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NURS 306 > Chapter 2: Pharmacologic Principles > Flashcards

Chapter 2: Pharmacologic Principles Flashcards

1
Q

Pharmacology

A

The study or science of drugs

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2
Q

Drug

A

Any chemical that affects the physiologic processes of a living organism

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3
Q

3 Areas of Pharmacology

A
  1. Pharmaceutics
  2. Pharmacokinetics
  3. Pharmacodynamics
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4
Q

Chemical Drug Name

A

Describes the drug’s chemical composition, molecular structure

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5
Q

Generic Drug Name

A

(Nonproprietary name)

One generic name for any particular drug regardless of where you go.

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6
Q

Why is it important to know the generic name of a drug?

A

Easy to pronounce than chemical name and we go by generic name for less confusion.

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7
Q

Trade Drug Name

A

Proprietary name. Multiple brand names. Ex) Motrin

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8
Q

Drug classification

A

Drugs grouped together based on their similar properties.

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9
Q

Pharmaceutics

A

The study of how various dosage forms influence the way in which the drug affects the body.

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10
Q

Pharmacokinetics (PK)

A
  • Study of what the body does to the drug.

- What happens to a drug from the time it is put into the body until the drug leaves the body.

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11
Q

Pharmacokinetics involves 4 processes (A,D,M,E)

A

Absorption, Distribution, Metabolism, Excretion

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12
Q

Pharmacodynamics

A

The study of what the drug does to the body. Involves drug to receptor relationships.

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13
Q

Pharmacotherapeutics (aka therapeutics)

A

Focuses on the clinical use of drugs to prevent and treat diseases.
It defines the principles of drug actions.

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14
Q

Toxicology

A

Study of adverse effects of drugs and other chemicals on living systems

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15
Q

Pharmacognosy

A

Study of natural drug sources (plants, animals, minerals)

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16
Q

Pharmacoeconomics

A

Focuses on the economic aspects of drug therapy.

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17
Q

The concept of pharmacokinetics is

A

Drug “entering” and “leaving” the body.

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18
Q

Drugs enter the body through

A

Absorption and distribution

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19
Q

Drugs leave the body through

A

Metabolism and excretion

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20
Q

PK: Absorption

A

Movement of a drug from its site of administration into the bloodstream for distribution to the tissues

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21
Q

What happens to a drug before it enters the systemic circulation?

A

It must pass through the liver before it reaches system circulation.
First-pass effect, bioavailability

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22
Q

First-pass effect

A

Reduces the bioavailability of the drug to less than 100%.

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23
Q

Bioavailability

A

The extent of drug absorption.

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24
Q

What factors affect the rate of drug absorption?

A

-How the drug is administered or it’s ROUTE of administration affects the rate and extent of absorption of that drug

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25
Q

Three basic routes of administration:

A
  1. External (GI tract)
  2. Parenteral (outside of GI, eg. Injections)
  3. Topical
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26
Q

Enteral Absorption

A
  • The drug is absorbed into the systemic circulation through the oral or gastric mucosa or the small intestine.
  • Includes, oral, sublingual, buccal, rectal.
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27
Q

Sublingually administered drugs are

A

absorbed rapidly because the area under the tongue has a large blood supply. Bypass the liver and yet are systemically bio available.

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28
Q

Parenteral Absorption includes

A

Intravenous, intramuscular, subcutaneous, intradermal, intraarterial, intrathecal, intraarticular

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29
Q

Parenteral Absorption is the

A

Fastest route by which a drug can be absorbed, followed by enteral and topical routes.

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30
Q

Medications given by the Parenteral route have the advantage of

A

Bypassing the first-pass effect of the liver.

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31
Q

Intravenous

A

Fastest delivery of drug into the bloodstream/circulation.

Aren’t subjected to first-pass effect.

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32
Q

Topical Absorption

A

Skin (including transdermal patches), eyes, ears, nose, lungs (inhalation), rectum, vagina

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33
Q

PK: Distribution

A
  • Once a drug enters the bloodstream (systemic circulation), it is distributed throughout the body.
  • Other definitions: transport of a drug to its site of action. Dispersion of drug throughout the tissues.
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34
Q

Distribution depends on

A
  1. Blood supply
  2. Protein-binding
  3. Water-soluble vs. fat-soluble
  4. Blood-brain barrier
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35
Q

Areas of rapid distribution in the body

A

The heart, liver, kidneys, brain.

