PHARM UPDATED

Pharmacology

study of medicines and how they affect the body

Drug

chemical agent capable of producing biologic responses

Medication

term for a drug after it is administered

Therapeutics

prevention of disease and treatment of suffering

Pharmacotherapy

application of drugs to treat disease

Biologics

agents naturally produced by living organisms

Biosimilar drug

biologic highly similar to an approved reference product

Interchangeable product

biosimilar proven to match reference product's effectiveness

Reference product

original FDA-approved biologic used for comparison

Purple Book

FDA online database of approved biosimilar products Complementary and alternative medicine (CAM) - therapies outside mainstream Western practice

Therapeutic classification

grouping drugs by the disease they treat

Pharmacologic classification

grouping drugs by their mechanism of action

Prototype drug

well-understood model drug representing its class

Mechanism of action

how a drug produces its physiologic effect

Chemical name

name based on standard chemical nomenclature

Generic name

name assigned by the U.S. Adopted Name Council

Trade name

name assigned by the drug's marketing company

Proprietary name

alternate term for a drug's trade name

Combination drug

product containing more than one active ingredient

Prescription drug

medication requiring a healthcare provider's order

Over

the-counter (OTC) drug - medication that does not require a prescription

Negative formulary

list of drugs that cannot be substituted generically

Bioavailability

physiologic ability of a drug to reach target cells

Pharmacoeconomics

subdiscipline examining costs and outcomes of drug therapy

Formulary

list of drugs and drug recipes

Pharmacopeia

reference summarizing drug purity and strength standards

Materia Medica

historical term for the study of herbal remedies

John Jacob Abel

considered the father of American pharmacology

Chemical group name

name based on a portion of a drug's chemical structure

U.S. Pharmacopeia (USP)

first comprehensive publication of U.S. drug standards

National Formulary (NF)

standards publication established by the APhA

Biologics Control Act (1902)

standardized quality of serums and blood products

Pure Food and Drug Act (1906)

gave government power to control drug labeling

Sherley Amendment (1912)

prohibited false therapeutic claims on drug labels Food, Drug, and Cosmetic Act (1938) - first law preventing sale of untested drugs Dietary Supplement Health and Education Act (1994) - requires clear labeling of dietary supplements Food and Drug Administration (FDA) - federal agency regulating drugs and biologics Center for Drug Evaluation and Research (CDER) - FDA branch overseeing prescription and OTC drugs Center for Biologics Evaluation and Research (CBER) - FDA branch regulating vaccines and biologics Center for Food Safety and Applied Nutrition (CFSAN) - FDA branch overseeing supplements and herbal products National Center for Complementary and Integrative Health (NCCIH) - agency researching safety of CAM therapies

Black box warning

FDA alert for drugs with serious safety risks

Childhood Vaccine Act (1986)

authorized FDA oversight of vaccine safety data

New Drug Application (NDA)

required submission before marketing a new drug

Electronic Orange Book

FDA database of approved drug products Prescription Drug User Fee Act (1992) - required manufacturer fees to fund drug review Advanced practice registered nurse (APRN) - nurse with prescriptive authority under state law

Certified nurse midwife (CNM)

APRN specializing in childbirth and women's health Certified registered nurse anesthetist (CRNA) - APRN specializing in anesthesia care

Nurse practitioner (NP)

APRN providing primary or specialty patient care Clinical nurse specialist (CNS) - APRN expert in a specialized practice area

Controlled substance

drug regulated under the Controlled Substances Act Controlled Substances Act (1970) - law establishing five drug abuse potential schedules Comprehensive Drug Abuse Prevention and Control Act - alternate name for the Controlled Substances Act

Schedule I drug

highest abuse potential, little accepted medical use

Schedule II drug

high abuse potential; refills are not permitted

Schedule III drug

moderate abuse potential with accepted medical use

Schedule IV drug

lower abuse potential than Schedule III drugs

Schedule V drug

lowest abuse potential among controlled substances Drug Enforcement Administration (DEA) - federal agency enforcing controlled substance laws

DEA registration number

required to prescribe or dispense controlled substances

Physical dependence

altered physical state from repeated drug use

Psychologic dependence

compelling desire to continue drug use without physical signs

Withdrawal

physical discomfort symptoms after stopping a dependent drug

Adverse event (AE)

undesirable sign or symptom from a medical product

Side effect

unintended, nontherapeutic reaction to a drug

Allergic reaction

hyperresponse of body defenses to a foreign substance

Anaphylaxis

severe, systemic, life-threatening allergic reaction Five rights of drug administration - right patient, drug, dose, route, and time Three checks of drug administration - verifying drug at removal, preparation, and bedside

Adherence

taking medication as prescribed or instructed

STAT order

medication needed immediately, given only once

ASAP order

medication given within thirty minutes of the order

Single order

drug given only once at a specific time

PRN order

medication given as needed based on assessment

Routine order

carried out within about two hours of writing

Standing order

order written in advance for specific circumstances

Automatic stop order

narcotic order discontinued after a set time unless renewed

Metric system of measurement

most common system used for drug dosing

Household system

older measurement system using teaspoons and cups

Apothecary system

older measurement system using grains and minims

Enteral route

includes oral, nasogastric, and gastrostomy administration

Enteric

coated tablet - dissolves in the small intestine, not the stomach

Sustained

release (SR) tablet - designed to dissolve slowly over an extended time

Sublingual route

medication placed under the tongue to dissolve

Buccal route

medication placed between the cheek and gum Orally disintegrating tablet (ODT) - dissolves quickly on the tongue without water

Nasogastric (NG) tube

tube from the nasopharynx into the stomach

Gastrostomy (G) tube

tube surgically placed directly into the stomach

Topical route

drug applied locally to skin or mucous membranes

Transdermal patch

delivers medication through the skin for systemic effect

Ophthalmic route

drug administration into the eye

Otic route

drug administration into the ear

Nasal route

drug administration into the nasal mucosa

Astringent effect

shrinking of swollen mucous membranes

Instillation

drug applied into a body cavity or orifice

Vaginal route

drug administration into the vagina

Rectal route

drug administration into the rectum

Parenteral route

administration by injection, bypassing the GI tract

Intradermal (ID) injection

injected into the dermis layer of skin

Subcutaneous injection

injected into tissue just below the dermis

Intramuscular (IM) injection

injected directly into muscle tissue

Ventrogluteal site

preferred intramuscular injection site for adults

Vastus lateralis site

preferred intramuscular injection site for infants

Deltoid site

IM site limited to small-volume injections in adults Intravenous (IV) administration - medication delivered directly into the bloodstream

IV bolus (push)

concentrated dose given directly via syringe

Intermittent infusion

small IV volume piggybacked onto a primary line

Pharmacokinetics

study of drug movement throughout the body

Active transport

movement against a concentration gradient requiring energy

Diffusion (passive transport)

movement from higher to lower concentration

Absorption

movement of a drug from administration site into circulation

Dissolution

process of a drug disintegrating and dispersing

Lipid solubility

property affecting how easily a drug crosses membranes

Ionization

degree to which a drug is charged, affecting absorption

First

pass effect - hepatic metabolism reducing a drug before systemic circulation

Distribution

transport of drugs throughout the body after absorption

Drug

protein complex - drug bound to plasma protein, unavailable for action