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Pharmocology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

pathophysiology

A

the study of altered health; the cellular and organ changes w/ disease and the effect that they have on the whole body

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2
Q

disease

A

interruption in normal body function

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3
Q

etiologic factors

A

thing that cause the disease to occur

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4
Q

risk factors

A

things that increase potential for development of disease

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5
Q

clinical manifestations

A

what does the disease present

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6
Q

signs

A

objective; something observer sees

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7
Q

symptoms

A

subjective; what patient says

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8
Q

syndrome

A

a lot of signs and symptoms together

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9
Q

complications

A

something happens b/c of the disease or treatment

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10
Q

sequelae

A

impairment following or are caused by disease

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11
Q

pharmacology

A

the study or science of drugs

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12
Q

pharmacotherapeutics

A

drug therapy; same drug may have different effects depending on patient factors (ex. age)

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13
Q

therapeutic effect

A

positive effect

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14
Q

adverse effect

A

negative effect

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15
Q

pharmacogenomics

A

influence of genetic factors on response to drugs

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16
Q

pharmaceutics

A

science of preparing and dispensing drugs

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17
Q

pharmacoeconomics

A

study of economic factors impacting the cost of drug therapy

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18
Q

pharmacognosy

A

study of drugs obtained from plant or animal source

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19
Q

toxicology

A

study of toxic drug effects and methods to manage

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20
Q

indication

A

why the drug is being used (condition)

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21
Q

prototype

A

agent to which all other drugs in the classification are compared.

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22
Q

combination drugs

A

drugs with more than one active ingredient

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23
Q

prodrug

A

inactive before metabolized

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24
Q

contraindication

A

condition that makes the drug potentially harmful to the patient

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25
Q

brand name

A

owned by company (capitalized)

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26
Q

generic name

A

name of the drug (lower case)

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27
Q

bioavailability of the drug

A

amount of the drug that can be used by the tissues; IV= 100%

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28
Q

pregnancy category A

A

studies in pregnant women have not shown a risk to the baby

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29
Q

pregnancy category B

A

animal studies, no risk, no sufficient evidence to show risk in animal or pregnant women

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30
Q

pregnancy category C

A

animal studies show risk, no human studies; use may be acceptable

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31
Q

pregnancy category D

A

evidence that risk but benefit may outweigh the risk

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32
Q

pregnancy category X

A

studies show fetal abnormalities or reaction. risk outweighs benefit

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33
Q

controlled substances are classified by their

A

abuse potential, defined control of distribution, storage, dispensing and use.

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34
Q

Schedule I

A

dispensing restrictions are only with approved protocol and an example is heroin or marijuana. the illegal drugs

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35
Q

Schedule II

A

dispensing restrictions are with written prescription only with no refills and must have a warning label, an example is cocaine or codeine.

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36
Q

Schedule III

A

dispensing restrictions are with written or oral prescription that expires in 6 months with no more than 5 refills in 6 months and must have a warning label, an example is hydrocodone.

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37
Q

Schedule IV

A

dispensing restrictions are with written or oral prescription that expires in 6 months with no more than 5 refills in 6 months and must have a warning label, an example is phenobarbital.

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38
Q

Schedule V

A

is with prescription or over the counter (can vary with state law), an example is cough medicine.

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39
Q

which route you use for the drug depends on

A

how quick it is absorbed

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40
Q

sublingual is _____ absorption than buccal due to the amount of blood flow

A

faster

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41
Q

pharmacodynamics

A

what the drug does to the body, the therapeutic effect

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42
Q

Pharmacokinetics

A

what the body does to the drug, example peak effect, absorption metabolism

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43
Q

pharmacokinetical processes determine

A

onset of drug, action, peak drug effect and duration of drug action

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44
Q

four main processes of pharmacokinetics

A

absorption (onset of drug action), distribution, metabolism (by the liver), excretion (by the kidneys, bile, lungs)

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45
Q

absorption of the drug

A

determines onset of action; affected by route of administration

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46
Q

oral medications can be affected by

A

presence of food or other drugs in the stomach (fatty foods slow absorption), acidity of the stomach (breaks down compounds), motility of the GI tract (anti-cholinergics slow peristalsis), and blood flow of the GI

