_______ causes a 406% increase in blood levels of felodipine, lovastatin, cyclosporine,
midazolam and many other drugs. EFFECTS P450 system. - ANS-Grapefruit juice
3 ways to cross a cell membrane - ANS-- channels and pores(electrolytes/ions)
- transport systems (P-glycoprotein)
- direct penetration of the membrane(lipid soluble)
5 + 5 drug rights - ANS-Right dose
Right drug
Right time
Right route
Right patient
Right assessment
Right to refuse
Right evaluation
Right Documentation
Right education
Absorption - ANS-determines intensity & time of the effects
Active tubular secretion - ANS-active transport systems in the renal tubule work to move
some drugs from the blood and into the urine (Acids and bases)
Advantages of IM - ANS-Better for poorly soluble drugs
permits depot preparations/slow release
after giving a Loading dose, we should continue giving.. - ANS-smaller maintenence doses
Agonist - ANS-Mimics body's regulatory action.
a molecule that, by binding to a receptor site, stimulates a response
Agonists have both ____ and ______. - ANS-Affinity and intrinsic activity
antagonist - ANS-works against the agonist by preventing receptor activation
Because drugs can be displaced if there is nowhere to attach, this can cause... -
ANS-toxicity
Because morphine is more potent than meperidine, is it a better drug? - ANS-no. You need
less to achieve the same result.
black box warning - ANS-A type of warning that appears in a drug's prescribing information
and is required by the U.S. Food and Drug Administration (FDA) to alert prescribers of
serious adverse events that have occurred with the given drug.
Blinding in experiments - ANS-single- just subjects dont know what they've received
Double-blinded- researchers and subjects dont know
Prevents personal bias
blood-brain barrier - ANS-Blood vessels (capillaries) that selectively let certain substances
enter the brain tissue and keep other substances out
competitive antagonist - ANS-REVERSIBLE-a pharmacologic antagonist that can be
overcome by increasing the concentration of agonist
Consequences of drug interaction - ANS-1. drug intensifies other drug
2.one drug reduces effect of another
, 3.new response may appear
Considerations for drug metabolism - ANS-Age-induction& inhibition of drug metabolizing
enz
Disadvantages of IM - ANS-discomfort, inconvenience,potential injury
Disadvantages of oral - ANS-variability
slow onset
inactivation by gastric acid risk
nausea/irritation
patient must be conscious and cooperative
Disadvantages of SubQ - ANS-Possible discomfort
inconvenient
potential for injury
limited volume , not in frail skin; not in blood disorders
dose-response relationship - ANS-the relationship between the different doses and the
responses they generate
down regulation - ANS-a compensatory reduction in receptor availability at the synapses of a
neuron because of constant exposure
desensitized or refractory
drug excretion - ANS-the process of eliminating medications, usually through the kidneys in
urine, but also through sweat, feces, and saliva, milk production
drug metabolization - ANS-structural enzyme change
drug tolerance requires - ANS-requires an increase in dosage to achieve the desired effect
drug tolerance(response problem) - ANS-decreased response to a drug as a reult of
repeated drug administration,
Drug with short half lives... - ANS-leave the body quickly
drug-drug interactions - ANS-when the effect of a medication is changed, enhanced, or
diminished when taken with another drug, including herbal substances
Drugs most commonly bind to.... - ANS-plasmaAlbumin
Drugs will ____with one another for sites on albumin - ANS-compete
Drugs with long half lives - ANS-leave slowly
Drugs with low affinity are less_______. - ANS-potent
Drugs with low affinity must be_________to bind to their receptors. - ANS-in high
concentrations
Effectiveness of a drug - ANS-elicits desired resonse
Example of a complete drug order - ANS-Acetaminophen 650 mg PO Q6H PRN PAIN/HA
Example of an intended and desired response for using multiple drugs: - ANS-Hypertension
multi drug use
Example of intensified therapeutic effect - ANS-+Ex: Sulbactum and ampicillin, sulbactum
inhibits the liver enzymes that would otherwise deactivate ampicillin, therefore allowing
ampicillin to work.
Excercising discretion for new drugs - ANS-Be neither the 1st to adopt a new drug or last to
abandon an old drug-Adopt a wait and see policy
Faster metabolization of a drug =____ - ANS-need a higher dosage
Food drug interactions can affect... - ANS--absorption and predicatability
-duration of effects
-enhance therepuetic effects
- increase toxicity
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