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measure to reduce adverse reactions to medication administration forewarn patients as to activities that may precipitate an adverse reaction
problems with trade names one drug may have different trade names because of different formulations
problems with trade names can be used for different products
why are highly lipid souble drugs are absorbed more rapidly than low-lipid soluble drugs high lipid soluble drugs cross membranes that separate them from the blood
parenteral outside the GI tract (injection by IV, subQ, IM)
at what rate should IV meds be administered over one full minute
how long does it take an IV drug injected in the AC to reach the brain 15 seconds
what are depot preparations preparations from which the drug is absorbed slowly over an extended time
what kinds of compounds do not pass freely from the maternal bloodstream into the fetus bloodstream ionized, highly polar, protein bound drugs remain in the bloodstream
benathine pcn G can be released at a therapeutical amount over one month from a single IM injection, what type of preparation would this be called depot preparation
what types of compounds pass freely from the maternal bloodstream to fetus? lipid soluble compounds and non-ionized compounds
what can occur when two highly protein bound drugs are given together compete for sites on the protein
what happens when two highly protein bound drugs are given together and compete for sites drug with weakest attraction becomes "free" and can reach toxic levels
high protein bound drug warfarin, ASA, Paroxetine
drugs that are highly bound to protein may exhibit (increased/ decreased) levels in the blood when the patient is gound to be in a malnourished state increased
biotransformation (drug metabolism) enzymatic alteration of drug structure
where does most drug metabolism take place liver
if two drugs are given that both utilize the same p450 hepatic microsomal system, the drug level in the blood of the drug that is not metabolized (increases/ decreases) increases
what age does hepatic maturation occur about 1 year after birth
drug metabolizing capacity in infants is (decreased/ increased) decreased
how is the first pass effect circumvented when a drug is given parenterally
what is an example of a drug that if given orally would be destroyed in the "first pass" through the GI tract nitroglycerin given sublingual
what aspect of pharacokinetics (absorption, distribution, excretion, metabolism) is affected in pts with kidney disease? excretion
the range of plasma drug level that falls between minimum effective concentration and teh toxic concentration is called what? therapeutic range
drug with narrow therapeutic rang is (more/ less) dangerous more
time requried for drug in the body to decrease by 50% is called? half-life
how many half lives does it take for a drug to reach plateu four half lives
drugs with long half-life need to be administered (more/ less) frequently than drugs that have a short half life less frequently
agonists molecules that activate receptors
antagonists molecules that prevent receptor activation
drugs that mimic the body's own regulatory molecules are called agonists
desensitizing occurs when teh receptors of a cell are continually exposed to an agonist; the cell becomes less responsive. down-regulation
the does required to produce a defined therapeutic response in 50% of the population is ED50
ratio of a drug's LD50 to its ED50 therapeutic index (measure of drug safety)
drug with high therapeutic index is (safe/ unsafe) safe
laxatives (reduce/ increase) absorption reduce (speeds passage of drugs throough intestine)
drugs that decrease peristalsis and cause increased drug time (and increased absorption) in the intestines morphine and atropine
When an inducing drug such as phenobarbital is taken concurrently with another medication, the metabolism of the other medications is (increased or decreased)? The metabolism is increased and the drug is excreted more rapidly
Accelerated metabolism would lead to (increased or decreased) blood levels of other drugs decreased
with inducing drug (more/ less) of the other medication would be needed more
grapefruit juice can (inhibit/ induce) the matabolism of certain drugs, thereby (raising/ lowering) their blood levels inhibit, raising
potential consequences when CCB's taken with grapefruit juice inhibits metabolism; can cause toxicity
how to administer drug "on an empty stomach" 1 hour before or 2 hours after meals
patient over what age account for over 50% of all adverse drug reactions (ADR's) elders over the age of 65
when do side effects usually occur soon after onset of drug, or in some cases weeks or months afterwards
can an allergic reaction occur without prior sensitizaiton to the immune system? must have prior sensitizaiton
define idiosyncratic effect uncommon drug response resulting from a genetic predisposition
succinylcholine is used to promote temporary paralysis. In some patients, the genes that code for succinylcholine-metabolizing enqymes are abnormal and lead to prolonged paralysis. idiosyncratic effect
life threatening response characterized by bronchospasm, laryngeal edema, drop in BP anaphylaxis
why is abrupt discontinuation of a medication discouraged withdrawal reactions possible
why are women more at risk for prolonged QT interval women have longer QT than men
what is the most common cause of acute liver failure and hepatoxicity drugs
teratogenic drug induced birth defect
3 most common causes of fatal medication errors human factor, communication mistakes, name confusion
why are elderly more sensitive organ dysfunction, polypharmacy, comorbidities, cognitive decline
a patient with kidney or liver dieae would require (higher/ lower) dose of medication lower
ability of a drug to reach the systemic circulation from its site of administration is known as what bioavailability
component of a drug response that is caused by psychologic factors and not by the biochemical or physiologic properties of the drug is known as what placebo
form of tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time is known as what? tachyphylaxis
decreased responsiveness to a drug as a result of repeated drug administration tolerance
a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency that takes aspirin or a sulfanilamide is at reisk for what disorder hemolysis (red blood cell destruction)
during pregnancy, increased renal blood flow leads to accelrated excretion of drugs. thes process may reuire (increased/ decreased) drug amount increase
SSRI's are schedule ______ drugs. not scheduled
medications with black box warning ssri's, salmeterol, avandia, metformin (sulfonlureas), antispychotics
which herbal remedy is an inducer and can decrease levels of warfarin, cyclosporine, ocp, antiretrovirals st johns wort
name a drug that is an inducer phenobarbital
diseae or condition produced by a doctor or other health care provider or drugs is known as what iatrogenic effect
do pharmacokinetics change throughout the lifespan yes
drugs that recommend genetic testing warfarin, carbamazepine, tratuzumab, abacavir