Chapter 2: Basics of Pharmacology Flashcards
Absorption
passage of a substance through some surface of the body into body fluids and tissues
Adverse reaction
undesired side effects or toxicity caused by a treatment
Agonist
drug that binds to the receptor and stimulates the receptor’s function
Antagonist
that which counteracts the action of something else, such as a muscle or drug
Biotransformation
chemical alteration that a substance undergoes in the body
Distribution
dividing and spreading of a medication to a target organ
Excretion
elimination of waste products from the body
Half-life
the length of time required for the concentration of a drug to decrease by one-half in the plasma
Idiosyncratic
relating to idiosyncrasy; how a person differs from another
Pharmacokinetics
study of metabolism and action of drugs with particular emphasis on the time required for absorption, duration of action, distribution in the body, and method of excretion
Side Effects
any action or effect other than that intended
Synergism
action of two or more agents or organs working with each other
Teratogenic
literally, creating a monster; anything that adversely affects normal cellular development in the embryo or fetus
Toxic
pertaining to, resembling, or caused by poison
Metabolism
breaking down into its constituents
How does each of the following affect absorption?
Acidity of drugs
Tattoo on the skin
Drug concentration
Acidity of drug: Can interact with stomach acid, thus changing the normal breakdown of the drug by the stomach acid.
Tattoo on the skin: May have decreased circulation because of scar tissue and tattoo ink, which will prevent absorption.
Drug concentration: Greater concentration leads to greater absorption.
Why do drugs that cross the blood-brain barrier tend to have strong negative effects?
These drugs ten to have strong effects because they cross other barriers, including the blood-testicular barrier and blood-placental barrier. Any drug that affects the brain also affects the central nervous system.
Why should a woman actively trying to get pregnant consult her physician before taking any over-the-counter (OTC) medication?
Even an OTC medication can cross the blood-placental barrier and potentially harm the fetus. She needs to consult her physician, who should know if a substance is teratogenic (dangerous to the fetus).
David has liver damage. How might that damage affect the way his body metabolizes drugs?
An impaired liver may not break down the drug, and it might accumulate, which could lead to toxic levels of the drug building up in the body.
What are the advantages and disadvantages of comprehensive books such as the PDR?
Comprehensive guides tend to be large and heavy and may not have the information readily available to administer the medications. They are very useful in identifying medications that are not in the original container. Clinical guides are usually small enough to put in a drawer or pocket. They provide useful information about how to administer a medication, including contraindications and side effects. Unfortunately they do not have nay way of identifying medications.
Cumulation means a drug causes disease.
True/False
False; Cumulation refers to the medication building up or accumulating in the body.
An antagonist blocks a drug from being effective.
True/False
True; an antagonist counteracts the action of a drug.
A drug’s half-life is the time needed to decrease the drug’s plasma concentration by 50%.
True/False
True; half-life is the length of time required for the concentration of a drug to decrease by one-half in plasma.
Psychotropic drugs can cross the blood-brain barrier.
True/False
True; psychotropic drugs cross the blood–brain barrier to affect the mind, emotion, or behavior of an individual.
Anticancer drugs do not cross the blood-placenta barrier.
True/False
False; anticancer drugs are teratogenic (cause birth defects), because they can cross the blood–placenta barrier.
Ototoxicity can damage the eyes.
True/False
False; ototoxity refers to the ability of a drug to damage the ears/hearing.
Idiosyncratic means safe for children.
True/False
False; idiosyncratic means unique reaction.
The primary organ of metabolism is the kidneys.
True/False
False; the primary organ of metabolism is the liver.
A package insert is a valuable source of information about medications.
True/False
True; package inserts, the PDR, medication handbooks, and pharmacists are all valuable sources of information about medications.
BUN is a blood test looking at the function of the kidneys.
True/False
True; blood urea nitrogen is a blood test that relates to kidney function
Which means leaving the body? A. Absorption B. Biotransformation C. Distribution D. Excretion E. Metabolism
D. Excretion is when the body gets rid of excess medication and waste products.
Which means moving through membranes? A. Absorption B. Biotransformation C. Distribution D. Excretion E. Metabolism
A. Absorption is the passage of a substance through some surface of the body into body fluids and tissues.
. Which means chemical alteration to another substance in the body? A. Absorption B. Biotransformation C. Distribution D. Excretion
B. Biotransformation (metabolism) is the chemi- cal alteration that a substance undergoes in the body.
Which means moving of the medication from site of administration to the target organ? A. Absorption B. Biotransformation C. Distribution D. Excretion
C. Distribution is the dividing and spreading of a medication to a target organ.
Ototoxicity occurs in the \_\_\_\_\_? A. Eyes B. Ears C. Liver D. Kidneys E. Brain
B. Ototoxicity is damage to the ears caused by medication.
Nephrotoxicity occurs in the \_\_\_\_\_\_? A. Eyes B. Ears C. Liver D. Kidneys E. Brain
D. Nephrotoxicity is damage to the kidneys caused by medication.
Which of the following are sources of information about medications? A. PDR (Physicians’ Desk Reference) B. USP/DI C. USP/NF D. Package insert E. All of the above
E. The PDR, USP/DI, USP/NF, and the package inserts are all medication resources, as are medication handbooks and pharmacists.
