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Nursing School > Basic Principles of Pharmacology > Flashcards

Basic Principles of Pharmacology Flashcards

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1
Q

Elicits response for which it is given

A

Effective

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2
Q

Cannot produce harmful effects

A

Safe

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3
Q

Elicits only responses for which it is given

A

Selective

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4
Q

Additional properties of an ideal drug

A

reversibility, predictability, ease of administration, freedom from drug interactions, low cost, chemical stability, simple generic names

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5
Q

Factors that determine intensity of drug responses

A

administration, pharmacokinetics (ADME), pharmacodynamics, individual variation

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6
Q

Dosage, route, time

A

administration

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7
Q

What the body does to the drug

A

pharmacokinetics

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8
Q

What the drug does to the body

A

Pharmacodynamics (d in dynamics = what drug does)

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9
Q

Drug interactions, physiologic variables, pathologic variables, genetic variables

A

Individual variation

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10
Q

Pre-administration assessment includes

A

collect baseline data (HR, BP), identify high risk patient (multi drug), assess patient capacity for self care (educate, teach back, how to administer)

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11
Q

Federal pure food and drug act

A

set standards for drug quality and purity, in addition to strength

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12
Q

Food, drug, and cosmetic act

A

all medications must be tested for safety, with results viewed by FDA

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13
Q

Harris-Kefauver agreements

A

Medications must be proven effective before marketing

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14
Q

Controlled substance act

A

Rules made for categorizing medications with potential for abuse

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15
Q

BPCA & PREA

A

Promote research in drug safety and efficacy in children with clinical trials

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16
Q

FDA amendments act

A

Include rigorous oversight of drug safety after approval

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17
Q

Controlled substances class I (++++)

A

high abuse potential, no accepted medical use

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18
Q

Examples of class I controlled substances

A

heroin, LSD, MDMA (ecstasy), marijuana

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19
Q

Controlled substances class II (++++)

A

high abuse potential, accepted medical use

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20
Q

Examples of class II controlled substanses

A

morphine, oxycodone (OxyContin), methamphetamine, fentanyl, Adderall

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21
Q

Controlled substances class III (+++)

A

moderate abuse potential, accepted medical use

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22
Q

Examples of class III controlled substances

A

ketamine, testosterone, anabolic steroids

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23
Q

Controlled substance class IV (++)

A

low abuse potential, accepted medical use

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24
Q

Examples of class IV controlled substances

A

Xanax, Valium, Ambien, tramadol

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25
Q

Controlled substance class V (+)

A

low abuse potential, accepted medical use

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26
Q

Examples of class V controlled substances

A

Lyrica, Lomotil, many codeine-containing cough syrups

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27
Q

What class has the highest abuse potential and which class has the lowest

A

Highest = class I
Lowest = class V

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28
Q

Most reliable way to objectively assess drug therapies

A

Randomized controlled trials

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29
Q

Three key features to randomized controlled trials

A

controls, randomization, blinding

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30
Q

Chemical medication nomenclature

A

describes the medication using chemistry nomenclature (N-acetyl-para-aminophenol)

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31
Q

Generic medication nomenclature

A

name of drug assigned by US Adopted Names Council that is less complex than chemical name (acetaminophen)

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32
Q

Trade medication nomenclature

A

name under which drug is marketed under for ease of use and recall (Tylenol, Ofirmev, APAP, Excedrin)

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33
Q

Sources of drug information

A

People (pharmacists, nurses, physicians), pharmaceutical reps), reference books, online database

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34
Q

Pharmacokinetics

A

what the body is made to do to the medication

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35
Q

Kinetics - ADME stands for

A

absorption, distribution, metabolism, excretion

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36
Q

Absorption of drug

A

movement from site of administration to blood stream, rate of absorption determines how soon effects will begin, amount of absorption determines how intense effects will be

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37
Q

Distribution of drug

A

movement of drugs into cells (IV is straight to distribution)

38
Q

Metabolism of drug

A

biotransformation or conversion of drugs into another form

39
Q

Excretion of drug

A

removal of drug from the body

40
Q

Elimination of drug

A

both metabolism and excretion combined

41
Q

Factors that can affect absorption

A

rate of dissolution, surface area (small intestine absorbs more), blood flow, lipid solubility, pH partitioning (acid base)

42
Q

Most common routes of drug administration

A

IV, IM, SQ, and PO

43
Q

Advantages of Intravenous route

A

rapid onset, permits large volumes and irritant drugs

44
Q

Disadvantages of IV route

A

irreversible, inconvenient, and expensive, not suited for self administration, risk for fluid overload, infection, and embolism, drugs must be WATER SOLUBLE

45
Q

IM and SQ injections barrier

A

capillary wall

46
Q

IM and SQ advantages

A

permits use of poorly soluble drugs and depot preparations

47
Q

IM and SQ disadvantages

A

uncomfortable, possibly painful, inconvenient with potential for injury

48
Q

PO (oral) barriers

A

epithelial lining of GI tract and capillary call, makes absorption slower and variable

49
Q

PO advantages

A

easy, convenient to administer, inexpensive, ideal for self administration, potentially reversible

