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Pharmacology Final > Final Study Guide > Flashcards

Final Study Guide Flashcards

1
Q

Understand ionization and how it pertains to the movement of a drug

A

Ionized (or charged) drugs are not absorbed as efficiently as un-ionized drugs are. Practically speaking, this means that if taken orally, a drug that is a weak acid will be absorbed primarily in the acidic environment; whereas, a drug that is a weak base will be absorbed in the alkaline environment small intestines.

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2
Q

Potency

A

the amount of drug necessary to produce a pharmacological effect

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3
Q

efficacy

A

how effective a drug is at producing a pharmacological effect

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4
Q

Schedule 1 drug

A
  • all drugs start here

- will remain here if no therapeutic effect

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5
Q

Schedules 2-4

A
  • ordered with prescription
  • records kept for two years
  • DEA sets quotas for amount manufactured/distributed
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6
Q

Schedule 5

A

-no prescription needed

records kept for 2 years

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7
Q

Schedule 2 drug

A

o High potential for abuse
o Prescription cannot be refilled
• Maximum 30 day supply
• Prescription must be rewritten on security paper
o Prescriptions can be refilled by phone, but a written prescription must follow 72 hours after

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8
Q

o SCHEDULE III
o Moderate to low physical dependence
o High psychological dependence
o Prescription must be renewed after 6 months of 5 refills

A

Schedule 3

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9
Q

Schedule 4

A

o Limited dependence

o Same prescription writing issues as Schedule III

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10
Q

Security paper

A

tamper resistant security prescription forms required for schedules 2-4

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11
Q

Chemical name

A

exact chemical composition of drug

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12
Q

official name

A

used in USP

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13
Q

Generic name

A

usually name given during testing

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14
Q

trade/brand name

A

copyrighted name whose use is restricted to single company

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15
Q

USP

A

o Full time director, voluntary team of pharmacologists, physicians, pharmacists, nurses, consumer activists
o Older drugs deleted in favor of newer more affective agents
o Gives average dose, toxicity, methods of administration
o How to prepare. Drugs, standards for tablet disintegration

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16
Q

National formulary

A

o Single drugs and formulas for drug mixtures

o Often include drugs deleted by USP

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17
Q

What are the two official drug reference books?

A

NF and USP

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18
Q

Ama drug evaluations

A

o Prepared by appointed experts
o Drugs grouped according to use
o Favorable and unfavorable judgements expressed

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19
Q

PDR

A

o Manufacturers buy space
o Similar to drug inserts
o Cross-referenced generic and chemical names
o Useful for drug identification and dosage forms

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20
Q

Drug facts and comparisons

A

o Grouped according to use
o Compares various drug forms
o Color photo section
o Includes over the counter medication

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21
Q

Local drug administration

A

o Skin:
• Antiseptic, cleansing, emollient
o Nasal mucosa
• Sprays, nose drops, decongestants, hemostatics
o If too much is applied, systemic absorption may happen
o Inhalation
• Antibiotics
• Detergents and enzymes for breaking up secretions
o Genitourinary
• Oral (swallow to stomach and intestine)
• Sublingual and buccal
• Rectal

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22
Q

Systemic drug administration

A

o Nasal mucosa: vasopressin, cocaine, heroin
o Inhalation: anesthetics, CO2, O2, NO
o Oral
• Simplest route into bloodstream
o Sublingual/ buccal
• For drugs destroyed by liver or digestive enzymes
• Do not chew, swallow or take with water
o Rectal
• Bypass liver and digestive enzymes
• Irritating to stomach
• Antiemetic
• Used for retention enemas or suppositories

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23
Q

Sympathetic

A

o Preganglionic neurons are located in thoracic and lumbar regions
o Fight or flight
o Decreased GI, pupil dilation, increased HR/BP
o During stressful conditions

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24
Q

Parasympathetic

A

o Rest and digest
o Increased GI, constricted pupils, lower HR/BP
o During relaxing conditions

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25
Q

How does the voluntary nervous system differ in terms of # of neurons

A

o Only controls skeletal muscle

o One long neuron instead of 2

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26
Q

Adrenergic receptors…Where are they located, what NT stimulates them?

