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PCP > Chapter 7 Pharmacology > Flashcards

Chapter 7 Pharmacology Flashcards

1
Q

Six rights of medication admn.

A

right PT, medication, dose, route, time, documentation

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2
Q

Government body that regulates pharmaceuticals

A

Health products and food board (HPFB)

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3
Q

what is included in the chemical name

A

describes the drugs chemical make up, composition and molecular structure

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4
Q

what’s is the generic name of a drug

A

aka the nonproprietary name, is a general name for a drug. not manufacture specific, typically created by company that first manufactures

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5
Q

what’s in the trade name

A

unique name in which original manufactures registers the drug to the HPFB

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6
Q

4 sources medication is derived from

A

animals, plants, minerals, and laboratory

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7
Q

when was the “controlled drugs and substances act” passed and what’s its purpose

A

1996, governs production, registration, distribution, and possession of narcotics and controlled substances

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8
Q

what is a schedule 1-4 controlled substance

A
  1. narcotics such as opium and cocaine. 2. canabis 3. stimulants and hallucinogens 4. anabolic steroids
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9
Q

how many animals do drugs need to be tested on before human trials

A

2

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10
Q

how many test phases does a drug go through, what are they

A

4; 1, healthy volunteers 2, homogenous group (half placebo and half real drug) 3, made available to large group, lasts several years 4, drug company can submit new drug form

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11
Q

how is a medication different in someone who is pregnant

A

affects the fetus and can alter mothers physiology

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12
Q

how does a pediatric’s metabolic rate compare to an adult

A

pediatrics often metabolise at a much higher rate then adults and may require relatively higher doses then adults

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13
Q

how does geriatrics metabolic rate compare to adults

A

it is slower then normal adults, often require small relative doses

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14
Q

two major types of peripheral nerves

A

afferent and efferent

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15
Q

what do afferent nerves do

A

carry sensory impulses from all parts of the body to the brain

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16
Q

what do efferent nerves do

A

carry messages from the brain to the muscles and organs

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17
Q

what are the two divisions of the peripheral nervous system

A

somatic and autonomic

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18
Q

what does the autonomic nervous system do?

A

sends sensory impulses from internal structures such as blood vessels and the heart through afferent nerves to the brain

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19
Q

what is the central nervous system

A

centre for all nervous system functions, receives input form all sensory neurons and then directs actions to be taken

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20
Q

what does your sympathetic nervous system do?

A

responsible for your fight or flight response, dominant during rest and activities

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21
Q

what does your parasympathetic nervous system do

A

dominant during periods of rest and relaxation

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22
Q

what is neurotransmission

A

process of chemically signalling between cells

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23
Q

what do nicotinic receptors do

A

responsible for sympathetic overactivity, neuromuscular dysfunction, includes tachycardia hypertension, dilated pupils, muscle fasciculation, muscle weakness

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24
Q

what do muscarinic receptors do

A

responsible for parasympathetic overactivity, brachycardia, miosis, sweating, blurred vision, excessive lacrimation, excessive bronchial secretions, wheezing, shortness of breath, coughing, vomiting, abdominal cramping, diarrhea, urinary and feral incompetence

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25
Q

what is the term for the attraction between a medication and its receptors

A

affinity

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26
Q

what is it called when a medication stimulates a response in a receptor site

A

agonist

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27
Q

what is a solution

A

liquid containing one or more chemical substances entirely dissolved

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28
Q

what is a suspension

A

preparation of a finely dissolved medication intended to be in a suitable liquid

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29
Q

what is a tincture

A

diluted alcoholic extract of a medication

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30
Q

what is a syrup

A

medication suspended in sugar and water

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31
Q

what is an elixir

A

solution with alcohol and flavouring added

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32
Q

what is an extract

A

concentrated preparation of a medication made by putting the medication into a solution

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33
Q

what is a capsule

A

cylindrical gelatin container enclosing a dose of medication

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34
Q

what is a tablet

A

a powdered medication shaped into a small disc

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35
Q

what method has the quickest rate of absorption

A

iv and io

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36
Q

what is the slowest method of absorption

A

topical

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37
Q

what does it mean if a drug produces a local effect

A

result from direct application of a drug to a particular location such as a topical lotion to the skin

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38
Q

what does it mean if a drug produces a systemic effect

A

drug is absorbed into the bloodstream, almost always effects more then one organ, however one organs reaction may be predominate

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39
Q

what are the three categories of administration

A

percutaneous, enteral, parental

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40
Q

what does it mean to administer percutaneously

A

applied to and absorbed through the skin or mucous membrane

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41
Q

what does is mean to administer enteraly

A

administered and absorbed somewhere along the gastrointestinal, typically administered orally

