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Module 1 > IM1- PHARM COMPREHENSIVE QUIZ (PHARM 1,2,3,4 > Flashcards

IM1- PHARM COMPREHENSIVE QUIZ (PHARM 1,2,3,4 Flashcards

1
Q

What is an adverse drug reaction (ADR)

A

“Any noxious, unintended, undesired effect that occurs at normal drug doses”

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2
Q

What are some mild ADR effects?

A
  1. Drowsiness
  2. Itching
  3. Nausea
  4. Rash
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3
Q

What are some severe ADR effects?

A
  1. Respiratory depression
  2. Organ injury
  3. Anaphylaxis
  4. Death
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4
Q

What are some ADR Considerations?

A
  1. What increases the risk?
    -Multiple illnesses
    -age
  2. What is the impact- for whom?
  3. How can harm be minimized
    • Checking the mar
      -Verify arm band
    • ask allergies
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5
Q

Define side effect

A

A nearly unavoidable secondary drug effect produced at therapeutic doses

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6
Q

Define toxicity

A

Any severe ADR, regardless of the dose that caused it

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7
Q

Define allergic reactions

A

Immune response, the intensity of which is determined by immune system, not dosage

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8
Q

Define idiosyncratic effect

A

Uncommon drug response resulting from genetic predisposition

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9
Q

Define Paradoxical effect

A

The opposite of the intended drug response

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10
Q

Define iatrogenic disease

A

Occurs as the result of medical care or treatment including disease produced by drugs.

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11
Q

Define physical dependence

A

Body has adapted to drug exposure in such a way that abstinence syndrome will develop if discontinued

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12
Q

Define carcinogenic effect

A

The ability of certain medications and chemicals to cause cancers

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13
Q

Define teratogenic effect

A

Drug-induced birth defect

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14
Q

What are some characteristics of hepatotoxic drugs. list 5

A
  1. Liver is the primary site of metabolism
  2. Drugs are leading cause of liver failure
  3. Over 50 commonly given drugs are hepatoxic
  4. Some drug metabolites are hepatoxic
  5. Combining hepatoxic drugs increases risk of liver injury.
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15
Q

What are characteristics of QT drugs?

A
  1. QT drugs - prolong QT interval
  2. Can cause life-threatening dysrhythmias
  3. QT drugs found in several drug classes
  4. Females at higher risk
  5. Multiple QT drugs should not be given concurrently
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16
Q

True or false: Some medications are not appropriate for patients with prolonged QT interval

A

True

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17
Q

How are kidneys affected by ADR

A
  1. Because kidneys filter metabolites out of body cumulative exposure can cause damage
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18
Q

How are the ears affected by ADR?

A
  1. Ototoxic reactions can cause permeant damage
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19
Q

How are the lungs affected by ADR?

A
  1. Can be pneumotoxic
    over 600 drugs are pneumotoxic
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20
Q

What are some questions you should ask when trying to determine if your patient is having an ADR?

A
  1. Did symptoms appear shortly after the drug was first used?
  2. Did symptoms abate when the drug was discontinued
  3. Did the symptoms reappear when the drug was reinstituted
  4. Is the illness itself sufficient to explain to explain the event
  5. Are other drugs in the regimen sufficient to explain the event.
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21
Q

What are some ways to minimize ADRs?

A
  1. Early identification is key
  2. Know major ADR’s that a drug can produce
  3. Monitoring of organ function if toxic drugs are being given
  4. Individualizing therapy
  5. Patient teaching
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22
Q

What are black box warnings?

A
  1. Strongest safety warning a drug can carry and still remain on the market
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23
Q

What does the black box warning contain?

A

Concise summary of the adverse effects of concern

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24
Q

True or false: The most serious medication warning required by the FDA is the black box warning?

A

True

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25
Q

What are some considerations when faced with a BBW? (black box warning)

A
  1. Does the potential benefit of treatment outweigh the risk?
  2. Are there safer (and equally effective) alternatives?
  3. Would a safer but less effective alternative be appropriate?
  4. Is the boxed warning applicable to this specific patient?
  5. Can action be taken to ameliorate the potential for an adverse reaction?
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26
Q

Define a medication error?