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47
Q

first pass effect

A

extent to which the drug is metabolized in the portal circulation prior to being absorbed into the systemic circulation

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48
Q

increased first pass effect equals

A

higher concentration of the drug (cant be given orally if first pass is too large)

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49
Q

depot drugs

A

slow absorption of drug over days/ months/ longer (some types of birth control)

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50
Q

for injections increase heat means

A

increased blood flow and increased onset

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51
Q

if the drug is stored (mostly in fat) there is ____ duration

A

increased

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52
Q

if bound to protein the drug is

A

inactive

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53
Q

when unbound drug (active) goes into the tissues, drug concentration decreases and

A

inactive drugs unbind from the protein

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54
Q

if the patient has low protein levels, there will be higher amounts of unbound proteins which leads to

A

toxicity

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55
Q

more bound drug means

A

an increase in duration

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56
Q

drugs that are highly lipid soluble are ____ likely to pass through the BBB and reach the CNS

A

more

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57
Q

biotransformation

A

the liver is the most important site, breaks down meds, Cytochrome P450 enzyme is responcible for most drug metabolism

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58
Q

steady state (therapeutic range)

A

when the amount of drug absorbed equals the amount of drug excreted; maximum therapeutic effect at this level, can only occur with repetitive administration

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59
Q

therapeutic drug monitoring

A

monitoring plasma levels of drugs with low safety margins (peaks and troughs)

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60
Q

therapeutic index

A

how quick the drug goes from minimum effectiveness to toxicity, larger number= safer dose

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61
Q

drugs act by

A

receptors, enzymes, nonselective interactions

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62
Q

efficacy

A

greatest maximal response that can be produced from a particular drug

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63
Q

receptor interactions

A

tighter fit = stronger reaction, lock (cell receptor site) key (drug)

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64
Q

agonist

A

binds to the receptor and cause natural response

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65
Q

partial agonist

A

causes the agonist response but not as strong

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66
Q

antagonist

A

causes the opposite response of natural chemicals (blocks any response) or competes with other drugs for same receptors

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67
Q

selective toxicity

A

when drug attacks only foreign cells, not healthy cells

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68
Q

nonselective interactions

A

target is cell membrane or metabolic activity in the cell

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69
Q

factors influencing drug effect

A

patient condition, psychological factors (placebo effect), drug dependence, drug tolerance

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70
Q

acute therapy

A

immediate, intensive drug treatment for the critically ill (OJ for low blood sugar)

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71
Q

maintenance therapy

A

to prevent progression of disease (anti-hypertensive for high BP)

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72
Q

supplemental therapy

A

supplies the body with what is needed for normal function (insulin)

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73
Q

palliative therapy

A

relief of pain, to improve quality of life

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74
Q

supportive therapy

A

maintains body functions when patient is recovering from illness (IV fluids)

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75
Q

prophylactic therapy

A

prevent illness (antibiotics before surgery)

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76
Q

empiric therapy

A

based on probabilities (treat pneumonia before culture is back)

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77
Q

adverse drug events

A

undesirable occurrence involving meds, can be non/preventable, can be from med error or just from the medication dose

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78
Q

idiosyncratic reaction

A

not the result of something known about the drug and not the result of an allergy, unexpected reaction

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79
Q

black box warning

A

significant potential for adverse effect

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80
Q

teratogenicity

A

any drug that causes harm to developing fetus or embryo

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81
Q

presence of food can ___ absorption and drug effect

A

decrease

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82
Q

additive drug effect

A

two drugs with similar classification produce combined response, 2+3=5

83
Q

synergistic drug effect

A

effect of two drugs is greater than just adding the two together, 2x3=6

84
Q

antagonistic drug effect

A

adding second drug causes a decrease in pharmacologic response, reverse effect

85
Q

incompatibility

A

two drugs are mixed and a chemical deterioration is caused

86
Q

the most accurate measurement of creatinine clearance is

A

with a 24 hour urine collection

87
Q

creatinine is in the muscles and is released with decreased muscle mass, this can cause a false _____ creatinine level