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42
Q

what does it mean to administer parentally

A

any route that does not cause medication to be absorbed through skin, mucous membrane or gastrointestinal tract

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43
Q

what does it mean to administer sublingually

A

referes to administering medication under the tongue

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44
Q

where is the buccal route of administration

A

its between the cheeks and gum

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45
Q

how does pulmonary administration work

A

delivering medication directly to the pulmonary system through inhalation or injection

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46
Q

what is a common way of continuing medication administration

A

start with a loading dose, which is a large dose that exceeds the body’s ability to eliminate the medication, followed by smaller maintenance doses to maintain therapeutic levels

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47
Q

what is the pH range of most medications

A

most medications fall in to the category of either weak acids or weak bases

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48
Q

how does a medications pH affects it ability to function as desired

A

pH of a medication affects its ability to ionize

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49
Q

what does bioavailability mean?

A

bioavailability refers to how much of the medication is still active when it reaches its target organ

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50
Q

what is the primary distribution method in the body

A

blood is the primary method, the PTs cardiac output is diminished for whatever reason the the medication will not move as quickly

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51
Q

what is the only way a medication can be used within the body

A

it must be a ‘free drug’. that means the medication molecule cannot be bound with anything

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52
Q

what do drugs typically bind to?

A

typically drugs will become bound to fat, muscle, tissue and bone

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53
Q

what does biotransformation mean?

A

manner in which the body metabolizes medication, only free drugs are able to be biotransfused

54
Q

what are the two ways that the body metabolizes medication

A
  1. transforming the medication into a metabolite

2. by making the medication more water soluble

55
Q

what is the first pass effect

A

blood coming from the gastrointestinal tract must pass through the liver before moving onto the rest of the body, this gives the liver the opportunity to partially or completely inactivate drugs before they reach their target organ

56
Q

what are the two phases that liver enzymes act on drugs

A

phase 1, enzymes may oxidize drug or bind it with oxygen molecules, may also hydrolyze by decomposing it in a reaction with water.
Phase 2, medication molecules combine with a chemical found in the body

57
Q

what are the three main mechanisms in which the kidney excretes medication remnants

A

1, glomerular filtration; passive process in which blood flows through glomeruli of the kidneys, differential in pressure forces waste out of blood
2. tubular secretion; active transport, medication bound to specific transporters aiding in elimination
3, partial reabsorption; some amount of the drug is being reabsorbed after filtration

58
Q

what are the 4 mechanisms that drugs use to act on the body

A

1, bind to receptor site
2, change the physical properties on the cells
3, chemically combine with other chemicals
4, may alter the normal metabolic pathway

59
Q

what is an antagonist

A

may block receptor site from being stimulated by other chemical mediators and inhibit normal response

60
Q

what is an agonist

A

stimulate the receptor site to cause the response it normally has

61
Q

what is up-regulation

A

medications that increase the number of receptor sites available

62
Q

what is down- regulation

A

as medications bind to receptor sites, the number of receptor site available decreases

63
Q

what are the 8 chief factors affecting drug responses

A

1, age 2, weight 3, sex 4, environment 5, time of administration 6, condition of PT 7, genetic factors 8, physiological factors

64
Q

what is an Iatrogenic response

A

adverse condition inadvertently induced in a PT by the treatment given

65
Q

what does cross tolerance mean?

A

pt could develop a tolerance as a result of prolonged administration of a separate medication

66
Q

what does tachyphylaxis mean?

A

condition in which PT rapidly becomes tolerant to a medication

67
Q

what is cumulative effect

A

if several doses of medication are given over a relatively short period of time which might result in either therapeutic or non-therapeutic levels

68
Q

what is the summation effect

A

it is an addictive effect, two medications given to the PT that have the same effect that doubles the response exhibited by the PT

69
Q

what is synergism

A

Pt receives two medications with the same effect but produces a response greater than the sum of their individual response

70
Q

what is interference

A

a direct biological interaction that takes place between two drugs

71
Q

what environmental factors must be considered in medication storage

A

extreme temperatures, exposure to direct sunlight, excessive humidity

72
Q

minimum requirements for storage of controlled substance

A

securely locked, substantially constructed cabinet with no sign or indication of what the cabinet is used for

73
Q

what 11 features are included on a medication profile

A

medication names, class, mech. of action, indications, pharmacokinetics, side effects, routes, dosage forms, dosages, contraindications, special considerations

74
Q

what does indications refer to?

