Introduction to Pharmacology Flashcards
1
Q
The study of the biological effects of chemicals.
In clinical practice, health care providers focus on how chemicals act on living organisms.
A
Pharmacology
2
Q
______________ - study the medication itself
A
Pharamcists
3
Q
Remember: Nurses - How we can administer medications safely; familiarize drugs that are about to be given; understand the effects of drugs
❗NURSES ADMINISTER
A
Yes
4
Q
Chemicals that are introduced into the body to cause change
A
Drugs
5
Q
A branch of pharmacology that uses drugs to treat, prevent, and diagnose diseases.
A
Pharmacotherapeutics/Clinical Pharmacology
6
Q
❗ 2 KEY CONCERNS
A
- The drug’s effect on the body (different effects)
- Body’s response to the drug
7
Q
4 Basic Terms: DPTC
A
Drugs, Pharmacology, Therapeutics, Clinical Pharmacology
8
Q
A ___ is defined as any chemical that can affect living processes.
A
drug
9
Q
The study of drugs and their interactions with living systems.
Encompasses the study of the physical and chemical properties of drugs as well as their biochemical and physiologic effects.
Includes knowledge on the history, sources, and uses of drugs as well as drug absorption, distribution, metabolism, and excretion. (ADME)
A
Pharmacology
10
Q
also known as pharmacotherapeutics
use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy.
The medical use of drugs
A
Therapeutics
11
Q
the study of drugs in humans.
the study of drugs in patients as well as in healthy volunteers
A
Clinical pharmacology
12
Q
___________ → Greek → Poison
A
Pharmakon
13
Q
Properties of an Ideal Drug
❗ESS❗
A
Effectiveness
Selectivity
Safety
14
Q
a drug that elicits the responses for which it is given.
________ is the most important property that a drug can have.
A
Effectiveness
15
Q
___________
is defined as one that cannot produce harmful effects even if administered in very high doses and for a very long time.
A
Safety
16
Q
is defined as one that elicits only the response for which it is given.
A
Selectivity
17
Q
REMEMBER:
Selectivity - for the desired effect to cure the symptom
All medications have effects.
No medication does 1 effect, it usually has other effects.
A
Yes
18
Q
Additional Properties of an Ideal Drug:
❗FLERP C❗
A
Reversible Action
Predictability
Ease of Administration
Freedom from Drug Interactions
Low Cost
Chemical Stability
19
Q
It is important that drug effects are reversible; we want drug actions to subside within an appropriate time
wearing off of drug
EX: Anesthesia - in 6 hrs you should be awake
A
Reversible action
20
Q
The certainty just how a given patient should respond
example: improvements on the patient’s status or the course of actions of medications
A
Predictability
21
Q
should be simple to administer;
the route should be convenient, and the number of doses per day should be low.
A
Ease of administration
22
Q
When the patient is taking 2 or more drugs, those drugs can interactions may augment or reduce drug responses.
A
Freedom from drug interactions
23
Q
REMEMBER: Drug to drug interactions - contraindication
A
YES
24
Q
An ideal drug should be easy to afford
A
Low Cost
25
ADMINISTRATION
_____________, ____________, ______________, ______________ of administration are important determinants of drug responses.
Poor patient compliance and medication errors by hospital staff can result in major discrepancies.
dosage, size, route and timing
26
Some drugs lose effectiveness during storage.
Others may be stable on the shelf, and can rapidly lose effectiveness when put into solution.
Because of chemical instability, stocks of certain drugs must be periodically discarded
shelf-life, correct storage, expirations
e.g. photosensiitve medications kept away from light
Chemical stability
27
Routes of Medication
Oral
IV
IM
Systemic
- Enteral
- Oral
- Sublingual
- Rectal
- Parenteral
- Inhalation
- Transdermal
- Injections
- IV
- IM
- SQ
- ID
- Intra-articular
- Intra-arterial
- Intrathecal
Local
- Topical
- Deeper tissues
- Arterial supply
Other
- Vaginal
- Otic
- Ophthalmic
- Intranasal
- Buccal
- Intraosseous
28
is the most frequently used drug administration route in clinical practice.
non-invasive
less expensive
safest way to deliver drugs
Oral route
29
Non-invasive VS. Invasive
Non-invasive - less danger, no involvement of bloodstream
Invasive -dangerous
30
reach their full strength at the time of administration.
most effective and fastest
Intravenous Route (IV)
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absorbed directly into the the capillaries in the muscle and sent into circulation
Intramuscular Route (IM)
32
Who absorbs faster? Male or female? Why?
