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Pharmacology

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The study of drugs

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Pharmacotherapy

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Therapy using drugs

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Local Effects

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The drug only affects one area of the body

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Systemic Effect

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The drug affects the whole body

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Chronic

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develops and worsens over an extended period of time; 6 months or greater

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Acute

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Sx appear and change or worsen rapidly, ie. heart attack, 6 months or less

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derived from plants, animals and minerals, now mostly synthetic compounds or semisynthetic drugs(in a lab; more stable, less allergic Reaction)

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drug sources

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effect on the body, therapeutic use, chemical characteristics

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3 ways drugs are classified

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usually the first drug of a particular group to be developed, the standard that newer, similar drugs are compared to

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prototype

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chemical name

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2-(4-isobutylphenyl)propanoic acid

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generic name

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ibuprofen-always lower case

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trade/brand name

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Advil, Motrin-always capitalized, more expensive

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prescription/legend drug

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must be ordered from a licensed health care provider and dispensed by a pharmacist

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non-prescription

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over the counter, does not require a prescription

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Greater autonomy, fast and convenient access, potential for earlier resumption of activities, fewer visits to a health care provider, increased effort to learn about Sx/conditions

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advantages of OTC medication

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inaccurate self-diagnosis, potential risk for choosing a wrong drug/product, delayed treatment from a health care professional, potential for adverse reactions and interations

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Disadvantages to OTC medication

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Food, drug, and cosmetic act

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1938- gave FDA control over drug safety

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Durham-Humphrey Admendment

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1951-Designated drugs that must be prescribed by a physician and dispensed by a pharmacist (controlled substances)(legend vs OTC drugs)

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Controlled Substance Act

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1970-Regulated distribution of narcotics and other abused drugs. Categorized these drugs according to therapeutic usefulness and potential for abuse.

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schedule I-V

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How many categories of controlled substances?

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Schedule I

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Substances have high abuse potential and no accepted medical use. heroin, marijuana LSD

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schedule II

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Substances that have high abuse potential and severe psychological and or physical dependence liability. Ex. narcotics/opioid analegesics, CNS stimulates/amphetamines, barbiturate sedative-hypnotics, lauratab. can never be ordered with refills and must be filled within 7 days of the date originally written. No faxing, has to be mailed or hand delivered by PT

question

Schedule III

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Substances that have less abuse potential than schedule II substances and moderate dependence liability. Ex. nonbarbiturae sedatives, nonamphetamine stimulants, medications that contain a limited quantity of certain narcotics. Prescriptions must be filled within 30 days of the date written and may be refilled up to 5 times within 6 months

question

Schedudle IV

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Substances that have less abuse potential than schedule III substances and limited dependence liability. Ex. benzodiazepines, sedative-hypnotics, some prescription appetite suppressants. Prescriptions must be filled within 30 days of the date written and may be refiled up to 5 times within a 6-months period

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Schedule V

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Substances that have limited abuse potential. Primarily are antitussives or antidiarrheals that contain small amounts of narcotics (codeine, Lomotil). May be dispensed by the pharmacist w/out a physicians prescription but with some restrictions.

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registered with DEA/provide number on all prescriptions, keep accurate records of all transactions, provide for secure storage: locked containers, recording on narcotic sheets/MAR, maintain accurate inventory, report discrepancies to proper authorities

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Controlled substances must be:

question

Drug enforcement administration, food and drug administration

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DEA stands for? FDA stands for?

question

FDA

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___ is responsible for ensuring that new drugs are safe and effective before approving a drug to be marketed. (it is long and expensive process that can be later withdrawn)

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Phase I: healthy, phase II: subjects with disease that the drug is being studied for, phaseIII: larger groups, placebos, phase IV: FDA reviews the study and decides if it can be put on the market.

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Four Phases:

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Right drug, dose, patient, route, time, reason, documentation, education, evaluation, refuse.

answer

10 rights

question

quality and safety education for nurses, promoting the improvement of quality and safety of health care systems

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what does QSEN stand for and what do they do?