50
Q

PO disadvantages

A

variability, inactivation by gastric acid and digestive enzymes; possible nausea/vomiting, patient must be conscious and cooperative

51
Q

Distribution of drug

A

transport of drug in body fluids from bloodstream to various tissues in body, and then site of action

52
Q

Factors affecting distribution

A

blood flow to tissues, fluid status, alterations to vessels & abscesses

53
Q

What type of drugs can cross the BBB (blood brain barrier)

A

lipid soluble drugs or those with a transport system can cross the BBB

54
Q

What do drugs bind to in the bloodstream

A

albumin, only unbound drugs can act on body

55
Q

What two structures can limit access of medications to certain parts of body

A

Blood brain barrier, placenta

56
Q

First pass effect

A

drugs that are highly metabolized lose much of their effectiveness due to first pass effect, may need higher doses or be administered via a different route to achieve therapeutic effect

57
Q

Removal of drugs from the body in the urine, bile, sweat, saliva, breast milk, and expired air, manipulating urinary pH can promote drug ionization and decrease passive reabsorption

A

Excretion

58
Q

Plasma drug levels

A

helps determine appropriate dosages, routes, and therapeutic effectiveness

59
Q

Trough

A

low point before dose due

60
Q

Peak

A

30 minutes after completed

61
Q

Half-life

A

time required for the amount of drug in the body to decrease by 50%

62
Q

Pharmacodynamics

A

what the drug does to the body, the effect is the turning on, off, promotion, or blocking of a response the body can already perform

63
Q

By knowing how drugs affect the body, nurses can

A

provide patient education, make decisions with PRN medications, evaluate patients for drug responses, collaborate with prescribers

64
Q

Efficacy (effectiveness)

A

largest effect that a drug can produce, increased height on the dose-response curve indicates more efficacy

65
Q

Potency

A

how much of a drug is needed to elicit a response

66
Q

Medications can affect four primary receptor families

A

cell membrane-embedded enzymes, ligand-gated ion channels, protein-coupled receptor systems, transcription factors

67
Q

Selectivity of drugs

A

more selective drugs will produce fewer side effects, opioids help relieve pain by acting on mu receptors in the CNS

68
Q

ED50

A

dose required to produce defined therapeutic response in 50% of the population

69
Q

LD50

A

dose that is lethal to 50% of animals treated

70
Q

Therapeutic index

A

measure of drugs safety using the ratio of LD50 to ED50; the higher the number the safer the drug

71
Q

Drug interactions

A

occurs whenever a patient takes two or more drugs and can be either intended or unintended and includes prescription drugs, OTC drugs, caffeine, nicotine, alcohol, illicit drugs

72
Q

How do antacids cause altered absorption

A

increases the ability of basic drugs to cross membranes

73
Q

How can Phenobarbital alter metabolism

A

accelerating metabolism of contraceptives, thus losing protection from pregnancy

74
Q

What happens when you increase urinary pH

A

alter excretion by decreasing passive reabsorption

75
Q

Nurses can help minimize adverse interactions by

A

minimizing number of drugs patient receives, take thorough history, adjust dosage, monitor for s/s toxicity

76
Q

How can calcium reduce absorption of tetracyclines

A

creates non-absorbable complexes

77
Q

Consuming food with saquinavir, type of antiviral for HIV can

A

increase absorption of the medication

78
Q

Grapefruit juice effect

A

Furanocoumarins and flavonoids can inhibit CYP3A4 metabolism and increase blood levels of certain medications; instead of being metabolized, more of the drug enters the blood and stays in the body longer.

79
Q

Medication instructions “with food”

A

take with or shortly after meal

80
Q

Medication instructions “on an empty stomach”

A

1 hour before meal or 2 hours after

81
Q

Adverse effect

A

any noxious (harmful), unintended, and undesired effect, ranging from mild to life threatening, that occurs at normal drug doses

82
Q

Side effect

A

nearly unavoidable secondary drug effect produced at therapeutic doses

83
Q

Organ-specific toxicity

A

nephrotoxicity, pulmonary toxicity, ototoxicity

84
Q

Hepatotoxicity

A

medications are leading cause of acute liver failure due to metabolism converting drugs to toxic products, monitor ALT and AST, assess for s/s liver injury

85
Q

Prolonged QT intervals creates risk for

A

dysrhythmias

86
Q

Pharmaceutical industry role in minimizing adverse drug reactions

A

produce safest medications possible

87
Q

Prescriber role in minimizing adverse drug reactions

A

select least harmful drugs, balance risk and benefits

88
Q

Nurses role in minimizing adverse drug reactions

A

evaluate patients for ADR, educate

89
Q

Medication guides are required when

A

patient adherence to directions for drug use is essential for efficacy, patient needs to know about potentially serious effects when deciding to use a drug

90
Q

Black box warnings

A

strongest warning on drugs, alerts prescribers and patients to potentially severe side effects

91
Q

Medication errors

A

any preventable event that may cause or lead to inappropriate medication use or patient harm; human factors, communication mistakes, and name confusion account for 90% of all errors

Nursing School (9 decks)

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