A

o Adrenergic receptors normally respond to norepinephrine neurotransmitter release in the body.
o Location: vasculature, heart, smooth muscle wrapping around brochiole.

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27
Q

Alpha adrenergic receptors…what they do where they are

A

contracts smooth muscle. Found in Peripheral blood vessels, vasculature.

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28
Q

Beta adrenergic (B1) what do they do, where are they located?

A

stimulates heart rate, strength. Heart is major place found.

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29
Q

Beta adrenergic receptors (B2) what do they do…. where are they found

A

Beta2 (B2) adrenergic receptors- relaxes smooth muscle, increases metabolic rate. (bronchiole tree)

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30
Q

2 types of nicotinic receptors and where are they found and what NT is used with them

A

o The 2 types of cholinergic receptors are muscarinic cholinergic receptors & nicotinic cholinergic receptors.
o found especially in smooth muscle of hollow organs
o neurotransmitter: acetycholine

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31
Q

Alpha agonist indications

A 
	Causes vasoconstriction
•	Relieves nasal congestion
•	Increases BP
	Topical to the eye
•	Dilates pupil for eye exam
•	Relieves redness/congestion
	Used to treat severe allergic reactions
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32
Q

Beta1 agonist indications

A 
	Increase cardiac output
	Treat severe allergic reactions
	Heart failure
	Atrioventricular block
	Shock
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33
Q

Beta2 agonist indications

A 
	Relaxation of bronchiolar smooth muscle
•	Asthma 
•	COPD
	Relaxes uterine muscle 
•	Pre-term labor contractions
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34
Q

Muscarinic Cholinergic agonist indications

A 
	Increase smooth muscle tone and contraction of GI tract
	Stimulate muscle of urinary tract
	Stimulate most exocrine glands
	Contract sphincter muscle of the eye
	Contraction of ciliary muscle
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35
Q

Nicotinic cholinergic indications

A

 Activate Ach receptors in ganglia
 Nicotine is only drug used therapeutically
 Used as nicotine replacement

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36
Q

Muscarinic Cholinergic antagonist indications

A 
	Supresses GI secretions and motility
•	Peptic ulcers
•	cramps/diarrhea associated with IBS
•	Acute pancreatitis
	Relaxes bladder
	Pupil dilation
	Bradycardia
	Dilates bronchi
•	COPD/asthma
	Parkinsons disease
	Andidotes for poisoning with muscarinic agonist 
	Preanesthetic medication
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37
Q

Nicotinic Cholinergic Angonist indications

A

 Facilitate surgery
 Facilitate electroconvulsive therapy
 Facilitate endotracheal intubation
 Treat tetanus

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38
Q

Alpha1 antagonist indications

A

 Vasodilation to prevent local necrosis
 Shock- vasodilation can pull fluid back into circulation
 Pheochromocytoma (adrenal tumor)
 Hypertension

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39
Q

Beta1 antagonist indications

A 
	Cardiac arrhythmias 
	Angina
	Hypertension
	Migraine prophylaxis 
	Controls signs of thyrotoxins
	Counteracts symptoms of hyperthyroidism
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40
Q

Contraindications for beta1 agonist

A

 Hypertension
 Hyperthyroidism
• Increased metabolism
• Heart palpitations

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41
Q

contraindications for alpha antagonist

A

 Hypotension (unless with arrhthmisa requiring treatment)
 Congestive heart failure, heart block
 caution: Diabetes

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42
Q

contraindications for alpha agonist

A

angina, hypertension

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43
Q

contraindications for beta2 antagonist

A

asthma, hypotension, CHF, heartblock

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44
Q

contraindications for nicotinic antagonist

A

glaucoma, gastric or urinary retention

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45
Q

contraindications for nicotinic and muscarinic agonists

A

extreme stimulation

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46
Q

• What is postural hypotension? What drugs cause it?

A

o Postural hypotension is when blood pressure drops upon standing after sitting or lying down
o Drugs used to treat high blood pressure, such as diuretics, beta-blockers, calcium-channel blockers, and angiotensin-converting enzyme (ACE) inhibitors.

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47
Q

What is a pressor?