A

Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer

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27
Q

True or false: A medication error can cause both direct and indirect harm?

A

True

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28
Q

What are causes of medication errors?

A
  1. Human factors
  2. Communication mistakes = 90% of fatal errors
  3. Name confusion
    4 Packaging, formulations and delivery services
  4. Labeling and reference materials
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29
Q

True or false: If the same dose of a drug is given to a big person and a small person, the drug concentration will be lower in the small person?

A

False- the drug concentration would be higher

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30
Q

What are some factors affecting individual response to a drug?

A
  1. Body composition
  2. Age
    -Infants– immature organ system
    • Older adults – decline in organ function
  3. Pathophysiology
  4. Tolerance
  5. Comorbidities and drug interactions
  6. Diet
  7. Patient compliance
  8. Medication Errors
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31
Q

How does kidney disease affect an individual response to a medication?

A

Reduces the rate of drug excretion- drugs may accumulate to toxic levels

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32
Q

How does liver disease affect an individual response to a medication?

A

Reduces rate of drug metabolism- drug may accumulate to toxic levels

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33
Q

How does tolerance affect an individual’s response to a drug?

A

it decreases responsiveness to a drug as a result of repeated drug administration

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34
Q

How does comorbidities and drug interactions play a factor in an individual’s response to a drug?

A
  1. Drugs taken to manage one condition may complicate management of another
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35
Q

How does a diet play a factor in an individual response to a drug?

A

Good diet can elicit therapeutic responses and reduce harm from ADR’s
Some foods can interact with drugs and cause ADR’s

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36
Q

How does patient compliance play a factor in an individual’s response to a drug?

A
  1. Failure to take
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37
Q

What are some reason a patient may not be able to comply with taking medication?

A
  1. Manual dexterity and visual acuity
  2. Intellectual capacity & Psychologic state
  3. Attitude and belief toward drugs
  4. Ability to pay
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38
Q

What are some geriatric concerns with drug therapy?

A
  1. Organ function
  2. Comorbidities
  3. Polypharmacy
  4. Noncompliance
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39
Q

In the elderly the ability to to absorb drugs……?

A
  1. Rate of absorption slows
  2. Gastric acidity declines
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40
Q

In elderly the ability of distribution is affected by many factors including…..

A
  1. Increased body fat % —> plasma drug levels reduced
  2. Decreased % lean body mass—> plasma drug levels increased
  3. Decreased total body water—> plasma drug levels increased
  4. Decreased serum albumin concentration —> plasma drug levels increased
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41
Q

In Elderly metabolism tends to _____ with age

A

decline (highly variable)

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42
Q

In elderly excretion begins to decline progressively in _____ adulthood (wait… what?? not sure what I was asking here sorry)

A

Early

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43
Q

What is the most important cause of ADR’s in older adults?

A

Excretion

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44
Q

True or false: ADR’s are 7 times more common in older adults?

A

True

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45
Q

ADR”s in the elderly population account for what percentage of hospital admissions?

A

16 %

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46
Q

ADR’s in the elderly population account for what percentage of all medication-related deaths?

A

50%

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47
Q

True or false: ADR’s are mostly dose related in elderly?

A

True

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48
Q

True or false: ADR’s in the elderly are unavoidable?

A

False– Mostly avoidable

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49
Q

True or false: older adults are less likely to share alcohol or recreation drug use?

A

True

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50
Q

True or false: Symptoms of ADR’s in the elderly tend to be nonspecific?

A

True

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51
Q

What are important risk factors for ADR’s in the elderly?

A
  1. Reduced renal function- drug accumulation
  2. Polypharmacy
  3. Greater severity of illness
  4. Low therapeutic index drugs
  5. Increased individual variation
  6. Inadequate supervision of long-term therapy
  7. Poor adherence
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52
Q

What is the goal of drug thearpy?

A

Reduce symptoms and improve quality of life

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53
Q

What should the nurse plan look like for drug therapy/preventing ADR’s?

A
  1. Assessment– drug history, compliance
  2. Monitoring– clinical responses & Plasma drug levels
  3. Teaching– How to take meds, strategies for compliance
  4. Advocating– simplest regimen possible, easy to open containers, large print, cost
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54
Q

What are the different approaches to medicne?

