Chapter 7 Pharmacology Flashcards
Six rights of medication admn.
right PT, medication, dose, route, time, documentation
Government body that regulates pharmaceuticals
Health products and food board (HPFB)
what is included in the chemical name
describes the drugs chemical make up, composition and molecular structure
what’s is the generic name of a drug
aka the nonproprietary name, is a general name for a drug. not manufacture specific, typically created by company that first manufactures
what’s in the trade name
unique name in which original manufactures registers the drug to the HPFB
4 sources medication is derived from
animals, plants, minerals, and laboratory
when was the “controlled drugs and substances act” passed and what’s its purpose
1996, governs production, registration, distribution, and possession of narcotics and controlled substances
what is a schedule 1-4 controlled substance
- narcotics such as opium and cocaine. 2. canabis 3. stimulants and hallucinogens 4. anabolic steroids
how many animals do drugs need to be tested on before human trials
2
how many test phases does a drug go through, what are they
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
how is a medication different in someone who is pregnant
affects the fetus and can alter mothers physiology
how does a pediatric’s metabolic rate compare to an adult
pediatrics often metabolise at a much higher rate then adults and may require relatively higher doses then adults
how does geriatrics metabolic rate compare to adults
it is slower then normal adults, often require small relative doses
two major types of peripheral nerves
afferent and efferent
what do afferent nerves do
carry sensory impulses from all parts of the body to the brain
what do efferent nerves do
carry messages from the brain to the muscles and organs
what are the two divisions of the peripheral nervous system
somatic and autonomic
what does the autonomic nervous system do?
sends sensory impulses from internal structures such as blood vessels and the heart through afferent nerves to the brain
what is the central nervous system
centre for all nervous system functions, receives input form all sensory neurons and then directs actions to be taken
what does your sympathetic nervous system do?
responsible for your fight or flight response, dominant during rest and activities
what does your parasympathetic nervous system do
dominant during periods of rest and relaxation
what is neurotransmission
process of chemically signalling between cells
what do nicotinic receptors do
responsible for sympathetic overactivity, neuromuscular dysfunction, includes tachycardia hypertension, dilated pupils, muscle fasciculation, muscle weakness
what do muscarinic receptors do
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
what is the term for the attraction between a medication and its receptors
affinity
what is it called when a medication stimulates a response in a receptor site
agonist
what is a solution
liquid containing one or more chemical substances entirely dissolved
what is a suspension
preparation of a finely dissolved medication intended to be in a suitable liquid
what is a tincture
diluted alcoholic extract of a medication
what is a syrup
medication suspended in sugar and water
what is an elixir
solution with alcohol and flavouring added
what is an extract
concentrated preparation of a medication made by putting the medication into a solution
what is a capsule
cylindrical gelatin container enclosing a dose of medication
what is a tablet
a powdered medication shaped into a small disc
what method has the quickest rate of absorption
iv and io
what is the slowest method of absorption
topical
what does it mean if a drug produces a local effect
result from direct application of a drug to a particular location such as a topical lotion to the skin
what does it mean if a drug produces a systemic effect
drug is absorbed into the bloodstream, almost always effects more then one organ, however one organs reaction may be predominate
what are the three categories of administration
percutaneous, enteral, parental
what does it mean to administer percutaneously
applied to and absorbed through the skin or mucous membrane
what does is mean to administer enteraly
administered and absorbed somewhere along the gastrointestinal, typically administered orally
what does it mean to administer parentally
any route that does not cause medication to be absorbed through skin, mucous membrane or gastrointestinal tract
what does it mean to administer sublingually
referes to administering medication under the tongue
where is the buccal route of administration
its between the cheeks and gum
how does pulmonary administration work
delivering medication directly to the pulmonary system through inhalation or injection
what is a common way of continuing medication administration
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
what is the pH range of most medications
most medications fall in to the category of either weak acids or weak bases
how does a medications pH affects it ability to function as desired
pH of a medication affects its ability to ionize
what does bioavailability mean?
bioavailability refers to how much of the medication is still active when it reaches its target organ
what is the primary distribution method in the body
blood is the primary method, the PTs cardiac output is diminished for whatever reason the the medication will not move as quickly
what is the only way a medication can be used within the body
it must be a ‘free drug’. that means the medication molecule cannot be bound with anything
what do drugs typically bind to?