A

reasons or conditions for which the medication is given

75
Q

what does contraindications refer to?

A

conditions in which it is inappropriate to administer medications

76
Q

what is an analgesics

A

medications that relieve pain and induce analgesia (absence of sensation of pain)

77
Q

most common class medication used for analgesia?

A

most common analgesics in pre-hospital setting is opioid agonist

78
Q

what are the three common forms of nonopiod analgesics

A

1, salicylates(aspirin)
2, NSAIDs nonsteroidal anti-inflammatory medication(ibuprofen)
3, para-aminophenol derivatives(Tylenol)

79
Q

what kind of drug is Naloxone(narcan)

A

narcan is an opioid antagonist that competitively binds at the opiate receptor sites

80
Q

what is an anaesthetic

A

medications intended to induce a lose of sensation to touch or pain

81
Q

what are the three types of anaesthesia ?

A

Systemic; aka as general anaesthesia. Regional anaesthesia; focuses on particular part fo body such as legs. Local anaesthesia; loss of sensation to touch or pain at a specific isolated spot

82
Q

what is the most common sedative used for invasive procedures

A

benzodiazepines; believed to affect the inhibitory neurotransmitter gamma-aminobutyrate acid (GABA) in the brain

83
Q

how can stimulation of the CNS be accomplished

A

1, increasing excitatory neurotransmitters

2, decreasing inhibitory neurotransmitters

84
Q

CNS agents are a class that produce physiologic and psychologic effects, what are the two groups that they are divided into

A

Specific agents; bring an identifiable mechanism with unique receptors for the agent.
Nonspecific agent; produce effects on different cells through a variety of mechanisms

85
Q

what effects can you expect when you stimulate the parasympathetic nervous system

A

causes pupils to constrict, bronchoconstriction, heart rate slows, reduces hearts contractile force, stimulates secretion from digestive glands, enhances smooth muscles

86
Q

all preganglionic and postganglionic parasympathetic nerves use what as the neurotransmitter?

A

ACh; has a short life span, it is deactivated by AChE.

87
Q

what are the two ACh receptors, collectively known as cholinergic receptors known as

A

Nicotinic receptors and muscarinic receptors. Nicotinic receptors are found in all autonomic ganglia and neuromuscular junctions. Muscarinic receptors are wide spread throughout the body and enable parasympathetic nervous system to be able to respond

88
Q

what does anticholinergic medication do?

A

works in opposition to the parasympathetic nervous system by blocking muscarinic and nicotinic receptors

89
Q

what is a medication called that is given to stimulate the sympathetic nervous system

A

sympathomimetics, can be selective or non selective

90
Q

what is a medication called that is given to inhibit the sympathetic nervous system

A

sympatholytics, can be selective or nonselective

91
Q

how do sympathomimetics work?

A

they stimulate the adrenal medulla so that it releases norepinephrine and epinephrine which are the major neurotransmitters in the sympathetic nervous system

92
Q

what are the 4 types of adrenergic receptors

A

alpha 1, alpha 2, beta 1 and beta 2

93
Q

what effects do alpha 1 receptors have

A

produce peripheral vasoconstriction, mild bronchoconstriction and speed metabolism

94
Q

what effects do alpha 2 receptors have

A

control the release of norepinephrine

95
Q

what effects do beta 1 receptors have

A

increase heart rate, cause cardiac muscle to contract, strengthen cardiac contraction, produce automaticity, trigger cardiac electrical conduction

96
Q

what effects do beta 2 receptors have

A

stimulate vasodilation and bronchodilaton

97
Q

when do beta 1 receptors come into play in the pre hospital setting

A

often we agonize the beta-1 receptors in attempt to treat cardiac arrest and hypotension

98
Q

when does the beta 2 receptors come into play in the pre hospital setting

A

stimulating the beta 2 receptors allows us to treat asthma and other diseases that cause excessive narrowing of the bronchioles

99
Q

what are three types of skeletal muscle relaxants?

