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Active absorption

Requires a carrier to move the drug against a concentration gradient. Requires energy.

Adverse reaction

More severe than side effects.

Agonists

Drugs that produce a response.

Antagonists

Drus that block a response.

Bioavailability

The percentage of the administered drug that reaches the systemic circulation.

Creatinine clearance

Most accurate test to determine renal function. Normal range = 85-135ml/min. Elderly/female may be lower.

Disintegration

The breakdown of a tablet into smaller particles

Distribution

The process by which the drug becomes available to body fluids & body tissues.

Duration of action

The length of time a drug has a pharmacologic effect.

Elimination

Body gets rid of the drug. Main route = kidneys (urine)

Dissolution

The dissolving of the smaller particles in GI fluid before absorption

Excipients

Fillers & inert substances used in drug preparation to allow the drug to take on a particular size/shape and to enhance drug dissolution

First-pass effect

Process in which the drug passes to the liver first.

Free drugs

Portion of drug not bound to protein. Active part of drug that causes an effect.

Half-life (t1/2)

The time it takes 1/2 of the drug to be eliminated

High therapeutic index

Wide margin of safety. Less dangerous.

Ligand-binding domain

The site on the receptor in which drugs bind.

Loading dose

Large initial dose to achieve an immediate drug response.

Low therapeutic index

Narrow margin of safety. Dangerous.

Metabolism

Taking the drug into the body.

Nonselective drugs

Drugs that affect various receptors.

Nonspecific drugs

Drugs that affect various sites.

Onset of action

The time it takes to reach the minimum effect concentration after a drug is administered.

Passive absorption

Occurs mostly by diffusion. No energy required.

Peak action

Occurs when the drug reaches its highest blood plasma concentration.

Peak drug level

Highest plasma concentration of drug at a specific time. Indicates rate of absorption.

Pharmaceutic phase

1st phase. Drug breaks down & is prepared for metabolism. Disintegration + dissolution.

Pharmacodynamics

The study of drug concentration & its effects on the body.

Pharmacogenetics

Effect of a drug action that varies from a predicted drug response because of genetic factors or heredity influence.

Pharmacokinetics

The process of drug movement to achieve drug action. Absorption + distribution + metabolism + excretion.

Pinocytosis

A process by which cells carry a drug across their membrane by engulfing drug particles.

Placebo effect

A psychologic benefit from a compound that may not have the chemical structure of a drug effect.

Protein-binding effect

Higher protein binding = less free (active) drug.

Rate limiting

The time it takes the drug to disintegrate and dissolve to become available for the body to absorb it.

Receptor families

1) Kinase-linked receptors 2)Ligand-gated ion channels 3)G protein-coupled receptor systems 4)Nuclear receptors

Side effects

Physiologic effects not related to desired drug effects.

Tachyphylaxis

A rapid decrease in response to a drug.

Therapeutic index (TI)

Estimates the margin of safety of a drug through the use of a ratio that measures the effective dose & lethal dose.

Therapeutic range/window

Drug concentration in the plasma. Should be between MEC & MTC.

Time-response curve

Evaluates the onset of drug action, peak action, & duration of action.

Tolerance

Decreased responsiveness over the course of therapy.

Toxic effects

Result from high plasma concentrations o a drug

Toxicity

Occur from overdosing/accumulation

Trough level

Lowest drug concentration in the plasma. Indicates rate of elimination.

A client asks why the oral dose of his pain medication is higher than the intravenous dose. The nurse explains that with the oral dose, some of the drug is absorbed from the GI tract and is metabolized by the liver to an inactive drug form. This reduces the amount of active drug and is called (the):

Hepatic first pass

A nurse is learning how to draw peak and trough levels of a medication. The nurse is aware that the trough level is the:

Lowest plasma concentration of a drug.

Isoproterenol (Isuprel) is an example of a medication that enhances the beta receptors in the body. Drugs that enhance a response are known as:

Agonists

When providing a medication, if the nurse wanted to select the route that ensures greatest bioavailability, that route is:

Intravenously

A client's creatinine clearance level is 105 ml/minute. Based on this information, a nurse would anticipate that the dose of the drug would be:

The same

A nurse is providing an oral medication for pain relief to a client. To attain the fastest pain relief, the nurse administers the medication so that it is most rapidly absorbed from the gastrointestinal (GI) tract. Which of the following has the fastest absorption?

Liquid suspension

The serum half-life (t1/2) of a drug is:

the time required after absorption for half of the drug to be eliminated

A nurse is administering a high dose of a medication in order to rapidly achieve a minimum effective concentration. This dose is known as the:

Loading dose

Because of hereditary influence, drug action may vary from a predicted drug response. This is known as:

Pharmacogenetics

Oral medication passes through several phases and processes in order to achieve a physiological response. What is the order?

Dissolution, Absorption, Distribution, Metabolism, Excretion

A client's serum protein and albumin levels are below normal values. For a drug that is highly protein-bound, there would be:

More free drug in circulation

A client is taking a drug that is moderately highly protein-bound. Several days later, the client takes a second drug that is 90% protein-bound. What happens to the first drug that is highly protein-bound?

The first drug is released from the protein and becomes more pharmacologically active.

A client is suffering from end-stage renal disease. Because of this condition, the nurse monitors drug levels to assess for:

Accumulation

Undesired effects are frequently associated with a client stopping a medication before completion of the full course. Physiologic effects, not related to the desired effect, that can be predicted or associated with the use of the drug are called:

Side effects

Drug tolerance to a frequently repeated administration of a certain drug is known as:

tachyphylaxis

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