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Pharmacology > Chapters 1-4 > Flashcards

Chapters 1-4 Flashcards

1
Q

What is pharmacology?

A

Study of biological effects of chemicals

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2
Q

What are drugs?

A

Chemicals that are introduced into a body with the intent to cause a change

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3
Q

What is pharmacotherapeutics?

A

Use of drugs to treat, prevent, and diagnose disease

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4
Q

What are controlled substances?

A

Any drug with an abuse potential (physical or psychological dependence)

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5
Q

Who monitors the prescription, distribution, storage, and use of controlled substances?

A

DEA

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6
Q

What is the Schedule of Controlled Substances?

A

Schedule I - Schedule V
C-I through CV
I = most risky (Ex: Heroin)
V = least risky of the risky substances (Ex: antitussives)

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7
Q

What is teratogenicity?

A

Adverse effects on a fetus

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8
Q

What is Category X?

A

Proven to have substantial adverse effects on a fetus

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9
Q

Brand Name or Trade Name of drug

A
  • Name given by drug company once approved by FDA
  • Given by companies that research, test, and manufacture drug
  • More expensive
  • Drug formula is patented
  • Insurance companies may not cover cost
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10
Q

Generic Name of drug

A
  • original name given to drug when submitted to FDA
  • Companies only manufacture the drug
  • significantly less expensive
  • Same active ingredient
  • Most states require generic drugs
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11
Q

What does DAW mean?

A

Dispense As Written

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12
Q

OTC drug concerns

A
  • can mask s/s of underlying disease
  • can interact/interfere with Rx drug therapies
  • Serious overdoses can occur if not taken as directed
  • Patients often do not report them to provider
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13
Q

What is Pharmacodynamics?

A

How the DRUG affects the body

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14
Q

What is Pharmacokinetics?

A

What the body does with the drug….
How the body acts on the drug

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15
Q

What are the 4 main mechanisms of action?

A
  • Receptor Action
  • Physical Action
  • Act on other chemicals in the body
  • Enzyme/Metabolic Action
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16
Q

What is involved in the receptor MOA?

A

Drugs act on receptor sites on the cell membranes

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17
Q

What is an Agonist?

A

drug that binds to the receptor site to INCREASE or STIMULATE a normal response

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18
Q

What is an Antagonist?

A

drug that binds to the receptor site to DEPRESS, BLOCK, or SLOW the normal response

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19
Q

What is a physical MOA?

A

*Changes the physical properties of cell or body fluids
*Such as: damage the cell wall or alter the pH

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20
Q

What is a Chemical MOA?

A

Creating chemical reactions in the body

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21
Q

What is an Enzyme/Metabolic MOA?

A

Processes in the body requiring multiple steps to have an effect => drugs interfere with one of these steps by stopping, delaying, or speeding it up

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22
Q

What is onset?

A

When a drug starts working

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23
Q

What is peak?

A

When the drug is at its highest

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24
Q

What is duration?

A

How long a drug works

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25
Q

What is critical concentration?

A

Amount of drug needed to cause a therapeutic effect

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26
Q

What is a loading dose?

A

Higher dose than normally used for treatment to get to a critical concentration faster

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27
Q

What is dynamic equilibrium?

A

The actual drug level in the body, dependent on how drug is absorbed and metabolized

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28
Q

What is the Therapeutic Index?

A

Ratio comparing the blood concentration at which a drug becomes toxic vs the concentration at which the drug is effective

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29
Q

What is absorption?

A

Starts when the drug enters the body, ends when it reaches circulating fluids and tissues

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30
Q

What is Passive Transport?

A

across a concentration gradient - no energy required

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31
Q

What is Active Transport?

A

Uses energy to move drug across a cell membrane, against the concentration gradient
*More important in excretion

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32
Q

What is filtration?

A

movement through pores of the cell membrane
*Pinocytosis

33
Q

What are factors that influence absorption?

A
  • Route: IV/IM are the fastest
  • Solubility: water and lipid soluble are “best”
  • Tissue Perfusion: needs to be adequate
  • Ionization: No charge is “best”
  • Size: smaller is absorbed faster
34
Q

What is Distribution?

