Drugs and Pharmacology Flashcards
What is pharmacology?
Pharmacology is the study of drugs or chemicals and their biological effect(s) on living organism.
What do drugs do?
Any substance that when administered to living organisms, produces a change in function at the cellular or metabolic pathway level.
What is a drug?
Any medication that has medicinalor healing properties and is used for treating diseaseor alleviating symptoms.
What are some sources of drugs?
Early daysDrugswere obtained from plant or animalsources (e.g. flowers, tissues of any living organism). Some drugs like morphine, digitalis and insulin are still derived from these sources.TodayDrugs are artificially made in a chemical laboratory.
What are twomajor categories of medicines in North America?
Drugs thatcan be obtained over the counter (OTC) and Drugs that require a prescriptionor prescription only medication.
T or F. Just as there are specialties in medicine or surgery, there are subspecialties in pharmacology.
True.Pharmacology is subdivided into several major areas with each one being an entire area of specialization.
Subspecialty: What is chemotherapy?
Study of the use of drugs in the treatment of cancerand other diseases.
Subspecialty: What is medicinal chemistry?
Study of new drug synthesis(process of artificially manufacturing drugs) as well as existing drugs
Subspecialty: What is molecular pharmacology?
Study of the interactionof drugs and subcellular components
Subspecialty: What is pharmacodynamics?
What a drug does to the body.
Subspecialty: What is pharmacokinetics?
What the body does to the drug.Metabolism - physical and chemical changes to the drug in the bodyAbsorption - how drugs get into the bloodstream Distribution - how drugs move from the bloodstream to tissuesExcretion - how a drug and its waste products are excretedMADE
Subspecialty: What is toxicology?
Study of harmful effects of drugs on living tissue.
Subspecialty: What is pharmacy?
Preparation and dispensing of medications.
Subspecialty: What is pharmacognosy?
Study of the physical and chemical propertiesof animal and plant sources of medication
Subspecialty: What is pharmacotherapeutics?
The clinical application of pharmacokineticsand pharmacodynamics
Subspecialty: What is biopharmaceutics?
Examines dosingand drug delivery methods.
Every drug has a minimumof ____ names. They are:
Three.
- chemical
- generic
- brand
T or F: Drugs sold in Canada must be approved and monitored to ensure that the quality is consistent and adverse effects are reported.
True.
When a drug is discovered or created, it is given a ______ name based on the elements in the drug.
Chemical.
In Canada, who reviews new drugs for safety and effectiveness?
The Therapeutic Products Directorate.
In the US, who reviews new drugs for safety and effectiveness?
The Food and Drug Administration (FDA)
Who approves all drugs that are sold in Canada?
The Federal Health Protection Branch. Different from the Therapeutic Products Directorate, which reviews only NEW DRUGS for safety and effectiveness.
Who governs the sale, possession, manufacture, and distribution of narcotics and other controlled substances including opium, cocaine and marijuana?
The Controlled Drugs and Substances Act
Who decides drug pricing in Canada?
Patented Medicine Prices Review Board
Once new drugs are reviewed by the Therapeutic Products Directoratefor safety and effectiveness, it is given a shorter name or ______ name.
Generic.
What is abrand/trade/proprietary name?
Name assigned by the pharmaceutical company that manufacturedthe drug.
New drugs are patent protected for a period of __ years.
20 years.
What does it mean when a drug is patent protected?
The manufacturing company is legally protectedfrom otherpharmaceutical companiescreating their own generic form for 20 years. After 20 years, any company can manufacture a generic copy of that drug.
How do drug patents help?
They help recoup the cost of research and development of new drugs.
What are characteristics of brand/trade/proprietary names?
Brand names are capitalized, easier toremember, easier to pronounce,shorter.CR(A)PS
What are characteristics of generic names?
Spelled using lower case.
What are characteristics of chemical names?
Based on theelementsin the drug which are usuallydifficult and complex.
acetaminophen > Tylenol
generic name > brand name
ibuprofen > Advil
generic name > brand name
Ativan > lorazepam
brand name > generic name
What is the difference in the quality, purity, effectiveness and safety between generic drugs and brand name drugs?
