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Pharmacology for Nurses > Chapters 1-3 > Flashcards

Chapters 1-3 Flashcards

1
Q

What is a drug?

A

Any chemical that can affect living things

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2
Q

What is pharmacology?

A

The study of drugs and their interactions with living systems

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3
Q

What is clinical pharmacology?

A

The study of drugs in humans

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4
Q

What is therapeutics?

A

The use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy

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5
Q

What are the three most important characteristics of a drug?

A

effectiveness, selectivity, and safety

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6
Q

What is the most important characteristic of a drug?

A

Effectiveness

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7
Q

How is a safe drug defined?

A

Defined as one that cannot produce harmful effects- even if administered in very high doses

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8
Q

What is meant by reversible action in drugs?

A

For most drugs, we want the effects to be reversible. Exp. we want anesthetics to subside within a certain amount of time.

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9
Q

What is meant by drug predictability?

A

A characteristic of a drug that allows the clinician to know how a patient will respond to a certain drug

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10
Q

What is the therapeutic objective of drug therapy?

A

To provide maximum benefit with minimal harm

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11
Q

What are some administration factors that determine the intensity of drug reactions?

A

medication errors and patient adherence

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12
Q

What is pharmacokinetics?

A

Process that determines how much of an administered dose gets to its site of action

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13
Q

What are the four major pharmacokinetic processes?

A

drug absorption, drug distribution, drug metabolism, and drug excretion

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14
Q

When does pharmacodynamics occur?

A

Once a drug has reached its site of action

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15
Q

What process can be thought of as the impact of the body on the drug?

A

Pharmacokinetics

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16
Q

What process can be thought of as the impact of drugs on the body?

A

Pharmacodynamics

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17
Q

What are the rights of drug administration?

A

right drug, right route, right time, right dose, right patient, right to refuse, right to education, right assessment, right evaluation

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18
Q

What are the two major areas that nurses can apply pharmacologic knowledge?

A

Patient care and patient education

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19
Q

What are the 8 aspects of drug therapy for nurses?

A

1) pre-administration assessment
2) dosage and administration
3) promoting therapeutic effects
4) minimizing adverse effects
5) minimizing adverse interactions
6) making “as needed” (PRN) decisions
7) evaluation responses to medication
8) managing toxicity

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20
Q

What are the three basic goals of pre-administration assessment?

A

1) collecting baseline data needed to evaluate therapeutic and adverse responses
2) identifying high risk patients
3) assessing the patient’s capacity for self-care

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21
Q

What are the five basic steps of the nursing process?

A

assessment, analysis (diagnosis), planning, implementation, evaluation

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22
Q

What 3 statements must a nursing diagnosis contain?

A

1) A statement of the patient’s actual or potential health problem
2) A statement of the problems probable cause or risk factors
3) The signs, symptoms, or other evidence of the problem

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23
Q

What is the goal of the pre-administration assessment?

A

Establishes the baseline data needed to tailor drug therapy to an individual

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24
Q

What is the analysis and diagnosis phase of treatment directed at?

A

1) judging the appropriateness of the prescribed therapy
2) identifying potential health problems treatment might cause
3) characterizing the patient’s capacity for self care

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25
Q

What is the planning and implementation phase of the nursing process in drug therapy?

A

1) defining goals
2) setting priorities
3) identifying interventions
4) establishing criteria for evaluation

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26
Q

What is the evaluation phase of the nursing process for drug therapy?

A

1) evaluate therapeutic responses and adverse reactions
2) evaluate adherence to prescribed medication
3) evaluate satisfaction with treatment

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27
Q

What was a major provision of the Harris-Keyauver amendments?

A

provision that required drugs to be proven effective before marketing

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28
Q

How many drug schedules are there and what are they?

A

1) schedule l- no accepted medical use and deemed high potential for abuse (Methamphetamine)

2) schedule 2-5 –> accepted medical use but has potential for abuse

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29
Q

What is the most reliable way of objectively assessing drug therapies?

A

Randomized Controlled Trials (RTC)

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30
Q

What are the three features of a randomized controlled trial?

A

use of controls, randomization, and blinding

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31
Q

What are the controls and why are they useful?

A

When a drug is being tested, old standard drugs or placebo’s are used as controls. These controls allow us to see if the new medication is more effective than the old standard medication

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32
Q

What is randomization?