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36
Q

Areas of slow distribution

A

Muscle, skin, fat, bone

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37
Q

What drug molecules can freely distribute to extravascular tissue?

A

Only drug molecules that are not bound to plasma proteins.

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38
Q

If a drug is bound to plasma proteins,

A

The drug-protein complex is generally too large to pass through the walls of blood capillaries into tissues.

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39
Q

Water-soluble vs. fat-soluble drug distribution

A

Water-soluble: while have a smaller volume of distribution and high blood concentrations.
Fat-soluble: have a larger volume of distribution and low blood concentrations.

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40
Q

Blood-brain barriers affect on drug distribution

A

Has barriers that make it difficult for drugs to pass through

41
Q

Metabolism is aka …

A

Biotransformation.

42
Q

What is the next step after absorption and distribution?

A

Metabolism

43
Q

The main organ for metabolism of drugs is

A

The liver.

44
Q

Other metabolic tissues include..

A

Skeletal muscle, kidneys, lungs, plasma and intestinal mucosa.

45
Q

PK: Excretion

A

The removal of drugs from the body.

46
Q

What is the primary organ used for elimination?

A

The kidneys

47
Q

What other organs play a role in the excretion of drugs?

A

The liver and the bowel.

48
Q

Biliary excretion

A

Excretion of drugs by the intestines.

Drugs eliminated by this route are taken up by the liver, released into the bile and eliminated in the feces.

49
Q

Enterohepatic recirculation

A

Once certain drugs are in the bile, they may be reabsorbed into the bloodstream, returned to the liver and again secreted into the bile.

50
Q

What are the PK factors?

A

Half-life, onset (start of therapeutic effect), peak (time required for drug to reach is maximum therapeutic response), duration, drug level

51
Q

Half-life

A

Time it takes for one half of the original amount of a drug to be removed from the body.

52
Q

Most drugs are considered to be effectively removed after

A

About five half-lives (around 97%)

53
Q

On-set

A

Time it takes for the drug to elicit a therapeutic response

54
Q

Peak

A

Time it takes for a drug to reach its maximum therapeutic response

55
Q

Duration

A

Time a drug concentration is sufficient to elicit a therapeutic response

56
Q

Peak level

A

Highest blood level

57
Q

Trough level

A

Lowest blood level

58
Q

Why must you monitor peak levels?

A

Because if the peak blood level is too high, then drug toxicity may occur.

59
Q

Why must you monitor blood trough level?

A

Because the drug may not be at therapeutic levels to produce a response.

60
Q

Why are peak and trough levels measured?

A

To verify adequate drug exposure, maximize therapeutic effects and minimize drug toxicity.

61
Q

Pharmacodynamics (PD): Mechanisms of Action

A
  1. Receptor interactions
  2. Enzyme interactions
  3. Nonselective interactions
62
Q

PD: Receptor interactions

A

Drugs bind to and interacts with receptors causing a drug response.
Agonist and antagonist.

63
Q

What is the action of the drug type, agonist?

A

Binds and activates receptor’s site, effects occur. Mimics the body’s natural hormone/chemical’s action, can also be enhanced effect.

64
Q

What is the action performed by the drug type, antagonist?

A

Binds, does not activate blocking/prevent the natural hormone/chemical’s action.

65
Q

Enzyme interactions

A

Drug chemically binds to an enzyme molecule in a way that alters (inhibits or enhances) the enzyme’s interaction with its normal target molecules in the body.

66
Q

Nonselective interactions

A

Do not interact with receptors or enzymes. Main targets are cell membranes and various cellular processes.
Ex) Antibiotics target bacterial cell wall.

67
Q

What are the types of therapies?

A

Acute therapy, maintenance therapy, supplemental/replacement therapy, palliative therapy, supportive therapy, prophylactic therapy, empiric therapy

68
Q

Acute therapy

A

Involves more intensive drug treatment and is implemented in the acutely ill (those with rapid onset of illness) or the critically ill.

