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NR-NUR124 | Pharmacology > [1] PRELIMS | INTRODUCTION TO PHARMACOLOGY > Flashcards

[1] PRELIMS | INTRODUCTION TO PHARMACOLOGY Flashcards

1
Q

Basic Principles of Pharmacology

The science concerned with history, sources, physical, and chemical properties of drugs, in ways in which drugs affect biological systems

A

Pharmacology

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2
Q

Basic Principles of Pharmacology

Chemical entities, both endogenous and foreign, that are capable of reacting with biological systems

A

Drug

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3
Q

Basic Principles of Pharmacology

Are chemicals that are introduced to cause some sort of change

A

Drugs

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4
Q

Basic Principles of Pharmacology

Science of preparing, compounding, and dispensing medicines

A

Pharmacy

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5
Q

Basic Principles of Pharmacology

Identification and preparation of crude drugs from natural sources

A

Pharmacognosy

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6
Q

Basic Principles of Pharmacology

Study of poisonous aspects of drugs

A

Toxicology

‘Toxic’ = ‘Posionous’

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7
Q

Branch of Pharmacology

Also known as clinical pharmacology

Uses drugs to treat, prevent, and diagnose diseases

A

Pharmacotherapeutics

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8
Q

Concerns of Pharmacotherpeutics

How the drugs are affected by the biological system

A

Pharmacokinetics

What the body does to the drug

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9
Q

Concerns of Pharmacotherapeutics

Effects of drugs in a biological system

A

Pharmacodynamics

What the drug does to the body

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10
Q

Drug Names

Chemical structure of the drug

A

Chemical name

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11
Q

Drug Names

Official nonproprietary name of drugs, universally accepted

A

Generic name/Official name

Ex. Diphenhydramine

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12
Q

Drug Names

Proprietary name, chosen by drug company

A

Brand name/Trade

Ex. Benedryl (Diphenhydramine)

A drug may have one generic name but many brand names

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13
Q

Sources of Drugs

  • P___ Source
  • M___ Source
  • A___ Source
  • S___ drug Source
  • M___ Source
A
  • Plant Source
  • Mineral Source
  • Animal Source
  • Synthetic drug Source
  • Microorganism Source
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14
Q

Drug Development

Tests to see if the drug is safe and its pharmocokinetics

20-100 subjects

A

Clinical Testing | Phase 1

3rd Stage

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15
Q

Drug Development

Where biologic products and chemical synthesis and optimization creates a lead compound

A

In Vitro Studies

1st Stage

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16
Q

Drug Development

Testing of the efficacy selectivity mechanism of the drug

A

Animal Testing

2nd Stage

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17
Q

Drug Development

Tests to see how if the drug works/effective in patients

100-200 patients

A

Clinical Testing | Phase 2

3rd Stage

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18
Q

Drug Development

Tests to see if the drug works double blind

1000-6000 patients

A

Clinical Testing | Phase 3

3rd Stage

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19
Q

Drug Development

Postmarketing surveillance of the drug which lasts for 10-20 years

Drug can be released to the market

A

Clinical Testing | Phase 4

4th Stage (Marketing)

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20
Q

Drug Development

Generics become available only after ____ years as the patent expires

A

20 years

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21
Q

Classification of Drugs

Need to be prescribed before acquired

A

Prescription Drugs

Ex. Antibiotics

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22
Q

Classification of Drugs

Medications that can buy without a prescription

A

Over the Counter Drugs (OTC)

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23
Q

Classification of Drugs

Drugs that are not yet known and are under clinical trials

A

Investigational Drugs (ID)

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24
Q

Classification of Drugs

Prohibited substances and should not be sold to the public

A

Ilicit or Street Drugs

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25
Q

Process of Pharmacokinetics

The entry of a drug into the systemic circulation from the site of administration

A

Absorption

Physical factors are to be considered prior to absorption

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26
Q

Physico-chemical Considerations For Drug Passage Across Barriers

  • ____ of plasma membrane
  • Presence of ____
  • ____ of extracellular environment
  • ____ of drugs
A
  • Selectively permeability of plasma membrane
  • Presence of membrane proteins
  • pH of extracellular environment
  • Ionization of drugs
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27
Q

Absorption

Where drugs administered orally are first exposed to the liver and may be extensively metabolized before reaching the rest of the body