A
  1. Integrative health
  2. Alternative medicine
  3. Complementary medicine
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55
Q

What is integrative health?

A

A coordinated approach to using complementary and conventional medicine

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56
Q

What is alternative medicine?

A

Used in place of conventional medicine

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57
Q

What is complementary medicine?

A

used together with conventional medicene

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58
Q

What are some characteristics of conventional medicine?

A
  1. Focuses on physical components of the ill patient
  2. Emphasis is placed on dx and cure based on physical symptoms
  3. Medicine, surgery, etc
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59
Q

What are some characteristics of alternative medicene?

A
  1. Takes a holistic “multibody” approach
  2. takes into considerations the complexity of each person
  3. Embraces self-healing forces, spirituality, balance between internal/external forces
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60
Q

Complementary and alternative medicine thought process is as follows….

A
  1. strong connection between mind and body—> self-reliance on healing—> body has own energy for healing—> use of nutrition and natural products—>emphasis on individuality —>
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61
Q

What has the use of CAM (Complementary and alternative medicine) increased?

A
  1. Overall dissatisfaction with conventional healthcare
  2. Desire for greater control over one’s health
  3. Need to blend cultural and philosophical congruence with personal beliefs about health and illness
  4. belief in the effectiveness of alternative therapies
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62
Q

What are major areas of therapeutic objectives?

A
  1. Anxiety
  2. Pain
  3. Illness
  4. Depression
  5. Insomnia
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63
Q

What are types of manipulative body and energy-based methods (complementary/alternative medicine)

A
  1. Massage therapy
  2. Reflexology
  3. Accupressure
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64
Q

What benefits can acupressure/acupuncture have?

A
  1. Pain relief
  2. Helps relieve migraine/headache
  3. Anesthesia
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65
Q

What benefits can yoga have?

A
  1. Life forces correct balance and flow
  2. Concentration, strength, flexibility, symbolic movements
  3. Helps with breathing, movement and posture
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66
Q

What benefits can Tai chi have?

A
  1. Promotes the flow of energy throughout the body
  2. Reduces sx. of fibromyalgia
  3. Used in cardiac rehab programs can lower BP
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67
Q

What is Reiki?

A

It is a Japanese technique for stress reduction and relaxation that also promotes healing

It is based on the idea that an unseen “life force energy” flows through us and is what causes us to be alive

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68
Q

What are some biologically based therapies?

A
  1. Dietary therapies
  2. Herbs
  3. Aromatherapy
  4. Vitamins
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69
Q

What are some reasons for dietary supplement?

A
  1. Perceived as “safer and healthier”
  2. Sense of control
  3. Emotional comfort
  4. Cultural influence
  5. Limited access to healthcare
  6. Convenience
  7. Aggressive marketing
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70
Q

True or false: FDA categorized herbals as food and nutritional supplements not as drugs?

A

True

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71
Q

Dietary supplement health and education acts….( review slide 15 complementary and alternative medicine power points)

A
  1. package labeling
  2. adverse effects
  3. Impurities, adulterants, variability
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72
Q

Current good manufacturing practices (CGMP)…. review slide 15 on complementary and alternative medicine PowerPoint)

A
  1. Require quality control procedures
  2. Labeling to reflect active and inactive ingredients
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73
Q

What are some federal reporting requirements
dietary supplement (nonprescription drug consumer protection act)

A
  1. Deaths
  2. Hospitalizations
  3. Life-threatening experiences
  4. Persistent or significant disabilities
  5. birth defects
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74
Q

What is the USP?

