1
NR I293 IExam I1 IStudy IGuide
Chapter I2
• Define Ithe Icommon Iterms Iused Iin Ipharmacology
o Pharmacokinetic- Ithe Istudy Iof Iwhat Ithe Ibody Idoes Ito Ithe Idrug; Iinvolves Ithe Iprocesses Iof
Iabsorption, Idistribution, Imetabolism, Iand Iexcretion; Ithe Istudy Iof Iwhat Ihappens Ito Ia Idrug
Ifrom Ithe Itime Iit Iis Iput Iinto Ithe Ibody Iuntil Ithe Iparent Idrug Iand Iall Imetabolites Ihave Ileft Ithe
Ibody; Irepresent Ithe Idrug Iabsorption Iinto, Idistribution Iand Imetabolism Iwithin, Iand
Iexcretion Ifrom Ithe Ibody
o Pharmacodynamics- Ithe Istudy Iof Iwhat Ithe Idrug Idoes Ito Ithe Ibody; Iinvolves Idrug–
Ireceptor Irelationships.
o First-pass Ieffect- Iinitial Imetabolism Iin Ithe Iliver Iof Ia Idrug Iabsorbed Ifrom Ithe IGI Itract
Ibefore Ithe Idrug Ireaches Isystemic Icirculation Ithrough Ithe Ibloodstream; Ireduces Ithe
Ibioavaibility Iof Iless Ithan I100%, Iwhereas Idrugs Iadministered Iby Ithe Iintravenous Iroute Iare
I100% Ibioavailable
o Bioavaibility- Ia Imeasure Iof Ithe Iextent Iof Ia Idrug Iabsorption Ifor Ia Igiven Idrug Iand Iroute
I(from I0% Ito I100%)
o Protein-binding
o Onset Iof Iaction- Itime Irequired Ifor Ia Idrug Ito Ielicit Ia Itherapeutic Iresponse Iafter Idosings
o Peak IEffect I– Ithe Itime Irequired Ifor Ia Idrug Ito Ireach Iits Imax. Itherapeutic Iresponse
o Duration Iof Iaction- Ithe Ilength Iof Itime Ithe Iconcentration Iof Ia Idrug Iin Ithe Iblood Ior Itissues
Iis Isufficient Ito Ielict Ia Iresponse
o Half-life I– Iin Ipharmacokinetics, Ithe Itime Irequired Ifor Ihalf Iof Ian Iadministered Idose Iof
Idrug Ito Ibe Ieliminated Iby Ithe Ibody, Ior Ithe Itime Iit Itakes Ifor Ithe Iblood Ilevel Iof Ia Idrug Ito Ibe
Ireduced
o Therapeutic Iindex- Iratio Ibtwn Itoxic Iand Itherapeutic Iconcentrations Iof Ia Idrug
o Trough Ilevel- Ilowest Iblood Ilevel; Ithe Ilowest Iconcentration Iof Ia Idrug Ireached Iin Ithe Ibody
Iafter Iit Ifalls Ifrom Iits Ipeak Ilevel, Iusually Imeasured Iin Iblood Isample Ifor Itherapeutic Idrug
Imonitoring
o Peak Ilevel- Ihighest Iblood Ilevel; Idone Iusually Iat I12th Ilevel Iafter I3rd Idose; Ithe Imax.