typically drugs will become bound to fat, muscle, tissue and bone
what does biotransformation mean?
manner in which the body metabolizes medication, only free drugs are able to be biotransfused
what are the two ways that the body metabolizes medication
- transforming the medication into a metabolite
2. by making the medication more water soluble
what is the first pass effect
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
what are the two phases that liver enzymes act on drugs
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
what are the three main mechanisms in which the kidney excretes medication remnants
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
what are the 4 mechanisms that drugs use to act on the body
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
what is an antagonist
may block receptor site from being stimulated by other chemical mediators and inhibit normal response
what is an agonist
stimulate the receptor site to cause the response it normally has
what is up-regulation
medications that increase the number of receptor sites available
what is down- regulation
as medications bind to receptor sites, the number of receptor site available decreases
what are the 8 chief factors affecting drug responses
1, age 2, weight 3, sex 4, environment 5, time of administration 6, condition of PT 7, genetic factors 8, physiological factors
what is an Iatrogenic response
adverse condition inadvertently induced in a PT by the treatment given
what does cross tolerance mean?
pt could develop a tolerance as a result of prolonged administration of a separate medication
what does tachyphylaxis mean?
condition in which PT rapidly becomes tolerant to a medication
what is cumulative effect
if several doses of medication are given over a relatively short period of time which might result in either therapeutic or non-therapeutic levels
what is the summation effect
it is an addictive effect, two medications given to the PT that have the same effect that doubles the response exhibited by the PT
what is synergism
Pt receives two medications with the same effect but produces a response greater than the sum of their individual response
what is interference
a direct biological interaction that takes place between two drugs
what environmental factors must be considered in medication storage
extreme temperatures, exposure to direct sunlight, excessive humidity
minimum requirements for storage of controlled substance
securely locked, substantially constructed cabinet with no sign or indication of what the cabinet is used for
what 11 features are included on a medication profile
medication names, class, mech. of action, indications, pharmacokinetics, side effects, routes, dosage forms, dosages, contraindications, special considerations
what does indications refer to?
reasons or conditions for which the medication is given
what does contraindications refer to?
conditions in which it is inappropriate to administer medications
what is an analgesics
medications that relieve pain and induce analgesia (absence of sensation of pain)
most common class medication used for analgesia?
most common analgesics in pre-hospital setting is opioid agonist
what are the three common forms of nonopiod analgesics
1, salicylates(aspirin)
2, NSAIDs nonsteroidal anti-inflammatory medication(ibuprofen)
3, para-aminophenol derivatives(Tylenol)
what kind of drug is Naloxone(narcan)
narcan is an opioid antagonist that competitively binds at the opiate receptor sites
what is an anaesthetic
medications intended to induce a lose of sensation to touch or pain
what are the three types of anaesthesia ?
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
what is the most common sedative used for invasive procedures
benzodiazepines; believed to affect the inhibitory neurotransmitter gamma-aminobutyrate acid (GABA) in the brain
how can stimulation of the CNS be accomplished
1, increasing excitatory neurotransmitters
2, decreasing inhibitory neurotransmitters
CNS agents are a class that produce physiologic and psychologic effects, what are the two groups that they are divided into
Specific agents; bring an identifiable mechanism with unique receptors for the agent.
Nonspecific agent; produce effects on different cells through a variety of mechanisms
what effects can you expect when you stimulate the parasympathetic nervous system
causes pupils to constrict, bronchoconstriction, heart rate slows, reduces hearts contractile force, stimulates secretion from digestive glands, enhances smooth muscles
all preganglionic and postganglionic parasympathetic nerves use what as the neurotransmitter?
ACh; has a short life span, it is deactivated by AChE.
what are the two ACh receptors, collectively known as cholinergic receptors known as
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
what does anticholinergic medication do?
works in opposition to the parasympathetic nervous system by blocking muscarinic and nicotinic receptors
what is a medication called that is given to stimulate the sympathetic nervous system
sympathomimetics, can be selective or non selective
what is a medication called that is given to inhibit the sympathetic nervous system
sympatholytics, can be selective or nonselective
how do sympathomimetics work?