None. Both generic and brand name drugs are subject to the same standards.Each product must meet regulations established by the Food and Drug Act.
T or F. Manufactures must prove to the Provincial Ministries of Health that active ingredients in brand medicine are as ___________ as the original product.
True.Quality Purity Safety -Dissolve (at same rate) Effectiveness AbsorptionQPS-DEA
What is the difference in price between brand and generic drugs?
Generic drugs cost 40-50% less than brand name drugs.
What is a narcotic?
A drug thatdulls sensibility,relives pain, andcauses sleepiness.
T or F. Most narcotics are not addictive.
False. Most narcotics areaddictive.
What is a newer term used for a narcotic?
Opioid analgesic.
What are 3 rules that help regulate narcotic use?
Narcotics must be keptlocked awayat all times. Arecordmust be kept of the a.name of person receiving, prescribingand administering the the narcotic, b.datethe prescription was filled, c.amount of drugremaining. Loss or theft of any narcotic must berecordedandreported to the governmentwithin10 days of discovery.
LRG - N(rpa)DALocked, Record, GovernmentName (receiving, prescribing, administering), Date, Amount of drug
What is the most imporant Canadia reference book for prescription drugs?
The Compendium of Pharmaceuticals and Specialties (CPS). The Compendium of Nonprescription Products (CNP).
What is the Compendium of Pharmaceuticals and Specialties (CPS)?
Annual alphabetical compilationof drugs also available in electronic form called thee-CPS.
Who produces the CPS?
The Canadian Pharmaceutical Association.
What is the most significant factor in the speed of drug action?
Therouteof drug administration.
What are the most common routes of drug administration?
Oralandparenteral(injection or infusion).
List the 6 methods of drug administration.
- Oral
- Parenteral
- Sublingual
- Rectal
- Inhalation
- Topical
O SPRIT!oral > sublingual > parenteral > rectal > inhalation > topical
What is the safest and most convenient method of administering drugs?
Oral administration
Oral administration usually requires ____ minutes before significant absorption.
30-60 minutes
With oral administration, absorption occurs in the __________________.
gastrointestrinal tract
How does food affect drug absorption when drugs are orally administered?
Food and water minimize gastric irritation,delays drug absorption, andprolongs the onset of drug action.
T or F. Drugs taken orally can be removed within the first few hours by gastric lavage/induced vomiting in case of drug overdose or accidental poisoining.
True.
What is done in a parenteral drug administration?
Drugs are given byinjectionfrom aneedle/syringeor aneedle/intravenous tubing.
List the eight routes of parenteral administration.
- Subcutaneous
- Intradermal
- Intramuscular
- Intravenous
- Intrathecal
- Intracavitary
- Intracardiac
- Intracapsular/Intraarticular
sub, dermal, muscle, venous, thecal, cavitary, cardiac, capsular/articularVTAMDS- CCCvitameds - cccvenous, thecal, articular, muscular, dermal, subcutaneous, cavitary, cardiac, capsular
What is the fastest route of parenteral administration and why?
Intravenous injection (IV) is the fastest route of parenteral administration because drugs enter thebloodstreamimmediately.
Intravenous injections are injected directly into a ____ and given when a drug can’t be injected into other _______.
Vein, tissues.
Which parenteral administration is used for spinal anesthesia and treatment of leukemia?
Intrathecalorintraspinalinjection.
What is the injection site for intrathecal injection?
Below the meninges(protective padding surrounding the brain and spinal cord).
What is the most frequently used injection in parenteral administration and why?
Which muscles are usually injected in an intramuscular injection?
Muscle of abuttockor anupper arm. Also thethighmuscle for epinephrine administration.
Which parenteral administration is used mainly for skin testing allergies and tuberculosis testing (Mantoux test)?
Intradermal.
Intradermal injections are injected within the layers of the ____.
Skin.
Subcutaneous injections are injected beneath the ____ into the ______ usually in th outer surface of the arm.
Skin, subcutaneous layer
How are subcutaneous and intradermal injections different?