A

First Pass Hepatic Metabolism

GI Tract -> Portal Circulation -> Systemic Circulation

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28
Q

Clinical Relevance of First Pass Hepatic Metabolism

Drugs with high first pass metabolism should be given in ____ to ensure that enough active drug reaches the desired site of action

A

doses sufficient enough

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29
Q

Absorption

The measure of the fraction of a dose that reaches the systemic circulation

A

Bioavailability

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30
Q

Bioavailability

By definition, ____ doses have 100% bioavailability

A

intravascular (IV)

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31
Q

Common Routes of Administration

  • Bioavailability: 100
  • Most rapid onset
A

Intravenous (IV)

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32
Q

Common Routes of Administration

  • Bioavailability: 75 to < or = 100
  • Large volumes often feasible, may be painful
A

Intramuscular (IM)

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33
Q

Common Routes of Administration

  • Bioavailability: 75 to < or = 100
  • Smaller volumes than IM, may be painful
A

Subcutaneous (SC)

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34
Q

Common Routes of Administration

  • Bioavailability: 5 to <100
  • Most convenient; first-pass effect may be important
A

Oral (PO)

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35
Q

Common Routes of Administration

  • Bioavailability: 30 to <100
  • Less first-pass effect than oral
A

Rectal (PR)

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36
Q

Common Routes of Administration

  • Bioavailability: 5 to <100
  • Often very rapid onset
A

Inhalation

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37
Q

Common Routes of Administration

  • Bioavailability: 80 to < or = 100
  • Usually very slow absorption, used for lack of first pass effect, prolonged duration of action
A

Transdermal

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38
Q

Process of Pharmacokinetics

Wherein drug reversibly leaves the bloodstream and enters the target organ

A

Distribution

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39
Q

Factors that influence Distribution

  • S____
  • B____
  • S____
  • P____
A
  • Size of the organ
  • Blood flow
  • Solubility
  • Protein binding
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40
Q

Distribution

Drug from ____ to ____

A

systemic circulation to organ and tissue

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41
Q

Distribution

Under physiologic condition, protein-binding capacity is (1) ____ than the drug concentration and the free fraction is (2) ____

A

(1) greater
(2) constant

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42
Q

Distribution

Plenty of drugs bind to plasma protein, (1) ____, with a balance (2) ____

A

(1) albumin
(2) between bound and free molecule

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43
Q

Distribution

  • [1] ____ (active, free) -> [2] ____ (inactive, bound)
A

[1] Drug + Protein
[2] Complex

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44
Q

Distribution

Sulfonamides and bilirubin in (1) ____
-> (2) ____ -> (3) ____

Sulfonamides should not be given to pregnant mothers and babies

A

(1) neonates
(2) Hyperbilirubinemia
(3) Kernicterus

Kernicterus causes cerebral palsy and hearing loss in neonates

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45
Q

Distribution

Warfarin and sulfonamides -> (1) ____ -> (2) ____

Warfarin (drug) is an anti-coagulant, it is bound to albumin (protein) which makes it inactive

A

(1) displacement of warfarin
(2) increase free Warfarin

Free Warfarin = Active Warfarin, resulting in increase risk of bleeding

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46
Q

Unique Barriers to Distribution

Most low molecular weight medicines cross this barrier

A

Placental Barrier

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47
Q

Criteria for Safe Drugs in Pregnancy

  • W____
  • L____
  • H____
A
  • Water-soluble
  • Large molecule
  • Highly protein-bound

These drugs will not cross the placental barrier, deeming it safe

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48
Q

Unique Barriers to Distribution

Permeable only to lipid soluble or low molecular weight drugs

Ex. Lithium, Ethanol, Levodopa, Dopamine

A

Blood Brain Barrier

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49
Q

Distribution

Drugs that can redistribute into fat tissue prior to elimination

A

Lipid-soluble Drugs

Redistributing into the fat tissue, the drug can go back once again into systemic circulation and increase the effect of the drug

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50
Q

Redistribution

CNS Drugs: The duration of action an initial dose may depend more in the ____

Ex. Thiopental

A

redistribution rate than on the half-life

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51
Q

Process of Pharmacokinetics

Is the metabolic converion of drug to more water soluble metabolites that are more easily excreted