A

normal

88
Q

Ways fluid moves

A

Intracellular, interstitial, and intravascular

89
Q

Intracellular compartment

A

2/3 of fluid in body

90
Q

Extracellular compartment

A

Interstitial spaces, plasma, transcellular

91
Q

Diffusion

A

Particles move from high concentration to low concentration

92
Q

Osmosis

A

Movement of water across semipermeable membrane, water moves to higher concentration

93
Q

Normal serum osmolarity is

A

275- 295 mOsm/kg

94
Q

Hypotonic fluids

A

Makes cells swell, less concentration of solutes than plasma, used for dehydration and hypernatremia

95
Q

Hypertonic fluids

A

Makes cells shrink, greater concentration of solutes than plasma

96
Q

Isotonic fluids

A

No change in cell size, causes little osmosis

97
Q

Capillary hydrostatic pressure

A

Pushes water into intravascular to interstitial

98
Q

Capillary oncotic pressure

A

pulls fluid into intravascular by protein

99
Q

tonicity

A

solution cause a change in water movement across a membrane due to osmotic forces

100
Q

increased tonicity = _______ stuff or solute

A

increased

101
Q

isotonic IV fluids

A

normal saline, ringer’s solution, lactated Ringer’s solution, D5 1/4 NS

102
Q

hypotonic IV fluids

A

5% dextrose in water (DW5), 0.45% saline (1/2 NS) and 0.225 saline (1/4 NS)

103
Q

hypertonic IV fluids

A

saline greater than 0.9% (3% and 5% saline), dextrose solutions greater than 5% (dextrose 10% and 50%), D5 NS, D5 LR, D5 1/2 NS

104
Q

colloid volume expanders

A

pull fluid to it, mobilizes edema from interstitial to vascular then the heart pumps it and the kidney filters it, ex. albumin or plasma protein fraction

105
Q

the most objective measure of fluid volume status is

A

a daily weight

106
Q

ADH

A

causes the reabsorption of water from the renal tubule, secreted from the pituitary

107
Q

low sodium or increase K causes the release of

A

aldosterone

108
Q

decreased renal perfusion causes the release of ____.

A

renin

109
Q

renin causes ______ and ______

A

vasoconstriction (increase BP) and release of angiotensin

110
Q

angiotensin I coverts to angiotensin II with _____

A

ACE (angiotensin converting enzyme)

111
Q

Angiotensin II causes ______ and ______

A

vasoconstriction (increase BP) and release of aldosterone

112
Q

aldosterone

A

reabsorbs NA and H2O and eliminate K

113
Q

increased ADH = _____ urine out

A

decreased

114
Q

natriuretic hormones

A

secreted in response to hypernatremia, promotes urinary excretion of sodium and water, decreases BP

115
Q

hypodipsia

A

decreased thirst

116
Q

polydipsia

A

increased thirst

117
Q

edema can be caused by

A

increased capillary hydrostatic pressure, decreased capillary oncotic pressure, increased capillary permeability, and decreased lymphatic flow

118
Q

pitting edema

A

can be anywhere, localized (ankle sprain) or generalized (distributed in the interstitial space)

119
Q

third spacing

A

edema, trapping of ECF in the transcellular space such as peritoneal cavity pleural space, pericardium

120
Q

chief intracellular electrolyte

A

K+

121
Q

chief extracellular electrolyte

A

Na+

122
Q

sodium normal levels

A

135-145 mEq/L

123
Q

sodium is important in ______ and ____

A

generation of nerve impulses and regulation of acid base

124
Q

why do we retain sodium with high bp

A

increase blood volume

125
Q

average adult requirement for sodium

A

.5 to 2.7 g

126
Q

hyponatremia

A

from water dilution or sodium loss, lead to hypotonic cells and lung/ brain edema

127
Q

signs of hyponatremia

A

n/v, anorexia, abdominal cramping, altered neurological function, coma, muscle twitching

128
Q

hyponatremia treatment

A

tolvaptan (pee off the water) or sodium replacement

129
Q

hypernatremia

A

water loss or sodium gain, cell dehydration, should feel thirsty ADH releases to gain water