A

o A pressor produces an increase in BP by constricting blood vessels

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48
Q

ace inhibitor..what it is, side effects

A

block the formation of angiotension II, decreasing BP through vasoconstriction and blocking aldosterone from being secreted.
• Enhance effects of thiazide diuretics
• Side effects:
 Persistant cough and orthostatic hypotension
 Hyperkalemia
 Angioedema

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49
Q

Beta blocker…MOA, who is it best for, side effects, what it does

A 
decrease HR and force of contraction
	Inhibit release of renin and angiotension II
	Best for patients under 40
	Side effects
•	Fatigue, activity intolerance,
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50
Q

calcium channel blockers… what they do, when not to use, side effects

A

 Block calcium channels in cardiac and arteriolar muscle, limiting degree of muscle contraction
 Do not use with HF and AV block
 Side effects
• Reflex tachycardia, peripheral edema, dizziness, fatigue and flushing
• Constipation, nausea, diarrhea

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51
Q

diuretics….what they do, side effects, contraindications

A 
	Reduce blood volume through urinary excretion of water and electrolytes
	Side effects
•	Potassium depletion
•	dehydration
•	hyperglycemia in diabetic patients
	Contraindications
•	Diabetes
•	Renal or liver disease
•	Cardiac arrhythmias
52
Q

What is angina? How is it treated?

A

o Insufficient blood supply to cardiac muscle causing pain (steady and intense)
o Treated by beta-adrenergic blockers and calcium channel blockers
 Beta-adrenergic
• Selectively blocks beta 1 receptors. Slow HR and reduces contractility
 Calcium channel blockers
• Relax arteriolar smooth muscle, reducing BP
• Slow cardiac conduction which decreases HR and work
• Dilate coronary arteries bringing more O2 to myocardium

53
Q

What are arrhythmias? How are they treated?

A 
o	Bradycardia (50-60 BPM)- cardiac stimulants 
o	Tachycardia (100-200 BPM)- sodium channel blocker/ calcium channel blockers, quinidine
o	Flutter (200-300 impulses/ minute)- beta-blockers
o	Filbrillation (<300/ minute) cant measure due to non-effective contraction- quinidine
54
Q

Anticoagulants. uses and side effects?

A

o Venous thrombosis, prevention of coronary thrombosis, Afib or valve disease
o Side effects
 Hemorrhage
 GI Bleed, gum bleed, nose bleed, uterine bleed

55
Q

Antianemics. what are they? common uses and dangers

A 
o	Replace missing factor (iron, Vitamin B12, folic acid, RBC, WBC, erythropoietin)
o	Side effects
	Mostly with iron
	Headaches, GI symptoms
	Death in children is possible
56
Q

Neurotransmitter involved with Epilepsy

A

Gaba

57
Q

Neurotransmitter involved with parkinsons

A

decreased dopamine..imbalance between dopamine and ACH

58
Q

Neurotransmitter involved with depression

A

decreased serotonin, norepinephrine, and dopamine

59
Q

Neurotransmitter involved with anxiety

A

Low GABA

60
Q

Neurotransmitter involved with schizophrenia

A

high dopamine

61
Q

Neurotransmitter involved with manic depression

A

high serotonin/ NE

62
Q

uses of CNS stimulants

A
  • ADHD
  • narcolepsy
  • weight contro
  • usually schedule 2 drugs
63
Q

Anesthetics…what do they do? How fast do they work?

A

o They give amnesia, analgesia, muscle relaxation

o Inhalation anesthetics work in seconds

64
Q

Antitussive…uses and side effects

A 
o	They prevent coughing (only when coughing is nonproductive)
o	Narcotic side effects
	Abuse
	Constipation, depress respiration, 
o	Non-narcotic side effects
	Dry mouth, nausea, vomiting
65
Q

H1 antagonist

A
  • antagonize therapeutic reactions, prevent symptoms from reacting
  • motion sickess
66
Q

H2 antagonist

A

decrease gastric secertion

-treat heartburn

67
Q

acute asthma treatment

A
  • sympathomimetics

- xanthines

68
Q

chronic asthma treatment

A
  • anticholinergic

- asthma prophylactic

69
Q

side effects of corticosteroid

A

o Hoarsness, dry mouth, local infections in mouth and pharynx
o Poor wound healing, salt/water retention, insomnia