A

Metabolism / Biotransformation

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52
Q

Fates of Drug Metabolism

  1. Active drug -> ____
  2. Active drug -> ____
  3. Prodrug -> ____

*Prodrug is an inactivated drug

A

(1) Inactive drug
(2) Less active metabolite
(3) Active drug

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53
Q

Phase I Metabolism

  • R____
  • O____
  • H____

Goal: to make the drug more water-soluble but it is still active

A
  • Reduction
  • Oxidation
  • Hydrolysis
54
Q

Phase II Metabolism

  • M____
  • G____
  • A____
  • S____

Goal: to make the drug more water-soluble but it is now inactive

A
  • Methylation
  • Glucuronidation
  • Acetylation
  • Sulfation
55
Q

Metabolism

Primary phase I enzyme system involved in the oxidative metabolism xenobiotics

Xenobiotics are foreign substances that are not in nature of the body

A

Cytochrome P450 System

56
Q

Metabolism - Cytochrome P450 System

Responsible for metabolism and synthesis of ____ like ____

A

endogenous compounds like steroids and prostaglandins

57
Q

Metabolism - CYP450 System

CYP 1A2 -> Substrate

A
  • Theophylline
  • Acetaminophen
58
Q

Metabolism - CYP450 System

CYP 1A2 -> Inducers

A
  • Aromatic hydrocarbons (smoke)
  • Cruciferous vegetables
59
Q

Metabolism - CYP450 System

CYP 1A2 -> Inhibitors

A
  • Quinolone
  • Macrolide
60
Q

Metabolism - CYP450 System

CYP 1A2 -> Genetic Morphism

61
Q

Metabolism - CYP450 System

CYP 2C9 -> Substrate

A
  • Phenytoin
  • Warfarin
62
Q

Metabolism - CYP450 System

CYP 2C9 -> Inducers

A

General Inducers

63
Q

Metabolism - CYP450 System

CYP 2C9 -> Inhibitors

64
Q

Metabolism - CYP450 System

CYP 2C9 -> Genetic Morphism

65
Q

Metabolism - CYP450 System

CYP 2D6 -> Substrate

A

Many CNS and CV Drugs

66
Q

Metabolism - CYP450 System

CYP 2D6 -> Inducers

A

None known

67
Q

Metabolism - CYP450 System

CYP 2D6 -> Inhibitors

A
  • Haloperidol
  • Quinidine
68
Q

Metabolism - CYP450 System

CYP 2D6 -> Genetic Morphism

69
Q

Metabolism - CYP450 System

CYP 3A4 -> Substrate

MOST ABUNDANT

A

60% of drugs

70
Q

Metabolism - CYP450 System

CYP 3A4 -> Inducers

A

General Inducers

71
Q

Metabolism - CYP450 System

CYP 3A4 -> Inhibitors

A

General Inhibitors

72
Q

Metabolism

Decrease rate of metabolism -> More drug present

A

Enzyme Inhibitors

73
Q

Metabolism

Increase rate of metabolism -> Less drug present

A

Enzyme Inducers

74
Q

Metabolism

Type of enzyme inhibitors from grapefruit juice

A

Furocoumarins

75
Q

Process of Pharmacokinetics

  • Termination of drug
  • Biotransformation to inactive metabolites
A

Elimination

76
Q

Elimination

  • Excretion via the (1) ____
  • Excretion via other modes like (2) ____, ____, and ____
A

(1) kidney
(2) billary ducts, lungs, and skin

77
Q

Elimination

The time to eliminate 50% of the given amount of drug or to decrease plasma level to 50% of the former drug level

A

Elimination Half-Life

78
Q

Elimination

  • The drug must have the conditions of being ____, ____, and ____ to be easily eliminated
A

polar, charged, and water-soluble

79
Q

Elimination

  • Drugs are eliminated either ____ or as ____
A

unchanged or as metabolites

80
Q

Elimination

  • ____ - for basic drugs
  • ____ - for acidic drugs
A
  • Acidification
  • Alkalinization
81
Q

Renal Elimination

  • Filtration is (1) ____
  • (2) ____ are filtered but ____ are not
A

(1) not saturable
(2) Ionized and nonionized / protein-bound drugs

82
Q

Modes of Elimination

  • Constant amount of the drug is being eliminated per unit of time
  • Rate of elimination is independent of plasma concentration
  • Fixed; No Half-Life

