Chapter 2 Pharmacologic Principles Flashcards
1
Q
What is the name for any chemical that effects the physiologic processes of a living organism?
A
drug
2
Q
Define Pharmacology
A
the study or science of drugs
3
Q
List the 3 different types of drug names, or names drugs are referred to as
A
* Chemical name * Generic name (non-proprietary name) * Trade name (proprietary name)
4
Q
Which type of drug name describes the drugs chemical composition and molecular structure?
A
Chemical name
5
Q
Who gives a drug it’s generic name?
A
United States Adopted Name Council
6
Q
Use of a drug’s trade name is restricted by the drugs patent owner. Who normally owns the drug patent?
A
the manufacturer
7
Q
What is Pharmacokinetics? (hint: what the body does to a parent drug and metabolites)
A
the process by which a drug is * absorbed (absorption) * distributed (distribution) * metabolized (metabolism) * excreted (excretion) (eliminated) by the body
8
Q
What is the name for the study of what the drug does to the body?
A
Pharmacodynamics
9
Q
What type of interactions is Pharmacodynamics referring to?
A
Drug-Receptor interactions (in living tissues)
10
Q
A measure of the extent of drug absorption for a given drug and route (hint: BA)
A
Bioavailability
11
Q
List 5 non-intravenous applications
A
* Oral * Rectal * Transdermal * Subcutaneous * Sublingual
12
Q
Name the one way that a drug can be administered that ensures that it’s bioavailability is 100%
A
intravenously
13
Q
Name the 3 phases of Drug Activity in order
A
I. Pharmaceutical Phase II. Pharmacokinetic Phase III. Pharmacodynamic Phase
14
Q
In which of the 3 Drug Activity phases does bioavailability associate with?
A
Pharmacokinetic Phase
15
Q
Name the 2 main places the drug is metabolized?
A
* Liver (most) * Kidney
16
Q
Define First Pass Effect
A
when an administered drug enters the liver and undergoes extensive biotransformation thus decreasing the concentration rapidly before it reaches it’s target.
17
Q
Define Pharmacotherapeutics
A
study of the therapeutic uses and effects of drugs
18
Q
the information that is listed under “Use” in the nursing drug reference book is what the drug was meant to be used for, also known as it’s label or ___ ________ ________
A
FDA Approved Labeling
19
Q
When someone administers a drug for a reason other than it’s FDA approved labeling to use the drugs side-effects for a purpose, this is not always reliable and is called ___ _____
A
off-label
20
Q
All drugs that are created have an FDA approved label. true or false?
A
true
21
Q
What two ways are drugs categorized into pharmacologic classes?
A
by there: *physiologic functions *primary disease states treated
22
Q
Different Dosage forms of drugs have different rates of dissolution (some dissolve faster/slower than others) Which dissolves/absorbs faster, a capsule or a tablet?
A
capsule
23
Q
Which dissolves/absorbs faster, a coated tablet or a suspension solution?
A
suspension solution
24
Q
Out of all the different Oral dosage forms of drugs, which one is the fastest and which one is the slowest to dissolve?
A
Fastest : Liquids, elixirs, syrups Slowest: Enteric coated tablets
25
What is the name for the study of how various dosage forms influence the way in which the drug affects the body?
Pharmaceutics
26
slower dissolution goes hand in hand with slower absorption. true or false?
true
27
What is it called when there is an undesirable occurrence related to administering or failing to administer a prescribed medication?
Adverse drug event
28
What type of "reaction" do you get when you have any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages?
Adverse Drug Reaction
29
A general term for any undesirable effects that are a direct response from one or more drugs?
Adverse Effects
30
What is the name for a drug that binds to and stimulates the activity of one or more receptors in the body?
Agonist
31
What is the common term for an immunologic hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication?
Allergic reaction (this is a type of adverse drug event)
32
What do you call a drug that binds to and inhibits the activity of one or more receptors in the body? (hint: also known as an inhibitor)
Antagonist
33
What is it called when there are one or more biochemical reactions involving a parent drug; this occurs mainly in the liver and produces a metabolite that that is either inactive or active; also known as metabolism?
