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NURS 305 - All Content > Intro to Pharm > Flashcards

Intro to Pharm Flashcards

1
Q

Who prescribes medication? (3)

A
  • Physician
  • NP
  • PA
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2
Q

Who dispenses medication?

A

Pharmacist

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3
Q

Who checks medication?

A

Pharmacist

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4
Q

Who administers medication?

A

Nurse

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5
Q

Approximately ______ of a nurse’s time is spent administering medications

A

40%

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6
Q

What are the key nursing assessments in medication administration? (3)

A
  • Labs
  • Vital signs
  • Focused physical assessment
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7
Q

What are the 5 steps of the nursing process?

A
  • Assessment
  • Diagnosing
  • Planning
  • Implementation
  • Evaluation
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8
Q

What are the 3 types of medication names?

A
  • Chemical
  • Generic
  • Trade (brand)
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9
Q

Which medication name is most important and often referred to?

A

Generic

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10
Q

______ refers to the actions of the body as medication passes through

A

Pharmacokinetics

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11
Q

What are the 4 main components of pharmacokinetics?

A
  • Absorption
  • Distribution
  • Metabolism
  • Excretion
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12
Q

How the medication enters the blood stream after administration refers to ______

A

Absorption

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13
Q

Absorption is dependent on the ______

A

Route of administration

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14
Q

______ is the extent of absorption

A

Bioavailability

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15
Q

What is bioavailability?

A

How quickly / how much of a drug reaches its target

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16
Q

How can gastric mucosa affect bioavailability?

A

Changes in pH can alter ability to absorb more acidic medications

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17
Q

How can administration of drugs with food affect bioavailability?

A

Some foods may absorb medications or alter pH

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18
Q

Absorption ranges from ______

A

0 - 100%

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19
Q

Which route of administration allows the fastest absorption?

A

IV

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20
Q

______ administration avoids pre-systemic metabolism

A

Sublingual

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21
Q

What are the enteral dosage forms? (3)

A
  • GI tract
  • Oral
  • Rectal suppositories
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22
Q

What are the parenteral dosage forms? (2)

A
  • Injectables
  • Solutions
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23
Q

What are the topical dosage forms? (5)

A
  • Aerosols
  • Creams
  • Inhalers
  • Transdermal
  • Vaginal suppositories
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24
Q

What are some examples of medications with fast absorption? (3)

A
  • Oral / buccal tablets
  • Suspension solutions
  • Powders
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25
Q

What are some examples of medications with slow absorption? (2)

A
  • Capsules
  • Enteric-coated tablets
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26
Q

What are some examples of variables contributing to absorption rate? (3)

A
  • Particle size
  • Combination drugs
  • Extended release / immediate release
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27
Q

Combination drugs improve ______

A

Compliance

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28
Q

NEVER crush ______

A

Extended release

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29
Q

How the medication exits the bloodstream and enters the cells to exert effect refers to ______

A

Distribution

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30
Q

What are some examples of variables contributing to distribution? (3)

A
  • Blood flow
  • Blood-brain barrier
  • Protein binding
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31
Q

______ are too large to pass through capillary walls

A

Bound drugs

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32
Q

Describe bound drugs (2)

A
  • Bound to plasma protein (albumin)
  • Inactive
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33
Q

Describe free drugs (2)

A
  • Freely distribute to extravascular tissue
  • Active
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34
Q

What occurs as a result of low albumin levels? (2)

A
  • Increased free drugs
  • Increased risk of toxicity
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35
Q

What can cause low albumin levels? (2)

A
  • Burns
  • Malnourishment
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36
Q

When is a drug considered “highly protein bound”?

A

If > 80% binds to a protein

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37
Q

What can occur from taking 2 or more highly protein bound drugs? (3)

A
  • Drugs compete for albumin
  • Increased free drugs
  • Unpredictable drug response
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38
Q

What are the compartments of distribution? (4)

A
  • Blood
  • Body water
  • Body fat
  • Tissues / organs
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39
Q

The ability of a drug to cross a cell membrane is dependent on ______

A

Water / lipid solubility

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40
Q

Describe hydrophilic drugs (2)

A
  • Low distribution volume
  • High blood concentration
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41
Q

Describe lipophilic drugs (2)

A
  • High distribution volume
  • Low blood concentration
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42
Q

______ drugs do not easily pass through cell membranes

A

Hydrophilic

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43
Q

______ drugs easily pass through cell membranes including the blood-brain barrier

A

Lipophilic

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44
Q

Breakdown of medication (typically by the liver) to an inactive form refers to ______

