Terms to Know for Exam

Controlled substances

Drugs that have a risk for abuse and dependency

Pharmacodynamics

Study of how drugs work, interact, and cause change → what the drug does to the body

Pharmacokinetics

Study of how medications travel through the body → what does the body do to the drug

Agonist

Binds to receptor site to cause the same reaction a natural chemical would cause → mimics natural body chemicals

• Ex: insulin

Competitive antagonism

Drugs compete for the same receptor sites and/or prevent breakdown of chemicals → antagonist prevents drug A from binding

• Ex: SSRI - selective serotonin recepto inhibitors

Noncompetitive antagonism

Drug reacts to specific receptor site on cell and causes a change in binding at a different receptor site → causes change at a separate receptor site its not bound to so Drug A cannot bind

• Don’t compete for the same receptor types

• Ex: Ketamine

Partial agonism

Drug acts as an agonist or antagonist depending on the receptor site → drug can bind and cause a reaction at one site and block at another site

• Ex: nalbuphine

Selective toxicity

Ability of foreign drug to attack only systems in foreign cells → self cells not targeted

Distribution

Movement of a drug into the body’s tissues

Blood Brain Barrier (BBB)

Highly selective layer of cells surrounding the vessels of the brain → water soluble drugs cannot pass but lipid soluble drugs can pass

Metabolism (Biotransformation)

Method by which drugs are transformed by the body → converts drugs and chemicals into nontoxic substances to prepare for excretion

First Pass Effect

Process where oral drugs are absorbed through the small intestine and metabolized in the liver into active and inactive metabolites → can deactivate a large percent of the dose before it reaches circulation

Excretion

Process of eliminating drug and metabolites from the body

Rights of Medication Administration

• Right patient

• Right time

• Right dose

• Right medication

• Right route

• Right documentation

Syndrome

Symptoms that occur together

Hyperlipidemia

Increase in the level of lipids in the blood → form hard plaques which can reduce blood flow

COX-1

Hemostatic functions

• Protects GI tract

• Protects Renal tract

• Monitors Platelet function

• Monitors Macrophage differentiation

Anti-platelet drugs

Medications that prevent blood clotting by inhibiting platelet aggregation → prevent platelet plug

Anticoagulant drugs

Medications that inhibit blood coagulation by interfering with clotting cascade → inhibits formation of thrombin to prevent formation of fibrin clots

Thrombolytic agents

Break down thrombus (clot)

Pruritis

Itching

Prupura

Bruising

aPTT (activated partial thromboplastin time)

Measures how long it takes blood to clot via the intrinsic and common coagulation pathways → used to monitor anticoagulant therapy

PTT (partial thromboplastin time)

Measure clotting time via intrinsic and common pathways → measures the same thing as aPTT

INR

Standardized way of measuring how long it takes blood to clot through the extrinsic pathway

Heparin Induced Thrombocytopenia (HIT)

Clotting disorder that causes unexplained low blood platelet count as a result of heparin treatment

Anemia

Abnormally low amount of RBCs or hemoglobin

Iron Deficiency Anemia (IDA)

Anemia caused by low iron that causes reduced hemoglobin production → most common of the anemias

• Low iron levels with elevated TIBC = iron deficiency anemia

Total Iron-Binding Capacity (TIBC)

Determines how well transferrin (iron transport protein) is available and how much of it is free to bind more iron → increases when iron stores are low

• Increased TIBC = decreased iron

Ferritin

Reflects stores of iron in the body → amount we have left

Primary/Essential Hypertension (HTN)

Hypertension with no known cause

Secondary hypertension

Hypertension caused by an identifiable underlying condition or disease

Stroke volume

Amount of blood pumped out of ventricles every time your heart beats

Total Peripheral Resistance

Amount of pressure your heart has to pump against

Autonomic nervous system

Powerful regulator of BP, affects HR and contractility

When blood pressure drops, ___ nervous system…

Sympathetic nervous system increases heart rate, contractility, and vasoconstriction, which raises blood pressure

When blood pressure is too high, ___ nervous system….

Parasympathetic nervous system helps lower it by reducing HR and output

Angiotensin II causes…

Vasoconstriction and aldosterone release

Aldosterone causes…

Kidneys to retain sodium and water → increases blood volume and blood pressure

Pancytopenia

Reduction in red blood cells, white blood cells, and platelets

Angioedema

Swelling of lips and tongue → life threatening because it can block the airway

Coronary Artery Disease

Vessels that supply the heart get narrowed

Angina

Chest pain due to lack of oxygen to the heart

Stable angina

Angina with no damage to heart muscle → usually occurs with predictable exertion and is relieved with rest or nitroglycerine

Unstable angina

Caused by more narrowing of arteries than stable angina, increased risk of complete blockage → usually occurs at rest and is relieved by medication

Arrhythmia

Irregular or abnormal heart rhythm

Dysrhythmia

Deviation from normal heart rhythm

Oliguria

Decreased renal blood flow leading to reduced urine output

Fibrillation

A rapid, uncoordinated heartbeat that can lead to ineffective pumping of blood → heart is quivering

Photosensitivty

Sensitivity to sunlight

Congestive Heart Failure (CHF)

Condition where heart is unable to pump effectively, leading to fluid buildup in the lungs and other body parts

Brain Natriuretic Peptide (BNP)

Indicator for diagnosing heart failure →

Elevation of BNP indicates…

ventricular dysfunction

BNP < 100

No heart failure

BNP 100-300

Possible heart failure

BNP > 300

Mild heart failure

BNP > 600

Moderate heart failure

BNP > 900

Severe heart failure

Right sided heart failure

Right ventricular walls are thin and weak → causes blood to back up in the liver and edema in lower extremities

• Usually caused by left sided heart failure

• Fluid back up in venous circulation

Left sided heart failure

Thickened left ventricular walls means ventricle can’t fill and reduces blood pumped out to the body → blood backs up into the lungs and causes pulmonary edema

• Fluid back up in pulmonary circulation

Glomeruli

Filters blood in the kidneys → waste and extra fluid go out into urine through ureters

Ureters

Carries urine to bladder

Bladder

Holds urine until excretion

Urethra

Carries urine from bladder to be excreted

Descending limb of Loop of Henle

Part of the nephron that reabsorbs water

Ascending limb of Loop of Henle

Part of the nephron that reabsorbs sodium and chloride ions

Blood Urea Nitrogen (BUN)

Measures nitrogen portion of urea and helps detect dehydration → elevated BUN is highly suggestive of kidney dysfunction

Serum creatinine

Evaluates for renal function and disease → creatinine levels don’t increase until at least 50% of renal function is lost

• Elevated serum creatinine = strong indication of kidney impairment or dysfunction

Creatinine clearance (24 hour urine)

Best indicator for overall kidney function → includes a 24-hour urine collection

• Declining creatinine clearance = reduced kidney function/impaired GFR

Glomerular Filtration Rate (GFR)

Best test to measure your level of kidney function and determine stage of kidney disease → GFR > 60 is normal

GFR < or = 90 mL/min

Indicates mild loss of kidney function

GFR < or = to 60 mL/min

May indicate kidney disease

GFR falls < 30

Indicates renal insufficiency or chronic renal failure → nephrologist consult to discuss treatment

GFR < 15

Start dialysis and attempt to get on transplant list

Albumin

Protein commonly found in blood plasma; its presence in urine can indicate kidney damage or disease