Biotransformation
34
Name the barrier system that restricts the passage of various chemicals and microscopic entities between the bloodstream and the central nervous system. (it still allows for passage of essential substances such as oxygen)
Blood-brain barrier
35
What do you call the name that describes the chemical composition and molecular structure of a drug?
Chemical name
36
What is Contraindiction?
A condition or factor (medical reason) to withhold a certain treatment or medicine due to the harm it would cause a patient
37
What is the general name for a large class of enzymes that play a significant role in drug metabolism and drug interactions?
Cytochrome P-450
38
What do you call it when someone has a compulsive or chronic need for a drug?
Dependence
39
What do you call the process where solid forms of drugs disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation?
Dissolution
40
What do you call any chemical that affects the physiologic processes of a living organism?
Drug
41
Also known as mechanism of action, what do you call the processes involved in the interaction between a drug and body cells ( the action of a drug on a receptor protein)?
Drug actions
42
What is drug classification?
A method of grouping drugs; may be based on structure or therapeutic use.
43
What are drug effects?
The physiologic reactions of the body to a drug. (they can be therapeutic or toxic and describe how the body is affected as a whole by the drug)
44
What do they call the development of congenital anomalies or defects in the developing fetus caused by the toxic effects of drugs? (hint: Drug-induced \_\_\_\_\_\_\_\_\_\_\_\_\_)
Drug-induced teratogenesis
45
What do you call it when there is an alteration in the pharmacologic or phartmacokinetic activity of a given drug caused by adding one or more additional drugs?
Drug interaction
46
Define Duration of action
The length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response
47
Name the Protein molecules that catalyze one or more of a variety of biochemical reactions, including those related to the body's physiologic processes as well as those related to drug metabolism
Enzymes
48
What is First-pass effect
the initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream
49
Are Generic names protected by trademark?
no
50
What is the name given to a drug by the United States Adopted Names Council? (hint: non-proprietary name)
Generic Name
51
Name the hereditary condition in which red blood cells break down when the body is exposed to certain drugs (hint: G6PD)
Glucose-6-phosphate dehydrogenase deficiency
52
In pharmacokinetics, what do they call the amount of time it takes for half of an administered dose of drug to be eliminated by the body? (hint: the word half is key)
Half-life
53
Other than an allergic reaction, what is it called when an individual patient has an abnormal and unexpected response to a medication? (hint: _____________ reaction)
idiosyncratic reaction
54
What is it called when two parenteral drugs undergo a reaction when mixed or given together that causes a chemical deterioration of at least one of the drugs?
Incompatibility
55
Define Intraarterial (don't overthink it)
within an artery
56
Define Intraarticular
within a joint
57
Define Intrathecal (the theca of the spine cord)
within a sheath
58
What do you call any preventable adverse drug event involving inappropriate medication use by a patient or health care professional? (does not matter if it causes harm or does not cause harm)
Medication error
59
What is the full name of the process of prescribing, dispensing, and administering of medications, and the monitoring of their effects? (hint: __________ \_\_\_ process)
Medication use process
60
What is an active metabolite?
Metabolites that have pharmacologic activity of their own (even if the parent drug is inactive)
61
What is an inactive metabolite?
Inactive metabolites lack pharmacologic activity they are drug waste products awaiting excretion from the body (via the urinary, gastrointestinal, or respiratory tract)
62
What do you call the chemical form of a drug that is the product of one or more biochemical (metabolic) reactions involving the parent drug?
Metabolite
63
Define onset of action
the amount of time required for a drug to elicit a therapeutic response after dosing
64
What is the name of the transporter protein that moves drugs out of cells and into the gut, urine, or bile?
P-glycoprotein
65
Define Parent drug
The chemical form of a drug that is administered before it is metabolized by the body into it's active or inactive metabolites
66
What is the name for a parent drug that is not pharmacologically active itself?
prodrug
67
When a prodrug (an inactive parent drug) is metabolized, what does it become?
pharmacologically active metabolites
68
What do they call the time required for a drug to reach it's maximum therapeutic response in the body?
Peak effect
69
What do they call the maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring
Peak Level
70
What is Pharmaceutics?
The science of preparing and dispensing drugs, including dosage form design
71
Define Pharmacodynamics
The study of the biochemical and physiologic interactions of drugs at their sites of activity
72
What is Pharmacoeconomics?
the study of economic factors impacting the cost of drug therapy
73
What is the word for the study of drugs that are obtained from natural plant and animal sources?
