lecture 1 Flashcards
What are the 3 things you need to know about drugs?
- potential side effects
- Drug interactions
- special populations
When a drug is ordered we need to know:?
the name of the drug its intended use the effects what it is suppose to do contra indications special considerations potential side effects
** relating to the presciption of a drug for a condition other than that for which it has been offically approved.
off-label
the conditions for which a drug is approved
indications
**how much of the drug is useful to our body.
bioavaliability; the degree to which a drug becomes avaliable to the target tissue after administration.
the study of drugs in human
clinical pharmacology
any chemical that can affect living organisms, or any substance taken to prevent, cure, or reduce symptoms of a medical condition
drug
use of drugs to diagnose diease, prevent, or treat diease or to prevent pregnancy
therapeutics
**N- acetyl- para- aminophenol
chemical name
**acetaminophen
generic name
**tylenol
trade name
**__,___,__ can affect bioavaliabilty.
inner ingredients
rate of absorbtion
tablet compression
**___ DO NOT exist
ideal drugs
the 3 most important characteristics of an ideal drug are:
effectiveness
safety
selectivity
**easy for patient; make it better for patient to take meds.
ease of administration ; ideal drug
with ease of administration, the patient had to have to ability to ___, ____, and ___.
pay
manual dexterity
visual acuity
**a single drug in a class that can be compared with all the other drugs in that class.
prototype drug; so becoming familiar with the prototype should allow you to predict characteristics of other drugs in that same class except for contra indications.
**drug interaction- 2 drugs together are?
beneficial and purposeful
**in the new drug development, what phases were given to healthy individuals? then what phase is given to actual patients?
1
2 &3
**in the new drug development, what phases was after markets and side effects occured in?
4
where drugs are evaluated for toxicities, pharmacokinectic properties and usefulness- can take 6 yrs or more- if a drug appears promising a pharm. company will submit an investiggational new drug to the FDA to behin testing a human substances.
preclinical testing in new drug development
in clinical testing, phase ___ are before drugs hit the market.
1,2,3
postmarketing surveillances- takes places once the popultation starts to use the drug, monitor for adverse effect in large populations.
phase 4
**respond to chemicals in the body
drug receptors… on cell and some in cell
**receptors are ___ that interact with ___ to elicit a cellular response.
proteins
endogenous ligands
chemical messager/ hormone respond to the cell.
(lock and key)
(will open receptors)
ligands
all a drug can do is ____ the actions of ___, drugs cannot make cells do anything they would not ordinarly do.
mimic or block
endogenous molecules
**maximum response cell can give.
simple occupancy theory; explains the activity off drugs at the receptor, trying to quantify the relationship between the drug concentraton and the observed affect anther way to say it is an attempt to quantify how much medicine we have to put into someone before we get the affect we want. (LOOK AT CHART)
the intensity of a drug response is ____ to the amount of receptors occupied by that drug. ___ if you fill up a cell with the drug that cell is used up.
(simple occupancy)
proportional
maximum response
the strenght of the interaction/attraction between the drug and its receptor- if something has a high affinity then that means its highly potent
affinity (modified occupancy)
addresses the abilty of the drug to activate he receptors once its bond to it– with high instrinsic activity are highly affective. [high max efficiency]
instrinsic activity (modified occupancy)
mimics the actions of the endogenous regulatory molecules- turns the cell on
agonists
block the action of regulatory molecules- turns the cell off
antagonist; prevent from doing what typically does.
cant activate maximal activation; doesnt do really good.
partial agonist
The nurse is using a drug handbood to determine the indications for drug furosemide (lasix). the term indications is defined as the :
conditions for what a drug is approved. p.10
While completing the health history, the nurse asks the client, “ What medications do you take regularly?”. Which drug name would the nurse expect the client to use in providing the answer?
Trade name p.10
When providing nursing care for the client, the nurse understands that drugs are:
one of the many tools avaliable to prevent or treat human suffering.
Which client characteristics, if noted in the client’s medical record, would the nurse consider important information that may affect the physiological response to various types of drug therapy? select all that apply.
a. 82 yr old and female
b. asian and obese
c. past medical history of kidney diesease
d. mother and sister of diabetes
e. has no medical insurance.
a,b,c,d
the nurse is looking up a drug that has been prescribed and wants to know the therapeutic classification for the drug. what of the following would indicate a therapeutic classification?