Iconcentration Iof Ia Idrug Iin Ithe Ibody Iafter Iadministration, Iusually Imeasured Iin Ia Iblood
Isample Ifor Itherapeutic Idrug Imonitoring
o Agonist- Idrug Ithat Ibinds Ito Iand Istimulates Ithe Iactivity Iof Ione Ior Imore Ireceptors Iin Ithe
Ibody
o Antagonist- Idrug Ithat Ibinds Ito Iand Iinhibits Ithe Iactivity Iof Ione Ior Imore Ireceptors Iin Ithe
Ibody; Ialso Icalled Iinhibitors
• Type Iof Itherapy:
o Acute Itherapy- Ioften Iinvolves Imore Iintensive Idrug Itreatment Iand Iimplemented Iin Iacutely
Iill I(those Iwith Irapid Ionset Iof Iillness) Ior Icritically Iill; Ioften Ineeded Ito Isustain Ilife Ior Itreat
Idisease
▪ Ex: Ivasopressors Ito Imaintain IBP Iand Icardiac Ioutput Iafter Iopen Iheart Isurgery
▪ Ex: Iintensive Ichemotherapy Ifor Ipt Iwith Inewly Idiagnosed Icancer
o Maintenance Itherapy- Idoesn’t Ieradicate Iproblems Ithe Ipt Imay Ialready Ihave Ibut Iwill
Iprevent Iprogression Iof Ia Idisease Ior Icondition; Iused Ifor Itreatment Iof Ichronic Iillnesses
▪ Ex: IHTN Iit Iwill Imaintain Ithe Ipt’s IBP Iwithin Igiven Ilimits Iwhich Iprevents Icertain
Iend-organ Idamage
▪ Ex: Ioral Icontraceptives Ifor Ibirth Icontrol
, 2
o Supplemental Itherapy- Ior Ireplacement Itherapy; Isupplies Ibody Iwith Ia Isubstance Ineeded
Ito Imaintain Inormal Ifunction; Isubstance Imay Ibe Ineeded Ibc Iit Icannot Ibe Imade Iby Ithe Ibody
Ior Ibc Iit Iis Iproduced Iin Iinsufficient Iquantity
▪ Ex: Iadministration Iof Iinsulin Ito Idiabetic Ipt’s
▪ Ex: Iiron Ito Ipts Iw/ Iiron-deficiency Ianemia
o Palliative Itherapy- Imake Ipt Ias Icomfortable Ias Ipossible; Ifocuses Ion Iproviding Ipts Iw/
Irelief Ifrom Isymptoms, Ipain, Iand Istress Iof Ia Iserious Iillness; Igoal Iis Ito Iimprove Iquality Iof
Ilife Ifor Iboth Ipt Iand Ifamily; Itypically Iused Iin Ithe Iend Istages Iof Ian Iillness Iwhen Iattempts Iat
Icurative Itherapy Ihave Ifailed; Iit Ican Ibe Iprovided Ialong Iwith Icurative Itreatment
▪ Ex: Iuse Iof Ihigh Idose Iopioid Ianalgesics Ito Irelieve Ipain Iin Ithe Ifinal Istages Iof Icancer
o Supportive Itherapy- Imaintains Iintegrity Iof Ibody Ifunctions Iwhile Ithe Ipt Iis Irecovering
Ifrom Iillness/trauma
▪ Ex: Iprovision Iof Ifluids Iand Ielectrolytes Ito Iprevent Idehydration Iin Ia Ipt Iw/ Iinfluenza
Iwho Iis Ivomiting Iand Ihas Idiarrhea
▪ Ex: Iadministration Iof Ifluids, Ivolume Iexpanders, Ior Iblood Iproducts Ito Ia Ipt Iwho Ilost
blood Iduring Isurgery
o Prophylactic Itherapy- Idrug Itherapy Iprovided Ito Iprevent Iillness Ior Iother Iundesirable
Ioutcome Iduring Iplanned Ievents
▪ Ex: Ipreoperative Iantibiotic Itherapy Ifor Isurgical Iprocedures. IAntibiotic Igiven
Ibefore Iincision Iis Imade Iso Iantibiotic Ican Ikill Iany Ipotential Ipathogens
▪ Ex: Iadministration Iof Idisease-specific Ivaccines Ito Iindividuals Itraveling Ito