A

United states pharmcopia

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75
Q

What do the USP, ConsumerLab, NPA, NSF are private quality certification programs…. what do they help with… review slide 17

A
  1. CGMP (current good manufacturing practice)
  2. Purity
  3. Identity
  4. Potency
  5. Dissolution
  6. Accuracy of labeling
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76
Q

What do RNs need to know? Alternative med (herbals)

A
  1. Major drawback:
    May delay important diagnosis and treatment
  2. Nursing intervention:
    Make certain MD or PCP is aware of patient’s use of herbals
  3. Nursing Action:
    What to assess & instruct patient regarding herbal therapy
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77
Q

What information should we try and gather from the patient about herbal information

A
  1. Always ask about the use of herbals when getting medication history
  2. What is their story- why the patient is using the plant medicine or alternative therapy
  3. Teach patients to look for products labeled ‘Standardized’ - these more likely to have accurate amounts and a more purified form of the herb
  4. Goal is to help patients be informed consumers
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78
Q

What are commonly used herbs?

A
  1. Gingko Bilboa
  2. Garlic
  3. Ginger root
  4. Feverfew
  5. Echinacea
  6. St. John’s Wort
  7. Valerian
  8. Kava
  9. Ephedra
  10. Cannabis*
  11. CBD*
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79
Q

What benefits can Ginko biloba have?

A
  1. Reduce memory problems, dementia, peripheral vascular disease
  2. Antioxidant & Vasodilatory properties
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80
Q

What should we be aware of when a patient is taking Ginko Biloba?

A

1.It can cause bleeding when used with anticoagulants
2. Avoid before surgery

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81
Q

What benefits can garlic have?

A
  1. Lowers cholesterol, lowers BP, natural antibiotic
  2. Natural anit-platelet agent
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82
Q

What should we be aware of when a patient is taking garlic?

A
  1. Potentiates anti-diabetic drugs
  2. avoid before surgery
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83
Q

What benefits can ginger root have?

A
  1. Used to treat nausea, joint pain
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84
Q

What should we be aware of when a patient is taking ginger root?

A
  1. Bleeding
  2. Irregular heart rate
  3. Blood pressure
  4. Blood sugar levels
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85
Q

What benefits can feverfew have?

A
  1. Helps with migraine prophylaxis
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86
Q

What should we be aware of when a patient is taking feverfew?

A
  1. Increased risk of bleeding
  2. Can cause uterine contractions. Avoid taking if pregnant can cause uterine contractions which can cause a spontaneous miscarriage
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87
Q

What benefits can Echinacea have?

A
  1. Builds immunity
  2. Wound healing
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88
Q

What are some things to be aware of when a patient is taking echinacea?

A
  1. Immune system suppression after use over 8weeks
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89
Q

What are some benefits of St. John’s wort

A
  1. May ease mild to moderate depression
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90
Q

What are some things to be aware of when a patient is taking St. John’s Wort

A
  1. Contraindicated for major depression
  2. Do not use with other anti depressants
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91
Q

What are some benefits of Valerian root?

A
  1. Generally safe, but ineffective
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92
Q

What are some things to be aware of when patient is taking valerian root

A
  1. Potentiates CNS depressants
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93
Q

What are some benefits of kava?

A
  1. Relieves anxiety
  2. Promotes sleep
  3. Relaxes muscles
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94
Q

What are some things to be aware of if a patient is taking Kava?

A
  1. Liver damage. No restrictions on the drug in the US but in Canada and European countries it is outlawed.
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95
Q

What are some benefits of Ephedra?

A

NONE- used to be used for a performance enhancement drug but it is NOT good for our bodies

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96
Q

What are some things you should know if a patient is taking ephedra?

A
  1. Damaging to heart and CNS
  2. Banned from sale in US
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97
Q

What are some things you should know about Cannabis/CBD

A

Cannabis is good for nausea. There is a prescription drug by the name of Marinol that is used in cancer patients.

CBD is not regulated at all for strength, purity

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98
Q

What are some mind & body interventions?

A
  1. Yogo, medication, spirituality, relaxation, guided imagery, music, hippotherapy, equine therapy
99
Q

What can musical therapy do?

