Question | Answer |
any chemical substance taken into the body for the purpose of affecting body function | drug |
were the primary source of drugs used on the human body | plants |
four ways that drugs are obtained | source of drugs |
iron, sulfur, potassium, silver, & gold are some of the ___ used to prepare drugs | minerals |
research lead to the use of substances from ___ as effective drugs | animals |
substances lacking in the human body can be replaced with similar substances from the | glands, organs & tissues of animals |
origin of drugs from an animal source even now includes ___ ___ | human extractions |
can be used to make a drug for treatment of growth disorders | pituitary gland from cadavers |
chemists use __ __ to make drugs to market for human consumption | synthetic sources |
evolved with human skills in labs & advanced understanding of chemistry; most actively pursues source of drugs by major companies today | synthetic (manufactured) sources |
produced from artificial rather than natural substances | drug compounds |
numerous antibiotics are | synthetic or semisynthetic |
1990s, development of drugs for treatment of life-threatening or other various conditions | investigational new drugs (INDs) |
slows progression of HIV infection in some patients; IND of 1990s | Zidovudine (AZT) (Retrovir) |
used to treat many different malignancies & also management of AIDS-related Kaposi's sarcoma; IND of 1990s | Interferon (Roferon A) |
used to slow progression of dementia in some Alzheimer patients; IND of 1990s | Tacrine (Cognex) |
combines Norvasc & Lipitor for simultaneous treatment of high blood pressure & high cholesterol; 1st to treat these 2 conditions with a single tablet; 21st century IND | Caduet |
first-line treatment for metastatic colorectal cancer; prevents formation of new blood vessels denying necessary nutrients needed for growth & metastasis; 21st century IND | Avastin |
physiological changes that occur in response to a drug | effect of drug |
reaches widespread areas of the body | systemic effect |
limited to area of body where administered | local effect |
four biological changes drugs undergo in the body | drug processes |
drug gets into the blood stream | absorption |
drug moves from bloodstream into tissues & fluids of the body | distribution |
physical & chemical alterations that a substance undergoes in the body | metabolism |
eliminating waste products of drug metabolism from the body | excretion |
if any of the four drug processes is hampered the drug __ and __ will be hampered | actions; effects |
mucosa of stomach, mouth, small intestine, or rectum; blood vessels in muscles/subcutaneous tissues; or dermal layers are the | primary site of absorption |
circulatory system, through capillaries & across cell membranes are the | primary site of distribution |
liver is the | primary site of metabolism |
kidneys, sweat glands, lungs, or intestines are the | primary site of excretion |
specific directions that accompany each drug are given to __ the absorption, distribution, metabolism, & excretion of the drug | enhance |
varies according to pH, lipid solubility, & presence/absence of food in the stomach | site of absorption of a drug |
drugs of a slightly acidic pH are absorbed well through the | stomach mucosa |
drugs of an alkaline pH are readily absorbed in the | small intestine |
given on an empty stomach so that the pH is not altered; if dairy, milk or antacids present it will not properly be absorbed | tetracycline |
oral medication for infants may not be absorbed well after feeding because the milk or formula ___ the acidity of the stomach | acidity |
substance ___ in lipid solubility are easily absorbed through the mucosa of the stomach | high |
alcohol and substances containing alcohol are soluble in | lipids |
substances soluble in lipids are rapidly absorbed through the __ __ | GI tract |
substance ___ in lipid solubility are absorbed best when given by means other than the GI tract | low |
not lipid soluble but given orally for suppression of intestinal bacteria before intestinal/bowel surgery or in treatment of bacterial diarrhea | neomycin |
food in the stomach tends to slow absorption due to a | slower emptying of the stomach |
if a fast drug effect is desired, an __ __ will facilitate quicker absorption | empty stomach |
medications that are irritating to the stomach can be buffered by the presence of | food |
reaching sites beyond the major organs may depend of the drugs ability to | cross a lipid membrane |
composed of high-density cells restricting passage of substances from the bloodstream much more than endothelial cells in capillaries elsewhere in the body | blood-brain barrier |