- beta-adrenergic antagonist
- antihypertensive
- diuretic
- calcium channel blocker
- antihypertensive
the nurse is asked by a family member: “ they’re giving mom Motrin and she takes Advil. Hasnt the wrong drug been ordered?” The nurse will respond, knowing that:
- Motrin and Advil are trade names for the same generic drug, ibuprofen.
The nurse knows that governmental drug legislation requires the drug manufactorer to prove that the drug is both safe and :
effective for a specified purpose p.21
the drug research participants with a particular disease is taking part in an investigative study to examine the effects of a new drug. previously, this drug was tested with healthy volunteers. in which phase of the clinical trail investigation is this client participating?
Phase 2
when considering various drug therapies, the nurse knows that most drug testing and approval occurs with which population?
caucasian males and may not be safe for other populations
the client requires that a refill prescription of a schedule II controlled substance be telephoned to the drug store. whn responding to the client, the nurse would consider which factor? refills of schedule II drugs:
are not permitted under federal law
the nurse knows that drugs that are subject to stricter regulations are those:
with high potential for abuse or dependency p.22
a nurse notes that multiple clients had a reaction to the same medication, a drug that has been avaliable for several years. which action should the nurse take? select all that apply.
- file an adverse event report with the FDA
- note the reaction in the client’s chart
- notify the health care provider who ordered the drug
- wait until the FDA send a notification of the drugs recall before informing the client
- compare each clients reaction to determine if it is the same
1,2,3
what the body does to chemicals. study of drug movement throughout the body.
pharmacokinetics
the study of what drugs do to the body and how they do it.
pharmacodynamics
what are the components to pharmacokinectics?
absorbtion- site of administration to blood
distribution- blood to action
metabolism- (biotransformation) change in drug structure so avaliable for use
excretion- out
Absorbtion, distriution, metabolsim, & excretion determine what we ___,___ and ___.
prescribe
how much
and how often the drug has to be taken
some drugs have to completely ____ to work.
metabolize
how the drug gets into the body.
absorbtion
- blood flow
- lipid solubility (meds get into cell easily)
- ph (going from one level to another)
what administration is less predictable?
p.o, by mouth
route of absorbtion that can be predicted right now & precise control.
parental (IV)
disadvantage- impossible to get out of system
what is the order of route of absorbtion?
IV, IM, SUBQ, PO
What route of absorbtion is rapid with water soluble?
IM and SUBQ
blood flow to tissue
distribution
keep things out of brain; hard to get passed; in children NOT completely formed.
blood brain barriers (distribution)
protein binding, the action ____.
last longer! only a little will fall off protein at a time.
recognize something there that did not use to be there.
cytochrome p450
- recognize bad
- some med have to be changed, but all meds need to chane so we can pee them out
- will change everything we put in our body
with ____, metabolism is the only thing not impacted
pregnancy!
This is the impact of the drugs on our bodies.
more often than not we want a specific area impacted by the drug- which is called ___.
pharmacodynamics
site of action
at least this much for body to respond to toxicity. you have to have minimum certain amount in your blood for the medicine to work.
minimum effective concentration (MEC)
-we draw blood levels to get an idea of how much medicine is at the site of action.
how often we need to give medicine depends on its ___.
half life
when the medicine has a ____, the pt does not need to take as often.
long half life
when the medicine has a ____, the pt need to take it more often.
short half life
is a ratio between the dosage of a drug that causes a lethal affect (LD) and the dosage that causes the therapeutic effect.
Therapeutic index (TI)
value determined by animals during the preclinical experiments. it is the dose that will kill 50% of a group of animals.
medical legal dose (LD50)
a drug that has a ___ therapeutic index is probably safe, one with a ___ therapeutic index you have to be concerned with
high, low
you need at least this much in your body to work.
therapeutic index
toxicity ___ allergic reaction.
IS NOT
time required for the amount of drug in the body to decrease by 50%.
half life
large dose; for therapeutic range, what goes out must be replaced.
loading dose.
____ is more important than potency!!
efficacy
drug- drug interaction; if you put two drugs together you will have an ___, or a ____, or a _____.
intensification of effects
reduction in effects
unique response
What trimester can affect the fetus the most?
ANY TRIMESTER can be harmful!
just because a drug is natural doesnt always mean its ___.
safe
if you dont have enough of the medicine in you body,it isnt going to work. what term is this?
minimum effect concentration
young people metabolizes because of ___.
organ immaturity.
if you are taking meds. on an empty stomach it should be __ before or ___ after
1 hr
2 hr
secondary effects affect produced at therapeutic doses
side effects
ADR caused by excessive/too much dosage
toxicity
this effects occurs at normal dose!
adverse drug effects