130
Q

hypernatremia SALT

A

Seizures muscle twitching skin flushed, Altered mental status agitation, Lethargy low grade fever, Thirst

131
Q

treatment of hypernatremia

A

daily weights, low sodium diet, if severe and hypovolemic hypotonic fluids, if severe and hypervolemic hypertonic fluids

132
Q

potassium

A

normal levels 3.5-5 mEq/L, insulin moves K into liver and muscles via NA K pump, 90% of daily intake is excreted by kidneys, needed for cardiac muscle contraction and electrical conduction

133
Q

high potassium sources

A

oranges, leafy greens, nuts, potatoes, and salt substitutes

134
Q

cells fire less easily with

A

decrease K+ or increased Ca or Mg

135
Q

cells fire more easily with

A

increase K or decreased Ca or Mg

136
Q

hypokalemia

A

need a heart monitor

137
Q

direct IV push K

A

can be fatal, never be IV push or IM

138
Q

_____ mEq per hour is the fastest K can be given and only if ______

A

20, if pt is on a heart monitor and through a deep line

139
Q

decreased urine volume to less than 20-30 mL/hr for 2 hours

A

should stop K infusion until situation is evaluated

140
Q

hyperkalemia

A

level rises above 5 mEq/l, less common but life threatening, release of aldosterone can cause kidney failure

141
Q

pseudohyperkalemia

A

hemolysis of blood sample due to tourniquet use, draw blood above site of K infusion, gives a false high K

142
Q

decrease K levels from

A

insulin. alkalosis, beta adrenergic stimulation, rapid cell building

143
Q

increased K levels from

A

acidosis, trauma to cells, exercise

144
Q

calcium

A

found in bones, reciprocal relationship with phosphate, normal level 8.6- 10.2 total, transmission of nerve impulses, blood clotting

145
Q

calcium 3 serum forms

A

bound to protein (40%), ionized calcium (50%), and bound to others such as phosphate (10%)

146
Q

hypocalcemia

A

less than 8.6 mg/dL, signs are muscle cramps dry brittle nails and hair trousseau’s sign and chvostek’s sign

147
Q

Trousseau’s sign

A

BP cuff 10mm above systolic for 3 mintues, causes carpopedal spasm

148
Q

Chvostek’s sign

A

tapping facial nerve anterior to ear results in ispsilateral facial muscle twitch

149
Q

hypercalcemia

A

level above 10.2, 50% mortality if not treated promptly, can cause kidney stones need to drink 3-4 L

150
Q

magnesium

A

normal level 1.5-2.5 mEq/L, generates ATP, smooth muscle relaxant, helps with blood clotting and bone formation, prevents seizures

151
Q

high magnesium sources

A

spinach broccoli potatoes whole grains tuna beef pork chicken raisins nuts milk tap water bananas oranges peanut butter

152
Q

hyperaldosteronism, insulin injection and loop diuretics

A

decrease potassium in blood

153
Q

PTH increase or calcitonin decrease =

A

calcium increase

154
Q

clinical manifestations of mg and ca

A

are similar but not equal

155
Q

hypomagnesium can be from

A

alcoholism

156
Q

hypermagnesium can be from

A

renal failure or chronic use of antacids or laxatives

157
Q

phosphate

A

normal- 2.7-4.5 mg/dl, in fish nuts and organ meat, deposited with Ca in bones and teeth, excreted by kidneys

158
Q

hyperphosphatemia

A

results from renal failure chemo large intake of vitamin D, s&s tetany and bleeding issues

159
Q

hypophosphatemia

A

from alcohol withdraw or malnourishment, manifestations of muscle weakness and confusion

160
Q

chemotaxis

A

wbc into site of injury

161
Q

Margination

A

lining of cells with wbc

162
Q

diapedesis

A

wbc out of blood to tissues

163
Q

after cell injury brief _____ occurs then _____ immediately follows

A

vasoconstriction, vasodilation

164
Q

vasodilation chemical mediators

A

endothelial cells retract, increase capillary permeability, and movement of fluid from capillaries into tissue (increased protein)

165
Q

Inflammation is

A

nonspecific

166
Q

fluid in the tissue first contains _____ then ____ and _____ causing the tissue to become ______.

