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compliance
Implementation or fulfillment of a prescriber’s or caregiver’s prescribed course of treatment or therapeutic plan by a patient. Also called adherence
adherence
Implementation or fulfillment of a prescriber’s or caregiver’s prescribed course of treatment or therapeutic plan by a patient. Same thing as compliance.
goals
Statements that are time specific and describe generally what is to be accomplished to address a specific nursing diagnosis
medication error
any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may or may not cause the patient harm.
noncompliance
an informed decision on the part of the patient not to adhere to or follow a therapeutic plan or suggestion. Also known as nonadherence.
nonadherence
an informed decision on the part of the patient not to adhere to or follow a therapeutic plan or suggestion. Same thing as noncompliance.
nursing process
an organizational framework for the practice of nursing. It encompasses all steps taken by the nurse in caring for a patient: assessment, nursing diagnoses, planning (with goals and outcome criteria), implementation of the plan (with patient teaching), and evaluation.
outcome criteria
Descriptions of specific patient behaviors or responses that demonstrate meeting of or achievement of goals related to each nursing diagnosis. These statements, like goals, should be verifiable, framed in behavioral terms, measurable, and time specific. Outcome criteria are considered to be specific, whereas goals are broad.
prescriber
any health care professional licensed by the appropriate regulatory board to prescribe medications (this includes nurse practitioners and physician’s assistants)
objective data
any information gathered through the senses or that which is seen, heard, felt, or smelled
subjective data
information shared through the spoken word by any reliable source, such as the patient, spouse, family member, significant other, and/or caregiver
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 (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 imunologic 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.
inhibitors
a drug that binds to and inhibits the activity of one or more receptors in the body. Also known as antagonists.
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<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 (0-100%)
biotransformation
one or more biochemical reactions involving a parent drug. Biotransformation occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as metabolism.
metabolism
one or more biochemical reactions involving a parent drug. Biotransformation occurs mainly in the liver and produces a metabolite that is either inactive or active. Also known as biotransformation.
blood-brain barrier
the barrier system that restricts the passage of various chemicals and microscopic entities 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 other patient characteristic, including current or recent drug therapy, that renders a particular form of treatment improper or undesirable.
Cytochrome P-450
the general name for a large class of enzymes that play a significant role in drug metabolism
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 cellular 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 effects
the physiologic reactions of the body to a drug. They can be therapeutic or toxic and describe how the function of the body is affected as whole by the drug. The terms onset, peak, and duration are used to describe drug effects (most often referring to therapeutic effects)
mechanism of action
the cellular processes involved in the interaction between a drug and body cells (e.g., the action of a drug on a receptor protein); also known as drug actions
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 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 own 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
half-life or elimination 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%
idiosyncratic reaction
an abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient
incompatibility
the characteristics 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
intraarticular
within a joint
intrathecal
within a sheath
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
onset of action
the time required for a drug to elicit a therapeutic response after dosing
parent drug
The chemical form of a drug that is administered before it is metabolized by the body’s biochemical reactions 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 physicochemical properties of drugs and their pharmacologic interactions with body receptors (evolve online course for pharmocolgy states what the drug does to the body)
Pharmacogenetics
the study of the influence of genetic factors on drug response, including the nature of genetic aberrations 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 (evolve online course for pharmocolgy states the discovery, research, and development of new drugs)
pharmacokinetics
the rate of drug distribution among various body compartments after a drug has entered the body. Phases of absorption, distribution, metabolism, and excretion (evolve online course for pharmocolgy states what the body does to the drug)
pharmacology
the broadest term for the study or science of drugs
pharmacotherapeutics
the treatment of pathologic conditions through the use of drugs (evolve online course for pharmocolgy states the properties of drugs, including therapeutic efficacy, time of onset of action, and duration)
prodrug
an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body
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) occurs 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 does
substrates