Pharmacognosy
74
What word means the study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body?
Pharmacokinetics
75
What do you call the treatment of pathologic conditions through the use of drugs?
Pharmacotherapeutics
76
Define Receptor
A molecular structure within or on the outer surface of a cell. Receptors bind specific substances (ex. drug molecules) and one or more corresponding cellular effects (drug actions) occur as a result of this drug -receptor interaction
77
What does Steady state mean?
the amount of drug removed via elimination, is equal to the amount of drug absorbed with each dose
78
Define substrates
substances (drugs or natural biochemicals in the body) on which an enzyme acts
79
What are Additive effects?
drug interactions where the effect of a combination of two or more drugs with similar actions is equivalent to the sum of the individual effects of the same drugs given alone
80
What are Synergistic effects?
drug interactions where the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone
81
What does Synergistic mean?
various parts working together to create an enhanced result
82
What do you call the process of measuring drug levels to identify a patient's drug exposure and to allow adjustment of dosages with the goals of maximizing therapeutic effects and minimizing toxicity?
Therapeutic Drug Monitoring
83
What is Therapeutic effect?
the desired or intended effect of a particular medication
84
What is the ratio between the toxic and therapeutic concentrations of a drug?
Therapeutic index
85
What is the word for the reduced response to a drug after prolonged use?
Tolerance
86
Define Toxic
poisonous
87
What do you call the condition of producing adverse bodily effects due to poisonous qualities?
Toxicity
88
what is Toxicology?
the study of poisons, including toxic drug effects, and applicable treatments
89
What is the word used to describe the lowest concentration of drug reached in the body after it falls from its peak level? (usually measured in a blood sample for therapeutic drug monitoring)
Trough level
90
Name 6 factors that affect Absorption
\* food or drink taken with drug \* dosage formulation \* status of the absorptive surface \* rate of blood flow to small intestine \* acidity of the stomach \* status of GI motility
91
when a drug is absorbed the Enteral Route, what does that mean?
absorbed into systemic circulation through the oral or gastric mucosa or the small intestine
92
When a drug has a high first pass effect, does this mean it is very strong (like a drug that's been administered through IV) or does a high first pass effect mean that the drug taken has been thoroughly processed in the liver until a majority of it is now in inactive form before it reaches systemic circulation
high first pass effect means that it has been processed in the liver (sometimes kidneys) and has lost a lot of its potency by being broken down before it reaches systemic circulation
93
When a drug is given through IV, what happens that makes it so that you get more of the drug reaching circulation?
it bypasses the liver which is where it will be processed or broken down during other routes of taking medication
94
What route gives us the fastest delivery into blood circulation?
Intravenous (IV)
95
What ways of administering drugs are considered to be Parenteral Route? ( 8 answers, 6 of them start with intra )
\* Subcutaneous \* Transdermal \* Intravenous \* Intramuscular \* Intradermal \* Intraarterial \* Intrathecal \* Intraarticular
96
All Topical Routes, except for which one, avoids first- pass effect?
Rectum
97
Name the 7 parts of the body that can be used as a Topical Route for medication administration
\* Skin \* Eyes \* Nose \* Ears \* Lungs (inhalation) \* Rectum \* Vagina
98
When protein-binding occurs, what does the drug bind to specifically?
Albumin
99
Once protein-binding occurs, what happens to the drug?
it greatly reduces the availability of the drug. The parts that bind to albumin become inactive because they can't exit through the cell wall because albumin is too big (only the free parts can enter circulation and remain active)
100
What barrier allows for molecularly larger drugs to gain access to the brain?
Blood brain barrier
101
What is drug distribution to it's target sites and the amount that arrives, dependent on? (three things mainly)
storage excretion metabolism
102
Name 4 areas of rapid distribution
Heart, liver, kidneys, brain
103
Name 3 areas of slow distribution
muscle, skin, fat
104
Some drugs are \_\_\_\_\_-soluble and some are \_\_\_-soluble
\* water soluble \* Fat soluble
105
What type of protein is albumin?
plasma protein
106
once a free drug binds to albumin, it becomes what?
bound and inactive
107
Once a free drug is bound to albumin it is now too large to pass through the _____ \_\_\_\_\_\_\_\_\_\_\_ into the tissues
blood capillaries
108
Unbound drug=
pharmacologically active
109
Bound drug=
pharmacologically inactive
110
A patient with low albumin levels will have a larger fraction of free/ unbound or active drugs which puts them at risk for drug \_\_\_\_\_\_\_\_
toxicity
111
Why would there be reason for concern or to pay attention when a person is taking 2 different medications that are both highly protein bound (both have affinity for protein)? What type of interaction would this lead to?