120mg -> 110mg -> 100mg -> 90mg

10mg is constantly being excreted

A

Zero Order Kinetics

Ex. Phenytoin, Ethanol, Aspirin

83
Q

Modes of Elimination

  • Constant fraction of the drug is eliminated per unit of time
  • Most drugs are eliminated this way
  • Half-Life is constant

120mg -> 60mg -> 30mg -> 15mg

A

First Order Kinetics

84
Q
  • Relates to drugs binding to their receptors and their effects

“What the drug does to the body”

A

Pharmacodynamics

85
Q

Pharmacodynamics

Drug enters the plasma and lasts until it reaches the minimun effective concentration (MEC)

A

Onset of Action

86
Q

Pharmacodynamics

Drug reaches its highest blood or plasma concentration

A

Peak Action

87
Q

Pharmacodynamics

Length of time the drug has a pharmacologic effect

A

Duration of Action

88
Q

Pharmacodynamics

The concentration level a drug must reach to exert its intended effect

A

Minimum Effective Concentration (MEC)

89
Q

Pharmacodynamics

Ability of the drug to bind to the receptor

How good the drug and the receptor recognize each other

90
Q

Pharmacodynamics

The quantity of the drug to achieve a desired effect

91
Q

Pharmacodynamics

Maximal effect an agonist can achieve at the highest practical concentrations

92
Q

Pharmacodynamics

A drug binding to receptors will elicit a response

93
Q

Type of Agonist

Produce a maximal response (maximal efficacy)

A

Full Agonist

94
Q

Type of Agonist

Less effective (incapable of eliciting maximal response)

A

Partial Agonist

95
Q

Pharmacodynamics

A drug binding to a receptor will elicit no response and it prevents the agonist from binding to the receptor

A

Antagonist

96
Q

Pharmacodynamics

  • Fraction of the population that responds at each dose against the log of the dose administered
  • At what specific dose will this drug be safe to give to the patient
A

Quantal Dose Response Curve

97
Q

Quantal Dose Response Curve

Means 50% of the population that took the drug at a specific dose will be able to get an effect from the drug

A

Median Effective (ED50)

98
Q

Quantal Dose Response Curve

Means 50% of the population that took the drug at a specific dose will have its toxic effects

A

Median Toxic (TD50)

99
Q

Quantal Dose Response Curve

Means 50% of the population that took the drug at a specific dose will die

A

Median Lethal (LD50)

100
Q

Quantal Dose Response Curve

  • Reveals the range of ____
A

intersubject variability

101
Q

Quantal Dose Response Curve

  • (1) ____ required to produce a specified response is determined in each (2) ____
A

(1) Minimum dose
(2) member of a population

102
Q

Pharmacodynamics

Measurment of drug safety

A

Therapeutic Index

103
Q

Therapeutic Index

Dosage range that can safely and effectively treat disease

A

Therapeutic Window

104
Q

Pharmacodynamics

Therapeutic Index = ____

A

TD50 / ED50

105
Q

When the drug level exceed the therapeutic range, ____ are likely to occur

A

toxic effects

106
Q

Toxic Effect of Drugs

Are physiologic effects of drugs not related to desired drug effects, may be desirable or undesirable

A

Side Effects

107
Q

Toxic Effect of Drugs

Are a range of untoward effects of drugs that cause mild to severe side effects

Mostly negative effects

A

Adverse Reactions

108
Q

Federal Drug Classifications / FDA Pregnancy Catergories

No evidence of risk

A

Category A

109
Q

Federal Drug Classifications / FDA Pregnancy Catergories

Animal Studies have shown adverse effect, but adequate studies in pregnant women have not demonstrated a risk to the fetus

A

Category B

110
Q

Federal Drug Classifications / FDA Pregnancy Catergories

There are no animal reproduction studies and adequate studies in human

A

Category C

111
Q

Federal Drug Classifications / FDA Pregnancy Catergories

Evidence of human fetal risk, but the potential benefits from the use of the drug in pregnant women maybe acceptable

A

Category D

112
Q

Federal Drug Classifications / FDA Pregnancy Catergories

Evidence of fetal risk and abnormalities

A

Category X

113
Q

Toxic Effect of Drugs

Regardless of the designated category or presumed safety, no drug should be administered during ____ unless it is clearly needed

