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Pharmacology > Day 1 Pharm > Flashcards

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
Q

How are drugs typically distributed?

A

On proteins (albumin)

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26
Q

What is the therapeutic effect?

A

Drug level in the blood that produces the desired effect

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27
Q

What is metabolism?

A

Chemical reaction in which the liver converts the drug to an inactive compound

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28
Q

Where does metabolism occur?

A

Liver, kidneys, lungs. plasma, intestinal mucosa

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29
Q

What do you need to be concerned about when it comes to dosing and a patient with liver disease.

A

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

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30
Q

What is excretion?

A

Elimination of drugs from the body

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31
Q

How do the kidneys perform excretion?

A

Excretes the inactive compounds from the body into the urine

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32
Q

What is half-life?

A

Time required for the body to eliminate 50% of the drug

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33
Q

What specific factors can increase half-life

A
  • Old age
  • Liver disease
  • Kidney disease
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34
Q

What is pharmacodynamics?

A

Drug’s actions and effects within the body

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35
Q

What are the two effects of pharmacodynamics?

A

Primary (desired)

Secondary (side effects)

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36
Q

What is physical dependence

A

Compulsion to use a drug due to withdrawal symptoms

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37
Q

What is phycological dependence?

A

Compulsion to use a drug for pleasure

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38
Q

What is pharmacogenetic disorder?

A

A genetic abnormal response to a drug

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39
Q

What are receptors?

A
  • Bind to drug molecules

* They alter functions of the cells which produce therapeutic effects

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40
Q

What is therapeutic response?

A

Alteration of a cell to achieve desired response

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41
Q

What is an agonist?

A

Drug that binds with a receptor to produce a therapeutic response

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42
Q

What happens when drugs alter the cellular environment?

A

Changes the physiologic function of the cell

* BP decrease, HR increase

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43
Q

What is an antagonist?

A

Drug that binds to a receptor stronger than the agonist which negates the effect ( narcan to morphine)

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44
Q

What is an adverse reaction

A

Undesired effect

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45
Q

What is an allergic reaction

A

Reaction that occurs due to the IMMUNE SYSTEM which views the drug as a foreign substance

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46
Q

What is a drug idiosyncrasy?

A

Abnormal reaction that only happens to a small % of the population

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47
Q

What is drug tolerance?

A

Decreased response requiring higher dosage

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48
Q

What is cumulative drug effect?

A

Occurs when you take another dose before the previous dose has had time to fully metabolize

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49
Q

What is it called when blood concentration levels for a drug exceed the therapeutic effect?

A

Toxicity

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50
Q

What kinds of diseases would you typically see drug toxicity?

A

Kidney or Liver disease

51
Q

What are pharmacogenetic reactions?

A

Trait that causes abnormal metabolism of a drug

52
Q

What is the risk of a G6PD patient taking sulfa or aspirin?

A

Pharmacogenetic reaction such as hemolysis

53
Q

What is the pharmaceutic phase?

A

The dissolution of a drug (breakdown)

54
Q

What are drug interactions

A

When one drug interacts or interferes with another

55
Q

What is the additive drug reaction

A

Drug effect equal to the sum of the two added together

56
Q

What is synergism?

A

Drug interaction that causes an increase in the drug’s effects GREATER than just the two combined

57
Q

What are the factors influencing drug response?

A
  • Age
  • Weight ( based on 150 lb person)
  • Gender
  • Disease
  • Route
  • Drug use and Pregnancy
58
Q

How does age influence drug response?

A

Affects the metabolism of the drug

59
Q

What are the 4 risk categories of drugs for pregnant women?

A 
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
Q

What are the 6 rights for administering drugs?

A
  • Patient
  • Drug
  • Dose
  • Route
  • Time/Exp
  • Documentation
61
Q

1mL = how man cc’s?

A

1 cc

62
Q

What are the unit of measurements for volume?

A

ml, l, cc

63
Q

How many mcg in a mg?

A

1000mcg = 1 mg

64
Q

How many mg in a g?

