therapeutic index and is therefore not very safe due to difficulty in dosing the drive safely
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Allergic response
An immune system antigens/antibody response after drug is taken again it involves the release of histamine, which leads to allergic signs and symptoms and possibly anaphylaxis; the most serious allergic response
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Idiosyncratic response
An unusual adverse effect of a drug, can be opposite response from what is anticipated. An individual's unique response to a drug, also called paradoxical effect
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Additive effect
When two or more drugs that are alike in therapeutic Effect are combined, and the resulting response is the sum of the drug effects. Can be an intentionally more therapeutic, or unintentionally cause harm
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Synergistic effect
When two or more unlike drugs, in terms of therapeutic effect or mechanism of action, are used together to produce a combined effect. Outcome response is greater then if either was used alone
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Potentiated effect
An interaction between drugs in which one of the two drugs is increased. I.e. A drug that has mild effect may enhance the effects of a second drug
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Drug
A chemical that can affect living processes
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Pharmacology
The study of drugs in their interactions with living systems
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Clinical pharmacology
The study of drugs in humans
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Therapeutics/Pharmacotherapeutics
The use of drugs to diagnose prevent or treat disease or to prevent pregnancy
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Right drug, right patient, right dose, right Route, right time, right documentation
Nursing responsibility six rights
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The patient and the disorder being treated
What drugs are contraindicated
Probable consequences of the interactions between drugs and patient
In order to anticipate problems the nurse must understand...
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Antitussives
Suppress cough reflex
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Antitussives prototype
Dextromethorphan (DMX)
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Dextromethorphan (DMX) Pharm. therapeutic
Used to treat constant nonproductive cough
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Dextromethorphan (DMX) pharmacodynamic
Directly affects the cough Center in the Medulla
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Dextromethorphan (DMX). Contraindications
Chronic cough associated with emphysema and asthma
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Dextromethorphan (DMX) adverse effects
Nausea, vomiting, drowsiness, dizziness, irritability, restlessness. Possible poisoning/overdose for euphoric effects
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Dextromethorphan (DMX). Drug interactions
- MAOIs
- fluoxetine
- quinidine
- sibutramine
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Dextromethorphan (DMX) asses
- Contraindications (emphysema and asthma)
- Pregnancy/class-c
- May cause drowsiness assess for operation of heavy equipment
- May impair motor/orientation – help ambulated- safety
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Dextromethorphan (DMX) important to asses
- Frequently assess respiratory status
- Ck for clear airwAy
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Other antitussives
- Codeine, hydrocodone
- Diphenhydramin Benadryl
- Benzonatate
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Codeine, hydrocodone
Oral, at CNS depressant. Works on medullary center
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Codeine, hydrocodone contraindications
Post op patients who need to cough and deep breathe and those with chronic cough
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Benzonatate
- Tessalon/ Tessalon perles
- Non-narcotic, anesthetizes stretch receptors in respiratory system to reduce cough reflex
- Used in endoscopy
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