affinity/attraction of a drug to a specific organ/cell | selective distribution |
selective distribution to CSF | amphetamines |
selective distribution to the ovaries, as a fertility drug | human chorionic gonadotropin (hCG) |
by virtue of their properties some drugs are distributed __ __ than others | more slowly |
2 drugs categorized in the same classification may be known to | act on the cells & achieve the effect more quickly |
biotransformation means transformed in | the liver |
drug is broken down to more water-soluble by-products, making it more easily secreted by the kidneys, during | biotransformation |
a patient may exhibit toxic effects of drug if | hepatic disease is present |
it is possible for some drugs to by pass the | process of metabolism |
drugs that are able to by pass the process of metabolism reach the kidneys unchanged and may later be | detected in the urine |
most drugs are excreted by | the kidneys |
refers to a condition that results from exposure to either a poison or a dangerous amount of a drug that is normally safe when given in a smaller amount | toxicity |
increased effect of a drug demonstrated when repeated doses accumulate in the body | cumulative effect |
cumulative effect may build to a dangerous/toxic level & can be of particular concern in | older adults |
to give just enough of the drug to cause the desired/therapuetic effect while keeping the amount below the level where toxic effects are observed | goal of drug therapy |
cardiac drug that must be given cautiously because of its potential for causing a cumulative effect | Digoxin |
must be adequate or digoxin will accumulate, leading to digoxin toxicity | circulation & renal function |
factors that affect speed & efficiency of drugs processed by the body | variables |
are slower in older adults, so attention must be paid to possible cumulative effects | metabolism & excretion |
have a lower threshold of response and react more rapidly/in unexpected ways; frequent assessment is imperative | children |
many drug dosages are always calculated on the basis of | the patient's weight |
because the ratio of fat per body mass differs and so do hormone levels women respond | differently than men to some drugs |
most drugs are contraindicated or dosage must be adjusted, if the | female is pregnant or nursing |
the more positive the patient feels about the medication, the more positive the | physical response |
beneficial effect in patient following particular treatment arising from patient's expectations about the treatment rather than from the treatment itself | placebo effect |
inactive substance that resembles a medication, although no drug is present (i.e. a sugar tablet or saline injection) | placebo |
attitudes towards medicines can be influenced positively/negatively by | cultural or religious beliefs |
when more than one medication is taken | combination |
combination may __ alter the normal expected response of each individual drug | alter |
action of 2 drugs working together in which one helps the other simultaneously for an effect that neither could produce alone | synergism |
action of 2 drugs in which one prolongs/multiplies the effect of the other | potentiation |
opposing action of 2 drugs in which 1 decreases/cancels out the effect of the other | antagonism |
important for prescribing physician to know all medications a patient is taking in order to | prevent undesirable drug interactions |
by giving small amounts of 2 drugs together effect can be achieved more safely than by giving a larger amount of one/other by itself, would be | desired synergism |
2 drugs given in combination can depress the CNS to dangerous levels, depending on strengths of each would be | undesirable synergism |
building up a high/safe level of an antibiotic in the blood, then simultaneously giving a drug that slows the kidney's excretion rate | desirable potentiation |
toxic effect that may result from a drug potentiating the level of another drug's concentration in the blood | undesirable potentiation |
narcotic antagonist cancels out effects of an overdoes of narcotics | desirable antagonism |
a drug that lowers the pH and prevents absorption of another drug | undesirable antagonism |
may bring about variations in speed of drug action or effectiveness | drug dosages |
amount of drug given for particular therapuetic or desired effect | dosage |
smallest amount of a drug that will produce a therapuetic effect | minimum dose |
largest amount of a drug that will produce a therapuetic effect without producing symptoms of toxicity | maximum dose |
initial high dose used to quickly elevate the level of the drug in the blood | loading dose |