Subcutaneous injections are injected into the tissue layerbetween the skin and the muscle while intradermal injections are injectedwithinthe layers of skin (dermis).
Which parenteral administration is injected into a body cavity?
Intracavitary injection.
List twoexamples of intracavitary injections.
- Peritoneal dialysis injection
* Some types of chemotherapy
Which parenteral administration is injected directly into the heart?
Intracardiac injection.
GIve an example of an intracardiac injection.
Epinephrine can be injected into the heart after cardiac arrest in an effort to bring back blood pressure.
Which parenteral administration is injected into a joint?
Intracapsular or intraarticular injection
Give an example of intracapsular injection.
Anti-inflammatory drugs can be injected in the shoulders, elbows, wrists, ankles (as in gout), knees, and hips
During sublingual administration of drugs, a tablet is placed under the _____ and allowed to dissolve.
Tongue.
Give an example of a drug that works well when administered sublingually.
Nitroglycerina vasodilator and muscle relaxant that relieves angina pectoris pain almost instantly.
When are drugs usually rectally administrated?
If the physician has the ordered a patient to haveNPO(nothing by mouth) or the patientcannot swallow.
What are suppositories and enemas?
The shape or form of a drugadministered rectally. Suppositories are cone shaped tablets meant to dissolve in the rectum/vagina while enemas are liquids or gases injected into the rectum.
What are the most common types of drugs given rectally?
Sedatives, antiemetics, and antipyretics.SEP
What are two ways to administer drugs by inhaling?
Spray or Mist – inhaled asdropletssuch asnebulizersfor asthmapatients,vaporizersornasal spray bottles
Gases –nitrous oxide, an anesthetic inhaled for general anesthesia ex. wisdom teeth extraction.
What are two types of topical application?
Dermal applications andmucous membraneapplications.
What is the difference between a cream and an ointment?
If skin iswet, usecream, if skin isdry, useointment.
What is a liniment?
Amedicated liquidused to counteract an inflammation or irritation
What aremucosal membrane applications?
Drugs in the form ofsterile liquidapplied bydrops. ex. eye, ear, and nose drops
What does drug action mean?
Describes how the bodymanages drugsafter they have been absorbed in theblood stream
What is individual variation?
An identical drug and/or dosage may produce an intense response in one individual and no observable effect in another. Variation occurs as the result of several factors >
List the factors that influence individual variation.
- Age
- Weight
- Gender
- Emotional State
- Placebo Effect
- Presence of Disease
AW PEG D!age weight placebo emotional state gender disease
Why are infants and children much more sensitive to the effects of drugs?
Theinability to metabolize drugsrelated toimmature enzyme systemsin the liver.
T or F. In the elderly, decreased liver enzymatic activity and reduced renal function results in a decreased ability to metabolize and to excrete drugs. therefore, dosages in the elderly are usually reduced.
True.
How are dosages determined for children?
By consideration of the child’sageorweight
T or F. Most adult dosages are calculated for the average adult height.
False. Weight.
T or F. Because of a higher percentage of body fat, males may experience a greater drug effect than females because a higher concentration of drugs will be exposed to the more active tissues.
False. Females experience a greater drug effect.
T or F. Some individuals who are excited or extremely anxious requires the same dose of tranquilizer or hypnotic as an individual who is not emotionally stimulated.
False. People who are emotionally stimulated may require alarger dose
What is the placebo effect?
Theinfluence of one’s mindon the course of treatment.
T or F. Patients with liver or kidney disease suffer a greater incident of adverse drug effects because they are unable to effectively eliminate drugs properly.
T.
What is drug absorption?
Drug absorption refers to theentrance of a drug into the bloodstream.
In order for absorption to occur, the drug must be dissolved within the ________.
Body fluids.
Drugs must pass through the membranes of the ________________ and __________ before they gain access to the blood. With the exception of __________ and _________ administration.
gastrointestinal lining and blood vessels. With the exception of intravenous or intra-arterial administration
What factors affect drug absorption of oral medications?