A

1000mg =1 g

65
Q

How many kg in a pound?

A

1 kg = 2.2lbs

66
Q

So when you have a patient’s weight in pounds how to you calculate it in kg?

A

Divide weight (in pounds) by 2.2

67
Q

What is the most frequent route of drug administration?

A

Orally

68
Q

What are the different ways to administer drugs orally?

A
  • Nasogastric
  • Buccal
  • Sublingual
69
Q

What are the ways to administer drugs via parenteral? (Listed in order of speed of absorption)

A
  • ID (1st and 2nd layer of skin - TST’s)
  • SC (between skin and muscle)
  • IM (rich supply of blood vessels)
  • IV
70
Q

Routes of administration that is applied to the skin and mucus membranes are?

A
  • Topical - (also includes suppositories and opth/optic)
  • Transdermal
  • Inhalation
71
Q

How does transdermal application of drugs work?

A

Maintains a relatively constant blood concentration and reduces possibility of toxicity
( Nicotine patches)

72
Q

What drugs fall under sedatives and hypnotics?

A
  • Barbiturates
  • Benzodiazepine
  • Melatonin antagonists
73
Q

What do sedatives and hypnotics do?

A
  • Depress CNS
  • sedation
  • sleep
  • unconsciousness
74
Q

What is the action of barbiturates?

A
  • Anticonvulsant
  • Depresses sensory cortex
  • Decreases motor activity
  • Drowsiness, Sedation, and Hypnosis
75
Q

What are barbiturates used for?

A
  • Sedation

* Seizures

76
Q

What types of seizures are barbiturates used for?

A

Tonic-clonic, epilepticus, and partial

77
Q

What should barbiturates not be used for?

A

Insomnia

78
Q

What are the adverse effects of barbiturates?

A
  • They slow shit down
  • Drowsiness
  • Nausea, Vomiting, Diarrhea
  • Hypoventilation
  • Bradycardia
  • Hypotension
  • Agitation, confusion
79
Q

What are some contraindications for barbiturates?

A
  • Sensitive to barbiturates
  • Hepatic impairment
  • Nephritic
  • Issues with airway
80
Q

What can antianxiety dugs be divided into?

A
  • Benzos

* Non-benzos

81
Q

What is the action of most benzos?

A
  • Depress CNS
  • Bind to benzo receptors in the GABA complex
  • Inhibitory neurotransmitter
  • Meant for Acute cases
82
Q

What are side-effects of benzos?

A
  • Tolerance due to long-term use

* Psychological/Physical dependence

83
Q

Do benzos have an analgesic affect?

A

NOPE

84
Q

What is the action of non-benzos?

A

Acts on brain’s dopamine and serotonin receptors

  • Meant for chronic conditions
  • DON’T confuse with SSRI’s
85
Q

What are the adverse effects of antianxiety meds?

A
  • Long term benzo use can cause withdrawal symptoms in 4-6 weeks
86
Q

What are the symptoms of withdrawal for long term benzo use?

A
  • Fatigue
  • Metallic taste
  • HA
  • Numbness in extremities
87
Q

What are some contraindications for antianxiety drugs?

A
  • Pre-existing CNS depression
  • Severe pain
  • Pregnancy (Class D)
  • Liver/Kidney issues
88
Q

What is the pregnancy classification for antianxiety drugs?

A

D

* BuSpar is class “B”

89
Q

What is the most common benzo used on DDG?

A

Diazepam

90
Q

What is the non-benzo used on DDG?

A

Hydrozyzine

91
Q

What are the antidepressants most used?

A

SSRI and SNRI

92
Q

What does SSRI stand for?

A

Selective Serotonin Reuptake Inhibitor

93
Q

What does SNRI stand for

A

Serotonin Norepinephrine Reuptake Inhibitor

94
Q

What are all the types of antidepressants?