69
Q

Maintenance therapy

A

Prevents progression of a disease or condition.

It is used for the treatment of chronic illnesses.

70
Q

Supplemental Therapy

A

Supplies the body with a substance needed to maintain normal function. Ex) iron

71
Q

Palliative therapy

A

Goal is to make the patient as comfortable as possible.

Focuses on providing patients with relief from symptoms, pain and stress of a serious illness.

72
Q

Supportive Therapy

A

Maintains the integrity of body functions while the patient is recovering from illness or trauma.

73
Q

Prophylactic therapy

A

Provided to prevent illness or other undesirable outcome during PLANNED events. Ex) preop mess

74
Q

Empiric Therapy

A

Based on clinical probabilities.
Involves drug administration when a certain pathological condition has a high likelihood of occurrence based on the patient’s initial presenting symptoms.

75
Q

Contraindications

A

Any characteristic of the patient, especially a disease state, that makes the use of a given medication dangerous for the patient.
IT IS IMPORTANT TO ASSESS FOR CONTRAINDICATIONS!

76
Q

Monitoring

A

Is important! Evaluating the clinical response of the patient to the treatment.

77
Q

One must be familiar with a drug’s:

A
  • intended therapeutic action (beneficial)

- unintended but potential adverse effects (predictable, adverse drug reactions)

78
Q

Therapeutic Index (TI) gonna be on test

A

Ratio between toxic and therapeutic concentrations of a drug (LD50 to ED50).
Expresses the margin of safety for a drug

79
Q

A large TI is considered ________ while a low TI ________________.

A

A large TI is considered safe while a low TI causes adverse reactions (not safe).

80
Q

Drug concentration

A

Drug levels to evaluate toxic effects, therapeutic response

81
Q

Patient’s condition

A

Drug response depends on medical and psychological conditions

82
Q

Tolerance

A

Decreasing response to repeated drug doses

83
Q

Dependence

A

Physiologic or psychological need for a drug

84
Q

Drug interaction

A

Additive effect, synergistic effect, or antagonistic effect.
May be beneficial or harmful.

85
Q

Adverse Drug events

A

Any undesirable occurrence involving medications. Predictable and well known.

86
Q

Adverse Drug Events include:

A
  1. Adverse drug reaction
  2. Medication error
  3. Allergic reaction
  4. Idiosyncratic reaction
87
Q

Adverse drug reaction

A

Unexpected, undesirable and occurs at therapeutic drug dosages

88
Q

Idiosyncratic reaction

A

Abnormal response to a normal drug dosage, genetically determined.
Ex) G6PD deficiency.

89
Q

Rate of Drug Absorption of Various Oral Preparations: From fastest to slowest

A
  • Oral disintegration, buccal tablets, and oral soluble wafers
  • liquids, elixirs and syrups
  • suspension solutions
  • powders
  • capsules
  • tablets
  • coated tablets
  • enteric-coated tablets
90
Q

If there are low albumin levels,

A

There is not enough albumin for a drug to bind to, therefore blood is free floating in the blood and can raise the risk for blood toxicity.

91
Q

Drug-drug interaction

A

Occurs when the presence of one drug decreases the actions of another drug that is administered at the same time

92
Q

High creatinine levels and B.U.N indicate

A

Problem with the kidneys.

93
Q

Allergic reaction

A

An immunologic hypersensitivity reaction resulting from unusual sensitivity of a patient to a particular medication.
A type of adverse drug event.

94
Q

psychological dependence

A

physiologic needs for a drug to avoid physical withdrawal symptoms. Addiction.

95
Q

partial agonist

A

drugs that bind to and activate a receptor, but have only partial efficacy at the receptor relative to a full agonist

96
Q

loading dose

A

a large initial dose of a substance or series of such doses given to rapidly achieve a therapeutic concentration in the body

97
Q

maintenance dose

A

the amount of a medication administered to maintain a desired level of the medication in the blood.

98
Q

pharmacologic reaction

A

an extension of a drug’s normal effects in the body.

NURS 306 (26 decks)

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