substances 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 (1+1>2)
therapeutic drug monitoring
The process of measuring drug peak and trough levels to gauge the level of a patient’s drug exposure and 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
toxicity
the condition of producing adverse bodily effects due to poisonous qualities
toxicology
the study of poisons, including toxic drug effects, and applicable treatments (evolve online course for pharmocolgy states the study of the side effects produced by a drug and how the drug influences the effectiveness of other drugs)
Trade name
the commercial name given to a drug product by its manufacturer; also called the proprietary name
through 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
active transport
the active (energy-requiring) movement of a substance between different tissues via biomolecular pumping mechanisms contained within cell membranes
diffusion
the passive movement of a substance between different tissues from areas of higher concentration to areas of lower concentration
elderly
person who is 65 years of age or older
neonate
person younger than 1 month of age; newborn infant
nomogram
a graphic tool for estimating drug dosages using various body measurements
pediatric
person wh0 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
bias
Any systematic error in a measurement process. One common effort to avoid bias in research studies involves the use of blinded study designs
black box warning
a type of warning that appears in a drug’s prescribing information, required by the US FDA alerting prescribers of serious adverse events that have occurred with the given drug
blinded investigational drug study
a research design in which the subjects are purposely unaware of whether the substance they are administered is the drug under study or a placebo. This method serves to eliminate bias on the part of research subjects in reporting their body’s responses to investigational drugs
controlled substances
any drugs listed on one of the “schedules” of the Controlled Substance Act (also called scheduled drugs)
double-blind investigational drug study
A research design in which both the investigator(s) and the subjects are purposely unaware of whether the substance administered to a given subject is the drug under study or a placebo. This method eliminates bias on the part of both the investigator and the subject
drug polymorphism
variation in response to a drug because of a patient’s age, gender, size, and/or body composition
expedited drug approval
Acceleration of the usual investigational new drug approval process by the U.S. FDA and pharmaceutical companies, usually for drugs used to treat life-threatening diseases
health insurance portability and accountability act (HIPAA)
an act that protects health insurance coverage for workers and their families when they change jobs. It also protects patient information. If confidentiality of a patient is breached, severe fines may be imposed
informed consent
written permission obtained from a patient consenting to the performance of a specific procedure, after the patient has been given information regarding the procedure deemed necessary for the patient to make a sound or “informed” decision
investigational new drug (IND)
a drug not approved for marketing by the FDA but available for use in experiments to determine its safety and efficacy; also, the actual name of the category of application that the drug manufacturer submits to the FDA to obtain permission for human (clinical) studies following successful completion of animal (preclinical) studies
investigational new drug application
the type of application that a drug manufacturer submits to the FDA following successful completion of required human research studies
legend drugs
another name for prescription drugs
narcotic
a legal term established under the Harrison Antinarcotic Act of 1914. It originally applied to drugs that produced insensibility or stupor, especially the opioids. The term is currently used in clinical settings to refer to any medically administered controlled substance and in legal settings to refer to any illicit or “street’ drug
orphan drugs
a special category of drugs that have been identified to help treat patients with rare diseases
over-the-counter drugs
drugs available to consumers without a prescription. Also called nonprescription drugs
nonprescription drugs
drugs available to consumers without a prescription (over-the-counter drugs)
placebo
an inactive (inert) substance, that is not a drug but is formulated to resemble a drug for research purposes
acquired disease
any disease triggered by external factors and not directly caused by a person’s genes
alleles
the two or more alternative forms of a gene that can occupy a specific locus (location) on a chromosome
chromatin
a collective term for all of the chromosomal material within a given cell
chromosomes
structures in the nuclei of cells that contain linear threads of deoxyribonucleic acid (DNA), which transmits genetic information, and are associated with ribonucleic acid (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)
allele variants that occur in the chromosomes 1% or more of the general population (i.e., they occur too frequently to be caused by a random recurrent mutation)
genetic predisposition
the presence of certain factors in a person’s genetic makeup, or genome, that increase the individual’s likelihood of eventually 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 (may be contained in multiple chromosomes, single chromosome, or single DNA or RNA)
genomics
the study of the structure and function of the genome, including DNA sequencing, mapping, and expresion, and the way genes and their products work in both health and disease
