NSG-2233-01 (23/FA): Pharmacology/Metrology Lilley et al. (2023) chapters 2-3, 8

Active transport

The active (energy-requiring) movement of a substance between different tissues via pumping mechanisms contained within cell membranes.

Diffusion

The passive movement of a substance (e.g., a drug) between different tissues from areas of higher concentration to areas of lower concentration. (Compare with active transport.)

Neonate

Pertaining to a person younger than 1 month of age; newborn infant.

Older adult

Pertaining to a person who is 65 years of age or older. (Note: Some sources consider "older adult" to be 55 years of age or older.)

Pediatric

Pertaining to a person who is 12 years of age or younger.

Polypharmacy

The use of many different drugs concurrently in treating a patient, who often has several health problems.

Additive effects

Drug interactions in which the effect of a combination of two or more drugs with similar actions is equivalent to the sum of the individual effects of the same drugs given alone. For example, 1 + 1 = 2 (compare with synergistic effects).

Adverse drug event

Any undesirable occurrence related to administering or failing to administer a prescribed medication.

Adverse drug reaction

Any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (as opposed to overdose).

Adverse effects

A general term for any undesirable effects that are a direct response to one or more drugs.

Agonist

A drug that binds to and stimulates the activity of one or more receptors in the body.

Allergic reaction

An immunologic hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication; a type of adverse drug event.

Antagonist

A drug that binds to and inhibits the activity of one or more receptors in the body. Antagonists are also called inhibitors.

Antagonistic effects

Drug interactions in which the effect of a combination of two or more drugs is less than the sum of the individual effects of the same drugs given alone (1 + 1 equals less than 2); it is usually caused by an antagonizing (blocking or reducing) effect of one drug on another.

Bioavailability

A measure of the extent of drug absorption for a given drug and route (from 0% to 100%).

Biotransformation

One or more biochemical reactions involving a parent drug; occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as metabolism.

Blood-brain barrier

The barrier system that restricts the passage of various chemicals and microscopic entities (e.g., bacteria, viruses) between the bloodstream and the central nervous system. It still allows for the passage of essential substances such as oxygen.

Chemical name

The name that describes the chemical composition and molecular structure of a drug.

Contraindication

Any condition, especially one related to a disease state or patient characteristic, including current or recent drug therapy, which renders a particular form of treatment improper or undesirable.

Cytochrome P-450

The general name for a large class of enzymes that plays a significant role in drug metabolism and drug interactions.

Dependence

A state in which there is a compulsive or chronic need, as for a drug.

Dissolution

The process by which solid forms of drugs disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation.

Drug

Any chemical that affects the physiologic processes of a living organism.

Drug actions

The processes involved in the interaction between a drug and body cells (e.g., the action of a drug on a receptor protein); also called mechanism of action.

Drug classification

A method of grouping drugs; may be based on structure or therapeutic use.

Drug effects

The physiologic reactions of the body to a drug. They can be therapeutic or toxic and describe how the body is affected as a whole by the drug.

Drug-induced teratogenesis

The development of congenital anomalies or defects in the developing fetus caused by the toxic effects of drugs.

Drug interaction

Alteration in the pharmacologic or pharmacokinetic activity of a given drug caused by the presence of one or more additional drugs; it is usually related to effects on the enzymes required for metabolism of the involved drugs.

Duration of action

The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response.

Enzymes

Protein molecules that catalyze one or more of a variety of biochemical reactions, including those related to the body's physiologic processes, as well as those related to drug metabolism.

First-pass effect

The initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream.

Generic name

The name given to a drug by the United States Adopted Names Council. Also called the nonproprietary name. The generic name is much shorter and simpler than the chemical name and is not protected by trademark.

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

A hereditary condition in which red blood cells break down when the body is exposed to certain drugs.

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 by 50% (also called elimination half-life).

Idiosyncratic reaction

An abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient.

Incompatibility

The characteristic that causes two parenteral drugs or solutions to undergo a reaction when mixed or given together that results in the chemical deterioration of at least one of the drugs.

Intraarterial

Within an artery (e.g., intraarterial injection).

Intraarticular

Within a joint (e.g., intraarticular injection).

Intrathecal

Within a sheath (e.g., the theca of the spinal cord, as in an intrathecal injection into the subarachnoid space).

Medication error

Any preventable adverse drug event (see above) involving inappropriate medication use by a patient or health care professional; it may or may not cause patient harm.

Medication use process

The prescribing, dispensing, and administering of medications, and the monitoring of their effects.

Metabolite

A chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug (see later). Active metabolites are those that have pharmacologic activity of their own, even if the parent drug is inactive (see prodrug). Inactive metabolites lack pharmacologic activity and are simply drug waste products awaiting excretion from the body (e.g., via the urinary, gastrointestinal, or respiratory tract).