Timerequired toemptythe stomach Acidityof the stomach Presenceoffoodin the stomach Other ingredientsin the tablet TEA POItime to empty stomach, acidity, presence of food, other ingredients
After a drug gains access to the blood, it is distributed to the various _____ and _____.
Tissues and organs.
List the 3 factors that determine whatpercentageof a drug will reach any one particular organ or area of the body.
- Plasma Protein Binding
- Blood Flow
- Blood Brain Barrier
peanut butter, boyfriend, body butterplasma protein binding, blood flow, BBB
T or F. Many drugs are attracted to proteins such as albumin and globulins.
True.
Tor F. Some drug molecules blind to plasma protein while a portion of drug molecules remain unbound or free in circulation.
True.
T or F. There is competition between drugs or other plasma substances for the same plasma protein-binding side, where one drug may displace another.
True.
In some cases of plasma protein binding, the competition causes the free drug concentration to ______ which can lead to adverse effects similar to overdose.
Increase.
Which organs in the body have the largest blood supply and are exposed to the largest amount of the drug?
The brain, liver and kidney.
Adipose or fat tissue don’t accumulate large amounts of most drugs because they receive a poor amount ob blood supply. What type of drugs enter adipose tissue easily?
Highly lipid-soluble drugs
Anadditional lipid barrierthat protects the brain byresisting the passageof microorganisms and otherwater-soluble molecules.
What is the blood brain barrier (BBB)?
T or F. A drugmusthave a certain degree oflipid solubilityif it’s to penetrate the BBB and gain access to the brain.
True.
__________ refers to thechemical alteration of various substances(e.g. drugs, foreign compounds) within the body.
Metabolism.
What is the purpose ofdrug metabolism?
Either
Inactivate a drug for the purpose of excretion
Activate the drug to produce atherapeutic effectorprolong the drug action
Inactivate for excretionActivate for therapeutic effectActivate to prolong the drug action
The ______ is the main organ involved in drug metabolism.
Liver.
T or F. Within the cells of the liver are a group of enzymes that function tometabolize foreign (drug) subtances. These enzymes takelipid soluble drugsand chemically alter them so they becomewater-soluble compounds.
True.
The ____ can excrete water-soluble compounds whereas lipod-soluble compounds are repeatedly reabsorbed back in the blood.
Kidneys.
What are the common pathways of drug excretion?
Through urine, feces, and exhaled gases. Some drugs are also excreted through sweat, saliva, and breast milk.
The _____ is the most important organ for drug metabolism but the _____ are the most important organs for drug excretion.
Liver, kidneys
T or F. The respiratory system plays a significant role in drug excretion.
False. There are however some drugs that are metabolized to products thatcanbe exchanged from the blood into the respiratory tract.
What organ excretes general anesthetic gases?
The lungs.
Drug action terminology: The action of drugs can beenhance, diminished, or inactivatedunder certain circumstances.
Drug interaction.
Drug action terminology: A sudden or delayed, unexpected or dangerous reaction to a drug.
Adverse reaction
Drug action terminology: The action of repeated doses of drugs that are not immediately eliminated from the body. Results in high accumulation of the drug in the body.
Cumulative action
Drug action terminology: Acquiredneedfor a drug that may producepsychological and/or physical symptomsof withdrawal when the drug is discontinued.
Dependence.
Drug action terminology: Thecombinedeffect oftwo drugsequal to the sum of their individual effects. Used to combat side effects.
Additive action.a + b = a or b
Drug interaction terminology: When the combined effect of two drugs is less than the effect of each drug alone. Often used to reverse an overdose or a toxic effect.
AntagonismA + B = a
Drug interaction terminology: Two drugs together cause each one to produce an effect neither could produce on its own
Synergism/potentiationa + b = Aan antihistamine taken with an opiod analgesic intensifies the effect of the narcotic so that less of the opiod is needed
What is the difference between drug-drug interaction, drug-food interaction, drug-herb interaction?
