MEDICATION CONCEPTS AND CONSIDERATIONS Flashcards

1
Q

◦ Any chemical that affects the physiologic processes of a living organism

Key, Receptor, or Drug

A

Drug

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2
Q

▪ Describes the drug’s chemical composition & molecular structure (IUPAC)

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪CHEMICAL NAME

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3
Q

▪ This name is generally NOT used in the clinical/prescribing setting

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪CHEMICAL NAME

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4
Q

▪ Name given by the United States Adopted Names Council

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪GENERIC NAME

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5
Q

▪ Named by Active ingredient

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪GENERIC NAME

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6
Q

▪ The drug has a registered trademark

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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7
Q

▪ use of the name is restricted by the drug’s patent owner (usually the manufacturer)

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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8
Q

2-Acetoxybenzoic acid

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

CHEMICAL NAME

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9
Q

Aspirin (acetylsalicylic acid)

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

GENERIC NAME

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10
Q

Aspro Clear®

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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11
Q

? Name is a patent protected name, patents EXPIRE over time (~17 years)

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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12
Q

? names last FOREVER

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

GENERIC NAME

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13
Q

The FDA says that generic drugs must be ? to brand name drugs

bioequivalent of biotransmited

A

bioequivalent

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14
Q

With NARROW THERAPEUTIC INDEX DRUGS such as seizure drugs the patient should have

a. Use the SAME manufacturer
b. Use a Different manufacturer
c. Not necessarily the BRAND
d. But a CONSISTENCY in the product they use

A

a. Use the SAME manufacturer
b. Not necessarily the BRAND
c. But a CONSISTENCY in the product they use

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15
Q

Examples of some drug classes where generally we do not change manufacturers?

a. Thyroid,
b. Epilepsy,
c. Transplant, and a few other conditions
d. None
e. All

A

e. All

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16
Q

Plants

a. Heparin
b. Digoxin
c. Penicillin
d. Zinc
e. Pancreas- insulin (originally)
g. Insulins
h. Morphine
i. Iron

A

b. Digoxin

h. Morphine

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17
Q

Animals

a. Heparin
b. Digoxin
c. Penicillin
d. Zinc
e. Pancreas- insulin (originally)
g. Insulins
h. Morphine
i. Iron

A

e. Pancreas- insulin (originally)

a. Heparin

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18
Q

Minerals

a. Heparin
b. Digoxin
c. Penicillin
d. Zinc
e. Pancreas- insulin (originally)
g. Insulins
h. Morphine
i. Iron

A

d. Zinc

i. Iron

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19
Q

Laboratory synthesis

a. Heparin
b. Digoxin
c. Penicillin
d. Zinc
e. Pancreas- insulin (originally)
g. Insulins
h. Morphine
i. Iron

A

g. Insulins

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20
Q

Microbiological

a. Heparin
b. Digoxin
c. Penicillin
d. Zinc
e. Pancreas- insulin (originally)
g. Insulins
h. Morphine
i. Iron

A

c. Penicillin

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21
Q
Controlled Substances (DEA Schedules)
Non-Controlled

Over the Counter, RX (Prescription), Dietary Supplements

A

RX (Prescription)

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22
Q

Over the Counter (OTC)
Behind the Counter (BTC)

Over the Counter, RX (Prescription), Dietary Supplements

A

Over the Counter

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23
Q

Vitamins
Herbals
Homeopathic

Over the Counter, RX (Prescription), Dietary Supplements

A

Dietary Supplements

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24
Q

Homeopathic

Over the Counter, RX (Prescription), Dietary Supplements

A

Dietary Supplements

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25
Q

RX (Prescription)

a. REGULATION- FDA,
b. REGULATION - The supplement manufacturers and
distributors

A

a. REGULATION- FDA,

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26
Q

Over the Counter

a. REGULATION- FDA,
b. REGULATION - The supplement manufacturers and
distributors

A

a. REGULATION- FDA,

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27
Q

Dietary Supplements

a. REGULATION- FDA,
b. REGULATION - The supplement manufacturers and
distributors