A

Improve physical, emotional, cognitive and social well being

100
Q

What is the nurse’s role with the different types of “medicine”

A
  1. Educate the public
  2. Teach signals of fraudulent practice
  3. Avoid healer who:
    • promote immediate relief of success
    • state that their way is the only sure therapy
    • refuse to work with other health care prodders
    • Claim to have all the answer
    • Use testimonial’s that claim amazing results
  4. Be non-judgmental despite personal opinions
  5. Build rapport by showing patient respect- if not, can be afraid to tell about CAM- drawback?
  6. Understand that C.A.M can be beneficial when used correctly
  7. Be aware that C.A.M can be dangerous if it interacts or interfere with conventional treatment
  8. Be aware that use of C.A.M is popular and increasing and must be included in the history and physical
  9. Know that herbals, in particular have significant effects on prescription drugs, body function and disease processes.
101
Q

True or false: C.A.M can be beneficial and dangerous

102
Q

Why are vaccines important?

A
  1. Vaccines protect against harmful diseases
  2. Vaccines are effective
  3. People of all ages benefit from vaccines
  4. vaccines protect public health
    -protect individual
    • protect populations
  5. vaccines have been highly vetted by the CDC and FDA
  6. Outbreaks can occur without heard immunity
103
Q

Who benefits most from vaccines?

A

Immunocompromised and chronic, young and old

104
Q

What are some vaccines for adults?

A
  1. influenza
  2. tetanus
  3. diptheria
  4. Shingles
  5. Pneumonia
105
Q

True or false: From the CDC: All adults need a seasonal flu (influenza) vaccine every year.

106
Q

Who benefits the most from the flu vaccine.

A
  1. People with chronic health conditions, pregnant women and older adults
107
Q

How often should a person get a tdap vaccine?

A

Every adult should get the Tdap vaccine once if they did not receive it as an adolescent to protect against pertussis and then a Td booster shot every 10 years.

Women should get the Tdap vaccine each time they are pregnant. Preferably at 27 though 36 weeks

108
Q

What does the shingles vaccine do?

A

It protects against shingles and the complications from the diseases

109
Q

The shingles vaccine is recommended for?

A

Healthy adults 50 years and older

110
Q

What does the pneumococcal polysaccharide vaccine (PPSV23) do?

A

protects against serious pneumococcal disease, including meningitis and bloodstream infections

111
Q

The pneumococcal polysaccharide vaccine (PPSV23) is recommended for?

A

All adults 65 years or older, and for adults younger than 65 who have certain health conditions

112
Q

What does the pneumococcal conjugate vaccine (PCV13) do?

A

Protects against serious pneumococcal disease and pneumonia

113
Q

The pneumococcal conjugate vaccine (PCV13) is recommended for?

A

All adults with a condition that weakens the immune system, cerebrospinal fluid leak, or cochlear implant,

114
Q

Vaccine information statements (VISs) are produced by who?

115
Q

True or false: Vaccine information statements (VISs) are not required by law?

A

False- They are required by law

116
Q

When do you give a Vaccine Information Statements (VISs)?

A

Prior to vaccination, every dose regardless of age and you must document that it was given

117
Q

True or false: Vaccine information statements (VISs) are available in over 40 languages

118
Q

What are some need to know facts about the Influenza vaccine

A
  1. Strongly recommended for young/old and pregnant.
    – will benefit both mom and boby
  2. If sick hold off till feeling better
  3. It takes about 2 weeks to develop protection
  4. Gilliam Baray syndrome can happen which can cause neurological disorders that progressive from the feet up the body causing paralysis. If a patient has experienced previously this they should not get the vaccine.
  5. Inactivated virus
119
Q

What are some things you should know about the Shingles vaccine?

A
  1. Given in a 2 dose series
  2. Do not give to pregnant women or breastfeeding women
120
Q

What should your documentation for vaccines include?

A
  1. The edition date of the VIS (found on the back at the right bottom corner)
  2. The date the VIS is provided (i.e., the date of the visit when the vaccine was administered)
  3. The office address and name and title of the person who administers the vaccine
  4. The date the vaccine is administered
  5. The vaccine manufacturer and lot number
121
Q

You can get ______ through cuts, scratches or wounds?

122
Q

Vaccines are an example of _______?

A

Active immunity

123
Q

Young, old and smokers are at higher risk for _____?

124
Q

What is the abbreviations for tetanus and diphtheria

125
Q

People who have this should not get the flu vaccine?

A
  1. Guillain-Barre
126
Q

Antibody exposure can lead to ______

A

Acquired Immunity

127
Q

When is flu season?