A

Movement of drug through systemic circulation to the body’s tissues

35
Q

Factors affecting distribution

A
  • Solubility
  • Ionization
  • Tissue Perfusion
36
Q

What does protein binding have to do with distribution?

A
  • Some (?) molecules need to be bound to a protein to be carried
  • It’s difficult for a protein bound molecule to cross a cell membrane
  • Only “free” unbound particles can cause a therapeutic effect
  • Some are tightly bound vs loosely bound
  • There is competition for protein-binding sites (?)
37
Q

How does the blood-brain barrier affect distribution?

A

Only lipid soluble drugs can cross the barrier

38
Q

What is Metabolism of a drug?

A

Process by which drugs are changed to less active chemicals

39
Q

What is the organ responsible for metabolism of drugs?

A

LIVER

40
Q

What is the first-pass effect?

A

Oral drugs go from the small intestine to the liver before circulation.
Liver enzymes deactivate a large portion of the drug
Inactive portion gets excreted
Active portion gets transported to the target tissue

41
Q

How does Parenteral administration affect drug metabolism?

A

Parenteral: IV/IM
* No first pass effect
* Lower med doses needed
* Still metabolized in the liver

42
Q

What are Hepatic Enzyme Systems and how do they affect drug metabolism?

A

They are enzyme systems responsible for metabolizing drugs
* Cytochrome P450 system is one of the systems commonly used by many drugs
* Drugs can stimulate or inhibit enzyme systems
* If a drug inhibits an enzyme system, it can build up and cause toxicity
* If two drugs use the same enzyme system, they should NOT be used together
* If the drugs stimulate the enzyme system, they’ll be metabolized more quickly and the drugs may be less effective

43
Q

What is Elimination in regards to drugs?

A

Removal of the drug from the body

44
Q

What is the organ responsible for elimination of drugs?

A

KIDNEYS

45
Q

What is the glomerular filtration method of elimination?

A

For WATER SOLUBLE drugs
Water and water soluble components pass from the blood into the renal tubule to be excreted

46
Q

What is the Active Transport method of elimination?

A

For NON-water soluble drugs
*Exchange drug molecules for acid or bicarbonate molecules in order to get into the renal tubule
*Have to consider renal function: kidney impairment could lead to impaired excretion and increased risk of toxicity

47
Q

What is Half-Life?

A

The time it takes for the amount of a drug in the body to decrease to one half of the previous dose

Factors that could affect it: Metabolism, Distribution, Elimination

48
Q

Factors influencing drug effects

A
  • Weight (studies are all done on avg. 150lb person)
  • Age (elderly => altered metabolism and excretion)
  • Gender (in males => IM route is faster because of more vascular muscles)
  • Physiological (hydration, etc)
  • Pathological Factors (disease effects)
  • Genetic factors
  • Immunological factors
  • Environmental factors
  • Tolerance
  • Accumulation
49
Q

Drug Interactions

A

When 2 or more substances are taken together.
Happens @ the points of absorption, metabolism, excretion, site of action
Alteration of therapeutic effect
Increase in adverse effects
Issues can be serious with drugs with a narrow margin of safety

50
Q

Drug - Drug or Drug-Alternative Therapy Interactions

A

interaction between prescription drugs, OTC drugs, herbal supplements, vitamins

51
Q

Drug - Food Interactions

A

Typically occurs with direct contact in the stomach
Exception: Grapefruit juice (If there is an interaction, grapefruit juice should not be ingested at all during the drug therapy)
Oral meds are usually best on an empty stomach

52
Q

Types of Adverse Effects

A
  • Primary Actions: too much of the desired effect
  • Secondary Actions: effects that were not intended
  • Drug Allergy: antibodies are formed to a particular drug, upon re-exposure, reaction occurs, could also be cross-allergies between drugs in same class
53
Q

Anaphylactic Drug Reaction

A

IMMEDIATE
Release of histamine => mucus membrane swelling, bronchi constriction
S/S: Hives, rash, trouble breathing, changes in BP, dilated pupils, diaphoresis, increased HR, panic - impending doom, respiratory arrest
Interventions:
Stop drug
Epinephrine (Subq)
Notify provider
Prevention: med bracelet, epi kit

54
Q

Dermatologic Reactions of drugs

A

Rashes, Hives
Stevens-Johnson Syndrome
Stomatitis

55
Q

Rashes and Hives: Assessment

A

Could be adverse reaction or allergy (systemic = allergy)
Check for rashes, lesions
Systemic: enlarged lymph nodes, fever, hepatomegaly

56
Q

What is Stevens-Johnson Syndrome?

