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PHARMACOLOGY > EXAMS 1 > Flashcards

EXAMS 1 Flashcards

1
Q

what is pharmacology

A

study of uses, effects and modes of actions of drugs.

includes the pharmacokinetics and pharmacodynamics in addition to physical and chemical properties of drug

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2
Q

science of pharm draws multiple disciples including

A 
anatomy
physiology
psych
chemistry
microbiology
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3
Q

what is a drug

A

any chemical that can affect living processes. can be man made or naturally occuring

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4
Q

what is clinical pharmacology

A

the study of drugs in humans. this can be applied to both patients and healthy volunteers in medical studies

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5
Q

pharmacotherapy

A

the use of drugs to diagnose, prevent or treat disease or to prevent pregnancy

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6
Q

historically sources of drugs

A

animals
plants
minerals

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7
Q

modern day sources of drugs

A
  • synthetic compounds manufactured in labs
  • natural molecules that are altered
  • biotechnology
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8
Q

prototype of opioid analgesics

A

morphine

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9
Q

what are prototype drugs

A

individual drugs that represent a group of drugs. also the standard to which new drugs are compared

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10
Q

Every drug has 3 names. what are they

A
  1. chemical
  2. Generic (non-proprietary)
  3. Brand (proprietary, trade)
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11
Q

How many generic names per drug

A

only 1 generic name per drug

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12
Q

who assigns generic names of drugs

A

assigned by United States Adopted Names Council

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13
Q

who creates brand names of drugs

A

created by drug companies

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14
Q

What names should you use for drugs. chemical, generic or brand

A

Always use GENERIC

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15
Q

a single drug can have multiple brand names. true or false

A

true. example ibuprofen can come in the from of advil, motrin, tylenol

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16
Q

products with the same brand name may have different ingredients internationally. true or false

A

True.

Allegra in the US is an allergy medication but in germany, its a migrane medication

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17
Q

generic names of drugs indicates what

A

indicates drug class

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18
Q

what is the pharmacologic class of drugs that ends in (-cillin)

A

penicillin antibiotic

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19
Q

what is the therapeutic use of drugs that ends in (-cillin)

A

bacterial infection

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20
Q

what is the pharmacologic class of drugs that ends in (-statin)

A

HMG-CoA reductase inhibitor

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21
Q

what is the therapeutic use of drugs that ends in (-statin)

A

high cholesterol

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22
Q

what is the pharmacologic class of drugs that ends in (-olol)

A

beta-blocker

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23
Q

what is the therapeutic use of drugs that ends in (-olol)

A

hypertension, astrial fibrillation

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24
Q

what is the pharmacologic class of drugs that ends in (-pril)

A

angiotensin-converting enzyme inhibitor

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25
Q

what is the therapeutic use of drugs that ends in (-pril)

A

hypertension

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26
Q

how many categories of controlled substances

A

schedule (I-V) 1-5

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27
Q

out of the 5 schedules of controlled substances. Which schedule is not accepted for medical use

A

Schedule 1.

examples are heroin, ecstasy(MDMA)

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28
Q

what schedule of control substances is the lowest abused potentially

A

schedule V

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29
Q

what does new drug development uses

A

uses a randomized controlled trial (RCT) design, randomization and binding

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30
Q

What is the randomized Controlled trial (RCT) design

A

comparing two patients with the same disease state. One is given experimental drug (treatment), one gets placebo or standard of care (control)

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31
Q

Why is randomization important in RCT new drug development

A

randomization prevents allocation bias

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32
Q

randomized Controlled Trial (RCT) allows researches to determine what?

A

allows researchers to determine if a new drug is better, worse or equal to standard care

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33
Q

Limitations During Drug Development

A
  • exclusion of some populations (minorities, women, pregnant women, children
  • failure to detect all adverse events
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34
Q

what does proton-pump inhibitors do

A

used to treat stomach related problems

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35
Q

drugs are considered hazardous if they are?

A 
carcinogenic
teratogenic
toxic to reproduction
genotoxic
toxic to organs
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36
Q

six rights of medication administration

A 
patient
drug
dose
route
time
documentation
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37
Q

what is pharmacokinetics

A

study of drug movement throughout the body

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38
Q

4 core processes of pharmacokinetics

A 
ADME
absorption
distribution(blood)
metabolism (enzymatic chnage)
elimination
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39
Q

3 primary methods of movement of drugs to the body

A
  • channels and pores
  • transport systems
  • direct penetration of the membrane
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40
Q

movement of drugs throughout the body during “ADME” involves?

