1
Study Guide for NR 293 Exam 1
Chapter 2
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; 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; represent the drug absorption into, distribution and metabolism within, and
excretion from the body
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; reduces the
bioavaibility of less than 100%, whereas drugs administered by the intravenous route are
100% bioavailable
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 elict 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 btwn 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; done usually at 12th level after 3rd dose; the max.
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
Ex: HTN it will maintain the pt’s BP within given limits which prevents certain
end-organ damage
Ex: oral contraceptives for birth control
, 2
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- drug therapy provided to prevent illness or other undesirable
outcome during planned events
Ex: preoperative antibiotic therapy for surgical procedures. Antibiotic given
before incision is made so antibiotic can kill any potential pathogens
Ex: administration of disease-specific vaccines to individuals traveling to
geographic areas where a given disease is known to be endemic
o Empiric therapy- based on clinical probabilities; involves drug administration when
certain pathologic condition has an uncertain but high likelihood of occurrence based on
the pt’s initial presenting symptoms
Ex: use of antibiotics active against the organism most commonly associated with
specific infection before results of C+S reports are available
Drug interaction:
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)
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 separetly (1+1 = less than 2)
Ex: antibiotic ciprofloxacin is given simultaneously with antacids, vitaminsm
iron, or dairy products (these drugs reduce absorption of ciprofloxacin and lead to
decreased effectiveness of the antibiotic)
o Incompatibility- commonly used to describe parenteral drugs; occurs when two
parenteral drugs or solutions are mixed together and result is chemical deterioration of
one or both of the drugs or the formation of physical precipitate; combination of two such
drugs usually produces a precipitate, haziness, or color change in the solution; before
, 3
administering an IV med always inspect back for precipitate and if bag appears cloudy or
visible flecks are seen it must be discarded and not given to pt.
Ex: combination of parenteral furosemide and heparin
Adverse drug reaction (ADR)- any reaction to a drug that is unexpected and undesirable and
occurs at therapeutic drug dosages; caused by processes inside pts body; may or may not be
preventable; mild ADR usually doesn’t require change in pt’s drug therapy or other interventions;
more severe ADR are likely to require changes to a pts drug regimen; Severe ADR can be
permanently or significantly disabling, life threatening, or fatal
o Pharmacologic reactions- extension of a drug’s normal effects in the body; predictable,
well known ADR resulting in minor or no changes in pt management; have predictable
frequency and intensity and occurrence is related to dose; usually resolve upon d/c of
drug therapy
Ex: drug that used to lower BP in a pt causes pharmacologic adverse drug
reaction when it lowers the BP to the point that the pt becomes unconscious
o hypersensitivity reaction (allergic reaction)- pt’s immune system is involved; immune
system proteins (immunoglobulins) recognize drug molecule (metabolites) or another
ingredient in a drug formulation as dangerous foreign substance and an immune response
can occur in which the immunoglobulin proteins bind to drug substance to attempt to
neutralize drug; result in mild (skin erythema or mild rash) to life threatening reactions
(constriction of bronchial airways and tachycardia)
o idiosyncratic reaction- not the result of known pharmacologic property of a drug or of a
pt allergy but occurs unexpectedly in particular pt; genetically determined abnormal
response ot normal dosages of a drug
Other Drug Effects
o Teratogenic- result in structural defects in fetus; drugs capable of crossing the placenta
causes drug induced teratogensis; drugs administered pregnancy can produce diff types of
congenital anomalies; most vulnerable 3rd week of development till after 3rd mo.
o Mutagenic- permanent changes in genetic composition of living organisms and consist of
alterations in chromosome structure, the number of chromosomes, or genetic code DNA
molecule; radiation, viruses, chemicals, and drugs can all act as mutagenic agents in
humans; drugs that affect genetic processes are active primarily during cell reproduction
(mitosis)
o Carcinogenic- effects are cancer causing effects of drugs, chemicals, radiation, and
viruses
Study Guide for NR 293 Exam 1
Chapter 2
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; 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; represent the drug absorption into, distribution and metabolism within, and
excretion from the body
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; reduces the
bioavaibility of less than 100%, whereas drugs administered by the intravenous route are
100% bioavailable
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 elict 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 btwn 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; done usually at 12th level after 3rd dose; the max.