geographic Iareas Iwhere Ia Igiven Idisease Iis Iknown Ito Ibe Iendemic
o Empiric Itherapy- Ibased Ion Iclinical Iprobabilities; Iinvolves Idrug Iadministration Iwhen
Icertain Ipathologic Icondition Ihas Ian Iuncertain Ibut Ihigh Ilikelihood Iof Ioccurrence Ibased
IonIthe Ipt’s Iinitial Ipresenting Isymptoms
▪ Ex: Iuse Iof Iantibiotics Iactive Iagainst Ithe Iorganism Imost Icommonly Iassociated Iwith
Ispecific Iinfection Ibefore Iresults Iof IC+S Ireports Iare Iavailable
• Drug Iinteraction:
o Additive Ieffect- I(1+1=2) Iwhen Itwo Idrugs Iwith Isimilar Iactions Iare Igiven Itogether Ibc Itheir
Iadditive Ieffects Iso Ismaller Idoses Iof Ieach Idrug Ican Ibe Igiven
▪ Ex: Icombinations Iof Ianalgesic Iproducts Iantihistamine Iand Iopioid Icombinations
I(promethazine Iand Icodeine) Ifor Itreatment Iof Icold Isymptoms
▪ Ex: Iacetaminophen Iand Iopioid Icombinations I(acetaminophen Iand Ioxycodone) Ifor
treatment Iof Ipain
o Synergistic Ieffect- Iwhen Itwo Idrugs Iadministered Itogether Iinteract Iin Isuch Ia Iway Ithat
Itheir Icombined Ieffects Iare Igreater Ithan Ithe Isum Iof Ithe Ieffects Ifor Ieach Idrug Igiven Ialone
I(1+1 I= Igreater Ithan I2)
▪ Ex: Icombination Iof Ihydrochlorothiazide Iwith Ilisinopril Ifor Itreatment Iof IHTN
o Antagonistic- Ioccur Iwhen Ithe Icombination Iof Itwo Idrugs Iresults Iin Idrug Ieffects Ithat Iare
Iless Ithan Ithe Isum Iof Ithe Ieffects Ifor Ieach Idrug Igiven Iseparetly I(1+1 I= Iless Ithan I2)
▪ Ex: Iantibiotic Iciprofloxacin Iis Igiven Isimultaneously Iwith Iantacids, Ivitaminsm
Iiron, Ior Idairy Iproducts I(these Idrugs Ireduce Iabsorption Iof Iciprofloxacin Iand Ilead
ItoIdecreased Ieffectiveness Iof Ithe Iantibiotic)
o Incompatibility- Icommonly Iused Ito Idescribe Iparenteral Idrugs; Ioccurs Iwhen Itwo
Iparenteral Idrugs Ior Isolutions Iare Imixed Itogether Iand Iresult Iis Ichemical Ideterioration Iof
Ione Ior Iboth Iof Ithe Idrugs Ior Ithe Iformation Iof Iphysical Iprecipitate; Icombination Iof Itwo Isuch
Idrugs Iusually Iproduces Ia Iprecipitate, Ihaziness, Ior Icolor Ichange Iin Ithe Isolution; Ibefore
, 3
administering Ian IIV Imed Ialways Iinspect Iback Ifor Iprecipitate Iand Iif Ibag Iappears Icloudy Ior
Ivisible Iflecks Iare Iseen Iit Imust Ibe Idiscarded Iand Inot Igiven Ito Ipt.
▪ Ex: Icombination Iof Iparenteral Ifurosemide Iand Iheparin
• Adverse Idrug Ireaction I(ADR)- Iany Ireaction Ito Ia Idrug Ithat Iis Iunexpected Iand Iundesirable Iand
Ioccurs Iat Itherapeutic Idrug Idosages; Icaused Iby Iprocesses Iinside Ipts Ibody; Imay Ior Imay Inot Ibe
Ipreventable; Imild IADR Iusually Idoesn’t Irequire Ichange Iin Ipt’s Idrug Itherapy Ior Iother Iinterventions;
Imore Isevere IADR Iare Ilikely Ito Irequire Ichanges Ito Ia Ipts Idrug Iregimen; ISevere IADR Ican Ibe
Ipermanently Ior Isignificantly Idisabling, Ilife Ithreatening, Ior Ifatal