A

crossing membranes

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41
Q

what drugs uses the channels and pores method of drugs gettin into the body

A

Sodium and potassium

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42
Q

What are the sizes of the channels drugs passes throug

A

channels are small

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43
Q

What is transport system?

A

movement of drugs from one side of the membrane to another

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44
Q

what is passive transport

A

movement via a concentration gradient

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45
Q

What is active transport

A

requires energy expendicture

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46
Q

All transport systems are selective or not

A

they are all selective

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47
Q

what role does drug structure play in its transportation

A

drug structure determines if the drug will be transported

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48
Q

what are P-glycoprotein (OGP) transporters

A 
trasnmembrane protein that transport drugs out of the cells. 
liver-bile
kidneys - renal tubule (urine)
placenta - maternal blood
intestine - intestinal lumen
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49
Q

What is the most common method of drug movement

A

Direct penetration of the membrane

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50
Q

What drugs passes through the membranes in the easiest way possible

A

lipophilic drugs pass through membranes the easiest

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51
Q

what molecules cannot readily cross membranes?

A

polar molecules and ions

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52
Q

What is absorption

A

the movement of drug from site of administration to the blood stream

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53
Q

what does the rate of absorption determine?

A

It determines how soon effects of the drug will begin

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54
Q

what is another name for rate of absorption

A

onset of action

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55
Q

what does amount of absorption determines

A

it determines how intense the effects will be

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56
Q

factors that affect rate of absorption

A
  • rate of dissolution
    -surface area
    -blood flow
    lipid solubility
    route of administration
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57
Q

Two main routes of administration

A

Enternal

Parenteral (IV, IM and SQ)

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58
Q

what does the route of administration has a large impact on

A

it has a large impact on rate and extent of absorption

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59
Q

what are the barriers to IV route medications?

A

No barries (absorption bypassed)

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60
Q

absorption pattern of IV medications

A

instant

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61
Q

Advantages of IV route medications

A
  • Rapid onset
  • precise control over drug levels
  • 100% bioavailability (cus everything goes straight to the blood stream)
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62
Q

What does bioavailability mean

A

the amount of drug that reaches bloodstream and can cause effect

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63
Q

Disadvantages of IV route of medication

A
  • Expensive
  • irrevisble
  • inconvenients
  • difficult to administer
  • Drug must go into solution
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64
Q

What are the barriers to IM and Subcutaneous (SQ) route medications?

A

capillary wall (easy to pass)

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65
Q

Absorption pattern of IM and SQ Route Medication

A
  • rapid with water soluble drugs and areas of high blood flow.
  • slower with poorly soluble drugs and low blood flow
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66
Q

Advantages of IM and SQ Route Medication

A
  • permits use of poorly soluble drugs

- permits use of depot formulation

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67
Q

disadvantages of IM and SQ Route Medication

A
  • possible discomfort
  • inconvenient
  • potential for injury
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68
Q

prototype of penicillin

A

antibiotic

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69
Q

what is blinding in new drug development

A

participants and or researchers are unaware of what group the participant is in. prevents bias too

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70
Q

what are the barries to absorption of oral (po) drugs

A

GI tract, capillary wall, PGP proteins

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71
Q

what is absorption pattern of oral (po) drugs

A
  • slow and variable

- impacted by rate of dissolution, lipohilicity, blood flow and pH partitioning

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72
Q

advatanges of oral route drugs

A

-easy
-convenient
-inexpensive
ideal for self medication
potentially reversible
-possibly safer than parenteral routes

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73
Q

disadavantages of oral route drugs

A
  • patient must be conscious and cooperative
  • variable bioavailability
  • variability in absorption and response
  • inactivation of some drugs by gastric acid
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74
Q

Parenteral administration is better when

A
  • there is a medical emergency
  • plasma levels need tight control
  • drug is destroyed by gastric acid (insulin)
  • drug could injure tissues
  • drugs cannot cross membranes
  • depot preparation needed
  • patient cannot take drugs by mouth
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75
Q

What is distribution

A

drug movement from the blood to other parts of the body

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76
Q

distributions of drugs are determined by

A
  • blood flow to tissues
  • ability to exit the bloodstream
  • ability to enter cells
77
Q

what is the important of well perfused tissues in drug distribution

A

drugs will reach that area

78
Q

tissues that are not well perfused will ??