What term means the point at which a medication has the maximum desired effect? A. Therapeutic level B. Therapeutic range C. Toxic level D. None of the above
A. A therapeutic level indicates that the amount of medication in the blood is in the desired range.
Agonists are taken together to: A. Interact with or counteract each other B. Work together C. Cause great pain D. Relieve great pain
B. Agonists work together.
The section of the PDR that is a product identification guide is the \_\_\_\_\_\_? A. White section B. Pink section C. Blue section D. Gray section
D. The gray section of the PDR is the product identification guide.
Why would the physician order you to give an antagonist?
An antagonist may be administered if a patient has been given an overdose of a drug, such as a narcotic for surgery, and the effects need to be reversed.
Why can a drug be toxic to a fetus without hurting the mother?
Drugs that are safe for pregnant women may be toxic to their fetuses, because a fetus is in a continual process of growing and developing, whereas the mother is already fully developed. If the medication is given during a crucial developmental stage (such as development of the brain, heart, spine), serious birth defects may occur.
Why should a person abstain from operating heavy equipment if he or she is given a narcotic for nausea and vomiting?
Narcotic side effects include hypotension, dizziness, sluggishness, and so forth. All of these effects make operating heavy machinery dangerous to the patient and those around him or her.
Why would a physician give two different drugs at subtherapeutic levels?
Drugs may be used at lower doses when given together because of the synergistic effect caused when they are used together. When given alone, a higher dose is needed for the drug to be effective.
The cabinet with all the drug resources is locked, and the key cannot be found. Where can you find out about an ordered medication before administering it?
When all else fails, you may call a pharmacist to ask for information or use the Internet for information. The pharmacist may be able to fax you a drug insert or advise you about the drug over the phone.
Mary is taking a blood thinner. She does not understand why she needs to have blood drawn monthly. How would you educate her?
Patients on blood thinners, such as warfarin (Coumadin), need to have their blood work monitored frequently, to make sure that their medication levels do not put them at risk of an inability to form clots or, conversely, at risk of their blood clotting too quickly. There is a fine line between keeping a patient from hemorrhaging or, conversely, having a blood clot that could lead to an embolism.
Daniel has cirrhosis of the liver. How may this affect his metabolism of drugs?
The liver is the primary organ of metabolism. If the liver is damaged in any way, medications will accumulate in the body, causing toxic effects.
Butler is coming in for a flu shot into the muscle. He insists that he wants the injection in his arm, not his buttocks. Both his arms are covered in tattoos. What would you do?
Explain to Mr. DePoy that injections need to be given in tissue that is free from tattoos, scars, or lesions, which allows for complete absorption of the medication.
Rose has diabetes. Because of her diabetes, she has increased blood pressure and kidney problems. How does this affect the distribution and elimination of drugs from her body?
Circulatory problems arise with hypertension, leading to variations in distribution. The medication may travel faster through the system than desired.
The kidneys are the major organs of elimination, so medication may build up in the body if the kidneys cannot eliminate it.
Jerry, an older patient, comes in with a paper bag containing assorted pills. He is not sure which he is supposed to be taking. What would you do?
DO NOT criticize the patient. Instead, provide education on how to store medication, providing a chart for the patient to take home. You would need to start by pulling a medication list from the patient’s chart. If the list is not current, you would need to contact the pharmacy where the patient obtains prescriptions for a current list. Then you would go to the identification guide in the PDR (gray section) and attempt to identify the pills he has brought in and then match them to the patient’s medication list. Separate the medications and label each container with the medication name and dose.
You draw blood from Gary, to check compliance with drug therapy, but the laboratory results show none of that drug in his blood. What could be happening? What would you do?
Ask Mr. Gledhill if all is going well with his medication. If he does not volunteer information, discuss the situation with the physician. Mr. Gledhill may not be able to afford medication or may be suffering unpleasant side effects. The physician will need to explore what is going on and try to find a solution to the issue.
Vera complains that she hears ringing in her ears ever since starting a new drug. What is this called, and what could be causing this?
Tinnitus is ringing of the ears and may be a sign of ototoxicity caused by a medication.
