allergic reaction
immune response related to prior exposure to the drug, re-exposure triggers an allergic response. Can range from mild itching to severe rash to anaphylaxis. Anaphylaxis is a life-threatening response characterized by broncho-spasm, laryngeal edema, and dr
allergic drugs
1.penicillin,
2.NSAIDS (aspirin),
3.Sulfonamide drugs- antihistamines, diuretics, oral hypoglycemic
idiosyncratic effect
uncommon drug response resulting from a genetic predisposition. Occurs the first time a drug is given
side effects
unavoidable secondary drug effect produced at therapeutic doses..drowsiness with antihistamines..predictable and intensity is dose dependent
toxicity
adverse drug reaction due to excessive dosing. severe hypoglycemia from insulin
carcinogenic effect
drugs used to treat cancer have the greatest carcinogenic potential
classification
drugs may be classified in a number of different ways. Typically the classification provide information about the chemical nature, pharmacologic action, or pharmacotherapeutic use of drugs
contraindication
situations when drug use should be avoided or alternative strongly considered. Most drugs are contraindicated in pregnancy and lactation. May be absolute (allergy) or relative.
dosage
the quantity or concentration of drug to be given. Safe dosage is the appropriate amount of the drug taken to ones age and size
drug
any chemical affecting the process of living organism
duration of action
the length of time that a drug concentration in the blood or tissue is sufficient to elicit a therapeutic response
first-pass effect
rapid hepatic inactivation of certain oral drugs
half life
time it takes for one half of the original amount of a drug in the body to be removed by 50 % . After about 5 half lives the most drugs are considered to be removed from the body 97% of the drug is removed
iatrogenic disease
iatros-physicaian...genic-to produce...it is a disease produced by a physician or by treatment. renal toxicity with aminoglycosides, blood dyscrasias with chemotherapy
incompatibilities
reaction occurs when two parenteral drugs or solutions are mixed together, resulting in chemical deterioration of the least one of the drugs
interactions
when the action of one drug is affected by the action of another drug, As number of drugs taken at one time increase, the risk of interaction also increase
additive effect
when 2 drugs with similar actions are giving together and allows a more therapeutic effect with fewer side effects due to smaller doses of each drug. opioid & non-opioid, anti hypertensive with diuretic
antagonist effect
combined effect is less than the effect produced by the active drug alone, second drug eliminates or diminishes activity of the first drug
synergistic effect
combination of two drugs producing a pharmacological effect that is greater than the sum of the two drugs.
loading dose
large initial dose to achieve steady state (plateau)
mechanism of action (MOA)
way that a drug produces a therapeutic effect. There are many different ways that a drug work
nursing consideration
this relates the nursing process to the medication
onset of action
the time it takes for the drug to elicit a therapeutic response( time the drug starts working)
peak effect
the time it takes for a drug to reach maximum therapeutic response in the body ( the time the drug is doing the best it can)
pharmacodynamics
the study of what the drug does to the body
pharmacokinetics
the study of what the drug does to the body AMDE
pharmacology
the science or study of drug and interactions with living things
physical dependence
develops with long term use of certain drugs such as opioid, alcohol, barbiturates, and amphetamines. If drug is discontinued the body will exhibit abstinence syndrome
plasma drug levels
the amount of drug present in the blood can predict whether or not the drug is going to be therapeutic or toxic
precautions
includes disease states or clinical situation when drug use involves risk or in which drug dosage modification is required
prototype
often the first drug developed in a particular class that can be used to present other drugs
routes
how the drug is given..oral parenteral, topical
steady state
physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose, After about 5 half lives, steady state is achieved. Once an individual reached steady state they have consistent levels of drugs
teratogenic effect
drugs that cause abnormal fetal development when give to pregnant women
therapeutic index/range
when the amount of the drug in the plasma is above the minimum effective concentration (MEC) and below the toxic concentration. Some drugs have a narrow therapeutic range like lithium