A

Metabolism

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45
Q

Describe biotransformation

A

Changing a drug from fat-soluble to water-soluble form for excretion

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46
Q

What are some methods of metabolism? (4)

A
  • Active to inactive
  • More soluble compound
  • Active metabolite (prodrug)
  • Less active metabolite
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47
Q

Hepatic metabolism targets ______ drugs

A

Lipophilic

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48
Q

______ are drug molecules that are metabolic targets of specific enzymes

A

Substrates

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49
Q

______ enzymes convert drugs to metabolites

A

Cytochrome P-450

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50
Q

Describe the first pass effect

A

Drug moves from small intestine to liver before entering circulation

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51
Q

What intervention must occur if liver metabolism inactivates the drug during the first pass effect?

A

Administer a higher dose to achieve the desired drug effect

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52
Q

What is drug half-life?

A

The time it takes for half of the drug to be eliminated by the body

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53
Q

Which components of pharmacokinetics can affect half-life? (3)

A
  • Absorption
  • Metabolism
  • Excretion
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54
Q

Knowing how long a drug remains in the body helps determine ______

A

Dosing frequency

55
Q

It takes approximately ______ half-lives to be effectively rid of a drug

A

4 - 5

56
Q

Once the steady state has been reached, consistent levels of drug correlate with …

A

Maximum therapeutic effects

57
Q

Absorption rate should match ______ rate

A

Excretion

58
Q

What are the possible sites of excretion? (3)

A
  • Kidneys
  • Lungs
  • GI tract
59
Q

What is the primary organ of excretion?

A

Kidneys

60
Q

Renal excretion occurs by what process?

A

Glomerular filtration

61
Q

What is the normal rate of glomerular filtration?

A

80 - 130 mL / min

62
Q

GI tract excretion occurs by what process?

A

Biliary secretion

63
Q

Describe the process of biliary secretion

A

Drugs are taken up by liver, released in bile, and eliminated in feces

64
Q

Drug effect onset starts …

A

At drug administration

65
Q

Drug effect onset ends …

A

When the therapeutic effect starts

66
Q

Describe the peak of drug effects

A

Absorption rate > elimination rate

67
Q

What is likely to occur during the peak of drug effects?

A

Side effects (hypoglycemia)

68
Q

What is the duration of drug effects?

A

Length of time drug produces the therapeutic effect

69
Q

What factors influence the duration of drug effects? (3)

A
  • Half life
  • Metabolism
  • Excretion
70
Q

Peak level has the ______ blood level of drug

A

Highest

71
Q

Trough level has the ______ blood level of drug

A

Lowest

72
Q

Describe drug toxicity

A

Peak level is too high

73
Q

______ is used to measure peak / trough levels

A

Therapeutic drug monitoring

74
Q

What are the goals of therapeutic drug monitoring? (2)

A
  • Maximize therapeutic effects
  • Minimize toxicity
75
Q

______ refers to what a medication does to the body

A

Pharmacodynamics

76
Q

What occurs during pharmacodynamics?

A

Drug binds to receptors to enhance / suppress actions of the body

77
Q

What are the 3 effects of pharmacodynamics?

A
  • Agonists
  • Antagonists
  • Partial agonists
78
Q

______ enhance / activate actions

A

Agonists

79
Q

What happens when an agonist binds to a receptor?

A

Response

80
Q

______ block / deactivate actions

A

Antagonists

81
Q

What happens when an antagonist binds to a receptor?

A

No response

82
Q

______ enhance actions but with lesser intensity

A

Partial agonists

83
Q

______ compete with agonists to bind to a receptor

A

Competitive antagonists

84
Q

What is therapeutic index?

A

Ratio between the lethal dose and the average effective dose

85
Q

A ______ therapeutic index indicates a safer drug

A

Wide

86
Q

What are the mechanisms of action in pharmacodynamics? (2)

A
  • Modify cell / tissue function
  • Modify strength of cell / tissue function
87
Q

______ refers to the use of drugs to treat, prevent, and diagnose disease

A

Pharmacotherapeutics

88
Q

What are the 2 key concepts of pharmacotherapeutics?