A

Subjects are assigned to either the test group or the control group

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33
Q

What is blinding?

A

A study in which people do not know what group they belong to (experimental or placebo)

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34
Q

What is the difference between a single blind and a double blind?

A

Single blinding means that only the test subjects are unaware of which group they belong to and a double blind is when the researches are unaware of which subjects are taking the different medications

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35
Q

What are the two principal steps in drug development?

A

preclinical testing and clinical testing

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36
Q

What is the purpose of preclinical testing?

A

Drugs are evaluated for toxicities, pharmacokinetic properties, and potentially useful biological effects

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37
Q

What are the characteristics of clinical testing?

A

Can take 2-10 years to complete, has four phases, phases 1-3 are completed before marketing, the fourth is completed after FDA approval for marketing

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38
Q

What kind of humans are involved in phase 1 testing?

A

Healthy individuals

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39
Q

What is the goal of phase 1 testing?

A

Evaluate drug metabolism, pharmacokinetics, and biological effects

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40
Q

Which humans are being tested in phase 2-3?

A

Patients

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41
Q

What is the goal of phase 2-3 testing?

A

determine therapeutic effects, dosage range, safety and effectiveness

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42
Q

What humans are used in phase 4 testing?

A

Opened to the public

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43
Q

What are the there types of drug names?

A

chemical name, generic name, and brand name

44
Q

What is the generic name (non-proprietary)?

A

assigned by the United States Adopted Names Council

45
Q

What is the brand name (proprietary)?

A

Names under which a drug is marketed

46
Q

What are chemical names?

A

Constitutes a description of drug using the nomenclature of chemistry

47
Q

What are over the counter drugs?

A

drugs that can be purchased without a subscription

48
Q

What are over the counter drugs?

A

drugs that can be purchased without a subscription

49
Q

What are the 3 ways drugs can cross the lipid bi-layer?

A

through channels/pores, with aid from transport mechanisms, or direct penetration of wall

50
Q

Which method of drug transport through the bi-layer is most common?

A

direct penetration

51
Q

What is an important drug transporter in the body?

A

P-Glycoprotein

52
Q

What does P-Glycoprotein do?

A

Transport drugs out of the cell

53
Q

What molecules are not lipid soluble?

A

Polar molecules and ions

54
Q

What factors affect drug absorption?

A

Blood flow, lipid solubility, and pH partitioning

55
Q

What are the 2 major routes of drug administration?

A

enteral (within gi tract) and parenteral (outside gi tract)

56
Q

What is absorption?

A

The movement of a drug from its site of administration into the blood stream

57
Q

What factors affect drug absorption?

A

Rate of dissolution, surface area (larger surface area), blood flow, lipid solubility, pH portioning

58
Q

What are the three oral medication packages?

A

Sustained release, enteric coated, and tablets

59
Q

What is a tablet and list characteristics?

A

picture of drug plus binders and fillers

60
Q

What are enteric coated preparations?

A

drugs that are covered with a material designed to dissolve in the intestine and not the stomach. Outer coating is usually made from wax, fatty acids, and shellacs

61
Q

What is the purpose of enteric coated medications?

A

protect drug from acid and pepsin, and protect the stomach from drugs that can irritate the lining

62
Q

What are sustained release medications and why are they used?

A

capsules filled with spheres that contain the actual drug. Because the spheres dissolve at different rates, the medication is released over a longer period of time, thus cause as reduction in the number of daily doses

63
Q

What is drug distribution?

A

drug movement from the blood to the interstitial space of tissues and from there into the cell

64
Q

What two factors can affect drug distribution?

A

tumors. and abscesses

65
Q

What is drug metabolism also known as?

A

Biotransformation

66
Q

Where does most drug metabolism take place?

A

Liver

67
Q

What is responsible for drug metabolism in the liver?

A

hepatic microsomal enzyme system (p450 system)

68
Q

What three enzymes metabolize drugs in the liver?

A

CYP 1, CYP 2 , and CYP 3

69
Q

What are the 6 therapeutic consequences of drug metabolism?

A

accelerated renal clearance, drug inactivation, increased therapeutic action, activation of pro drugs, increased toxicity, and decreased toxicity

70
Q

What is the most important characteristic of drug metabolism?

