FINAL

Question 1

Drug Names

Answer 1

• Chemical: structure
• Generic: original name for common understanding
• Trade (brand) Name: assigned by pharmaceutical company
  > fillers/binders differ btwn brand & generic; may alter bioavailability

Question 2

Therapeutic Classification

Answer 2

• Usefulness in treating diseases or disorders
• Pathology they intend to treat
• Functional classification (Mosby’s)
• EX: analgesics, antihypertensives

Question 3

Pharmacologic Classification

Answer 3

• Physiological effect at molecular/tissue lvl
• Chemical classification (Mosby’s)
• EX: calcium channel blocker

Question 4

Factors Affecting Oral Absorption

Answer 4

• Molecular Weight: too big, can’t pass membrane
• Lipid Solubility: small & highly lipid soluble drugs rapidly through membrane (passive diffusion)
  > low lipid-soluble drugs: facilitated diffucion, active transport, pinocytosis
• Surface area of gastrointestinal mucosa
• Blood flow to gastrointestinal system
• Rate of gastric emptying
• Oral prep: disintegratable > liquid > suspension solutions > powders > capsules > tablets > coated tabs > enteric-coated tabs
• Admin of multiple drugs simultaneously (interaction)
• Foods & fluids admind w/ drugs

Question 5

Factors Affecting Distribution

Answer 5

• Blood flow to organs/tissues
  > areas of rapid perfusion/distribution: heart, liver, kidney, brain
  > areas of slow distribution: muscle, skin, fat
• Ability to cross blood-brain barrier or fetal/placental barrier

Question 6

Factors Affecting Distribution - Drug Properties

Answer 6

• Protein Binding (albumin)
  > highly protein bound = less available for distribution
• Water Solubility vs Lipid Solubility
  > highly water-soluble drugs stay in bloodstream; go more places
  > highly lipid-soluble drugs more readily pass lipid cell membranes & deposit in adipose tissue

Question 7

Factors Influencing Drugs Effects

Answer 7

• Age
• Gender
  > men: more vascular muscles
  > women: more fat cells; slow release
• Physiological Factors
  > hydration, acid-base, electrolytes
• Pathological Factors
  > disorders change conditions for drugs (vascular, GI, liver, kidney disease)
• Genetic Factors
  > lack enzymes, cultural differeneces
• Psychological Factors
  > attitude: placebo effect, trust in HCP
• Envir’t Factors
  > temp, relaxed envir’t
• Tolerance
  > larger dose needed
• Interactions
  > 2 or more drugs

Question 8

Drug-Drug Interactions

alerts effectiveness

Answer 8

• Site of Absorption
  > one drug prevents or accelerates absorp of another drug
• During distribution/site of action
  > drugs compete for binding site of another; one drug gets bumped off
  > opposing mechanisms of action
  > drugs w/ similar AEs
• During metabolism
  > 1 drug stims or blocks metabolism of another drug
• During excretion
  > 1 drug competes for other to be excreted; leads to accumulation/toxicity

Question 9

Drug-Food Interactions

Answer 9

• Prevent absorp (oral route)
  > incrd acid production; speeds breakdown of drug
  > milk products: calcium binds drug; dcrd absorp
  > chemical reaction (iron binds w/ tetracycline)
• Incrd or dcr drug’s effect (any route)
  > food affects liver enzyme
  > EX: grapefruit juice affects liver enzymes up to 48hrs after ingested; liver enzyme inhibitor; leads to toxic effects of some drugs

Question 10

Drug Excretion

Answer 10

• Kidneys are primary organ for excretion of drugs from body
• Kidney Dysfunction: drugs not excreted effectively; reach toxic lvls
• Nurse: monitor kidney func to avoid drug toxicity or AKI
• Liver/bowel are secondary site for excretion
  > drugs processed by liver, released into bile, eliminated in feces

Question 11

Drug Metabolism

Answer 11

• Liver is primary site
  > hepatic microsomal enzyme system: inactivates/breakdown drug for excretion; some to active form
  > changes in hepatic microsomal enzymes can affect drug metabolism
• Metabolic activity may be dcrd in some pts
  > infants & elderly, genetic disorders, severe liver disease
  > dosages reduced in dcrd liver func to prevent toxicity
• Liver transforms some drugs to active form (prodrug)
• Nurse:
  > liver disease is a caution/contra when adming certain drugs
  > monitor liver funcs to avoid drug toxicity or injury to liver

Question 12

Enzyme Induction

Answer 12

• Affects metabolism
• Incrd activity of enzyme system by presence of 1st drug; speeds metabolism of 2nd drug using same enzyme system; cannot reach needed therapeutic lvls
• Why some drugs cannot be taken together

Question 13

Enzyme Inhibited

Answer 13

• Affects metabolism
• Some drugs inhibit enzyme system; make less effective
• Drugs will not be broken down for excretion
• Blood lvl of drug incrs to toxic lvl

Question 14

Anaphylaxis

Answer 14

• Adverse reaction
• Involves massive systematic response (histamine)
• Leads to bronchoconstriction, shock, & death
• CMs:
  > hypotension
  > tachycardia
  > dyspnea
  > edema
  > hives
  > itching
  > resp or cardiac arrest

Question 15

Agonist Drugs

Answer 15

Cholinergic Agonist: mimics acetylcholine
> cause same acitivity of natural chemicals would cause at tht site
- Incrs saliva production
- Slows HR
- Constricts bronchioles
- Stimulates digestive process
- Incrs urination