o Pharmacologic Ireactions- Iextension Iof Ia Idrug’s Inormal Ieffects Iin Ithe Ibody; Ipredictable,
Iwell Iknown IADR Iresulting Iin Iminor Ior Ino Ichanges Iin Ipt Imanagement; Ihave Ipredictable
Ifrequency Iand Iintensity Iand Ioccurrence Iis Irelated Ito Idose; Iusually Iresolve Iupon Id/c Iof
Idrug Itherapy
▪ Ex: Idrug Ithat Iused Ito Ilower IBP Iin Ia Ipt Icauses Ipharmacologic Iadverse Idrug
Ireaction Iwhen Iit Ilowers Ithe IBP Ito Ithe Ipoint Ithat Ithe Ipt Ibecomes Iunconscious
o hypersensitivity Ireaction I(allergic Ireaction)- Ipt’s Iimmune Isystem Iis Iinvolved; Iimmune
system Iproteins I(immunoglobulins) Irecognize Idrug Imolecule I(metabolites) Ior Ianother
Iingredient Iin Ia Idrug Iformulation Ias Idangerous Iforeign Isubstance Iand Ian Iimmune Iresponse
Ican Ioccur Iin Iwhich Ithe Iimmunoglobulin Iproteins Ibind Ito Idrug Isubstance Ito Iattempt Ito
Ineutralize Idrug; Iresult Iin Imild I(skin Ierythema Ior Imild Irash) Ito Ilife Ithreatening Ireactions
I(constriction Iof Ibronchial Iairways Iand Itachycardia)
o idiosyncratic Ireaction- Inot Ithe Iresult Iof Iknown Ipharmacologic Iproperty Iof Ia Idrug Ior Iof Ia
Ipt Iallergy Ibut Ioccurs Iunexpectedly Iin Iparticular Ipt; Igenetically Idetermined Iabnormal
Iresponse Iot Inormal Idosages Iof Ia Idrug
• Other IDrug IEffects
o Teratogenic- Iresult Iin Istructural Idefects Iin Ifetus; Idrugs Icapable Iof Icrossing Ithe Iplacenta
Icauses Idrug Iinduced Iteratogensis; Idrugs Iadministered Ipregnancy Ican Iproduce Idiff Itypes Iof
rd rd
Icongenital Ianomalies; Imost Ivulnerable I3 Iweek Iof Idevelopment Itill Iafter I3 Imo.
o Mutagenic- Ipermanent Ichanges Iin Igenetic Icomposition Iof Iliving Iorganisms Iand Iconsist Iof
Ialterations Iin Ichromosome Istructure, Ithe Inumber Iof Ichromosomes, Ior Igenetic Icode IDNA
Imolecule; Iradiation, Iviruses, Ichemicals, Iand Idrugs Ican Iall Iact Ias Imutagenic Iagents Iin
Ihumans; Idrugs Ithat Iaffect Igenetic Iprocesses Iare Iactive Iprimarily Iduring Icell Ireproduction
I(mitosis)
o Carcinogenic- Ieffects Iare Icancer Icausing Ieffects Iof Idrugs, Ichemicals, Iradiation, Iand
Iviruses
NR I293 IExam I1 IStudy IGuide
Chapter I2
• Define Ithe Icommon Iterms Iused Iin Ipharmacology
o Pharmacokinetic- Ithe Istudy Iof Iwhat Ithe Ibody Idoes Ito Ithe Idrug; Iinvolves Ithe Iprocesses Iof
Iabsorption, Idistribution, Imetabolism, Iand Iexcretion; Ithe Istudy Iof Iwhat Ihappens Ito Ia Idrug
Ifrom Ithe Itime Iit Iis Iput Iinto Ithe Ibody Iuntil Ithe Iparent Idrug Iand Iall Imetabolites Ihave Ileft Ithe
Ibody; Irepresent Ithe Idrug Iabsorption Iinto, Idistribution Iand Imetabolism Iwithin, Iand
Iexcretion Ifrom Ithe Ibody
o Pharmacodynamics- Ithe Istudy Iof Iwhat Ithe Idrug Idoes Ito Ithe Ibody; Iinvolves Idrug–
Ireceptor Irelationships.