Onset of action

The time required for a drug to elicit a therapeutic response after dosing

P-glycoprotein

A transporter protein that moves drugs out of cells and into the gut, urine, or bile.

Parent drug

The chemical form of a drug that is administered before it is metabolized by the body into its active or inactive metabolites (see metabolite). A parent drug that is not pharmacologically active itself is called a prodrug. A prodrug is then metabolized to pharmacologically active metabolites.

Peak effect

The time required for a drug to reach its maximum therapeutic response in the body.

Peak level

The maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring.

Pharmaceutics

The science of preparing and dispensing drugs, including dosage form design.

Pharmacodynamics

The study of the biochemical and physiologic interactions of drugs at their sites of activity. It examines the effect of the drug on the body.

Pharmacoeconomics

The study of economic factors affecting the cost of drug therapy.

Pharmacogenomics

The study of the influence of genetic factors on drug response that result in the absence, overabundance, or insufficiency of drug-metabolizing enzymes (also called pharmacogenomics

Pharmacognosy

The study of drugs that are obtained from natural plant and animal sources.

Pharmacokinetics

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. Pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body.

Pharmacology

The broadest term for the study or science of drugs.

Pharmacotherapeutics

The treatment of pathologic conditions through the use of drugs.

Prodrug

An inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body.

Prototypical drug

The first form of a drug, or first in a class of drugs. Throughout this book, prototypical drugs will be denoted as a "key drug."

Receptor

A molecular structure within or on the outer surface of a cell. Receptors bind specific substances (e.g., drug molecules), and one or more corresponding cellular effects (drug actions) occur as a result of this drug-receptor interaction.

Steady state

The physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose.

Substrates

Substances (e.g., drugs or natural biochemicals in the body) on which an enzyme acts.

Synergistic effects

Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone. For example, 1 + 1 is greater than 2 (compare with additive effects).

Therapeutic drug monitoring

The process of measuring drug levels to identify a patient's drug exposure and to allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity.

Therapeutic effect

The desired or intended effect of a particular medication.

Therapeutic index

The ratio between the toxic and therapeutic concentrations of a drug.

Tolerance

Reduced response to a drug after prolonged use.

Toxic

The quality of being poisonous (i.e., injurious to health or dangerous to life).

Toxicity

The condition of producing adverse bodily effects because of poisonous qualities.

Toxicology

The study of poisons, including toxic drug effects, and applicable treatments.

Trade name

The commercial name given to a drug product by its manufacturer; also called the proprietary name.

Trough level

The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug monitoring.

Acquired disease

Any disease triggered by external factors and not directly caused by a person's genes (e.g., an infectious disease, noncongenital cardiovascular diseases).

Alleles

The two or more alternative forms of a gene.

Chromosomes

Structures in the nuclei of cells that contain threads of DNA, which transmit genetic information, and are associated with RNA molecules and synthesis of protein molecules.

Gene

The biologic unit of heredity; a segment of a DNA molecule that contains all of the molecular information required for the synthesis of a biologic product such as an RNA molecule or an amino acid chain (protein molecule).

Gene therapy

New therapeutic technologies that directly target human genes in the treatment or prevention of illness.

Genetic disease

Any disorder caused directly by a genetic mechanism.

Genetic material

DNA or RNA molecules or portions thereof.

Genetic polymorphisms (PMs)

Variants that occur in the chromosomes of 1% or more of the general population

Genetic predisposition

The presence of certain factors in a person's genetic makeup, or genome that increases the individual's likelihood of developing one or more diseases.

Genetics

The study of the structure, function, and inheritance of genes.

Genome

The complete set of genetic material of any organism.

Genomics

The study of the structure and function of the genome and the way genes and their products work in both health and disease.

Genotype

The particular alleles present at a given site on the chromosomes that determine a specific genetic trait for that organism (compare phenotype).

Heredity

The characteristics and qualities that are genetically passed from one generation to the next through reproduction.

Human Genome Project (HGP)

A scientific project of the US Department of Energy and National Institutes of Health (NIH) to describe in detail the entire genome of a human being.

Inherited disease

Genetic disease that results from defective alleles passed from parents to offspring.

Nucleic acids

Molecules of DNA and RNA in the nucleus of every cell. DNA makes up the chromosomes and encodes the genes.

Personalized medicine

The use of molecular and genetic characterizations of both the disease process and the patient for the customization of drug therapy.

Pharmacogenetics

A general term for the study of the genetic basis for variations in the body's response to drugs, with a focus on variations related to a single gene.

Pharmacogenomics

A branch of pharmacogenetics (see earlier) that involves the survey of the entire genome to detect multigenic (multiple-gene) determinants of drug response.

Phenotype

The expression in the body of a genetic trait that results from a person's particular genotype (see earlier) for that trait.

Recombinant DNA (rDNA)

DNA molecules that have been artificially synthesized or modified in a laboratory setting.