70
Q

Bacteriostatic

A

stop microbial growth, limits spread of infection, relies on host immune system

71
Q

tetracycline

A

bacteriostatic..broad

72
Q

chloramphenical

A

broad, bacteriostatic

73
Q

bacteriocidal

A

kill bacteria, decrease # of viable pathogens, preferred for patients with compromised immunity, good for life threatening infections

74
Q

penicillin

A

broad, bacteriostatic

75
Q

cepholosporins

A

bacteriostatic

76
Q

carbapenems

A

broad, bacteriostatic

77
Q

monobactems

A

bacteriostatic

78
Q

glycopeptides

A

bacteriostatic

79
Q

aminoglycosides

A

bacteriostatic

80
Q

fluoroquinolone

A

broad, bacteriostatic

81
Q

macrolides

A

bacteriostatic

82
Q

sulfonamides

A

broad bacteriostatic

83
Q

erthyromycin

A

broad bacteriostatic

84
Q

cell wall synthesis inhibitors

A

kill bacteria by preventing synthesis or repair of cell wall

85
Q

penicillins (MOA)

A

inhibit last step of cell wall synthesis

86
Q

Cepholosporins (MOA)

A

cell wall synthesis inhibitor

87
Q

Monobactams

A

Cell wall synthesis inhibitor

88
Q

Aminoglycosides

A

bind directly and irreversibly to 30s ribosomal subunit

89
Q

tetracycline

A

bind reversibly to the 30s subunit go the bacterial ribsome and inhibit protein synthesis

90
Q

Trentoin side effects

A
  • temporary worsening of skin
  • more susceptible to sunburn
  • might accelerate carcinogenic effect of UV light
91
Q

tetracyline side effects

A

 Gastric upset, vaginitis, skin and fungal infections
 Decreases effectiveness of oral contraception
 Contraindicated in pregnancy

92
Q

erythromycin side effects

A

 Gastric upset, vaginitis, skin and fungal infections

93
Q

cisrentic acid side effects

A

 Severe birth defects

 Dry cracked skin, alopecia, hypertriglyceridemia, hepatitis, acute pancreatitis, pseudotumor, joint/muscle pain

94
Q

oral zinc side effects

A

GI bleeding

95
Q

Topical corticosteroids

A

can make acne worse if it is the inflammatory kind

96
Q

open angle glaucoma..what causes it?

A

draining canals become clogged overtime causing an increase in IOP

97
Q

narrow angle glaucoma..what causes it?

A

the iris is pushed or pulled forward blocking the drainage angle of the eye

98
Q

when are steroids used for eye conditions?

A
  • allergic reactions of the eye
  • severe injury
  • non-pus producing inflammations
99
Q

Emollient..what is it..when is it used

A

fatty or oily substances that may be used to soften or soothe irritated skin and mucous membrane

100
Q

Keratolytic..what is it..when is it used

A

keratin dissolvers: soften scale and loosen the outer horny layer of the skin

101
Q

Secretion in kidneys

A

certain molecules are secreted from blood to urine

102
Q

filtration in kidneys

A

water and solutes are filtered from the plasma in the glomerulus

103
Q

reabsorption in kidneys

A

things are reabsorbed from the nephron back into circulation

104
Q

How to correct alkalosis

A
  • Decreases respiratory rate, retaining CO2. Carbonic acid dissociates into H+ (neutralizes excess OH-)
  • Kidneys: eliminates excess HCO3- by absorbing less bicarb and more chloride
  • Retain needed H+ by secreting less H+ and more K+
105
Q

How to correct acidosis

A
  • Increase RR, removing CO2 and carbonic acid
  • Kidney: reabsorbs more bicarb instead of chloride in the proximal tubule
  • Secretes more H+ than K+ in distal tubule
106
Q

What is a diuretic? What is the MOA of most diuretics

A

o Diuretics hold water to increase urine volume
o Most of them inhibit inhibition of Na+, Cl-, and HCO3-
o All result in decreased Na+ reabsorption