Because then both medications will be competing for binding sites to albumin and a greater than normal amount of one drug or the other will remain free and will cause toxicity or too high of a drug level. A drug-drug interaction
112
What is the main organ where metabolism takes place?
Liver
113
Name all of the places in the body that metabolism takes place in ( hint: K- PILLS )
\* Kidneys \* Plasma \* Intestinal mucosa \* Liver \* Lungs \* Skeletal Muscle
114
Although metabolism typically inactivates drugs, some drug metabolites are pharmacologically active, sometimes even more so than the parent compound. true or false?
true
115
What is a metabolite? (extra info: metabololites have pharmacological activity)
The chemical form of the drug that is the product of one or more reactions involving the parent drug
116
What is the parent drug?
the initial drug that was administered to the patient
117
An inactive metabolite is a "\_\_\_" (a term that prof. Ragnone used)
a dud (no pharmacological activity, a waste product)
118
Metabolites that are inactive (the duds) are a waste product and will be excreted, most likely by which organ? (hint: main organ for excretion)
kidneys (main organ)
119
Metabolism is the _________________ of a drug into an active or inactive form
biotransformation
120
List two factors that decrease metabolism (highlighted from PP)
\*Cardiovascular dysfunction \*Renal Insufficiency
121
List the three factors that increase metabolism (highlighted from PP)
\* Fast acetylator \* Barbiturate Therapy \* Rifampin Therapy
122
What 2 major things can a delayed drug metabolism lead to? (HL on PP)
it can lead to ====\> an accumulation of the drug it can also lead to ====\> prolonged action of the drug, which can lead to ============\> drug toxicity
123
Once we give a patient medication, do we just leave and not return or is there something we should be doing?
after giving a patient medication we should be monitoring the effects of the drugs to make sure what's supposed to happen is happening, if not, we will notice that something unexpected is occurring that could be harmful or fatal to patient.
124
When monitoring a patient, we are looking to see the effects of the drug, and that is based on the __________ of the drug
metabolism
125
What does stimulating drug metabolism cause? (HL on PP)
Diminished pharmacologic effects (HL on PP)
126
Name the 3 organs involved in excretion or elimination of drugs from the body
\* Kidneys \* Liver \* Bowel
127
Drugs that have been metabolized by the Liver become more Polar and \_\_\_\_\_-\_\_\_\_\_\_\_. This helps which organ (responsible for most of the excretion), do it's job much more easily?
water-soluble Kidneys
128
If a patient has kidney malfunctions, we are going to see problems with excretion of a drug. If there's problems with excretion of the drug, then we can possibly see ____________ of the drug. (hint: one of the 2 things that a delayed drug metabolism can lead to
accumulation of the drug (if you can't excrete it properly then there will be a build up in your system)
129
Are most drugs fat-soluble or water-soluble? (hint: remember what form they are in when excreted)
water-soluble
130
Glomerular Filtration will only remove drugs or metabolites that are not bound to ________ present in blood plasma.
proteins
131
What is responsible for excreting drugs from the Kidneys?
Glomerular Filtration (GFR)
132
What is Half-Life?
a measure of how quickly a drug is removed from the body
133
What do you call the time it takes for one half of the original amount of a drug to be removed from the body?