A

Occurs between October and May

128
Q

Shingles is caused by…….

A

Varicellazoster

129
Q

The transfer of antibodies leads to…..

A

Passive immunity

130
Q

Tetanus can cause…..

A

muscle tightening

131
Q

A thick coating in throat is called

A

Diphtheria

132
Q

Who should get the shingles vaccine?

A

people who are 50 years or older

133
Q

What is a reversible action?

A

Able to be metabolized by the body or chemically nullified by another drug

134
Q

What is predictability in regards to pharmacology

A

knowing how the patient will respond

135
Q

Define what a drug is

A

Any chemical that can affect the living process

136
Q

Define pharmacology

A

The study of drugs and their interactions with living systems

137
Q

Define Clinical pharmacology

A

The study of drugs in humans

138
Q

Define therapeutics in pharmacology

A

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

139
Q

What are the three most important properties of an ideal drug

A

Effectiveness, selectivity, safety

140
Q

What is ease of administration?

A

Convenient route, low number of doses per day

141
Q

True or false: A patient is more likely to take a medication that is can be taken easily and as little as possible

142
Q

True or False: The easier it is to administer the more willing a patient might be to take it

143
Q

When thinking about an ideal drug what does freedom from drug interaction mean?

A

To not intensify or reduce effects of other drugs

144
Q

When thinking about an ideal drug what does low cost mean

A

Easily affordable

145
Q

When thinking about an ideal drug what does low cost mean

A

Easily affordable

146
Q

True or false: A patient sometimes has to choose between providing for their family and taking an important medication due to cost

147
Q

When thinking about our ideal drug what does chemical stability mean

A

Indefinitely retain effectiveness and potency

148
Q

True or false: We would rather have a simple generic name that is easy to recall and pronounce?

149
Q

True or false: We would rather have a simple generic name that is easy to recall and pronounce?

150
Q

True or false: The toxicity of a drug means little to us

151
Q

What is a big factor in how a medication might work on someone?

152
Q

True or false: Patients who have poor liver and kidney function will have a variability in how drugs work.

153
Q

True or false: The food we eat has no effect on the medications we take?

A

False- some food will have adverse (bad) reactions to some meds

154
Q

True or false: No two people will respond the same to a medication?

155
Q

Our therapeutic objective is what?

A

To provide maximum benefits with minimal harm

156
Q

What is pharmacokinetics?

A

Explains how a drug moves through the body

157
Q

What is pharmacodynamics

A

Explains how a drug effects the body

158
Q

Nursing plan with pharmacology in mind—> What are 3 preadministration assessment goals?

A

Collect data, id high risk patients, assess patients’ capacity for self-care.

159
Q

True or false: A baseline of vitals is not important to the pharmacology aspect of nursing

160
Q

Why is obtaining a baseline of vitals important?

A

Allows us to see what effect a drug may have on the patient.

161
Q

Why collect baseline date?

A

Safety, response, id high risk patient and assess patients ability of self care

162
Q

When obtaining our baseline data what are areas we should assess?

A

Patient history
Physical exam
lab results
blood pressue/vs
blood surgar
height and weight

163
Q

Name some risk factors that would classify a patient as high-risk

A

1.liver and kidney functions– this is because of their ability to metabolize drugs
2. Genetic Factors
3. Drug allergies
4.Pregnancy– will the drug cause harm to mom or baby?
5. Elderly– metobolism slows way down so drugs stay in system longer,
6- pediatric– very small doses

164
Q

True or false: As a nurse we are not allowed to make a medical dx but we are allowed to use our nursing judgement to make the best poss. decisions

165
Q

True or false: An example of a nursing goal for a patient in pain could be– for next 8 hours is to keep the patient pain free.

166
Q

When we implement our plan for drug admin is patient education important?

167
Q

Why would we evaluate the patient after administrating meds

A

To assess for therapeutic responses, assess for drug reactions and interactions, adherence to prescribed regimen, satisfaction w/tx.

168
Q

What is the first stage of new drug development

A

Preclinical testing

169
Q

What is the second stage of new drug development

A

Clinical testing

170
Q

How many phases are in clinical testing?