Bigger muscle, faster absorption (in males) - due to muscle volume
33
Determine the route: ointment for skin problems
Topical route
34
what the drug does to the body
Pharmacodynamics
35
what the body does to the drugs
Pharmacokinetics
36
the science dealing with interactions between the chemical components of living systems and the foreign chemicals
Pharmacodynamics
37
Drug Actions
Drugs work in one of four ways: ❗RIDI❗
to replace or act as substitutes for missing chemicals.
to increase or stimulate certain cellular activities.
to depress or slow cellular activities
to interfere with the functioning of foreign cells, such as invading microorganisms or neoplasms (chemotherapeutic drugs)
38
drugs act at specific areas on cell membranes called ______________
Receptor Sites
39
how enzymes fit their substrate. The active site of an enzyme is structured to fit a specifically shaped substrate. Once the substrate binds to the active site, the enzyme will facilitate the reaction and release products of the reaction.
EX: Prostaglandins - pain receptor
Lock and Key Model
40
Drugs can also cause their effects by interfering with the enzyme systems that act as a catalyst for various chemical reactions.
Drug-Enzyme Interactions
41
The ability of a drug to attack only those systems found in foreign cells.
Affects an enzyme unique to bacteria, causing bacterial cell death without disrupting normal human cell functioning
No such thing as a perfect drug, only an ideal drug.
Selective Toxicity
42
involves the study of absorption, distribution, metabolism (biotransformation), and excretion of drugs. (ADME)
Pharmacokinetics
43
Pharmacokinetics
In clinical practice, pharmacokinetic considerations include the_______________, ____________, _______________, _______________, _______________________, and the_______________________.
onset of drug action,
drug half-life,
timing of the peak effect,
duration of drug effects,
metabolism or biotransformation of the drug,
and the site of excretion.
44
4 Major Pharmacokinetic Processes
Drug Absorption
Drug Distribution
Drug Metabolism
Drug Excretion
45
is the movement of a drug into the bloodstream after administration.
The transportation of the unmetabolized drug from the administration site to the body circulation system.
Drug absorption
46
the disbursement of an unmetabolized drug as it moves through the body's blood and tissues.
Distribution
47
the biotransformation of pharmaceutical substances in the body so that they can be eliminated more easily.
Drugs can be metabolized by
oxidation,
reduction,
hydrolysis,
hydration,
conjugation,
condensation, or
isomerization;
Metabolism
48
The enzymes involved in metabolism are present in many tissues but generally are more concentrated in the ________.
liver
49
is the removal of an administered drug from the body, either as a metabolite or unchanged drug.
(kidney)
excretion
50
There are many different routes of excretion, including __________, _______, __________, ____________, _____________.
Also __________ - via breastfeeding
❗BUFSS M❗
bile
urine
feces
sweat
saliva
milk
51
the amount of drug that is needed to cause a therapeutic effect
Desired dose
- For the desired effect
Critical Concentration
52
some drugs that take a prolonged period to reach a critical concentration; if their effects are needed quickly, a _____________________ is recommended.
Loading Dose
53
a drug used to increase the strength of heart concentrations.
Digoxin (Lanoxin)
54
used to treat asthma attacks are often started with a loading dose to reach the critical concentration.
Xanthine bronchodilators
55
TRUE OR FALSE. The critical concentration then is maintained by using the recommended dosing schedule after the loading dose.
True
56
REMEMBER: Loading dose - first dose of antibiotic won't work asap. Dose that is much higher than the prescribed dosage started to trigger the body.
Yes
57
the actual concentration that a drug reaches in the body results from a dynamic equilibrium involving
Several factors:
Absorption from the site of entry
Distribution to the active site
Biotransformation (metabolism) in the liver
Excretion from the body
Dynamic Equilibrium
58
refers to what happens to a drug from the time it is introduced to the body until it reaches the circulating fluids and tissues.
Absorption
59
Drugs can be absorbed from many different areas in the body:
❗Ms. Grandmother saw Lisa❗
1. Through the GI tract (orally or rectally administered)
2. Through mucous membranes.
3. Through the skin
4. Through the lungs
5. Through muscles or subcutaneous tissues
60
Drugs can be absorbed into cells through various processes:
Passive Diffusion
Active Transport
Filtration
61
major process through which drugs are absorbed into the body.
occurs across a concentration gradient; when there is a greater concentration of drug on one side of a cell membrane move to an area of lower concentration.
