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Day 1 Pharm Flashcards

1
Q

What do prescription drugs require?

A

Written prescription by an accredited authorized prescriber provider.

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2
Q

Are faxed prescriptions allowed?

A

No

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3
Q

What is the manual of the medical department instruction number?

A

NAVMED P-117

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4
Q

How are most prescriptions ordered?

A

Electronically

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5
Q

How are all controlled drugs prescribed?

A

DD 1289

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6
Q

What is the AMAL for drugs on a DDG?

A

634

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7
Q

What goes on a DD 1289?

A
  • Full name
  • Date
  • Age and DOB
  • Full name of drug, form, dosage, and qty
  • Directions
  • Signature
  • Refill authorization
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8
Q

Are refills authorized for narcotics?

A

NO

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9
Q

Other than prescribing controlled meds, what other reason is there for an IDC to use DD 1289?

A

Directed by CO or higher authority

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10
Q

What is the form for poly-prescriptions?

A

NAVMED 6710/6

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11
Q

What are poly-prescriptions used for?

A

When prescribing multiple medications

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12
Q

What is pharmacokinetic?

A

Activities of the drug after it enters the body
* Absorption, distribution, metabolism, excretion
( In, Around, Used, Out)

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13
Q

What is a fundamental concept of pharmacokinetic?

A

Drug clearance - elimination of drugs from the body

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14
Q

What is absorption

A

Transfer of drug from body fluids to tissues

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15
Q

What are the two types of absorption?

A

Active and Passive

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16
Q

What is active absorption?

A

When the drug is actively moved across the membrane using a carrier molecule (protein or enzyme)

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17
Q

What is passive absorption?

A

Diffusion basically

High concentration to lower concentration

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18
Q

What types of drugs use passive absorption?

A

Water soluble

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19
Q

What is pinocytosis?

A

Packman

* Cells engulf the drug particle across the membrane

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20
Q

What is bioavailability?

A

The percentage of the administered drug that actually reaches the systemic circulation

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21
Q

When does bioavailability occur for oral drugs?

A

After the medication is absorbed and metabolized by the liver

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22
Q

What percentage of bioavailability is available for oral first pass hepatic metabolism durgs?

A

20-40%

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23
Q

What are factors that impact bioavailability?

A
  • Drug form (tab, capsule, etc)
  • Route
  • Liver health
  • GI mucosa and motility
  • Food
  • Solubility (fat vs water)
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24
Q

Are fat soluble or water soluble drugs absorbed faster?

A

Fat soluble ( probably due to active absorption and the cell membrane is made of lipids)