Drug-drug interactiontwo drugs administered together can affect the response of either oneDrug-food interactionsome drugs are inactivated when food is present in the stomachDrug-herb interactionsome drugs areenhancedin the presence of herbal remedies
Drug action terminology: an over responsiveness to drug action - even to small doses. Allergic reaction
Hypersensitivity
Drug action terminology: theside effectsof treatment
Iatrogenic
Drug action terminology: An abnormal drug response occuring in individuals who have apeculiar, often hereditarydefectin their body chemistry which produces an effect totally unrelated to the drug’s normal pharmacological action.
Idiosyncrasy
T or F. Idiosyncrasy is a form of allergy.
False. Ex. agitation when taking sleeping pills
T or F. Overdoses are limited to doses that clearly exceed the normal dosage recommended by the manufacturer.
False. Not limited to excess. The optimal drugs of many drugs varies from person to person. What may be anaveragedose for the majority of individuals will be an overdose for some and an underdose for others.
Drug action terminology: A drug-induced change in the skinthat results in the development of a rash/sunburn when exposed to thesun or ultraviolet lamps
Photosensitivity
Drug action terminology: Normal, expected, and predictable responses to a drug thataccompanies the intended responsesought in treatment.
Side effects.
T or F. Side effects are part of a drug’s pharmacological activity and are unavoidable.
True.
Drug action terminology: the effect of drugs that producebirth defects
Teratogenic effect
Drug action terminology: The effects of a given dose of drug diminish as the drug is administered over a period of time; therefore, larger doses must be given. Body tissues become accustomed to the drug’s presence and react to it less vigorously
Tolerance
When a patient finds that the usual dose of codeine is no longer sufficient to relieve pain and has to increase the dosage (which creates a risk for addiction), this is called _________.
Harmful tolerance
T or F. Tolerance can only be harmful in treatment.
False. Tolerance can be beneficial
____________ is an adverse reaction to the administration of a drug. The drug has becomepoisonousto the body. Goes beyond side effects in that which it produces harmful changes
Drug toxicity
T or F. Toxicology can be due to a one time overdose or normal doses given over a period of time
True.
Vitamin _ is the antidote for toxic levels of Coumadin.
K
Vitamin _ deficiency can cause night blindness and lack of resistance to infections
A
Vitamin _ deficiency can cause hemolysis
Vitamin E
Vitamin _ deficiency can cause hemorrhages
Vitamin K
Minerals make up approximately ___ of body weight, 75% of which are _______ and ________.
4%. Calcium and phosphorus.
MInerals and vitamins are not used for fuel, they join with other nutrients to ensure __________ of the body cells.
Proper functioning
Mineral role: hardness of bones and teeth; blood clotting
Calcium
Mineral role: Formation of bones and teeth; energy storage; energy transfer
Phosphorus
Mineral role: Proper functioning of the muscles and nerves; bone formation
Magnesium
Mineral role: Helps to maintain intracellular osmotic pressure; nerve conduction; muscle contraction
Potassium
Mineral role: Essential part of insulin; regulates various body activities such as energy storage
Sulfur
Mineral role: Main electrolyte responsible for water balance; needed for neuromuscular function
Sodium
Mineral role: Required for hydrochloric acid formation by stomach glands to aid in digestion
Chlorine
before meals
ac
after meals
pc
ad, as, au
right ear, left ear, both ears
c (with bar on top), s (with bar on top)
with, without
gt; gtt
drop, drops
HS/hs
hour of sleep (bedtime)
nothing by mouth
NPO
od, os, ou
right eye, left eye, both eyes
PR
per rectum
PRN vs ad lib
as needed, as desired
Sig
label; instructions
SC or SUBQ or subq
subcutaneous injection
new drug synthesis
medicinal chemistry
drug effects on the body
pharmacodynamics
drug’s absorption, distribution metabolism, and excretion over time
pharmacokinetics
interaction of drugs and components inside the cell or on the cell surface
molecular pharmacology
use of drugs in treatment of cancer and infectious disease
chemotherapy
studies of harmful effects of drugs on the body
toxicology
administration of drugs by mouth
oral administration
administration of drugs placed under the tongue that dissolve in saliva
sublingual
administration of drugs inserted into the rectum
rectal