A

promotion of renal drug clearance

71
Q

What is a prodrug?

A

a compound that is pharmacological inactive as administered and then undergoes conversion to its active form

72
Q

What is the first pass effect?

A

refers to the rapid hepatic inactivation of certain oral drugs

73
Q

What is drug excretion?

A

the removal of drugs from the blood

74
Q

What organ accounts for most drug excretion?

A

kidneys

75
Q

what are the 3 steps of renal excretion?

A

glomerular filtration, tubular secretion, and tubular reabsorption

76
Q

What is hepatic recirculation?

A

repeating cycle in which a drug is transported from the liver

77
Q

What is glomerular filtration?

A

its where renal excretion first occurs, capillary network surround Bowmans capsule, as blood flows through glomerulus, fluids and small molecules are forced through including drugs. Drugs bound to proteins (albumins) are too large to pass through and thus do not

78
Q

what is passive tubular reabsorption?

A

at the distal site of the renal tubule, drug concentrations in the blood are lower than that of the tubule, thus blood moves from the tubule into the blood. Because lipid soluble drugs can readily cross the membranes, drugs that are lipid soluble readily get reabsorbed

79
Q

what is tubular secretion (active)?

A

Transport pumps and p glycoprotein pump drugs from the blood into the tubular urine

80
Q

what can pH dependent ionization be useful for?

A

used to accelerate renal excretion of drugs. because ions are not lipid soluble, drugs that are ionized at the pH of the urine will remain in the tubule and be excreted.

81
Q

why are plasma drug concentrations important?

A

there is a direct correlation between therapeutic and toxic responses and the amount of drug present in plasma

82
Q

what are the two plasma drug levels that are of clinical significance?

A

the minimum effective concentration and the toxic concentration

83
Q

what is the minimum effective concentration?

A

the plasma drug level below which therapeutic effects will not occur

84
Q

what is the toxic concentration?

A

occurs when plasma drug levels climb too high

85
Q

what is the therapeutic range?

A

the level between he minimum effective concentration and the toxic concentration

86
Q

what is the objective of drug dosing?

A

maintain plasma drug levels within the therapeutic range

87
Q

what is meant by half life?

A

the time required for the amount of drug in the body to decrease by 50%

88
Q

what determines the dosing interval?

A

a drugs half life

89
Q

when does drug plateau occur?

A

when the amount of drug eliminated between doses equals the dose administered

90
Q

on average, when will plateau be reached?

A

approximately 4 half lives

91
Q

what is meant by a loading dose?

A

when plateau must be achieved more quickly, a large initial dose can be administered

92
Q

what is meant by a maintenance dose?

A

after high drug levels have been established with a loading dose, smaller doses can be administered. these are called maintenance doses

93
Q

what is the dose response relationship?

A

the relationship between the size of the dose and the intensity of the response

94
Q

dose response relationships are graded, what does this mean?

A

It means that as doses increase, the response becomes progressively larger

95
Q

what is maximal efficacy?

A

largest effect that a drug can produce

96
Q

what is potency?

A

the amount of drug we must give to elicit an effect

97
Q

What is a drug rector?

A

any functional macromolecule in a cell to which a drug binds to

98
Q

What are the 4 primary drug receptors?

A

cell-membrane embedded enzymes, ligand gated ion channels, g-protein coupled receptor systems, and transcription factor

99
Q

what are drug agonists?

A

drugs that mimic the body’s own regulatory molecules

100
Q

what are drug antagonists?

A

drugs that block the actions of endogenous regulators

101
Q

what is intrinsic activity?

A

allow the agonist to activate a response

101
Q

what is intrinsic activity?

A

allow the agonist to activate a response

102
Q

What is the difference between competitive antagonists and non-competitive antagonists?

A

non-competitive antagonists bind irreversibly to receptors. the effect is similar to decreasing the amount of available receptors. Competitive antagonists bind reversibly to receptors (most antagonists are competitive)

103
Q

what is the therapeutic index?

A

a measure of a drugs safety, it is the ratio of a drugs Lethal dose LD50 to its average effective dose ED50

104
Q

what is the ED50?

A

a dose that is required to produce a defined therapeutic response in 50% of the population

Pharmacology for Nurses (1 decks)

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