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25
How are drugs typically distributed?
On proteins (albumin)
26
What is the therapeutic effect?
Drug level in the blood that produces the desired effect
27
What is metabolism?
Chemical reaction in which the liver converts the drug to an inactive compound
28
Where does metabolism occur?
Liver, kidneys, lungs. plasma, intestinal mucosa
29
What do you need to be concerned about when it comes to dosing and a patient with liver disease.
May require lower dose due to the increased chance of drug toxicity because the half-life may increase * Or just use a drug that isn't metabolized by the liver
30
What is excretion?
Elimination of drugs from the body
31
How do the kidneys perform excretion?
Excretes the inactive compounds from the body into the urine
32
What is half-life?
Time required for the body to eliminate 50% of the drug
33
What specific factors can increase half-life
* Old age * Liver disease * Kidney disease
34
What is pharmacodynamics?
Drug's actions and effects within the body
35
What are the two effects of pharmacodynamics?
Primary (desired) | Secondary (side effects)
36
What is physical dependence
Compulsion to use a drug due to withdrawal symptoms
37
What is phycological dependence?
Compulsion to use a drug for pleasure
38
What is pharmacogenetic disorder?
A genetic abnormal response to a drug
39
What are receptors?
* Bind to drug molecules | * They alter functions of the cells which produce therapeutic effects
40
What is therapeutic response?
Alteration of a cell to achieve desired response
41
What is an agonist?
Drug that binds with a receptor to produce a therapeutic response
42
What happens when drugs alter the cellular environment?
Changes the physiologic function of the cell | * BP decrease, HR increase
43
What is an antagonist?
Drug that binds to a receptor stronger than the agonist which negates the effect ( narcan to morphine)
44
What is an adverse reaction
Undesired effect
45
What is an allergic reaction
Reaction that occurs due to the IMMUNE SYSTEM which views the drug as a foreign substance
46
What is a drug idiosyncrasy?
Abnormal reaction that only happens to a small % of the population
47
What is drug tolerance?
Decreased response requiring higher dosage
48
What is cumulative drug effect?
Occurs when you take another dose before the previous dose has had time to fully metabolize
49
What is it called when blood concentration levels for a drug exceed the therapeutic effect?
Toxicity
50
What kinds of diseases would you typically see drug toxicity?
Kidney or Liver disease
51
What are pharmacogenetic reactions?
Trait that causes abnormal metabolism of a drug
52
What is the risk of a G6PD patient taking sulfa or aspirin?
Pharmacogenetic reaction such as hemolysis
53
What is the pharmaceutic phase?
The dissolution of a drug (breakdown)
54
What are drug interactions
When one drug interacts or interferes with another
55
What is the additive drug reaction
Drug effect equal to the sum of the two added together
56
What is synergism?
Drug interaction that causes an increase in the drug's effects GREATER than just the two combined
57
What are the factors influencing drug response?
* Age * Weight ( based on 150 lb person) * Gender * Disease * Route * Drug use and Pregnancy
58
How does age influence drug response?
Affects the metabolism of the drug
59
What are the 4 risk categories of drugs for pregnant women?
``` JUST KIDDING THERE'S 5 A - No risk/remote B - No evidence C - Can't rule out risk D - Definitely Risk X - Don't fucking give ```
60
What are the 6 rights for administering drugs?
* Patient * Drug * Dose * Route * Time/Exp * Documentation
61
1mL = how man cc's?
1 cc
62
What are the unit of measurements for volume?
ml, l, cc
63
How many mcg in a mg?
1000mcg = 1 mg
64
How many mg in a g?
1000mg =1 g
65
How many kg in a pound?
1 kg = 2.2lbs
66
So when you have a patient's weight in pounds how to you calculate it in kg?
Divide weight (in pounds) by 2.2
67
What is the most frequent route of drug administration?
Orally
68
What are the different ways to administer drugs orally?
* Nasogastric * Buccal * Sublingual
69
What are the ways to administer drugs via parenteral? (Listed in order of speed of absorption)
* ID (1st and 2nd layer of skin - TST's) * SC (between skin and muscle) * IM (rich supply of blood vessels) * IV
70
Routes of administration that is applied to the skin and mucus membranes are?
* Topical - (also includes suppositories and opth/optic) * Transdermal * Inhalation
71
How does transdermal application of drugs work?
Maintains a relatively constant blood concentration and reduces possibility of toxicity ( Nicotine patches)
72
What drugs fall under sedatives and hypnotics?
* Barbiturates * Benzodiazepine * Melatonin antagonists
73
What do sedatives and hypnotics do?
* Depress CNS - sedation - sleep - unconsciousness
74
What is the action of barbiturates?
* Anticonvulsant * Depresses sensory cortex * Decreases motor activity * Drowsiness, Sedation, and Hypnosis
75
What are barbiturates used for?
* Sedation | * Seizures
76
What types of seizures are barbiturates used for?