171
Q

During phase I of clinical testing who participates?

A

Healthy volunteers/healthy patient volunteers

172
Q

During phase II of clinical testing who participates?

A

Patients in which the drug is targeted

173
Q

What is the main purpose in clinical testing phase II

A

Testing for therapeutic use and dosage

174
Q

What is the main purpose in clinical testing phase III

A

Testing for safety and effectiveness

175
Q

When does FDA approval come during the new drug development stages?

A

In clinical stages– phase III once the drug has been deemed safe and effective.

176
Q

What is the main purpose of stage IV in clinical testing

A

Post clinical trial or surveillance

177
Q

What are the requirements for OTC drug labels

A

Plain language, readable type and user friendly format

178
Q

What is the label format for OTC drugs?

A

Active ingredients listed first, uses, warning, directions, inactive ingredients

179
Q

What is pharmacokinetics?

A

How a drug moves through the body

180
Q

What are some questions that should come to mind when thinking in terms of pharmacokinetics?

A
  1. How does the drug get into the body and where does it go?
  2. What does the body do to/with the drug?
  3. How does the body get rid of the drug?
181
Q

What is the process of a drug through the body?

A
  1. absorption
  2. distribution
  3. metabolism
  4. excretion
182
Q

True or false: different drugs are metabolized by different organs?

183
Q

True or false: the majority of drugs are metabolized by the liver

184
Q

Where are the majority of drugs excreted?

185
Q

What is absorption?

A

The movement of a drug from its site of administration into the blood

186
Q

In pharmacology rate is determines what?

A

How soon a drugs effects will take place

187
Q

In pharmacology amount determines what?

A

how intense the drugs effects will be

188
Q

Name 6 factors that affect the process of absorption.

A
  1. Rate of dissolution
  2. surface area
  3. blood flow
  4. Lipid solubility
  5. pH partitioning
  6. Route of administration
189
Q

True or false: With rate of dissolution the quicker a drug dissolves the slower the effect will be?

190
Q

True or false: With surface area the larger the surface area the quicker the drug is absorbed

191
Q

True or false: Our body prefer drugs that are lipid soluble because it is easier for them to enter our blood stream.

192
Q

What are the two major groups in routes of administration?

A

Enteral (gastrointestinal GI tract)
Parenteral (outside of the GI tract)

193
Q

Is oral meds considered enteral or parenteral?

194
Q

Is IV, subQ and IM considered enteral or parenteral?

A

Parenteral

195
Q

What are the advantages to PO meds?

A
  1. Safer than injections
  2. ideal for self-administration
  3. easy, convenient and inexpensive
196
Q

What are the disadvantages to PO meds?

A

1.Can cause GI irritation
2. Requires cooperative patient
3. Inactivation
4. Variability

197
Q

What are some barriers to absorption with PO meds?

A
  1. Epithelial lining of GI tract
  2. capillary wall
198
Q

What is the absorption pattern for PO meds?

A

Slow and variable

199
Q

True or false: no one patient absorbs the drugs the same

200
Q

What are some advantages of IV drugs? List 4

A
  1. Rapid onset
  2. Control
  3. permits use of lg fluid volumes
  4. permits use of irritant drugs (chemo drugs)
201
Q

What are some disadvantages of IV drugs? List 4

A
  1. High cost, difficulty, inconvenience
  2. irreversibility
  3. infection
    4.high risk
202
Q

What are the barriers of absorption for IV drugs?

A

None goes directly into blood stream

203
Q

What is the absorption pattern for IV drugs?

A

Instantaneous and complete

204
Q

What are the advantages of IM and subQ drugs?

A

1.Can be used for poorly soluble drugs
2. Can be used for depot preparations

205
Q

What are depo preparations?

A

One time injection that last over a period of weeks to months

206
Q

What are some disadvantages to IM and subQ drugs?
list 4

A
  1. discomfort
  2. inconvenience
  3. can cause muscle and nerve injury with improper technique
  4. bleeding risk
207
Q

What are the barriers of absorption for IM and SubQ drugs?

208
Q

What is the absorption pattern for IM and subQ drugs?

A

Water solubility
blood flow

209
Q

When is parenteral administration preferred?

