Chapter 2

Blood-brain barrier

The barrier system that restricts the passage of various chemicals and microscopic entities (e.g., bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen. (p. 27)

Chemical name

The name that describes the chemical composition and molecular structure of a drug. (p. 19)

Contraindication

Any condition, especially one related to a disease state or patient characteristic, including current or recent drug therapy, that renders a particular form of treatment improper or undesirable. (p. 31)

Cytochrome P-450

The general name for a large class of enzymes that playa significant role in drug metabolism and drug interactions. (p. 27)

Dependence

A state in which there is a compulsive or chronic need, as for a drug. (p. 32)

Dissolution

The process by which solid forms of drugs disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation. (p. 21)

Drug

Any chemical that affects the physiologic processes of a living organism. (p. 19)

Drug actions

The processes involved in the interaction between a drug and body cells (e.g., the action of a drug on a receptor protein); also called mechanism of action. (p. 20)

Drug effects

The physiologic reactions of the body to a drug. They can be therapeutic or toxic and describe how the body is affected as a whole by the drug. The terms onset, peak, and duration are used to describe drug effects (most often referring to therapeutic effe

Drug-induced teratogenesis

The development of congenital anomalies or defects in the developing fetus caused by the toxic effects of drugs. (p. 35)

Drug interaction

Alteration in the pharmacologic or pharmacokinetic activity of a given drug caused by the presence of one or more additional drugs; it is usually related to effects on the enzymes required for metabolism of the involved drugs. (p. 32)

Duration of action

The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response. (p. 29)

Enzymes

Protein molecules that catalyze one or more of a variety of biochemical reactions, including those related to the body's physiologic processes as well as those related to drug metabolism. (p. 30)

First-pass effect

The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream. (p. 22)

Generic name

The name given to a drug by the United States Adopted Names Council. Also called the nonproprietary name. The generic name is much shorter and simpler than the chemical name and is not protected by trademark. (p. 19)

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

A hereditary condition in which red blood cells break down when the body is exposed to certain drugs. (p. 34)

Half-life

In pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50% (also called elimination half-life). (p. 29)

Idiosyncratic reaction

An abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient. (p. 34)

Incompatibility

The characteristic that causes two parenteral drugs or solutions to undergo a reaction when mixed or given together that results in the chemical deterioration of at least one of the drugs. (p. 33)

Intraarterial

Within an artery (e.g., intraarterial injection). (p.23)

Intraarticular

Within a joint (e.g., intraarticular injection). (p.23)

Intrathecal

Within a sheath (e.g., the theca of the spinal cord, as in an intrathecal injection into the subarachnoid space). (p.23)

Medication error

Any preventable adverse drug event (see above) involving inappropriate medication use by a patient or health care professional; it may or may not cause patient harm. (p. 33)

Medication use process

The prescribing, dispensing, and administering of medications, and the monitoring of their effects. (p. 33)

Metabolite

A chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug (see later). Active metabolites are those that have pharmacologic activity of their own, even if the parent drug is inactive (see prod

Onset of action

The time required for a drug to elicit a therapeutic response after dosing. (p. 29)

Parent drug

The chemical form of a drug that is administered before it is metabolized by the body's biochemical reactions into its active or inactive metabolites (see metabolite). A parent drug that is not pharmacologically active itself is called a prodrug. A prodru

Peak effect

The time required for a drug to reach its maximum therapeutic response in the body. (p. 29)

Peak level

The maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring. (p. 30)

Pharmaceutics

The science of preparing and dispensing drugs, including dosage, form, design. (p. 20)

Pharmacodynamics

The study of the biochemical and physiologic interactions of drugs at their sites of activity. It examines the physicochemical properties of drugs and their pharmacologic interactions with body receptors. (p. 20)

Pharmacoeconomics

The study of economic factors impacting the cost of drug therapy. (p. 20)

Pharmacogenomics

The study of the influence of genetic factors on drug response, including the nature of genetic aberrations that result in the absence, overabundance, or insufficiency of drug-metabolizing enzymes (also called pharmacogenomics; see Chapter 8). (p. 34)

Pharmacognosy

The study of drugs that are obtained from natural plant and animal sources. (p. 20)

Pharmacokinetics

The study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body. Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body. (

Pharmacology

The broadest term for the study or science of drugs. (p. 19)

Pharmacotherapeutics

The treatment of pathologic conditions through the use of drugs. (p. 20)

Prodrug

An inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body. (p. 27)

Receptor

A molecular structure within or on the outer surface of a cell. Receptors bind specific substances (e.g., drug molecules), and one or more corresponding cellular effects (drug actions) occurs as a result of this drug-receptor interaction. (p. 30)

Steady state

The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose. (p. 29)

Substrates

Substances (e.g., drugs or natural biochemicals in the body) on which an enzyme acts. (p. 27)

Synergistic effects

Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone. For example, 1 + 1 is greater than 2 (compare with additive effects). (p. 33)

Therapeutic drug monitoring

The process of measuring drug levels to identify a patient's drug exposure and to allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity. (p. 30)

Therapeutic effect

The desired or intended effect of a particular medication. (p. 30)

Therapeutic index

The ratio between the toxic and therapeutic concentrations of a drug. (p. 32)

Tolerance

Reduced response to a drug after prolonged use. (p. 32)

Toxic

The quality of being poisonous (i.e., injurious to health or dangerous to life). (p. 20)

Toxicity

The condition of producing adverse bodily effects due to poisonous qualities. (p. 30)

Toxicology

The study of poisons, including toxic drug effects, and applicable treatments. (p. 20)

Trade name

The commercial name given to a drug product by its manufacturer; also called the proprietary name. (p. 19)

Drug classification

A method of grouping drugs; may be based on structure or therapeutic use. (p. 20)

Trough level

The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug monitoring. (p. 30)