genotype
the particular alleles present at a given site (locus) on the chromosomes of an organism that determine a specific genetic trait for that organism
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 to describe in detail the entire genome of a human being
inherited diseases
genetic diseases that result from defective alleles passed from parents to offspring
nucleic acids
molecule of DNA and RNA in the nucleus of every cell. DNA makes up the chromosomes and encodes the genes
personalized medicine
the use of tools such as molecular and genetic characterizations of both disease processes and the patient for the customization of drug therapy
pharmacogenomics
a branch of pharmacogenetics 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 for that trait
proteome
the entire set of proteins produced from the information encoded in an organism’s genome
proteomics
the detailed study of the proteome, including all biologic actions of proteins
recombinant DNA (rDNA)
DNA molecules that have been artificially synthesized or modified in a laboratory setting
medical error
broad term commonly used to refer to any error in any phase of clinical patient care that causes or has the potential to cause patient harm
medication reconciliation
a procedure implemented by health care providers to maintain an accurate and up-to-date list of medications for all patients between all phases of health care delivery
affective domain
the most intangible component of the learning process. Affective behavior is conduct that expresses feelings, needs, beliefs, values, and opinions
cognitive domain
the domain involved in the learning and storage of basic knowledge. It is the thinking portion of the learning process and incorporates a person’s previous experiences and perceptions
learning
the acquisition of knowledge or skill
psychomotor domain
the domain involved in the learning of a new procedure or skill; often called the doing domain
teaching
a system of directed and deliberate actions intended to induce learning
alternative medicine
herbal medicine, chiropractic, acupuncture, reflexology, and any other therapies traditionally not emphasized in Western medical schools but popular with many patients
complementary medicine
alternative medicine when used simultaneously with, rather than instead of, standard Western medicine (using conventional medicine and alternative medicine at the same time)
conventional medicine
the practice of medicine as taught in Western medical schools
dietary supplement
Acceleration of the usual investigational new drug approval process by the U.S. Food and Drug Administration (FDA) and pharmaceutical companies, usually for drugs used to treat life-threatening disease
herbal medicine
the practice of using herbs to heal
herbs
plant components including bark, roots, leaves, seeds, flowers, and fruits of trees, shrubs, and wood vines, and extracts of these plants and materials that are valued for their savory, aromatic, or medicinal qualities
iatrogenic effects
unintentional adverse effects that are caused by the actions of a prescriber or other health care professional or by a specific treatment
phytochemicals
the pharmacologically active ingredients in herbal remedies
addiction
strong psychologic or physical dependence on a drug or other psychoactive substance
amphetamine
a drug that stimulates the central nervous system
enuresis
urinary incontinence
habituation
development of tolerance to a substance following prolonged medical use but without psychologic or physical dependence (addiction)
illicit drug use
the use of a drug or substance in a way that it is not intended to be used or the use of a drug that is not legally approved for human administration
intoxication
stimulation, excitement, or stupefaction produced by a chemical substance
Korsakoff’s psychosis
A syndrome of anterograde and retrograde amnesia with confabulation (making up of stories) associated with chronic alcohol abuse; it often occurs together with Wernicke encephalopathy
micturition
urination, the desire to urinate, or the frequency of urination
narcolepsy
a sleep disorder characterized by sleeping during the day, disrupted nighttime sleep, cataplexy, sleep paralysis, and hypnagogic hallucinations
opioid analgesics
synthetic pain-relieving substances that were originally derived from the opium poppy. Naturally occurring opium derivatives are called opiates
physical dependence
a condition characterized by physiologic reliance on a substance, usually indicated by tolerance to the effects of the substance and development of withdrawal symptoms when use of the substance is terminated
psychoactive properties
drug properties that affect mood, behavior, cognitive processes, and mental status
psychologic dependence
a condition characterized by strong desires to obtain and use a substance
raves
increasingly popular all-night parties that typically involve dancing, drinking, and the use of various illicit drugs
roofies
pills that are classified as benzodiazepines. They have recently gained popularity as a recreational drug; chemically known as flunitrazepam
substance abuse
the use of a mood- or behavior-altering substance in a maladaptive manner that often compromises health, safety, and social and occupational functioning, and causes legal problems
Wernicke’s encephalopathy
A neurologic disorder characterized by apathy, drowsiness, ataxia, nystagmus, and ophthalmoplegia; it is caused by thiamine (vitamin B1) deficiency secondary to chronic alcohol abuse.
withdrawal
a substance-specific mental disorder that follows the cessation or reduction in use of a psychoactive substance that has been taken regularly to induce a state of intoxication

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