A

serous fluid, plasma proteins, albumin, edematous

167
Q

the injured cell activates ____ from ____ which creates ____ and traps _____

A

fibrin, fibrinogen, a blood clot, bacteria to prevent spread

168
Q

blood flow through the capillaries in the area of inflammation ______ as fluid is lost and viscosity ____

A

slows, increases

169
Q

neutrophils

A

first to arrive at injury site, phagocytize bacteria and foreign material, short life spam (24-48 hrs), released by bone marrow

170
Q

neutrophils as pus is composed of

A

dead neutrophils at the site, digested bacteria, other cell debris

171
Q

increased use of immature neutrophils (bands) causes a

A

shift to the left

172
Q

inflammation does not

A

always equal infection

173
Q

monocytes

A

second WBC to the injury, attracted to the site by chemotactic factors, there within 3-7 days after inflammation, when the enter the tissue they transform to macrophages

174
Q

macrophages

A

assist in phagocytosis, have a longer lifespan and can multiply, often from chronic inflammation, can fuse to form a giant cell

175
Q

lymphocytes

A

arrive later at site, primarily for cell mediated (t cells) immunity and humoral (B cells) immunity, differentiate into b lymphocytes and T lymphocytes

176
Q

chemical mediators

A

histamine (vasodilation, swelling, itching), serotonin (same as hist. but also stimulates smooth muscle contraction) kinins (ex bradykinin, smooth muscle contraction, vasodilation, and pain)

177
Q

cytokines

A

sounds the alarm, directors

178
Q

prostaglandins

A

potent vasodilators, part of fibril response

179
Q

thromboxane

A

powerful vasoconstrictor, promote clots, causes brief vasoconstriction at site

180
Q

leukotriene

A

form the slow reacting substance of anaphylaxis (constricts smooth muscle, increase vascular permeability), stimulates chemotaxis

181
Q

serous exudate

A

clear, blister, early inflammation

182
Q

serosanguineous exudate

A

RBC and serous fluid, surgical drain

183
Q

fibrinous exudate

A

sticky, fibrin leaking into interstitial space

184
Q

catarrhal exudate

A

mucus, runny nose

185
Q

purulent exudate

A

pus, WBC and dead cells

186
Q

response to inflammation

A

increased C reactive protein (created in the liver), increased pulse and RR, malaise lethargy fever

187
Q

types of immunity

A

innate (from birth, first line defense) and acquired (developed, active or passive)

188
Q

adaptive immunity is specific to an ____, has ____, and is ____

A

antigen, memory, systemic

189
Q

acquired passive immunity

A

doesn’t last, natural (from mother to child) and artificial (injection of serum from immune human)

190
Q

acquired active immunity

A

natural (contact with antigen through infection) and artificial (immunization with antigen)

191
Q

antigens are the

A

invader

192
Q

thymus gland

A

shrinks with age (decrease cellular immunity), involved in differentiation and maturation of t lymphocytes

193
Q

natural killer cells

A

involved in cell mediated immunity, large lymphocytes, don’t require prior sensitization

194
Q

b lymphocytes

A

humoral immunity (antigen antibody response), plasma cells (secrete antibodies), memory b cells (more intense faster second exposure)

195
Q

t cytotoxic cells

A

CD8 lab, attack antigens, antigen specific by exposure to antigen, some become t memory cells instead of attacking

196
Q

t helper cells

A

CD4 lab, regulate cell mediated and humoral response, produce cytokines

197
Q

5 immune globulins

A

IgG, IgA, IgM, IgD, IgE

198
Q

IgM

A

largest in size, primary immune response, active disease (pt is miserable)

199
Q

IgG

A

largest in amount, only one that can cross placenta, secondary immune responce

200
Q

IgA

A

found in secretions

201
Q

IgD

A

found in plasma, assists in differentiating and activation of B lymphocytes

202
Q

IgE

A

causes symptoms of allergic reaction

203
Q

effects of aging on the immune system

A

more tumors, thymus shrinks (decreased cell mediated immunity) delay in allergy response, decreased primary and secondary responses

Pharmocology (8 decks)

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