114
Q

Bioethical and Legal Aspect

Self-determination

115
Q

Bioethical and Legal Aspect

Trust through truth-telling

116
Q

Bioethical and Legal Aspect

Do no harm

A

Non-maleficence

117
Q

Bioethical and Legal Aspect

Prevent harm, do good

A

Beneficence

118
Q

Bioethical and Legal Aspect

Give to each person their right or due

119
Q

Bioethical and Legal Aspect

Not to divulge information without consent

A

Confidentiality

120
Q

Bioethical and Legal Aspect

An act to promote, require, and ensure the production of an adequate supply, distribution, use, and acceptance of drugs and medicines identified by their generic name

A

RA 6675 (Generics Act of 1988)

121
Q

Bioethical and Legal Aspect

All prescriptions must contain the following information: Name of the prescriber, office address, license no., Professional Tax Receipt (PTR) No., patient’s name, age, sex, and date of prescription

A

RA 5921 (Pharmacy Act)

122
Q

Bioethical and Legal Aspect

Act that identifies drugs that can harm the population through its illegal use

A

RA 6425 (Dangerous Drugs Act of 1972)

123
Q

What to do if there are Unclear Orders

  • Question the (1) ____
  • Consult (2) ____ if the prescribing doctor is not available
  • Ask the doctor to (3) ____
  • Be familiar with the (4) ____
A

(1) prescribing doctor
(2) another doctor
(3) clearly write the drug order in a clearer way
(4) drug dosage

124
Q

What to do if there are Telephone Orders

  • Depends on (1) ____
  • Write the (2) ____
  • Ask the doctor to (3) ____
  • (4) ____ back to the doctor
  • Immediately write it to the (5) ____
  • (6) ____
A

(1) hospital policies
(2) order (drug name, dosage, route, and frequency)
(3) repeat the order
(4) Read the order
(5) doctor’s orders sheet
(6) Document

125
Q

Bioethical and Legal Aspects

  • Clearly written (drug name, route, frequency)
  • Specific circumstance for PRN (as needed) medication
  • Do not accept unclear order if needed, if indicated as warranted
A

Standing Orders

126
Q

Bioethical and Legal Aspects

  • Verbal orders - emergency only!
A

Emergency/Verbal Orders

127
Q

Key Points in Giving a Medication

  1. ____
  2. ____ the drug
  3. ____
  4. ____ the drug
  5. ____ while taking medication
  6. ____ of medication
A
  1. Name of drug
  2. Reason of taking the drug
  3. The dose
  4. Specific time to take the drug
  5. What specific things should or should not do while taking medication
  6. Possible side effect of medication
128
Q

Checklist for Health Teaching in Drug Therapy

  1. Comprehensive ____
  2. ____ of drug therapy
  3. ____
  4. ____ and ____
  5. When to ____
  6. ____ and ____ interactions
  7. Required changes in ____
  8. Demonstration of ____
  9. ____ associated with ADLs as appropriate
  10. ____
  11. ____ to financial resources
  12. Developing ____
  13. ____
A
  1. Comprehensive drug and health history
  2. Reason for medication of drug therapy
  3. Expected results
  4. Side effects and adverse reactions
  5. When to notify physician, pharmacist, or HCP
  6. Drug-drug and drug-food interactions
  7. Required changes in activites of daily living
  8. Demonstration of learning
  9. Medication schedule associated with ADLs as appropriate
  10. Recording/Documentation
  11. Discussing and monitoring the disease to financial resources
  12. Developing back-up system
  13. Community resources
129
Q

10 Rights in Drug Administration

A
  1. ® Client
  2. ® Drug
  3. ® Route
  4. ® Dose
  5. ® Time
  6. ® to Education
  7. ® Assessment
  8. ® Documentation
  9. ® Evaluation
  10. ® to Refuse
130
Q

Nursing Responsibilites

  • (1) ____
  • (2) ____
  • Intervening to make (3) ____
  • Providing patient (4) ____
  • Monitoring the overall patient care plan to ____
A

(1) Administering drugs
(2) Assessing drug effects
(3) drug regimen more tolerable
(4) teaching about drugs and drug regimen
(5) prevent medication errors

NR-NUR124 | Pharmacology (16 decks)

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