they stimulate the adrenal medulla so that it releases norepinephrine and epinephrine which are the major neurotransmitters in the sympathetic nervous system
what are the 4 types of adrenergic receptors
alpha 1, alpha 2, beta 1 and beta 2
what effects do alpha 1 receptors have
produce peripheral vasoconstriction, mild bronchoconstriction and speed metabolism
what effects do alpha 2 receptors have
control the release of norepinephrine
what effects do beta 1 receptors have
increase heart rate, cause cardiac muscle to contract, strengthen cardiac contraction, produce automaticity, trigger cardiac electrical conduction
what effects do beta 2 receptors have
stimulate vasodilation and bronchodilaton
when do beta 1 receptors come into play in the pre hospital setting
often we agonize the beta-1 receptors in attempt to treat cardiac arrest and hypotension
when does the beta 2 receptors come into play in the pre hospital setting
stimulating the beta 2 receptors allows us to treat asthma and other diseases that cause excessive narrowing of the bronchioles
what are three types of skeletal muscle relaxants?
Central acting, Direct acting, Neuromuscular blocking
Medications that affect the heart rate are said to have a _____ effect
Chronotropic, can have a positive or negative effect
drugs that effect changes in the force of contraction are called what
Inotropic, can have a positive or negative effect
drugs that alter the velocity of the conduction of electricity through the heart is said to have a _______ effect
dromotrophic, can have a positive or negative effect
what are cardiac glycosides
class of medication that are derived from plants, block certain ionic pumps in the heart cells’ membranes, which indirectly increases calcium concentrations
what are the 4 types of antidysrhythmIc medications
sodium channel blockers, beta blockers, potassium channel blockers, calcium channel blockers
how do sodium channel blockers work
slow conduction through the heart
how do beta blockers work
reduce the adrenergic stimulation in the beta receptors
how do potassium channel blockers work
increases the heart’s contractility (positive inotropy) and work against re-entry of blocked impulses
how do calcium channel blockers work
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
what are the treatment goals of antihypertensives
keep blood pressure within normal limits, maintain or improve blood flow, reduce stress placed on heart.
what effects do diuretic medications have on the body
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
what do loop diuretics do
lower the concentration of sodium and calcium ions in the body
what do angiotensin-converting enzyme ACE inhibitors do
target the renin-angiotensin-aldosterone system. ACE inhibitors suppress the the conversion of angiotensin I to angiotensin II
what does angiotensin II receptor antagonists do
block angiotensin II from binding to its receptor sites.these medications have been used to treat heart failure and vascular disease
what is a fibrinolytic agent
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
what is the leading cause of death in many developed parts of the world
dylipidemia (abnormal amount of lipids in blood such as cholesterol) major risk factor for cardiovascular disease.
what is the most popular class for cholesterol called
statins(HMG CoA reductase inhibitors) which inhibit the last step in cholesterol development by the body
many respiratory emergency treatments attempt to expand the respiratory tract. Using sympathomimetic medications which effect which receptors?
alpha, beta 1 and beta 2 receptors
what is the preferred receptor target when treating respiratory emergencies with decreased O2 going to vital organs
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
what is the second line treatment in respiratory emergencies
class known as xanthines, relieve airway constriction by relaxing smooth muscles bronchioles and stimulating cardiac muscles to work harder. notable Xanthine is caffeine
what is the most common medication administered in the prehospital setting
oxygen
what are the two medical options for treating thyroid disorders
1, medications to suppress the activity of the thyroid(hyperthyroidism) 2, replace missing thyroid hormones(used in hypothyroidism)
what are the two different effects of medications you may administer during labour
1, precipitating labour
2, inhibiting labour
what does tocolytic medication do?
suppress the force and frequency of uterine contractions
what is the most common type of medication administered for the male reproductive system
erectile dysfunction medication
how do most medications effect the female reproductive system
most medications intended for the female reproductive system carry out their effects by altering the reproductive hormones.
what is an antineoplastic medication
medications that are designed to combat cancer, such as chemotherapy
what are NSAIDs
Nonsteroidal Anti-inflammatory medications, designed to reduce pain, inflammation, and fever. work by inhibiting the COX enzymes
how is Aspirin different from other NSAIDs
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
what is a uricosuric medication
designed to lower the uric acid levels in the blood by increasing it excretion by the kidneys into the urine
serums, vaccines and other immunising agents fall into what category
immunobiologic medications
what is one important vitamin and mineral that we focus on in a prehospital setting
Thiamine (vitamin B12) thiamine aids in converting carbohydrates into energy. Alcoholics, among others tend to be deficient in this
what are the primary ways in which antidotes function
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