A
  • Dermatologic Reaction
  • Very rare but serious
  • dark red papules on extremities
  • appear in a circle/ring shape
  • no itching or pain
57
Q

Interventions for Dermatologic Reactions

A

Mild cases: benefit vs. discomfort
skin care
teaching
medications to treat effects

58
Q

What is stomatitis?

A

Dermatologic Reaction
Inflammation of mucus membranes

59
Q

Stomatitis assessment

A

look for gingivitis, glossitis, difficulty swallowing, bad breath, pain in mouth or throat

60
Q

Stomatitis Interventions

A

Frequent mouth care
Frequent small meals with non-irritating foods
dental consultation
medications: anti-fungal, local anesthetics

61
Q

Liver/Hepatic Injury from Toxic effects of drugs

A

Liver metabolizes drug, first pass effect
Impairment = possible toxicity of drug

62
Q

Assessment for Liver/Hepatic Injury

A

CNS: Fever, malaise
GI: N/V, abdominal pain, urine or stool color (dark brown urine, pale stool)
Skin: Jaundice (also sclera of eyes)
Changes in Labs:
elevated AST, ALT
abnormal bilirubin levels
changes in clotting factors: PT/INR, PTT

63
Q

Interventions for hepatic injury

A

discontinue the drug
small frequent meals
skin care
cool environment
rest periods

64
Q

Kidney Injury from toxic effects of drugs

A

Kidneys excrete drugs
Impairment = accumulation of drug in body

65
Q

Assessment for Kidney injury

A

CNS: fatigue, malaise, irritability
Skin: Rash
Edema
Decreased urine output
Changes in labs:
Elevated BUN, Cr
Decreased HCT
Electrolyte imbalances

66
Q

Interventions for Renal injury

A

Positioning (for edema)
diet/fluid restrictions
skin care
electrolyte replacement
rest
may need to discontinue drug
may need dialysis

67
Q

Toxic effects of drugs: Poisoning

A

damage to multiple body systems due to overdose
emergency life support measures may be needed
death can occur

68
Q

Toxic effects of drugs: CNS
Assessment

A
  • Confusion, delirium, hallucinations
  • Insomnia, drowsiness, bizarre dreams
  • Hyper or hypo-reflexia
  • Numbness, tingling, paresthesia (pins and needles)
  • Seizures
69
Q

Toxic effects of drugs: CNS
Interventions

A
  • safety measures to prevent injury
  • patient education to prevent injury
  • orientation as needed
  • decrease dose or discontinue drug
70
Q

Toxic Effects of drugs: Teratogenicity

A

Category X
Pregnant women must be informed and must consent
Some drug effects are not known (unethical to run studies)

71
Q

Placebo Effect

A

A positive attitude can increase effects

72
Q

Absolute Contraindication

A

NEVER administer
Life Threatening

73
Q

Relative Contraindication

A

Discuss benefit vs risk
contact provider

74
Q

Caution

A

may administer with additional nursing considerations

75
Q

Evaluation of drug therapy

A

Patient Response to drug:
Therapeutic effect
Adverse effects
Effectiveness of teaching plan
Effectiveness of comfort and safety measures
Compliance of regimen

76
Q

Nursing Responsibilities in Pharmacology

A
  • Administer drugs
  • Assess drug effects
  • Intervene when adverse effects occur
  • Provide patient teaching
  • Monitor to prevent medication errors
77
Q

Reporting of medication errors

A

Nurse => report to institution

Institution => FDA and US Pharmacopeia

78
Q
A

Pharmacology (10 decks)

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