A

has less drug exposure example abscess or tumor

79
Q

most drugs must exit the blood to have an effect. true or false

A

true

80
Q

where do drugs exit the blood at?

A
  • drugs exit the blood at capillary beds
  • large spaces between cells for drugs to pass through
  • movement to intertidal spaces is easy
81
Q

what does the blood brain barrier in the central nervous sites do?

A
  • prevents easy passage cus theres tight junctions between cells
82
Q

for drugs to cross the blood brain barrier, the drug must be what?

A

drugs must be lipophilic or have specific transporters

83
Q

drug molecules bound to proteins can leave the blood. true or false

A

false. they cannot leave the blood

84
Q

proteins are larger than drugs and will remain in the blood stream

A

true

85
Q

drug molecules unbound or free can?

A

they can leave the blood unlike drug molecules bonded to proteins

86
Q

what can protein binding do?

A
  • can restrict distribution and source of drug interactions
87
Q

what is metabolism in drugs

A

the method by which drugs are inactivated or biotransformed in the body

88
Q

most drug metabolisms occurs in _____ by the _____

A

occurs in the liver by cytochrome P450 enzyme system

89
Q

CYP450 can be further broken down into subcategories of?

A

CYP34A and CYP2C9

90
Q

besides the liver, metabolism can also happen in?

A

serum, lungs and kidneys

91
Q

what happens when drugs are metabolized?

A
  • drug inactivation
  • increased therapeutic action
  • activation of pro drugs
    increased or decreased drug toxicity
    accelerated renal clearance of drugs
92
Q

the first-pass effect impacts what type of drugs

A

impacts drugs taken orally

93
Q

the liver has the potential to inactivate all drug before it reaches site of action. true or false

A

true

94
Q

all drugs undergo rapid hepatic inactivation. true or false

A

false. only some drugs

95
Q

after absorption of drug in the GI tract, where does the drug goes to?

A

drug goes to the liver via portal circulation

96
Q

what are some special considerations for metabolism

A
  • age
  • induction and inhibition of drug metabolizing (CYP450) enzymes
  • nutritional status
  • completions between drugs
97
Q

what is the most common and important route of drug excretion?

A

via the kidneys

98
Q

facts that affect renal excretion?

A
  • age

- competition for active tubular transport

99
Q

what are some non-renal routes of drug excretion

A
  • feces
  • bile
  • lungs
100
Q

the onset of action and intensity of drug effects can be predicated with the use of?

A

ADME

101
Q

what are plasma(serum) drug levels?

A

it’s the lab measurement of the amount of drug in the blood at a point in time

102
Q

plasma levels and drugs levels have what kind of correlation?

A

they have a direct correlation at the site of action

103
Q

why is it important to monitor plasma (serum) drug levels

A

it can help determine weather if too much drug is present which is toxic

or

too little drug is present which is subtherapeutic

104
Q

define the term minimum effective concentration (MEC):

A

smallest concentration of drug that will cause an effect

105
Q

define toxic contractions of plasma levels

A

plasma levels about this will have toxic effects

106
Q

define therapeutic range of plasma levels

A

it’s the range between the minimum effective concentration (MEC) and the toxic concentration

107
Q

what is the goal of the therapeutic range

A

to keep the drug levels in the safe range between the toxic concentration and the minimum effect concentration

108
Q

medication may have a _____ or _____ therapeutic range

A

wide or narrow

109
Q

after single dose of medication, drug levels rise during which of the ADME

A

drug level rises during the absorption/distribution

110
Q

where do drug levels fall after taking a single dose of medication?

A

drug levels fall during elimination (metabolism/excretion)

111
Q

what is the latent period of a drug?

A

it’s the period until drug takes effect

112
Q

drugs will exert therapeutic effect until it falls below??