Half-Life
134
When a drug has a very long Half-Life, it'll take longer for the drug to reach a Steady State of blood levels to have the therapeutic effect. true or false?
true
135
We use half-life to estimate the dosage level or frequency of administration of a drug to get them to a safe ___________ drug level in the \_\_\_\_\_. (not too little, not too much)
therapeutic blood
136
Most drugs are effectively removed at about _ Half-Lifes
5 Half-Lifes
137
Define Onset
the time it takes for a drug to elicit a therapeutic response (example: onset time for Rapid acting Insulin is 15-30 minutes)
138
define Peak
the time it takes for a drug to reach it's maximum therapeutic response (example: Peak for Rapid acting Insulin is a 1/2 hr to 1.5 hrs)
139
Define Duration
The time a drug concentration is sufficient to elicit a therapeutic response, a sustained effect after the peak (example: duration of rapid acting insulin would be 3-4 hours)
140
When we do therapeutic drug monitoring for a patient, sometimes that includes blood draw. There are two terms that we need to know that associate with therapeutic drug monitoring. What is the term for highest blood level? What is the term used for lowest blood level? (HL on PP)
Peak Level= Highest blood level Trough Level= Lowest blood level
141
If a medication is very strong, we don't want it to exceed the peak because it can lead to toxicity which can be very mild or it can be quite severe and cause _________ damage to an organ.
permanent
142
We may not even get therapeutic effect of a drug if the ______ level gets too low. (HL on PP)
trough
143
What is the goal of a drug?
to produce a therapeutic action at the target site
144
Once a drug reaches it's target site, it can modify the cell or tissue by increasing or decreasing what? There are 3 different things that it may modify.
it can increase or decrease the.. \* rate \* strength \* or function
145
Can a drug make a cell or tissue perform a function it was not designed to perform?
no
146
True or false? Sometimes we do not know a drugs mechanism of action
true ( sometimes it will say " this is the action of the drug, but through research we do not know how this action or reaction occurs") (do not know if it's through receptor or an enzyme etc.)
147
When a drug binds to a receptor, it will do one of two things. Name them
\* elicit a physiologic response \* block a physiologic response
148
define agonist
a chemical that binds to a receptor site and activates the receptor to produce a biological response
149
define antagonist
a drug that counteracts the effects of another drug. a competitive antagonist competes with the agonist for the binding site.
150
Patients will have a combination of different therapies (Pharmacotherapeutic Therapies) specific to their needs, whether it's to prevent an illness, manage an illness, etc.)
true or false
true
there are 7 different types of therapies mentioned in the text
151
As we monitor our patients for the desired effects of a drug, we need to assess for contraindications. What are contraindications?
anything that may interfere with the drug and makes the use of a drug dangerous for a patient.
examples: \*a disease process that prevents them from having this type of drug
\*being pregnant
\*being allergic to the drug
152
One of the most important things you can do as a nurse administering medications is to _monitor_ your patient.
You need to be familiar enough with the meds that you know what they are ________ to do and the potential _______ effects.
\*intended
\*potential adverse effects
153
An adverse effect of a drug can be unintended yet \_\_\_\_\_\_\_\_\_\_\_.
predictable
154
What do you call the ratio of a drug's toxic level to the level that provides therapeutic benefits
Therapeutic Index
(a low therapeutic index tells us that the difference between a toxic level and a therapeutic level is very little)
155
What do you call any reaction to a drug that is unexpected and undesirable?
Adverse Drug Reaction
156
A drug with a very low Therapeutic Index has a very high chance of having an adverse reaction.
true or false?
true
157
When a patient has been on a medication for a long period of time they need higher doses to have the same therapeutic effect. What is this called?
Tolerance
158
What is it called when there is a physiologic or psychological need for the drug?
Dependence
159
What is an analgesic medication?
painkiller
160
What is a drug interaction?
an alteration of a drug by one of many things, another drug, a food, an herbal remedy, etc.
161
List the 4 kinds of Drug Interactions
\* Additive effect: ( 1+1=2 )
\* Synergistic effect: ( 1+1=6 )
\* Antagonistic effect: ( 1+1=1.5 )
\* Incompatibility: Cannot Add Together
(especially IV meds, they might crystalize, they might form a toxic compound)
(normally parenteral drugs)
162
When a drug does what it's expected and prescribed to do but then it may do too much of what it was meant to do and cause a problem. Like if you administer Insulin and you expect it to lower the patients' blood sugar but then the patients blood sugar levels go dangerously low. What type of reaction is this?
Pharmacologic reaction
163
Medication Error means one of the 6 rights of medication administration was not followed.
What are the 6 rights of medication administration?
1. Right Patient
2. Right Drug
3. Right Dose
4. Right Time
5. Right Route
6. Right Documentation