the initial high dose, of a loading dose, is often | the maximum dose |
the initial dose, of a loading dose, is often followed by a series of | lower maintenance doses |
dose required to keep the drug blood level at a steady state in order to maintain desired effect | maintenance dose |
amount of drug that will produce harmful side effects or symptoms of poisoning | toxic dose |
dose that causes death | lethal dose |
customarily given based on adult body weight of 150 lb; adjusted according to variations from the norm | therapuetic dose |
most significant factor in the speed of drug action | route of administration |
sometimes based on degree of speed, cost, or safety | the route of administration |
some medications can be given only by one route because | absorption occurs by that route only |
some medications, given by one route only, can be ___ or ___ when given by another route | dangerous; toxic |
oral (PO), nasogastric tube (NG), and rectal (R) are | GI tract routes |
include any route of administration other than gastrointestinal tract | parenteral routes |
sublingual (SL)/buccal, Injection, topical, & inhalation are all | parenteral routes of administration |
intravenous (IV), intramuscular (IM), subcutaneous (subQ), intradermal (ID), intracardiac, intraspinal, intracapsular are all | injection routes of administration |
dermal (D) & mucosal | topical (T) routes of administration |
may depend on (1) desired effect, (2) absorption qualities, & (3) how supplied | doctor's choice of route of administration |
is easiest, but effects are slower due to time required for disintegration of drugs in alimentary canal before absorption | oral route of administration |
fastest, given in small amounts, effects immediate, dangerous if given in amounts intended for other routes; administered by IV push or bolus, or diluted solutions infused by IV drip | IV route of administration |
concentrated drug solution | bolus |
administered by a physician, RN, or paramedic | IVs |
IVs are the best route for treatment of emergencies because of | speed of action |
when a patient can take nothing by mouth or the drug is not suitable for GI absorption it is given | parenterally |
because the muscles are highly vascular the __ __ is fairly rapid | intramuscular route |
any unexpected or dangerous reaction to a drug; unwanted effect; onset may be sudden or develop over time | adverse drug effects |
effect from maternal drug administration that causes development of physical defects in a fetus | teratogenic effect |
unique, unusual response to a drug | idiosyncrasy |
opposite effect from what is expected | paradoxical |
decreased response to drug that develops after repeated doses are given; drug dosage must be increased or drug replaced, in order to achieve desired effect | tolerance |
acquired need for drug that may produce physiological/physical symptoms of withdrawal when drug discontinued | dependence |
no physical symptoms of withdrawal other than anxiety; craving | physiological dependence |
when cells actually have a need for the drug; withdrawal symptoms include retching, nausea, pain, tremors, & sweating | physical dependence |
immune response to a drug; may be of varying degrees | hypersensitivity |
hypersensitivity may develop after previous __ __ of a drug | uneventful uses |
hypersensitivity more likely to exist in patient with | other known allergies |
nausea, vomiting, & diarrhea are not considered | signs of allergies |
severe, possibly fatal, allergic response | anaphylactic reaction |
include itching, uticaria, hyperemia, vascular collapse, shock, cyanosis, laryngeal edema, & dyspnea | signs of anaphylactic reaction |
includes CPR if indicated & drugs as required, such as epinephrine to raise blood pressure, corticosteroid to reduce inflammation and body's immune response, or antihistamine to reduce redness, itching & edema | treatments for anaphylactic reaction |
antibiotics especially penicillin; x-ray dyes containing iodides; & insect stings have been noted often to cause | anaphylaxis |
knowledge of adverse drug reactions should be included in the | patient's history |
getting accurate drug history & listing known allergies is a __ __ of the health care worker | critical function |
absorption is the __ biological change process that drugs undergo when they are ingested | initial |
drugs whose actions are limited to a __ __ of the body have local effects | specific location |
the pharmacokentic affect of a medication taken with food is that food tends to | slow drug absorption |
age, weight, psychological state, & sex are the __ __ that affect the speed & efficiency of drug processing | major variables |