A

b. REGULATION - The supplement manufacturers and

distributors

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28
Q

◦ Means that these drugs require periodic monitoring

Over the Counter, RX (Prescription), Dietary Supplements

A

RX (Prescription)

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29
Q

◦ They must be prescribed by a health care professional

Over the Counter, RX (Prescription), Dietary Supplements

A

RX (Prescription)

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30
Q

◦ Means that these are generally safe and don’t require periodic monitoring

Over the Counter, RX (Prescription), Dietary Supplements

A

Over the Counter

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31
Q

▪ Government Agency that reviews and approves drugs in U.S.A

DEA, FDA

A

FDA

32
Q

▪ Clinical Trials Goal: Drug is SAFE AND EFFECTIVE

DEA, FDA

A

FDA

33
Q

? - Categories A through X Pregnancy

New method or Old method

A

Old method

34
Q

? - Labeling Pregnancy

New method or Old method

A

New method

35
Q

Pregnancy Category B should be “safer” than Category C, but not always the case

New method or Old method

A

Old method

36
Q

▪ Categories don’t give you any details-Drug is “category B”, ok so what do I tell the patient?

New method or Old method

A

Old method

37
Q

New method
Registry, risk summary, clinical considerations, data

Lactation, Pregnancy, Females and Male of Reproductive Potential

A

Pregnancy

38
Q

New method

Risk summary, clinical considerations, data

A

Lactation

39
Q

New method

Pregnancy/Infertility

A

Females and Male of Reproductive Potential

40
Q

No risk to human fetus

Cat.
B, A, D, X, C

A

Cat A

41
Q

No risk to animal fetus, information for humans unavailable

A

Cat B

42
Q

ADE to animal fetus, information for humans unavailable

A

Cat C

43
Q

Possible fetal risk in humans have been reported, However in selected cases consideration of potential benefit vs risk may warrant use of these drugs in pregnant women

A

Cat D

44
Q

Fetal abnormalities and risk in humans and animals. Should not be given to pregnant women

A

Cat X

45
Q

Which method focus on labeling pregnancy risk

New method or Old method

A

New method

46
Q

Risk Evaluation and Mitigation Strategies (REMS DRUGS)
Which is true

a. Benefits > Risk, but we monitor for risk
b. Pharmacy and Prescriber register
c. Monthly requirements and criteria
d. Teamwork between patient, pharmacy and prescriber
e. None
f. All

A

f. All

47
Q

Which Rems Drug
Antipsychotic- lowers Absolute Neutrophil Count (ANC)

Clozapine- Clozaril®
Isotretinoin (Accutane®)

A

Clozapine- Clozaril®

48
Q

Which Rems Drug
Used to Treat: Acne

Clozapine- Clozaril®
Isotretinoin (Accutane®)

A

Isotretinoin (Accutane®)

49
Q

Which Rems Drug
◦ =increased risk for infection

Clozapine- Clozaril®
Isotretinoin (Accutane®)

A

Clozapine- Clozaril®

50
Q

Which Rems Drug
◦ Pregnancy Category: X (highly teratogenic!)

Clozapine- Clozaril®
Isotretinoin (Accutane®)

A

Isotretinoin (Accutane®)

51
Q

Called iPLEDGE ?

A

Rems Drugs

52
Q

Isotretinoin (Accutane®)

a. Enroll patient into Clozapine registry
b. Patient, Pharmacy, Prescriber enroll together
c. Report labs to REMS Program
d. Pregnancy test PRIOR to start
e. Monitor ANC at baseline and periodically
f. DURING therapy (refills), and 1 month AFTER stopping the drug
g. Educate about signs/symptoms of Neutropenia (infection)

A

b. Patient, Pharmacy, Prescriber enroll together
d. Pregnancy test PRIOR to start
f. DURING therapy (refills), and 1 month AFTER stopping the drug