A

Central acting, Direct acting, Neuromuscular blocking

100
Q

Medications that affect the heart rate are said to have a _____ effect

A

Chronotropic, can have a positive or negative effect

101
Q

drugs that effect changes in the force of contraction are called what

A

Inotropic, can have a positive or negative effect

102
Q

drugs that alter the velocity of the conduction of electricity through the heart is said to have a _______ effect

A

dromotrophic, can have a positive or negative effect

103
Q

what are cardiac glycosides

A

class of medication that are derived from plants, block certain ionic pumps in the heart cells’ membranes, which indirectly increases calcium concentrations

104
Q

what are the 4 types of antidysrhythmIc medications

A

sodium channel blockers, beta blockers, potassium channel blockers, calcium channel blockers

105
Q

how do sodium channel blockers work

A

slow conduction through the heart

106
Q

how do beta blockers work

A

reduce the adrenergic stimulation in the beta receptors

107
Q

how do potassium channel blockers work

A

increases the heart’s contractility (positive inotropy) and work against re-entry of blocked impulses

108
Q

how do calcium channel blockers work

A

block the inflow of calcium into the cardiac cells, thereby decreasing the force of contraction and automaticity. may also decrease the conduction velocity. antidysrhythmic and antihypertensive properties

109
Q

what are the treatment goals of antihypertensives

A

keep blood pressure within normal limits, maintain or improve blood flow, reduce stress placed on heart.

110
Q

what effects do diuretic medications have on the body

A

cause the kidneys to remove excess amounts of salt and water in the body, thereby reducing stress placed cardiovascular system. in particular they lower the preload on the heart and decrease stroke volume

111
Q

what do loop diuretics do

A

lower the concentration of sodium and calcium ions in the body

112
Q

what do angiotensin-converting enzyme ACE inhibitors do

A

target the renin-angiotensin-aldosterone system. ACE inhibitors suppress the the conversion of angiotensin I to angiotensin II

113
Q

what does angiotensin II receptor antagonists do

A

block angiotensin II from binding to its receptor sites.these medications have been used to treat heart failure and vascular disease

114
Q

what is a fibrinolytic agent

A

once a blood clot has formed a fibrinolytic agent may be administered to dissolve the thrombus and prevent it from breaking off and entering the blood stream

115
Q

what is the leading cause of death in many developed parts of the world

A

dylipidemia (abnormal amount of lipids in blood such as cholesterol) major risk factor for cardiovascular disease.

116
Q

what is the most popular class for cholesterol called

A

statins(HMG CoA reductase inhibitors) which inhibit the last step in cholesterol development by the body

117
Q

many respiratory emergency treatments attempt to expand the respiratory tract. Using sympathomimetic medications which effect which receptors?

A

alpha, beta 1 and beta 2 receptors

118
Q

what is the preferred receptor target when treating respiratory emergencies with decreased O2 going to vital organs

A

Beta 2 receptors, medications targeting beta 2 receptors produce smaller increases in heart rate and force of contraction and, thereby, dramatically decreases bodys rate of O2 consumption

119
Q

what is the second line treatment in respiratory emergencies

A

class known as xanthines, relieve airway constriction by relaxing smooth muscles bronchioles and stimulating cardiac muscles to work harder. notable Xanthine is caffeine

120
Q

what is the most common medication administered in the prehospital setting

A

oxygen

121
Q

what are the two medical options for treating thyroid disorders

A

1, medications to suppress the activity of the thyroid(hyperthyroidism) 2, replace missing thyroid hormones(used in hypothyroidism)

122
Q

what are the two different effects of medications you may administer during labour

A

1, precipitating labour

2, inhibiting labour

123
Q

what does tocolytic medication do?

A

suppress the force and frequency of uterine contractions

124
Q

what is the most common type of medication administered for the male reproductive system

A

erectile dysfunction medication

125
Q

how do most medications effect the female reproductive system

A

most medications intended for the female reproductive system carry out their effects by altering the reproductive hormones.

126
Q

what is an antineoplastic medication

A

medications that are designed to combat cancer, such as chemotherapy

127
Q

what are NSAIDs

A

Nonsteroidal Anti-inflammatory medications, designed to reduce pain, inflammation, and fever. work by inhibiting the COX enzymes

128
Q

how is Aspirin different from other NSAIDs

A

it targets the COX 1 enzyme instead of the COX enzyme. which reduces platelet aggregation. provides great benefit in PTs who are suspected of having myocardial infraction

129
Q

what is a uricosuric medication

A

designed to lower the uric acid levels in the blood by increasing it excretion by the kidneys into the urine

130
Q

serums, vaccines and other immunising agents fall into what category

A

immunobiologic medications

131
Q

what is one important vitamin and mineral that we focus on in a prehospital setting

A

Thiamine (vitamin B12) thiamine aids in converting carbohydrates into energy. Alcoholics, among others tend to be deficient in this

132
Q

what are the primary ways in which antidotes function

A

antidotes can function antagonistically by blocking receptor sites that would otherwise be stimulated by the agent. they can transform the agent into an inert, nonhazardous form to facilitate excretion. They may also bind to an agent to prohibit its absorption into the blood stream

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