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
Ex: HTN it will maintain the pt’s BP within given limits which prevents certain
end-organ damage
Ex: oral contraceptives for birth control
, 2
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- drug therapy provided to prevent illness or other undesirable
outcome during planned events
Ex: preoperative antibiotic therapy for surgical procedures. Antibiotic given
before incision is made so antibiotic can kill any potential pathogens
Ex: administration of disease-specific vaccines to individuals traveling to
geographic areas where a given disease is known to be endemic
o Empiric therapy- based on clinical probabilities; involves drug administration when
certain pathologic condition has an uncertain but high likelihood of occurrence based on
the pt’s initial presenting symptoms
Ex: use of antibiotics active against the organism most commonly associated with
specific infection before results of C+S reports are available
Drug interaction:
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)
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 separetly (1+1 = less than 2)
Ex: antibiotic ciprofloxacin is given simultaneously with antacids, vitaminsm
iron, or dairy products (these drugs reduce absorption of ciprofloxacin and lead to
decreased effectiveness of the antibiotic)
o Incompatibility- commonly used to describe parenteral drugs; occurs when two
parenteral drugs or solutions are mixed together and result is chemical deterioration of
one or both of the drugs or the formation of physical precipitate; combination of two such
drugs usually produces a precipitate, haziness, or color change in the solution; before
, 3
administering an IV med always inspect back for precipitate and if bag appears cloudy or
visible flecks are seen it must be discarded and not given to pt.
Ex: combination of parenteral furosemide and heparin
Adverse drug reaction (ADR)- any reaction to a drug that is unexpected and undesirable and
occurs at therapeutic drug dosages; caused by processes inside pts body; may or may not be
preventable; mild ADR usually doesn’t require change in pt’s drug therapy or other interventions;
more severe ADR are likely to require changes to a pts drug regimen; Severe ADR can be
permanently or significantly disabling, life threatening, or fatal
o Pharmacologic reactions- extension of a drug’s normal effects in the body; predictable,
well known ADR resulting in minor or no changes in pt management; have predictable
frequency and intensity and occurrence is related to dose; usually resolve upon d/c of
drug therapy
Ex: drug that used to lower BP in a pt causes pharmacologic adverse drug
reaction when it lowers the BP to the point that the pt becomes unconscious
o hypersensitivity reaction (allergic reaction)- pt’s immune system is involved; immune
system proteins (immunoglobulins) recognize drug molecule (metabolites) or another
ingredient in a drug formulation as dangerous foreign substance and an immune response
can occur in which the immunoglobulin proteins bind to drug substance to attempt to
neutralize drug; result in mild (skin erythema or mild rash) to life threatening reactions
(constriction of bronchial airways and tachycardia)
o idiosyncratic reaction- not the result of known pharmacologic property of a drug or of a
pt allergy but occurs unexpectedly in particular pt; genetically determined abnormal
response ot normal dosages of a drug
Other Drug Effects
o Teratogenic- result in structural defects in fetus; drugs capable of crossing the placenta
causes drug induced teratogensis; drugs administered pregnancy can produce diff types of
congenital anomalies; most vulnerable 3rd week of development till after 3rd mo.
o Mutagenic- permanent changes in genetic composition of living organisms and consist of
alterations in chromosome structure, the number of chromosomes, or genetic code DNA
molecule; radiation, viruses, chemicals, and drugs can all act as mutagenic agents in
humans; drugs that affect genetic processes are active primarily during cell reproduction
(mitosis)
o Carcinogenic- effects are cancer causing effects of drugs, chemicals, radiation, and
viruses