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The Joint Commission, if not safe, they will shut you down, enhance safety

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National Patient safety goals

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Institue for safe medication practices, identifies high alert medications

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what does ISMP stand for? and what do they do?

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labeling medication syringes, bottles. Anticoagulants, medication reconciliation

answer

3 targeted high risk activities involving medications

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A=safest, C=unknown, X=known danger

answer

Pregnancy categories for safety are?

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Beers Criterion

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____ ____ is a list of inapproperate meds that should not be given to the elderly

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american hospital formulary service, physicians desk reference (PDR/look up a drug by the picture), drug handbooks

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3 drug reference books

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False

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T or F, the trade or brand name is related tot he chemical or official name and is independent of the manufacturer

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False-restricted the importation, manufacture, sale and use of opium, cocaine, marijuana and other drugs that the Act defined as narcotics.

answer

the harrison narcotic act prohibits fraudulent claims of drug effectiveness

question

True

answer

prescriptions for schedule II drugs cannot be refilled

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True

answer

controlled drugs are categorized according to therapeutic usefulness and potential for abuse

question

True

answer

the food and drug administration (FDA) is responsible for assuring the new drugs are safe and effective before approving the drugs and allowing them to be marketed

question

Phototype

answer

indivddual drugs that represent groups of drugs are called___

question

chemical

answer

drugs are classified according to their effects on particular body systems, their therapeutic uses, and their___characteristics

question

systemic

answer

drugs may be given for local or___effects

question

drug

answer

the goals of most pharmacoeconomic research is to identify ___ therapy regiments that provide the desired benefits at the least cost

question

III

answer

Phase___ studies help to determine whether the potential benefits for the drug outweigh the risks

question

cellular

answer

drug action occurs at the ____ level

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drugs

answer

---- can stimulate or inhibit cellular function

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exchange materials with environment, obtain energy from nutrients, synthesis hormones, neurotransmitters, enzymes, structural proteins, duplicate/reproduce, communicate

answer

5 common characteristics of cells

question

pharmacokinetics

answer

---involves drug movement through the body

question

absorption, distribution, metabolism, excretion

answer

4 processes of pharmacokinetics

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absorption

answer

the process whereby a drug moves from the site of entry into the body toward the circulatory system

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route, presence of food/other drugs, gastrointestinal function, dosage form, bioavailability, blood flow

answer

6 factors affecting absorption

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bioavialability

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the portion of a dose that reaches the circulatory system and is available to act on body cells

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distribution

answer

transport of drug molecules within the body.

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distribution

answer

depends largely on the adequacy of blood circulation

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plasma protein binding, blood-brain barrier, pregnancy/lactation precautions

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3 factors affecting distribution

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metabolism

answer

the process by which the body breaks down and concerts medication into active chemical substances

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liver

answer

the primary site of drug metabolism is the _____

question

first pass effect

answer

some drugs are extensively metabolized in the liver, with only part of a drug dose reaching the circulatory system. also called presystemic metabolism

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excretion

answer

elimination of a drug from the body

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circulatory system, kidneys, bowel, lungs, skin

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excretion requires adequate functioning of the ____,___,___,___,___

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kidneys

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the primary sit of drug excretions is the

question

serum drug levels

answer

measurement of the amount of the drug in the blood

question

minimum effective concentration

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--- must be present before a drug exerts its pharmacological action on a body cells

question

toxic concentration

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is the level that toxicity occurs

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therapeutic range

answer

___is between high and low concentrations of a drug

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peak

answer

is the highest concentration and peak drug action occurs

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trough

answer

lowest level that medication is present in the body

question

onset of action (MEC), peak, duration of action, trough

answer

serum levels of drugs indicate

question

serum half life

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the time it takes the concentration of a drug to decrease by 50%, different for each drug, determined by the rate of metabolism and excretion

question

pharmacodynamics

answer

what the drug does to the body

question

receptors

answer

pharmacodynamics chemically binds with ____ at the cellular level

question

T

answer

T or F pharmacodynamics create agonist or antagonist effects

question

T

answer

T or F pharmacodynamics can change the permeability of cell membranes

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T

answer

T or F pharmacodynamics can modify the synthesis, release, or inactivation of neurohormones