Passive Diffusion
62
a process that uses energy to actively move a molecule across a cell membrane.
often involved in drug excretion in the kidney.
Active Transport
63
commonly used in drug excretion.
involves movement through pores in the cell membrane. either down a concentration gradient or as a result of the pull of plasma proteins
Filtration
64
Remember:
PD - higher to lower concentration
AT - needs energy (ATP)
Adenosine triphosphate
F - movement through pores
Yes
65
happens when the drug is taken per orem (by mouth)
a large percentage of the oral dose is destroyed at this point and never reaches the tissues.
___________________- absorption happens, then medication passes through many systems then only few is left for the targeted or specific tissue
First-pass Effect
66
a protective system of cellular activity that keeps substances away from the CNS.
drugs that are not lipid-soluble are not able to pass the BBB.
Blood Brain Barrier
67
a drug that can pass the BBB.
Mannitol
68
the nurse must always check the the ability of a drug to pass into the breast milk when giving a drug to a breat-feeding mother
Placenta and Breast Milk
69
________________ happens in the:
enzymes in the liver
lining of the GI tract
Biotransformation
70
the removal of a drug from the body.
Excretion
71
Some of the routes to excrete drugs: ❗SLSBF u❗
Skin,
saliva,
lungs,
bile,
feces
urine
72
organs that plays the most important role in drug excretion;
kidneys
73
drugs that have been made water soluble in the liver are often readily excreted from the kidney by the ______________________
glomerular filtration
74
To check for kidney function - what methods
BUN
Creatinine
GFR - best way or method
75
the time it takes for the amount of drug in the body to decrease to one-half of the peak level it previously achieved.
EXAMPLE: if a patient takes 20mg of a drug with a half life of 2 hours, the 10 mg of the drug will remain 2h after administration. 2h later, 5mg will be left, in 2 more hours, only 2.5 mg will remain.
Half-life
76
term used to describe how a drug or other substance produces an effect in the body
course of the action of the medication before it takes effect.
Mechanism of Action
77
undesirable effect of the drug
expected
Side Effects
78
refers to the maximum concentration of medication in the body and the client shows evidence of greatest therapeutic effect
Maximum strength
Note: Monitor possible reversible reactions
Peak
79
refers to the length of the time the medication produces its desired therapeutic effect.
For example the duration of oral acetaminophen is four to six hours at which time the client will likely require an additional dose for pain
Duration
80
refers to when the medication first begins to take effect
Onset of Medication
81
Example:
insulin - _____ cells in __________ of pancreas
- Humalog insulin has an onset of 15 minutes.
- Peak or maximum strength is in 30 minutes.
2pm insulin injected
2:30 peak
Onset- the start of the effect
Peak- to check for signs of hypoglycemia
beta
islets of langerhans
82
Informations about the drug
Folded paper in a medicine box
Drug Literature
83
Side effects - expected effects
Nausea, vomiting, diarrhea (N/V/D) - common for most medications
Adverse effects - unexpected
yes
84
undesired effects that may be unpleasant or dangerous.
Most common effect: drug allergy
Adverse Effects
85
Adverse effects can occur for many reasons:
❗TOSU❗
The drug may have other effects on the body besides the therapeutic effect.
The patient is sensitive to the drug being given.
The drug's action on the body causes other responses that are undesirable.
The patient is taking too much or too little of the drug leading to adverse effects.
86
87
Desired therapeutic effect
Primary Actions
88
primary effect + beneficial or harmful effect
Secondary Actions
89
H1 - allergy
H2 - responsible for gastric
histamine
90
H2 blockers - Tidine
Famotidine
Cimetidine
Nizatidine
Ranitidine
Primary -suppresses gastric juices, suppress acid production in your stomach
Secondary - dilates bronchioles
yes
91
Some patients have an unusually strong reactions to a drug
This reaction can be triggered by high doses or a certain amount of medication.