o First-pass Ieffect- Iinitial Imetabolism Iin Ithe Iliver Iof Ia Idrug Iabsorbed Ifrom Ithe IGI Itract
Ibefore Ithe Idrug Ireaches Isystemic Icirculation Ithrough Ithe Ibloodstream; Ireduces Ithe
Ibioavaibility Iof Iless Ithan I100%, Iwhereas Idrugs Iadministered Iby Ithe Iintravenous Iroute Iare
I100% Ibioavailable
o Bioavaibility- Ia Imeasure Iof Ithe Iextent Iof Ia Idrug Iabsorption Ifor Ia Igiven Idrug Iand Iroute
I(from I0% Ito I100%)
o Protein-binding
o Onset Iof Iaction- Itime Irequired Ifor Ia Idrug Ito Ielicit Ia Itherapeutic Iresponse Iafter Idosings
o Peak IEffect I– Ithe Itime Irequired Ifor Ia Idrug Ito Ireach Iits Imax. Itherapeutic Iresponse
o Duration Iof Iaction- Ithe Ilength Iof Itime Ithe Iconcentration Iof Ia Idrug Iin Ithe Iblood Ior Itissues
Iis Isufficient Ito Ielict Ia Iresponse
o Half-life I– Iin Ipharmacokinetics, Ithe Itime Irequired Ifor Ihalf Iof Ian Iadministered Idose Iof
Idrug Ito Ibe Ieliminated Iby Ithe Ibody, Ior Ithe Itime Iit Itakes Ifor Ithe Iblood Ilevel Iof Ia Idrug Ito Ibe
Ireduced
o Therapeutic Iindex- Iratio Ibtwn Itoxic Iand Itherapeutic Iconcentrations Iof Ia Idrug
o Trough Ilevel- Ilowest Iblood Ilevel; Ithe Ilowest Iconcentration Iof Ia Idrug Ireached Iin Ithe Ibody
Iafter Iit Ifalls Ifrom Iits Ipeak Ilevel, Iusually Imeasured Iin Iblood Isample Ifor Itherapeutic Idrug
Imonitoring
o Peak Ilevel- Ihighest Iblood Ilevel; Idone Iusually Iat I12th Ilevel Iafter I3rd Idose; Ithe Imax.
Iconcentration Iof Ia Idrug Iin Ithe Ibody Iafter Iadministration, Iusually Imeasured Iin Ia Iblood
Isample Ifor Itherapeutic Idrug Imonitoring
o Agonist- Idrug Ithat Ibinds Ito Iand Istimulates Ithe Iactivity Iof Ione Ior Imore Ireceptors Iin Ithe
Ibody
o Antagonist- Idrug Ithat Ibinds Ito Iand Iinhibits Ithe Iactivity Iof Ione Ior Imore Ireceptors Iin Ithe
Ibody; Ialso Icalled Iinhibitors
• Type Iof Itherapy:
o Acute Itherapy- Ioften Iinvolves Imore Iintensive Idrug Itreatment Iand Iimplemented Iin Iacutely
Iill I(those Iwith Irapid Ionset Iof Iillness) Ior Icritically Iill; Ioften Ineeded Ito Isustain Ilife Ior Itreat
Idisease
▪ Ex: Ivasopressors Ito Imaintain IBP Iand Icardiac Ioutput Iafter Iopen Iheart Isurgery
▪ Ex: Iintensive Ichemotherapy Ifor Ipt Iwith Inewly Idiagnosed Icancer
o Maintenance Itherapy- Idoesn’t Ieradicate Iproblems Ithe Ipt Imay Ialready Ihave Ibut Iwill
Iprevent Iprogression Iof Ia Idisease Ior Icondition; Iused Ifor Itreatment Iof Ichronic Iillnesses
▪ Ex: IHTN Iit Iwill Imaintain Ithe Ipt’s IBP Iwithin Igiven Ilimits Iwhich Iprevents Icertain
Iend-organ Idamage
▪ Ex: Ioral Icontraceptives Ifor Ibirth Icontrol
, 2
o Supplemental Itherapy- Ior Ireplacement Itherapy; Isupplies Ibody Iwith Ia Isubstance Ineeded
Ito Imaintain Inormal Ifunction; Isubstance Imay Ibe Ineeded Ibc Iit Icannot Ibe Imade Iby Ithe Ibody
Ior Ibc Iit Iis Iproduced Iin Iinsufficient Iquantity
▪ Ex: Iadministration Iof Iinsulin Ito Idiabetic Ipt’s
▪ Ex: Iiron Ito Ipts Iw/ Iiron-deficiency Ianemia
o Palliative Itherapy- Imake Ipt Ias Icomfortable Ias Ipossible; Ifocuses Ion Iproviding Ipts Iw/
Irelief Ifrom Isymptoms, Ipain, Iand Istress Iof Ia Iserious Iillness; Igoal Iis Ito Iimprove Iquality Iof
Ilife Ifor Iboth Ipt Iand Ifamily; Itypically Iused Iin Ithe Iend Istages Iof Ian Iillness Iwhen Iattempts Iat