A
  • Tricyclic
  • Monoamine Oxidase Inhibitors
  • Selective Serotonin Reuptake Inhibitors
  • Serotonin Norepinephrine Reuptake Inhibitor
  • Serotonin Reuptake Inhibitor/ Antagonist
  • Dopamine/Norepinephrine Reuptake Inhibitor
95
Q

What is the action of TCA’s?

A

Tricyclic Antidepressant

  • Increases levels of norepinephrine and serotonin by inhibiting their reuptake
  • Blocks acetylcholine
96
Q

What is the action if MAOI’s?

A

Monoamine Oxidase Inhibitors

  • Inhibits activity of monoamine oxidase
  • Increases endogenous neuro-hormones
97
Q

What is the action of SSRI’s?

A

Selective Serotonin Reuptake Inhibitor

* Increase serotonin by inhibiting neuronal uptake to CNS

98
Q

What are the conditions that antidepressants can be used for?

A
  • Depression
  • Anxiety (SSRI’s)
  • OCD
  • Smoking Cessation
99
Q

What are the adverse affects of TCA’s?

A
  • Dry mouth
  • Blurred vision
  • Postural hypotension
  • Urinary Retention
  • Constipation
  • Hypotension
100
Q

What are the adverse affects of MAOI’s?

A
  • Food interactions
  • Vertigo
  • Nausea
  • Dry mouth
101
Q

What are the adverse affects of SSRI’s?

A
  • Nausea
  • Sexual dysfuncton
  • insomnia
  • Weight gain
102
Q

What are the contraindications for TCA’s?

A
  • Sensitivity to TCA’s
  • Co-use with MAOI’s within 14 days
  • MI’s
103
Q

What are the contraindications for MAOI’s?

A
  • CVA disease
  • Hypertension
  • CHF
  • Elderly
104
Q

What are the contraindications for Welbutrin?

A
  • Seizure disorder
105
Q

What are the contraindications for SSRI’s?

A
  • patients who smoke
106
Q

Should you ever stop benzo use abruptly

A

Fuck no

107
Q

How long does it take for antidepressants to take effect?

A

4-6 weeks

108
Q

Should you ever stop antidepressants abruptly?

A

Fuck no

109
Q

What natural remedy should you not take with antidepressants?

A

St. Johns Wart

110
Q

What should not be taken with MAOI’s because it could result in death?

A

Sertraline (SSRI)

111
Q

What is the first line medication for depression?

A

SSRI’s

* such as sertraline

112
Q

What is the action of antipsychotic drugs?

A
  • Blocks dopamine receptors in the brain
113
Q

What is acetylcholine?

A

Neurotransmitter or chemical messenger

* Transfers signals between cells to impact how the body functions

114
Q

What does an anticholinergic do?

A

Blocks the action of acetylcholine

115
Q

What are antipsychotic drugs classified as?

A
  • Typical (1st generation)

* Atypical (2nd generation) - less adverse reactions

116
Q

What drug is limited to schizophrenia unresponsive to conventional therapy?

A

Clozapine

117
Q

What drug is used to treat intractable hiccups?

A

Chlorpromazine

118
Q

What are the adverse effects of antipsychotic drugs?

A
  • Anticholinergic
  • Extrapyramidal
  • Tardive dyskinesia
  • Neuroleptic malignant syndrome
119
Q

What are the symptoms associated with anticholinergic?

A
  • Dry mouth
  • hypotension
  • sedation
120
Q

What are the symptoms associated with extrapyramidal?

A
  • Parkinson like symptoms
  • Akathisia ( restless)
  • Dystonia (facial grimace)
121
Q

What are the symptoms associated with tardive dyskinesia?

A

Movement of the tongue, face, mouth, or jaw

122
Q

What are the symptoms associated with neuroleptic malignant syndrome?

A
  • Hyperthermia
  • progresses over 24-72 hrs
  • Haloperidol (drug mainly causes this)
123
Q

Contraindications to antipsychotic drugs?

A
  • Severely depressed

* Hypotension

124
Q

What should patient management be for antipsychotics?

A

Assess deviation from normal

Pharmacology (19 decks)

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