Tonic-clonic, epilepticus, and partial
77
What should barbiturates not be used for?
Insomnia
78
What are the adverse effects of barbiturates?
* They slow shit down * Drowsiness * Nausea, Vomiting, Diarrhea * Hypoventilation * Bradycardia * Hypotension * Agitation, confusion
79
What are some contraindications for barbiturates?
* Sensitive to barbiturates * Hepatic impairment * Nephritic * Issues with airway
80
What can antianxiety dugs be divided into?
* Benzos | * Non-benzos
81
What is the action of most benzos?
* Depress CNS * Bind to benzo receptors in the GABA complex * Inhibitory neurotransmitter * Meant for Acute cases
82
What are side-effects of benzos?
* Tolerance due to long-term use | * Psychological/Physical dependence
83
Do benzos have an analgesic affect?
NOPE
84
What is the action of non-benzos?
Acts on brain's dopamine and serotonin receptors * Meant for chronic conditions * DON'T confuse with SSRI's
85
What are the adverse effects of antianxiety meds?
* Long term benzo use can cause withdrawal symptoms in 4-6 weeks
86
What are the symptoms of withdrawal for long term benzo use?
* Fatigue * Metallic taste * HA * Numbness in extremities
87
What are some contraindications for antianxiety drugs?
* Pre-existing CNS depression * Severe pain * Pregnancy (Class D) * Liver/Kidney issues
88
What is the pregnancy classification for antianxiety drugs?
D | * BuSpar is class "B"
89
What is the most common benzo used on DDG?
Diazepam
90
What is the non-benzo used on DDG?
Hydrozyzine
91
What are the antidepressants most used?
SSRI and SNRI
92
What does SSRI stand for?
Selective Serotonin Reuptake Inhibitor
93
What does SNRI stand for
Serotonin Norepinephrine Reuptake Inhibitor
94
What are all the types of antidepressants?
* Tricyclic * Monoamine Oxidase Inhibitors * Selective Serotonin Reuptake Inhibitors * Serotonin Norepinephrine Reuptake Inhibitor * Serotonin Reuptake Inhibitor/ Antagonist * Dopamine/Norepinephrine Reuptake Inhibitor
95
What is the action of TCA's?
Tricyclic Antidepressant * Increases levels of norepinephrine and serotonin by inhibiting their reuptake * Blocks acetylcholine
96
What is the action if MAOI's?
Monoamine Oxidase Inhibitors * Inhibits activity of monoamine oxidase * Increases endogenous neuro-hormones
97
What is the action of SSRI's?
Selective Serotonin Reuptake Inhibitor | * Increase serotonin by inhibiting neuronal uptake to CNS
98
What are the conditions that antidepressants can be used for?
* Depression * Anxiety (SSRI's) * OCD * Smoking Cessation
99
What are the adverse affects of TCA's?
* Dry mouth * Blurred vision * Postural hypotension * Urinary Retention * Constipation * Hypotension
100
What are the adverse affects of MAOI's?
* Food interactions * Vertigo * Nausea * Dry mouth
101
What are the adverse affects of SSRI's?
* Nausea * Sexual dysfuncton * insomnia * Weight gain
102
What are the contraindications for TCA's?
* Sensitivity to TCA's * Co-use with MAOI's within 14 days * MI's
103
What are the contraindications for MAOI's?
* CVA disease * Hypertension * CHF * Elderly
104
What are the contraindications for Welbutrin?
* Seizure disorder
105
What are the contraindications for SSRI's?
* patients who smoke
106
Should you ever stop benzo use abruptly
Fuck no
107
How long does it take for antidepressants to take effect?
4-6 weeks
108
Should you ever stop antidepressants abruptly?
Fuck no
109
What natural remedy should you not take with antidepressants?
St. Johns Wart
110
What should not be taken with MAOI's because it could result in death?
Sertraline (SSRI)
111
What is the first line medication for depression?
SSRI's | * such as sertraline
112
What is the action of antipsychotic drugs?
* Blocks dopamine receptors in the brain
113
What is acetylcholine?
Neurotransmitter or chemical messenger | * Transfers signals between cells to impact how the body functions
114
What does an anticholinergic do?
Blocks the action of acetylcholine
115
What are antipsychotic drugs classified as?
* Typical (1st generation) | * Atypical (2nd generation) - less adverse reactions
116
What drug is limited to schizophrenia unresponsive to conventional therapy?
Clozapine
117
What drug is used to treat intractable hiccups?
Chlorpromazine
118
What are the adverse effects of antipsychotic drugs?
* Anticholinergic * Extrapyramidal * Tardive dyskinesia * Neuroleptic malignant syndrome
119
What are the symptoms associated with anticholinergic?
* Dry mouth * hypotension * sedation
120
What are the symptoms associated with extrapyramidal?
* Parkinson like symptoms * Akathisia ( restless) * Dystonia (facial grimace)
121
What are the symptoms associated with tardive dyskinesia?
Movement of the tongue, face, mouth, or jaw
122
What are the symptoms associated with neuroleptic malignant syndrome?
* Hyperthermia * progresses over 24-72 hrs * Haloperidol (drug mainly causes this)
123
Contraindications to antipsychotic drugs?
* Severely depressed | * Hypotension
124
What should patient management be for antipsychotics?
Assess deviation from normal

Pharmacology (19 decks)

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