Basic Pharm Topics Flashcards
Identify the three basic characteristics of drugs.
- Effectiveness,
- Safety,
- Selectivity
How to visually discriminate between generic and trade drug names?
generic = lowercase,
Trade = Uppercase
What are the important naming rules for OTC medications?
OTCs must clearly list the generic name of the drug contained within the product
Identify the primary goals of medical administration.
- reduce medical errors,
- increase patient adherence
What is the goal of pharm?
To provide maximum benefit with minimum harm.
Describe pharmacologic Assessment (ADPIE).
establish a baseline, then ongoing
Describe pharmacologic Diagnose (ADPIE).
identifying health problems
Describe pharmacologic Planning (ADPIE).
- identifying interventions,
- the 10 rights,
- minimize adverse effects, interactions
- risks, signs for toxicity
Describe pharmacologic Implementation (ADPIE).
intervention, collaboration
Describe pharmacologic Evaluation (ADPIE).
determine success/effectiveness
Landmark drug legislation in response to Thalidomide tragedy.
1962 Harris-Kefauver Amendments
Landmark drug legislation for scheduling of drugs.
1970 Controlled Substances Act
Describe the Thalidomide tragedy.
Thalidomide given to pregnant women, infants born with malformations of arms, legs.
Describe the scheduling of drugs.
Ranks drugs according to abuse potential and medicinal use.
* Schedule I is the highest,
* Schedule 5 is the lowest
Briefly describe pharmacokinetics.
movement of drugs through the body (what the body does to the drug)
Briefly describe pharmacodynamics.
what the drug does to the body
List the components of pharmacokinetics.
There are four.
* Absorption
* Distribution
* Metabolism
* Excretion
Identify the factors affecting drug absorption.
There are five.
* Rate of dissolution (gradient movement)
* Surface area (think of a patch)
* Blood flow (delivery driver)
* Lipid solubility (friendly environment)
* pH (working conditions)
Describe some advantages of the enteral route.
easy, convenient, safe
Describe some advantages of the intravenous route.
rapid onset, precise control of drug levels, possible dilution in large volume of fluids
Describe some advantages of the IM/Subcut routes.
deliver meds with poor water solubility,
fast & slow
Describe some disadvantages of the enteral route.
Highly variable absorption,
requires patient cooperation.
Describe some disadvantages of the intravenous route.
expensive, inconvenient,
immediate/irreversible,
risks for: infection, fluid overload, embolism
Describe some disadvantages of the IM/Subcut routes.
discomfort, inconvenient, infection, nerve damage, requires tissue perfusion
Identify the factors affecting distribution.
There are three.
* Blood flow
* Flow out of vascular system
* Ability to enter cells
Identify a pathologic blood flow issue related to pharmacologic distribution.
exemplar: abscesses/tumors cause poor/abnormal blood flow
Identify a natural feature of the body that prevents drugs from exiting the vascular system.
exemplar: blood brain barrier
Identify the main factors of metabolism that affect pharmacology.
There are three main ones.
* First pass effect
* Nutritional status
* Competition between drugs
Briefly describe the first pass effect.
A rapid reduction of oral medication as they must first pass through the liver before reaching the rest of the body.
Briefly describe how nutrition affects pharmacology.
adequate nutrition provides the required cofactors for hepatic enzymes that break down drugs
Briefly describe competition between two drugs.
Drugs that compete for the same metabolic pathway may cause a decrease in metabolism in 1 or more of the drugs.
Identify some of the many non-renal routes of drug excretion.
breastmilk, bile, lungs, sweat, saliva
Briefly define half-life of a drug.
the time until the amount of a drug in the body is reduced by half
What is the effect of half-life on drug dosing?
The length of the half-life determines the frequency of dosing (the shorter the HL, the more frequent the dosing).
Briefly define the peak of a drug.
The highest level of a drug after a dose.
When is the peak tested?