Icurative Itherapy Ihave Ifailed; Iit Ican Ibe Iprovided Ialong Iwith Icurative Itreatment
▪ Ex: Iuse Iof Ihigh Idose Iopioid Ianalgesics Ito Irelieve Ipain Iin Ithe Ifinal Istages Iof Icancer
o Supportive Itherapy- Imaintains Iintegrity Iof Ibody Ifunctions Iwhile Ithe Ipt Iis Irecovering
Ifrom Iillness/trauma
▪ Ex: Iprovision Iof Ifluids Iand Ielectrolytes Ito Iprevent Idehydration Iin Ia Ipt Iw/ Iinfluenza
Iwho Iis Ivomiting Iand Ihas Idiarrhea
▪ Ex: Iadministration Iof Ifluids, Ivolume Iexpanders, Ior Iblood Iproducts Ito Ia Ipt Iwho Ilost
blood Iduring Isurgery
o Prophylactic Itherapy- Idrug Itherapy Iprovided Ito Iprevent Iillness Ior Iother Iundesirable
Ioutcome Iduring Iplanned Ievents
▪ Ex: Ipreoperative Iantibiotic Itherapy Ifor Isurgical Iprocedures. IAntibiotic Igiven
Ibefore Iincision Iis Imade Iso Iantibiotic Ican Ikill Iany Ipotential Ipathogens
▪ Ex: Iadministration Iof Idisease-specific Ivaccines Ito Iindividuals Itraveling Ito
geographic Iareas Iwhere Ia Igiven Idisease Iis Iknown Ito Ibe Iendemic
o Empiric Itherapy- Ibased Ion Iclinical Iprobabilities; Iinvolves Idrug Iadministration Iwhen
Icertain Ipathologic Icondition Ihas Ian Iuncertain Ibut Ihigh Ilikelihood Iof Ioccurrence Ibased
IonIthe Ipt’s Iinitial Ipresenting Isymptoms
▪ Ex: Iuse Iof Iantibiotics Iactive Iagainst Ithe Iorganism Imost Icommonly Iassociated Iwith
Ispecific Iinfection Ibefore Iresults Iof IC+S Ireports Iare Iavailable
• Drug Iinteraction:
o Additive Ieffect- I(1+1=2) Iwhen Itwo Idrugs Iwith Isimilar Iactions Iare Igiven Itogether Ibc Itheir
Iadditive Ieffects Iso Ismaller Idoses Iof Ieach Idrug Ican Ibe Igiven
▪ Ex: Icombinations Iof Ianalgesic Iproducts Iantihistamine Iand Iopioid Icombinations
I(promethazine Iand Icodeine) Ifor Itreatment Iof Icold Isymptoms
▪ Ex: Iacetaminophen Iand Iopioid Icombinations I(acetaminophen Iand Ioxycodone) Ifor
treatment Iof Ipain
o Synergistic Ieffect- Iwhen Itwo Idrugs Iadministered Itogether Iinteract Iin Isuch Ia Iway Ithat
Itheir Icombined Ieffects Iare Igreater Ithan Ithe Isum Iof Ithe Ieffects Ifor Ieach Idrug Igiven Ialone
I(1+1 I= Igreater Ithan I2)
▪ Ex: Icombination Iof Ihydrochlorothiazide Iwith Ilisinopril Ifor Itreatment Iof IHTN
o Antagonistic- Ioccur Iwhen Ithe Icombination Iof Itwo Idrugs Iresults Iin Idrug Ieffects Ithat Iare
Iless Ithan Ithe Isum Iof Ithe Ieffects Ifor Ieach Idrug Igiven Iseparetly I(1+1 I= Iless Ithan I2)
▪ Ex: Iantibiotic Iciprofloxacin Iis Igiven Isimultaneously Iwith Iantacids, Ivitaminsm
Iiron, Ior Idairy Iproducts I(these Idrugs Ireduce Iabsorption Iof Iciprofloxacin Iand Ilead
ItoIdecreased Ieffectiveness Iof Ithe Iantibiotic)
o Incompatibility- Icommonly Iused Ito Idescribe Iparenteral Idrugs; Ioccurs Iwhen Itwo
Iparenteral Idrugs Ior Isolutions Iare Imixed Itogether Iand Iresult Iis Ichemical Ideterioration Iof
Ione Ior Iboth Iof Ithe Idrugs Ior Ithe Iformation Iof Iphysical Iprecipitate; Icombination Iof Itwo Isuch
Idrugs Iusually Iproduces Ia Iprecipitate, Ihaziness, Ior Icolor Ichange Iin Ithe Isolution; Ibefore
, 3
administering Ian IIV Imed Ialways Iinspect Iback Ifor Iprecipitate Iand Iif Ibag Iappears Icloudy Ior
Ivisible Iflecks Iare Iseen Iit Imust Ibe Idiscarded Iand Inot Igiven Ito Ipt.