53
Q

Clozapine- Clozaril®

a. Enroll patient into Clozapine registry
b. Patient, Pharmacy, Prescriber enroll together
c. Report labs to REMS Program
d. Pregnancy test PRIOR to start
e. Monitor ANC at baseline and periodically
f. DURING therapy (refills), and 1 month AFTER stopping the drug
g. Educate about signs/symptoms of Neutropenia (infection)

A

a. Enroll patient into Clozapine registry
c. Report labs to REMS Program
e. Monitor ANC at baseline and periodically
g. Educate about signs/symptoms of Neutropenia (infection)

54
Q

(sold without prescription)

Over the Counter, RX (Prescription), Dietary Supplements

A

Over the Counter

55
Q

(need prescription)

Over the Counter, RX (Prescription), Dietary Supplements

A

RX (Prescription)

56
Q

▪If drugs are found to have any dependency or abuse potential,
they are grouped into “schedules”

FDA or DEA

A

DEA

57
Q

The 5 schedules are categorized based on:

a. Abuse potential,
b. SUD, misuse
c. Medical use
d. Dependency potential
e. None
f. All

A

f. All

58
Q

▪These drugs are commonly referred to as:

a. Controlled Substances,
b. Scheduled Drugs
c. Narcotics
d. None
e. All

A

e. All

59
Q

Marijuana, Heroin, LSD

Schedule 1-5?
Abuse Potential?
Medical Use?
Dependency Potential?

A

Schedule 1
High
None
Severe

60
Q

Codeine with APAP
(acetaminophen)

Schedule 1-5?
Abuse Potential?
Medical Use?
Dependency Potential?

A

Schedule 3
Less than 2
Accepted
Moderate to low

61
Q
Codeine, oxycodone, cocaine, hydrocodone
with APAP (acetaminophen)

Schedule 1-5?
Abuse Potential?
Medical Use?
Dependency Potential?

A

Schedule 2
High
Accepted
Severe

62
Q

Benzodiazepines

Schedule 1-5?
Abuse Potential?
Medical Use?
Dependency Potential?

A

Schedule 4
Less than 3
Accepted
Limited

63
Q

Most cough medications
containing an opioid

Schedule 1-5?
Abuse Potential?
Medical Use?
Dependency Potential?

A

Schedule 5
Less than 4
Accepted
Limited

64
Q

If a prescriber wants to prescribe a controlled substance (II-V), they need a DEA license

True or False

A

True

65
Q

Schedule III- (C III)- NO REFILLS

True or False

A

False

Schedule II (C II)

66
Q

▪ Physician Assistants, Nurse Practitioners, Dentists, etc.
can prescribe Schedule drugs with DEA Liscense

T or F

A

True

67
Q

Which is true about schedule drugs
▪ADMINISTRATION
a. Keep them in secure areas (locked)
b. Have another nurse witness the discarding of controlled substances

A

both

68
Q

Increased risk of pediatric deaths due to Tramadol and Codeine

T or F

A

T

69
Q

The study of how genetic differences in a single gene influence variability in drug response (PK and PD)

PHARMACOGENOMICS or PHARMACOGENETICS

A

▪PHARMACOGENETICS-

70
Q

▪ Genetic Polymorphisms

PHARMACOGENOMICS or PHARMACOGENETICS

A

▪PHARMACOGENETICS-

71
Q

▪ The Study of how genetic difference in multiple genes influence variability in drug response

PHARMACOGENOMICS or PHARMACOGENETICS

A

▪PHARMACOGENOMICS-

72
Q

Codeine is a Pro-Drug

T or F

A

T

73
Q

Which is true about Codeine

a. Genetic Polymorphisms
b. CYP2D6
c. More than 70 different alleles have been discovered
d. Patients can be:
e. “ultra-rapid” metabolizers
g. “poor” metabolizers

A

All

74
Q

Pediatric deaths when prescribed Codeine

Indirect or Direct

A

Direct

75
Q

Infant deaths when Mother is breastfeeding while taking Codeine

Indirect or Direct

A

Indirect