30m-1hr after infusion completed
Briefly describe the trough of a drug.
The lowest level of a drug between doses.
When is the trough tested?
30m before the next scheduled dose
What is the word or phrase that identifies the goal of serum drug levels?
Therapeutic concentration
What word or phrase identifies the least useful amount of serum drug level?
Minimum effective concentration
What is a loading dose?
Starting with a larger dose or series of doses before moving to a maintenance dose.
What is the purpose of a loading dose?
to quickly achieve a therapeutic concentration.
What is a maintenance dose?
The ongoing dose required to maintain therapeutic concentration.
Briefly describe agonist.
Binds to, ACTIVATES receptors.
Briefly describe antagonists.
Binds to receptors, PREVENTS activation.
Compare the affinity of agonists and antagonists.
Both have high affinity for the receptors.
Compare the intrinsic activity of agonists and antagonists.
- agonists have high intrinsic activity (activation).
- antagonists have no intrinsic activity (inactivation).
Briefly describe maximal efficacy.
largest effect a drug can produce
Briefly describe drug potency.
The strength of the effect from an amount of the drug. (A potent drug produces effects at low doses.)
Describe how potency relates to drug effectiveness.
Potency does not make a drug effective, two drugs of different potency can be equally effective.
Identify the 10 rights of administration.
- patient, dose, route, medication, time
- assessment
- patient education
- patient refusal
- documentation
- evaluation
Briefly describe the adverse effects on the CNS.
stimulation or depression
Briefly identify the adverse effects of anticholinergic medications.
- dry mouth,
- difficulty urinating
(eyes, smooth muscle, exocrine glands, heart)
Briefly identify some adverse effects related to the cardiovascular system.
postural hypotension,
lightheadedness/dizziness,
(vessels of the heart)
Briefly identify the adverse effects on the GI tract.
vomiting, diarrhea, constipation, bleeding (irritation of the GI tract)
Briefly identify the adverse hematologic effects.
bleeding, infection (common, potentially life-threatening)
Briefly describe hypersensitivity/allergy as an adverse medication effect.
when someone develops an immune response to a med
Identify MILD signs of medication hypersensitivy/allergy.
itching, rash, sneezing
Identify SEVERE signs of medication hypersensitivity/allergy.
angioedema, anaphylaxis
Name medications given for angioedema.
Benadryl
Name medications given for anaphylaxis.
Epinephrine
Briefly describe adverse effects of immunosuppression.
decreased or absent immune response, can mask signs of infection
Identify some meds that cause immunosuppression effects.
steroids, transplant meds
Briefly define contraindication.
Reasons to avoid use with an individual patient.
Briefly define precaution.
Reasons for increased caution when used in patients that meet certain criteria.
What is a Category X drug?
evidence of risk to fetus outweighs benefits
Identify differences in drug distribution in children.
- higher water concentration, lower fat
- immature blood brain barrier
- limited protein binding capacity
Identify differences in drug metabolism in children.
- different liver function,
- different respiratory rate
Identify differences in drug excretion in children.
- immature renal development
Identify Pharmacotherapeutic concerns in geriatric patients.
polypharmacy, chronic comorbidities
Identify cardiovascular considerations for geriatric pharmacology.
decreased cardiac output, decreased body water, increased body fat
Identify GI considerations for geriatric pharmacology.
poor absorption and distribution
Identify test for renal function in geriatric patients before considering certain medications.
Creatinine clearance should be assessed in the elderly.
Define cardiac preload.
Volume of blood in the ventricles at end of diastole (ending diastolic pressure).
Define cardiac afterload.
Resistance left ventricle must overcome to circulate blood.
Common reasons for increased preload.
Increased in:
* hypervolemia
* regurgitation (of valves)
* heart failure
Common reasons for increased afterload.
Increased in:
* hypertension
* vasoconstriction
Briefly describe the effect of afterload on cardiac workload.
When afterload increases, cardiac workload increases.