107
Q

Uses for diuretics that act on the proximal tubule, ascending loop of henle, distal tubule

A 
o	Proximal tubule
	Inhibits reabsorption of HCO3-
o	Ascending loop of henle
	Inhibits Cl- reabsorption
o	Distal tubule
	Potassium sparing diuretics
	Mimics effect of aldosterone antagonist
108
Q

Uses for furosemide

A

o Loop diuretics
o Retains effect of blood vessels (vasodilation)
o Powerful inhibitor of Cl- reabsorption from ascending limb of loop of henle
o Can cause up to 4 liters of urine to be formed within the first few hours

109
Q

Uses for osmotic diuretics

A

o Withdraw water from overhydrated cells
o Maintain high volume of urine
o Prevent renal failure following hemolytic reaction, shock, hemorrhage, surgery
o Helps eliminate drug overdose such as barbiturates or salicylates

110
Q

causes and symptoms of hyperkalemia

A 
Causes 
•	Decreased aldosterone
•	Renal failure
•	Cellular damage
•	Metabolic acidosis
	Symptoms
•	Decreased neuromuscular function
•	AV block, cardiac arrest
111
Q

causes and symptoms of hypokalemia

A 
•	Decreased K+
•	Increased GI loss
•	Metabolic alkalosis 
•	Increased aldosterone secretion
	Symptoms
•	Decreased neuromuscular function
•	Increased HR, impaired conduction
112
Q

Causes and symptoms of hypercalcemia

A 
	Causes
•	Hyperparathyroidism
•	Vitamin D intoxication
•	Excessive mineral intake
•	Acidosis
•	Bone cancer
	Symptoms
•	Nerve membranes less excitable
•	Increased HR
•	Stones and calcium deposits
•	polyuria
113
Q

Causes and symptoms of hypocalcemia

A 
•	Hypoparathyroidism
•	Too little vitamin D
•	Chronic renal insufficiency
•	Bed rest and inactivity
•	Alkalosis
•	Stored blood
	Symptoms
•	Nerve membranes more excitable (irritability, tetany, convulsions)
•	Heart weak
114
Q

causes and symptoms of hypermagnesemia

A 
	Causes
•	Renal insufficiency
•	Acidosis may make worse
	Symptoms
•	Sedation and depression
•	Muscle weakness
115
Q

causes and symptoms of hypomagnesemia

A 
•	Starvation
•	Diarrhea
•	Overtake of Ca++
	Symptoms
•	Increased irritability
•	Convulsions
•	Cardiac arrhythmia
116
Q

acquired immunity

A
  • Vaccine: suspension of either attenuated or killed microorganisms
  • Toxoid: toxin modified so that it is nontoxic by stikk antigenic
117
Q

passive immunity

A
  • Mother to fetus or nursing infant
  • Antivenins
  • Rhogam
118
Q

uses for adrenocorticosteroid

A
  • anti-inflammatory

- pallative care

119
Q

uses for glucocorticosteroid

A
  • Addisons disease
  • Suppress ACTH
  • Suppress inflammatory response
  • Bronchodilation
  • Some types of cancer
120
Q

mineralocorticoid treatment

A

adrenal insufficiency

121
Q

side effects of glucocorticoid treatment

A 
	Atrophy of adrenal gland
	Delayed healing
	Reduces resistance to infections
	Peptice ulcers
	Amenorrhea
	Mimic’s cushings syndrome
122
Q

side effects of insulin deficiency

A

 Hyperglycemia
 Polyuria, thirst, dehydration
 Ketoacidosis (fruity breath, hunger)
 Vascular damage (eye, extremities, heart)

123
Q

indications for oral hypoglycemic agents

A

 Stimulates insulin release
 Alter receptor sensitivity
 Change livers response to insulin

124
Q

side effects of hormone therapy

A 
	Memory problems
	Tiredness
	Digestive issues
	Weight gain
	Muscle and bone changes
	Headaches
125
Q

uses for biphophonates

A 
	Prevention and treatment of osteoporosis
	Pagets disease
	Myeloma
	Primary hyperparathyroidism
	Osteogenesis imperfecta 
	Bone fragility

Pharmacology Final (1 decks)

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