e.g. you’ve been taking a drug a long time but it was given in a higher dose then you developed it
Hypersensitivity
92
the body’s immune system reacts to a specific drug
Drug Allergy
93
Drug Allergy -Since birth
Hypersensitivity - Ma develop allergy
yes
94
Types of Drug Allergy
CASD
Anaphylactic Reaction
Cytotoxic Reaction
Serum Sickness Reaction
Delayed Allergic Reaction
95
multi-systemic allergic reaction
Airway blockage
Throat swells
Rash, hives urticaria
Lips and periorbital edema
Tongue
Throat
Involves histamine
Anaphylactic Reaction
96
reactions that involves the immune systems
Cytotoxic Reaction
97
involves the tissues, organs
Joint swelling
Rash and hives
Serum Sickness Reaction
98
Dermatological reactions
Rash
Hives
Stomatitis
99
the normal flora that protects the body from invasion of bacteria, viruses, fungi, etc. is destroyed. (antibiotics)
Superinfections
100
Toxicity
Liver injury
Renal injury
Poisoning
101
Ototoxic-
Nephrotoxic-
Hepatotoxic -
Ototoxic- ears
Nephrotoxic- kidneys
Hepatotoxic - liver
102
bone marrow suppression caused by drug effects.
Blood dyscrasia
103
Suppression - drugs affects the production of RBC
Depression - own disease
yes
104
Symptoms can be anemia, leukopenia, thrombocytopenia or any blood disorders.
__________________ - all RBC, WBC, all components of blood are low
Pancytopenia
105
Highest to Lowest drug absorption
IV
IM
SUBCUTANEOUS
ORAL
TOPICAL
106
Nursing Pharmacology: Nursing Responsibilities
❗AMATI❗
Administering drugs
Assessing drug effects
Intervening to make the drug regimen more tolerable
Providing patient teaching about drugs and the drug regimen
Monitoring the overall patient care plan to prevent medication errors.
107
Sources and Evaluation of Drugs
Sources of drugs : ❗SIPA❗
chemicals that might prove useful as drugs can come from many
natural sources, such as plants, animals, or inorganic compounds, or they may be developed synthetically.
108
Plants and plant parts have been used as medicines.
______________ products used to treat cardiac disorders
______________ used for sedation
- drugs may also be processed using a synthetic version of the active chemical found in a plant. e.g
_______________ leaf: a synthetic version allows for an accepted form to achieve the desired the therapeutic effect in cancer patients
Digitalis
Opiates
Marijuana
109
Used to replace human chemicals that are not produced because of disease or genetic problems.
Animal Products
110
The process of altering DNA to produce a substance
Genetic Engineering
111
Salts of various elements can have therapeutic effects in the human body.
Inorganic Compound
112
decrease gastric acidity
Aluminum
113
prevention of dental cavities,
prevention of osteoporosis
Fluoride
114
tx of iron deficiency anemia
Iron
115
tx of rheumatoid arthritis
Gold
116
Scientists use genetic engineering to alter bacteria to produce chemicals that are therapeutic and effective.
Alter chemicals with proven therapeutic effectiveness to make it better.
Synthetic Sources
117
Drug Evaluation
Preclinical Trials - chemicals may have therapeutic value and are tested on animals.
2 purposes:
To determine whether they have the presumed effects in living tissue
To evaluate any adverse effects
118
At the end of clinical trials, chemicals are discarded for the following reasons:
TTTS
1. The chemical lacks therapeutic activity when used with living animals.
2. The chemical is too toxic to living animals to be worth the risk of developing into drugs.
3. The chemical is highly teratogenic.
4. The safety margins are so small that the chemical would not be useful in the clinical setting.
119
A ___________ is anything a person is exposed to or ingests during pregnancy that's known to cause abnormalities. It affects the fetus inside the uterus.
teratogen
120
use healthy human volunteers to test the drugs
trials are performed by specially trained clinical investigators
Phase 1 Studies
121
Phase 1:
Reasons chemicals are dropped from the the process: TATT
They lack therapeutic effect in human.
They cause unacceptable adverse effects.
They are highly teratogenic
They are too toxic
122
allow clinical investigators to try the drug in patients who have the disease that the drug is meant to treat.
The subject has the condition
Phase 2 Studies
123
Phase 2 Studies
Reasons chemicals are dropped from the process: ETAR
It is less effective than anticipated.
Too toxic when used with patients.
Produces unacceptable adverse effects
Has a low benefit-to-risk ratio
124
prescribers observe patients very closely for any adverse effects.
prescribers ask patients to keep journals and record any symptoms they experience.
prescribers then evaluate the reported effects to determine whether they are caused by the disease or by the drug.
information are collected and shared with the FDA ( food and drug adminstration)
Phase 3 Studies
125
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127
128
129
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