A

minimum effective concentration (MEC)

113
Q

define the serum half life

A

the time required for the amount of drug in the body to decrease by 50%

114
Q

serum half-life are determined by?

A

metabolism and excretion

115
Q

drugs with short half half-life???

A

leaves the body quickly

116
Q

drugs with long-half life??

A

leaves the body slowly

117
Q

about 100% of drugs leave the body in how many half-lives

A

leaves the body in 5 half-lives

118
Q

what is the dosing interval of short half-life drugs?

A

dosing more frequently cus they leave the body quickly

119
Q

what is the dosing interval of long half life drugs?

A

dosing less frequent cus they take long to leave the body

120
Q

multiple doses can cause what to drug levels?

A

multiple doses can cause drug levels to build up in the body and eventually reach plateau

121
Q

what is another name of plateau stage?

A

steady-state

122
Q

describe what happens at the plateau stage?

A

when the amount of drugs administered is equal to the amount eliminated

123
Q

how many half-lives is needed to reach the plateau/steady state?

A

about 4 half lives

124
Q

what is loading dose?

A

large dose of drug given to reach close to plateau levels

125
Q

what is maintenance dose?

A

smaller doses given to maintain plateau levels

126
Q

what is pharmacodynamics (PD)

A
  • drugs actions on target cells and their corresponding response
  • what drug does to the body and how it does it
127
Q

why is it important to understand basic pharmacodynamics

A
  • educating patients
  • making decisions to administer as need (prn)drugs
  • evaluating patients for harmful or therapeutic effects of drugs
128
Q

most drugs interrupts with____ to have a therapeutic effect

A

receptors

129
Q

what are receptors

A

functional proteins in a cell that the drug binds to to produce an effect

130
Q

when drug is bound to a receptor? response or no response

A

response

131
Q

when a drug is not bound to receptor response or no response

A

no response

132
Q

drug binding to receptors is usually____

A

reversible

133
Q

the general equation for drug interaction with receptors

A

D+R = D-R COMPLEX - RESPONSE

134
Q

receptors interact with what kind of compounds

A

endogenous

135
Q

drugs can only mimic or block the actions of _____compounds

A

endogenous

136
Q

can drugs give cells new functions?

A

no they cannot. they can only enhance or prevent actions typically caused by endogenous compounds

137
Q

what are agonist

A
  • moclecules that activates receptors or mimic the effects of an endogenous molecule
138
Q

agonists always make processes got faster

A

false. they can make processes go slower if that is the physiologic action of the receptor it binds to

139
Q

what are partial agonist

A

agonist with only moderate activity. the maximal effect a partial agonist can produce is less than a full agonist

140
Q

what is an antagonist

A

a molecule that prevents receptor activation

141
Q

does antagonist have their own effects effects on receptors?

A

they have no effects of their own on receptors

142
Q

how does antagonist produce their effects on receptors?

A

antagonist produces their effects by preventing activation of the receptors by endogenous substance

143
Q

physiologic variables that determine the intensity of a drug response

A
  • age, gender, weight
144
Q

pathologic variables that determine the intensity of a drug response

A

changes in organ function

145
Q

genetic variables that determine the intensity of a drug response

A

differences in enzymes that metabolize drugs

146
Q

what is the Drug-Drug interactions (DDI)

A

action of one drug may be increased or decreased by the presence of another drug.

can occurs anytime a patient takes more than 1 drug

147
Q

interactions of DDI can?

A
  • intended and desired

- unintended and undesired

148
Q

DDI are very important for what drugs?

A

important for drugs with a narrow therapeutic index

149
Q

risk of serious DDIs is directly proportional to_____

A

the number of drugs a patient takes

150
Q

what is the grape juice effect

A

grapefruit juice can inhibit some hepatic drug metabolizing enzymes.

increases concentration of drugs broken down by those enzymes

151
Q

what are the drug food interactions

A
  • can cause increase or decrease drip absorption
  • increased toxicity
  • decreased drug efficacy (direct impact of drug actions green. example leafy vegetables [vitamin K]and warfarin
152
Q

what are adverse drug reactions (ADR)

A

any anxious, unintended and undesired effect that occurs at a normal drug doses

153
Q

adverse drug reactions (ADR) can have an intensity ranges from_______ to ______

A

mild to life threatening

154
Q

what is an allergic reaction of a drug?