hepatotoxicity
drugs are the leading cause of acute liver failure, combing hepatotoxic drugs with certain other drugs may cause the risk of liver damage....lipid lower drugs..oral hypoglycemic, anti-seizure drugs, anitfungals, anti tubercular, immune suppressants, antir
Liver function test LFT
obtained as a baseline and periodically 3 months throughout therapy
Aspartame aminotransferase (AST)
Alanine aminotransferase (ALT)
levels are normally low but rise with liver damage
liver damage symptoms
jaundice, dark urine, light colored stools, N/V, malaise, abnormal discomfort, loss of appetite
cardiotoxcity
drugs that interfere with electrical conduction or mechanical function of the heart
qt interval
time it takes for the ventricles of the heart to contract and relax. Cardiotoxic drugs will length the qt interval and lead to life threatening arrhythmia....antidysrhythmics, antibiotics, anticancer drugs, anti-psychotics, ACE inhibitors, calcium channel
grapefruit juice
inhibits the metabolism of the drugs and raise drug level. Inhibition of the CYP3A4 continues for 3 days after drinking grapefruit...CC, caffeine, estrogen, benzodiazepines, statins, cyclosporine
chemical name
describes a drug chemical composition and molecular structure
generic name
everyday, official (nonproprietary) name given to a drug by manufacturer who first develops the drug. longer and more complicated than the trade name.....ibuprofen, acetaminophen, digoxin
trade/proprietary/brand name
indicated that the drug is registered and that its use is restricted to the owner of the drug. legally on record for 17 years. Having multiple trade names for a single generic drug can impair recognition and increase possibility of drug errors
Parenteral
a general term for any route other than the alimentary canal
IV
instant absorbtion since the drug is injected into bloodstream...rapid onset...cost inconvenience, irreversibility, complications
IM
drug inject muscular tissue, only barrier to absorption is the capillary wall......can administer poorly soluble drug..depot preparations,,absorbed slowly decreasing frequency...discomfort and inconvenience
SQ
drug injected into adipose tissue ,less blood flow
enteral
drug is absorbed into the systemic circulation through the oral or gastric mucosa, the small intestine
oral
two barriers to absorption, GI tract epithelial and capillary walls ...easy convenient....variability, inactivation, patient must be able to swallow, local irritation
liquids
syrups, elixirs, suspensions, powers, capsules, tablets
enteric coated
covered with material so the drug dissolves in the intestines protects drugs stomach acid. protects stomach from irritation drugs
extended release
capsules/ tablets filled with tiny spheres that contain actual drug. The sphere dissolves at variable rates and allows steady release of drug throughout the day
topical
lotions, trans dermal patches, ophthalmic and otic drops
maintenance therapy
chronic pain
palliative care
comfort measure...treat symptoms not diseases
Schedule I
a category of drugs not considered legitimate for medical use. Included are heroin, lysergic acid diethylamide (LSD), and marijuana.
Schedule II
a category of drugs considered to have a strong potential for abuse or addiction but that also have legitimate medical use. Included are opium, morphine, and cocaine
Schedule III
a category of drugs that have less potential for abuse or addiction than Schedule I or II drugs and have a useful medical purpose. Included are short-acting barbiturates and amphetamine
Schedule IV
a medically useful category of drugs that have less potential for abuse or addiction than those of Schedules I, II, and III. Included are diazepam and chloral hydrate.
Schedule V
a medically useful category of drugs that have less potential for abuse or addiction than those of Schedules I through IV. Included are antidiarrheals and antitussives with opioid derivatives
Pregnancy Category A
Adequate and well-controlled human studies have failed to demonstrate a risk to the fetus in the first trimester of pregnancy (and there is no evidence of risk in later trimesters).
Pregnancy Category B
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women h
Pregnancy Category C
Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Pregnancy Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigation or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Pregnancy Category X
Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigation or marketing experience, and the risks involved in use of the drug in pregnant women