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receptor theory of drug action

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the concept that certain drugs produce their effects by acting specifically at a receptor site on a cell or within the cell or its membrane

question

non receptor drug actions

answer

drugs that do not act on receptor sites

question

dosage, route of administration, drug-diet interactions, drug-drug- interactions

answer

4 drug related variable that affect drug actions

question

age, body weight, genetic and ethnic characteristics, gender, pathological conditions, psychological considerations

answer

6 patient related variable that affect drug actions

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loading dose

answer

--------dose is administered at the beginning of drug therapy. it is larger than the regular dose, usded to attain a more rapid therapeutic blood level of the dug

question

maintenance dose

answer

------ dose is needed to keep blood levels at a steady state or constant level

question

additive effect

answer

occurs when two drugs with similar pharmacologic action are taken

question

synergistic effect

answer

occurs when tow drugs with different sits or mechanisms of action are taken

question

adverse effect

answer

unexpected or dangerous reaction of a drug

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antidote

answer

drug that is given to antagonize the toxic effects of another drug

question

placebo effect

answer

when a patient experiences a response to a placebo, positive or negative, or they may appear to have side effects

question

tolerance

answer

when the body becomes accustomed to a particular drug over time so that larger doses must be given

question

cross-tolerance

answer

tolerance to pharmacologically related drugs

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adverse effects of drugs

answer

is an undesired response to a drug, all drugs can produce them

question

adverse effects of drugs

answer

can be common or rare, mild, severe, local or widespread, van be very serious

question

black box warnings

answer

on the label of a prescription drug or in the literature describing it. it is usually added after a large number of serious adverse effects have occurred.

question

pregnancy categories

answer

are used to identify risk of fetal injury from drugs used by the mother during pregnancy

question

a(safest)-x(known danger)

answer

pregnancy categories rang from -- to ---

question

category A

answer

Safe. risk to the fetus has not been demonstrated in well controlled studies in pregnant women

question

category B

answer

animal reproduction studies have not demonstrated risk to the fetus, and there are no well controlled studies in pregnant women

question

category C

answer

animal reproduction studies have not demonstrated risk to the fetus, and there are no well controlled studies in pregnant women, however, potential benefits may outweigh potential risk in use of drug in pregnant women

question

category D

answer

evidence of risk to the fetus has been demonstrated. however, the benefits may outweigh the risk in pregnant women if the drug is needed in a life threatening situation and other safe drugs cannot be used or are ineffective

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category X

answer

not safe

question

drug toxicity

answer

results from excessive amounts of a drug and may damage body tissues

question

drug overdose

answer

can result in a single large dose or prolonged ingestion of smaller doses

question

start treatment as soon as possible, support and stabilize vital functions, prevent further damage, administer antidotes

answer

4 main goals in drug overdose treatment

question

Acetylcysteine, PO

answer

antidote and route of OD of Acetaminophen

question

Flumazenil, IV

answer

antidote and route of OD of Benzodiazepines

question

Succimer (Chemet), PO

answer

antidote and route of OD of Lead

question

Naloxone (Narcan), IV

answer

antidote and route of OD of Opoid analgesics

question

Sodium bicarbonate, IV

answer

antidote and route of OD of Aspirin

question

activated charcoal

answer

the "universal antidote", it absorbs the toxins and rarely causes problems

question

Naloxone

answer

___ is used to relieve respiratory depression associated with morphine

question

dose

answer

Body weight affects drug action mainly in relation to___

question

placenta

answer

during pregnancy, drugs cross the ----- and may harm the fetus

Pharmacology Unit 1 – Flashcards

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