▪ Ex: Icombination Iof Iparenteral Ifurosemide Iand Iheparin
• Adverse Idrug Ireaction I(ADR)- Iany Ireaction Ito Ia Idrug Ithat Iis Iunexpected Iand Iundesirable Iand
Ioccurs Iat Itherapeutic Idrug Idosages; Icaused Iby Iprocesses Iinside Ipts Ibody; Imay Ior Imay Inot Ibe
Ipreventable; Imild IADR Iusually Idoesn’t Irequire Ichange Iin Ipt’s Idrug Itherapy Ior Iother Iinterventions;
Imore Isevere IADR Iare Ilikely Ito Irequire Ichanges Ito Ia Ipts Idrug Iregimen; ISevere IADR Ican Ibe
Ipermanently Ior Isignificantly Idisabling, Ilife Ithreatening, Ior Ifatal
o Pharmacologic Ireactions- Iextension Iof Ia Idrug’s Inormal Ieffects Iin Ithe Ibody; Ipredictable,
Iwell Iknown IADR Iresulting Iin Iminor Ior Ino Ichanges Iin Ipt Imanagement; Ihave Ipredictable
Ifrequency Iand Iintensity Iand Ioccurrence Iis Irelated Ito Idose; Iusually Iresolve Iupon Id/c Iof
Idrug Itherapy
▪ Ex: Idrug Ithat Iused Ito Ilower IBP Iin Ia Ipt Icauses Ipharmacologic Iadverse Idrug
Ireaction Iwhen Iit Ilowers Ithe IBP Ito Ithe Ipoint Ithat Ithe Ipt Ibecomes Iunconscious
o hypersensitivity Ireaction I(allergic Ireaction)- Ipt’s Iimmune Isystem Iis Iinvolved; Iimmune
system Iproteins I(immunoglobulins) Irecognize Idrug Imolecule I(metabolites) Ior Ianother
Iingredient Iin Ia Idrug Iformulation Ias Idangerous Iforeign Isubstance Iand Ian Iimmune Iresponse
Ican Ioccur Iin Iwhich Ithe Iimmunoglobulin Iproteins Ibind Ito Idrug Isubstance Ito Iattempt Ito
Ineutralize Idrug; Iresult Iin Imild I(skin Ierythema Ior Imild Irash) Ito Ilife Ithreatening Ireactions
I(constriction Iof Ibronchial Iairways Iand Itachycardia)
o idiosyncratic Ireaction- Inot Ithe Iresult Iof Iknown Ipharmacologic Iproperty Iof Ia Idrug Ior Iof Ia
Ipt Iallergy Ibut Ioccurs Iunexpectedly Iin Iparticular Ipt; Igenetically Idetermined Iabnormal
Iresponse Iot Inormal Idosages Iof Ia Idrug
• Other IDrug IEffects
o Teratogenic- Iresult Iin Istructural Idefects Iin Ifetus; Idrugs Icapable Iof Icrossing Ithe Iplacenta
Icauses Idrug Iinduced Iteratogensis; Idrugs Iadministered Ipregnancy Ican Iproduce Idiff Itypes Iof
rd rd
Icongenital Ianomalies; Imost Ivulnerable I3 Iweek Iof Idevelopment Itill Iafter I3 Imo.
o Mutagenic- Ipermanent Ichanges Iin Igenetic Icomposition Iof Iliving Iorganisms Iand Iconsist Iof
Ialterations Iin Ichromosome Istructure, Ithe Inumber Iof Ichromosomes, Ior Igenetic Icode IDNA
Imolecule; Iradiation, Iviruses, Ichemicals, Iand Idrugs Ican Iall Iact Ias Imutagenic Iagents Iin
Ihumans; Idrugs Ithat Iaffect Igenetic Iprocesses Iare Iactive Iprimarily Iduring Icell Ireproduction
I(mitosis)
o Carcinogenic- Ieffects Iare Icancer Icausing Ieffects Iof Idrugs, Ichemicals, Iradiation, Iand
Iviruses