A
  • Drug’s effect on the body
  • Body’s response to the drug
89
Q

______ therapy occurs in the acutely ill phase, and is needed to sustain life or treat disease

A

Acute

90
Q

______ therapy is used to prevent progression of a disease of condition

A

Maintenance

91
Q

______ therapy is replacement therapy to supply the body with a substance to maintain normal function

A

Supplemental

92
Q

Name an example of a medication used for supplemental therapy

A

Insulin

93
Q

______ therapy is used to make a patient comfortable; relief of symptoms

A

Palliative

94
Q

______ therapy is used to maintain integrity of body functions while recovering

A

Supportive

95
Q

What are some examples of supportive therapy? (3)

A
  • Nutrients
  • Electrolytes
  • Blood
96
Q

______ therapy is used to prevent illness during planned events

A

Prophylactic

97
Q

Name an example of a medication used for prophylactic therapy

A

Pre-operative antibiotics

98
Q

______ therapy is based on clinical probabilities

A

Empiric

99
Q

Name an example of a medication used for empiric therapy

A

Antibiotics prior to culture and sensitivity reports

100
Q

______ are unintended pharmacologic effects that occur when a medication is administered correctly

A

Adverse events

101
Q

Describe an example of an adverse event

A

Severe kidney impairment with antibiotic use

102
Q

______ are secondary unwanted effects that occur due to drug therapy

A

Side effects

103
Q

Describe an example of a side effect

A

Diarrhea with antibiotic use

104
Q

What are the 3 methods of med error prevention?

A
  • Verification
  • Clarification
  • Reconciliation
105
Q

What is verification?

A

Current medications, OTC, and herbals

106
Q

What is clarification?

A

Reviewing to ensure medications and dosages are appropriate

107
Q

What is reconciliation?

A

Investigation of discrepancies and changes in orders

108
Q

What are the 4 types of ADRs?

A
  • Pharmacologic reaction
  • Hypersensitivity reaction
  • Idiosyncratic reaction
  • Drug interaction
109
Q

What is a pharmacologic reaction?

A

Extension of a drug’s desired effect

110
Q

Describe an example of a pharmacologic reaction

A

Hypotension from anti-hypertensive drug

111
Q

Describe hypersensitivity reactions (3)

A
  • Immunoglobulins recognize a drug as foreign
  • Immunoglobulins bind to neutralize
  • Chemical mediators are released
112
Q

What are some examples of chemical mediators released during a hypersensitivity reaction? (3)

A
  • Histamines
  • Cytokines
  • Inflammatory substances
113
Q

What is an idiosyncratic reaction?

A

Deficiency or excess of drug metabolizing enzymes

114
Q

What is a drug interaction?

A

Multiple drugs produce an unwanted effect

115
Q

______ refers to the obsessive desire for euphoria from a drug (addiction)

A

Psychological dependence

116
Q

Using a medication beyond medical necessity may constitute ______

A

Drug abuse

117
Q

______ are of most concern regarding substance abuse / addiction

A

Narcotics

118
Q

______ have the highest potential for abuse and lack any acceptable medical use

A

Schedule 1 drugs

119
Q

Name an example of a schedule 1 drug

A

Heroin

120
Q

What is drug tolerance?

A

Decreased response from repeated doses of a drug

121
Q

What are some important considerations regarding toxicology (poisoning / overdose)? (2)

A
  • Safe storage of medications
  • Knowledge of reversal / antidote agents
122
Q

_______ refers to the study of how genetics effect response to medications

A

Pharmacogenomics

123
Q

Describe the special considerations of pediatrics in medication effect (3)

A
  • Slower gastric emptying
  • Blood brain barrier not fully developed
  • Kidneys not fully developed
124
Q

Pediatric doses are typically ______ based

A

Weight / BSA

125
Q

Distribution altered with lower circulating protein levels = ______

A

Higher circulating drugs

126
Q

Describe the special considerations of geriatrics in medication effect (2)

A
  • Altered pharmacokinetics
  • Increased risk of drug interactions
127
Q

What methods are used to ensure drug safety for older adults? (2)

A
  • Serum drug levels
  • Decreased dosages
128
Q

Describe the special considerations of pregnancy / lactation in medication effect (3)

A
  • Drugs may be passed through the placenta
  • Drugs may be passed through breast milk
  • Teratogenesis
129
Q

What is teratogenesis?

A

Potential to cause birth defects

130
Q

Drug response is dependent on ______

A

Adherence

131
Q

Herbal and homeopathic remedies can …

A

Inhibit or accelerate drug metabolism

132
Q

What does patient teaching begin?

A

Admission (first encounter)

133
Q

Patient teaching must be ______

A

Individualized

134
Q

What drug uses are important to ask during the health history? (3)

A
  • Prescribed
  • OTC
  • Herbal / homeopathic remedies

NURS 305 - All Content (20 decks)

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