A

an immune reacting to a drug. requires prior exposure to the body to the sensitized.

155
Q

intensity of response of allergic reaction is_______ of drug dose administered

A

independent

156
Q

what is an idiosyncratic effect

A

uncommon drug response resulting from a genetic predisposition

157
Q

what is a paradoxical effect

A

opposite of the intended drug response

158
Q

what is latrogenic disease

A

disease that occurs as a result of medical care or treatment

159
Q

what is a the carcinogenic effect

A

ability of a drug or environmental chemicals to cause cancer

160
Q

what is teratogenic effect

A

drug induced child defect.

defects to new child born due to some drug that may have been administered to the parents

161
Q

what are hepatotoxic drugs

A

leading causes of a cute liver failure

162
Q

effect of QTc prolong drugs

A

QTcs are medications that increase the length of the QTcs interval (ventricular repolarization)

patients are at risk of developing arrhythmias

163
Q

what percentage of ADRs are identified before a drug comes to the market?

A

only about 50%

164
Q

what is wrong with the 5 rights of medication

A

the approach lacks application of pharmacology to patient centered care

165
Q

10 rights of medication

A 
patient 
drug
dose
time
route
reason
documentation
patient education
evaluation 
to refuse mediacation
166
Q

what are the nursing processes

A 
assessment 
diagnosis - dosage and administration 
planning - minimize adverse effect
implementation - drug administration, patient educa
evaluation
167
Q

what are some most common fatal medication errors

A

overdose
wrong drug
wrong route

168
Q

how are medication errors classified

A
  • direct - cause harm directly example overdose
  • indirect - cause harm indirectly cus there wasn’t enough to treat the condition. example antibiotic dose too low and ineffective
169
Q

90% of medication errors are attributed to what?

A

human factors

  • performance deficit
  • knowledge deficits
  • miscalculation of dose
  • communication mistakes (poor handwriting/ miscommunication of drug name/dose/route)
  • name confusion
170
Q

what are some ways to reduce medication errors

A
  • create environment of just culture
  • encourage patients and family members be active participants in care
  • provide healthcare workers with necessary tools to dispense and administer medications safely
  • replace handwriting with typed orders
171
Q

pediatric patients are more sensitive to drugs

A

true

172
Q

there’s greater interpatient variability in drug effects among pediatrics. true or false

A

true

173
Q

pharmacodynamics in differences in pediatrics are due to?

A
  • differences in target cell sites
  • changes in number of protein receptors
  • chnages in body composition over time
174
Q

what group of people are at risk for more intense and prolonged drug responses

A

neonates and infants

175
Q

how are protein bindings in infants

A

protein bindings are lower in infants

176
Q

children tend to require higher doses of medications than adults. true or false

A

true

177
Q

metabolism remains high in children over 1 year but starts to decrease at what age?

A

starts to decrease at age 2

178
Q

adults from 65 and above are more sensitive to drugs than younger adults. true or false

A

true

179
Q

older adults experience higher rates of adverse drug reactions ADRs and drug-drug interactions DDI. true or false

A

true

180
Q

factors that contribute to ADRs

A
  • changes in Pharmacokinetics
  • multiple disease states and severity of disease
  • multi- drug therapy
  • poor adherence
181
Q

alteration in receptors occur in what group of people

A

adults

182
Q

beta blocking drugs are _____ effective in older adults

A

less

183
Q

warfarins are _____ effecting in older adult

A

more

184
Q

changes in receptors can cause

A

increase sensitivity to drugs

decrease efficacy of drugs

185
Q

pharmacokinetics (PK) in older adults (metabolism)

A

decreased hepatic blood flow
decreased hepatic mass
decreased hepatic enzyme activity

results in decreased drug exposure

186
Q

pharmacokinetics (PK) in older adults (excretion)

A

decreased renal blood flow
decreased GFR
decreased number of nephrons

results in increased drug exposure

187
Q

advertise drug reactions in older adults are ____ more common and of eyes avoidable

A

seven times

188
Q

adverse drug reactions in older adults contribute to ____% of all hospital admissions

A

-16%

189
Q

adverse drug reactions in older adults causes ___% of medication related deaths

A

50%

PHARMACOLOGY (7 decks)

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