Study Guide for NR 293 Exam 1 Chapter 2 Elaborations With Complete Solutions

 Define the common terms used in pharmacology o Pharmacokinetic- the study of what the body does to the drug; involves the processes of absorption, distribution, metabolism, and excretion o Pharmacodynamics- the study of what the drug does to the body; involves drug–receptor relationships. o First-pass effect- initial metabolism in the liver of a drug absorbed from the GI tract before the drug reaches systemic circulation through the bloodstream o Bioavaibility- a measure of the extent of a drug absorption for a given drug and route (from 0% to 100%) o Protein-binding o Onset of action- time required for a drug to elicit a therapeutic response after dosings o Peak Effect – the time required for a drug to reach its max. Therapeutic response o Duration of action- the length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response o 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 o Therapeutic index- ratio between toxic and therapeutic concentrations of a drug o Trough level- lowest blood level; the lowest concentration of a drug reached in the body after it falls from its peak level, usually measured in blood sample for therapeutic drug monitoring o Peak level- highest blood level. Concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring. o Agonist- drug that binds to and stimulates the activity of one or more receptors in the body o Antagonist- drug that binds to and inhibits the activity of one or more receptors in the body; also called inhibitors  Type of therapy: o Acute therapy- often involves more intensive drug treatment and implemented in acutely ill (those with rapid onset of illness) or critically ill; often needed to sustain life or treat disease  Ex: vasopressors to maintain BP and cardiac output after open heart surgery  Ex: intensive chemotherapy for pt with newly diagnosed cancer o Maintenance therapy- doesn’t eradicate problems the pt may already have but will prevent progression of a disease or condition; used for treatment of chronic illnesses 2  Ex: HTN it will maintain the pt’s BP within given limits which prevents certain end-organ damage  Ex: oral contraceptives for birth control o Supplemental therapy- or replacement therapy; supplies body with a substance needed to maintain normal function; substance may be needed bc it cannot be made by the body or bc it is produced in insufficient quantity  Ex: administration of insulin to diabetic pt’s  Ex: iron to pts w/ iron-deficiency anemia o Palliative therapy- make pt as comfortable as possible; focuses on providing pts w/ relief from symptoms, pain, and stress of a serious illness; goal is to improve quality of life for both pt and family; typically used in the end stages of an illness when attempts at curative therapy have failed; it can be provided along with curative treatment  Ex: use of high dose opioid analgesics to relieve pain in the final stages of cancer o Supportive therapy- maintains integrity of body functions while the pt is recovering from illness/trauma  Ex: provision of fluids and electrolytes to prevent dehydration in a pt w/ influenza who is vomiting and has diarrhea  Ex: administration of fluids, volume expanders, or blood products to a pt who lost blood during surgery o Prophylactic therapy- treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma  Ex: preoperative antibiotic therapy for surgical procedures. Antibiotic given before incision is made so antibiotic can kill any potential pathogens o Empiric therapy- treatment of an infection before specific culture information has been reported or obtained o Definite therapy- the administration of antibiotics based on known results of culture and sensitivity testing identifying the pathogen causing infection  Drug interactions: o Additive effect- (1+1=2) when two drugs with similar actions are given together bc their additive effects so smaller doses of each drug can be given  Ex: combinations of analgesic products antihistamine and opioid combinations (promethazine and codeine) for treatment of cold symptoms  Ex: acetaminophen and opioid combinations (acetaminophen and oxycodone) for treatment of pain o Synergistic effect- when two drugs administered together interact in such a way that their combined effects are greater than the sum of the effects for each drug given alone (1+1 = greater than 2) 3  Ex: combination of hydrochlorothiazide with lisinopril for treatment of HTN o Antagonistic- occur when the combination of two drugs results in drug effects that are less than the sum of the effects for each drug given separately (1+1 = less than 2)  Ex: antibiotic ciprofloxacin is given simultaneously with antacids, vitamins, iron, or dairy products (these drugs reduce absorption of ciprofloxacin and lead to decreased effectiveness of the antibiotic) o Incompatibility- c