A
  1. emergencies
  2. situations requiring tight control
  3. GI incompatibility
    • destruction of drugs by GI system
    • drugs that would cause GI injury
  4. tx with drugs that cannot cross membranes
  5. condition better treated with long-acting preparation
  6. patients who cannot or will not take oral preparation.
210
Q

True or false: if a patient is having a life threatening issue the best route of administration is the enteral administration

211
Q

What is distribution?

A

The movement of drugs through the body

212
Q

Review the distribution process on slide 15 on the pharm 2 lecture

213
Q

What is drug metabolism?

A

The enzymatic alteration of drug structure to a more water-soluble form that can be excreted.

214
Q

What are some special factors/consideration in drug metabolism?

A
  1. age- the very young and very old have a decreased metabolism
  2. first-pass effect- some meds are totally metabolized by the liver the first time they pass through
  3. Nutrional status
  4. competition between drugs. - One drug may completely neutralize the other
215
Q

What is excretion?

A

the removal of drugs from the body

216
Q

Drugs and their metabolites can exit the body through…..

A
  1. bile
  2. urine/feces
    3.sweat/saliva
  3. breast milk
  4. expired air
217
Q

What is plasma drug levels?

A

Correlation between the response to a drug and level in plasma

218
Q

What are two important levels in monitoring of drug responses?

A
  1. MEC- Minimum effective concentration
  2. Toxic concentration
219
Q

What is the therapeutic range when monitoring drug responses?

A

Determines whether the drug can be safely given

220
Q

When monitoring drug responses what does drug- half life mean?

A

Determines dosing intervals

221
Q

Define drug half-life

A

Defined as the time required for the percentage of a drug in the body to decrease by 50%.

222
Q

Why is it important to understand a drugs half-life?

A

So we understand how often a patient needs to take a drug

223
Q

When monitoring drug responses what is repeated dosing mean?

A

Determines rate and extent of accumulation

224
Q

In repeated dosing what does peak mean?

A

Highest level of drug in the body–> normally peak of a drug is one to two hours after a dose

225
Q

In repeated dosing what does trough mean?

A

Lowest level of drug in the body–> usually just before the next dose

226
Q

What is a loading dose?

A

Its a higher dose to get blood levels of the drug up then taper to get a maintenance dose or everyday dose. Example is a zpack.

227
Q

What is pharmacodynamics?

A

It is the affect a drug has on the body

228
Q

What is dose-response relationship?

A

Relationship between the size of a an administered dose and the intensity of the response produced

229
Q

What is dose-response relationship?

A

Relationship between the size of an administered dose and the intensity of the response produced

230
Q

True or false: the more drug you give the more affects you should have?

231
Q

What is ED50

A

Stands for average effective dose. Typically the standard dose we use when starting a patient on a med

232
Q

What is LD50?

A

Lethal dose in 50% of test animals

233
Q

What does the dose-response relationship tell us?

A

It determines

  1. Relative potency- min amount of a drug needed to elicit a response
  2. maximum efficacy- max response a drug can elicit
234
Q

Understand the therapeutic index

A

Take time to review slide 28 on the pharm two power point

235
Q

True or false: we want to have a very wide range between the effective dose and the lethal dose?

236
Q

True or false: The narrower the space between the effective dose and lethal dose the safer the drug?

A

False- the wider the space the safer the drug

237
Q

What does the TI or therapeutic index tell us?

A

Allows us to know how wide of an index we have to work with when administering does of meds.

238
Q

What are three possible drug to drug interactions?

A
  1. Potentiate
  2. inhibit
  3. new response
239
Q

What is potentiate?

A

Intensifies the effects of two or more drugs

240
Q

What is inhibit mean when talking about a drug to drug interaction?

A

reduce the effects

241
Q

What is a new response drug to drug interaction?

A

Effect not seen with single drug alone

242
Q

What does it mean to have an empty stomach?

A

At least 1hr before or 2 hours after a mean

243
Q

What are some drug-food interactions?

A
  1. absorption
  2. drug metabolism
  3. drug toxicity
  4. drug action
  5. timing

Module 1 (20 decks)

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