MEDICATION CONCEPTS AND CONSIDERATIONS Flashcards by Shaquan Moore

Q

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

Key, Receptor, or Drug

A

Drug

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Q

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

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪CHEMICAL NAME

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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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Q

▪ Name given by the United States Adopted Names Council

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪GENERIC NAME

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Q

▪ Named by Active ingredient

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

▪GENERIC NAME

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Q

▪ The drug has a registered trademark

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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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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Q

2-Acetoxybenzoic acid

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

CHEMICAL NAME

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Q

Aspirin (acetylsalicylic acid)

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

GENERIC NAME

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Q

Aspro Clear®

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

BRAND/TRADE NAME

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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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Q

? names last FOREVER

GENERIC NAME, CHEMICAL NAME, BRAND/TRADE NAME

A

GENERIC NAME

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Q

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

bioequivalent of biotransmited

A

bioequivalent

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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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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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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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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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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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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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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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Q

Controlled Substances (DEA Schedules)
Non-Controlled

Over the Counter, RX (Prescription), Dietary Supplements

A

RX (Prescription)

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Q

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

Over the Counter, RX (Prescription), Dietary Supplements

A

Over the Counter

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Q

Vitamins
Herbals
Homeopathic

Over the Counter, RX (Prescription), Dietary Supplements

A

Dietary Supplements

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Q

Homeopathic

Over the Counter, RX (Prescription), Dietary Supplements

A

Dietary Supplements

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RX (Prescription) a. REGULATION- FDA, b. REGULATION - The supplement manufacturers and distributors

a. REGULATION- FDA,

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

a. REGULATION- FDA,

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

b. REGULATION - The supplement manufacturers and | distributors

◦ Means that these drugs require periodic monitoring Over the Counter, RX (Prescription), Dietary Supplements

RX (Prescription)

◦ They must be prescribed by a health care professional Over the Counter, RX (Prescription), Dietary Supplements

RX (Prescription)

◦ Means that these are generally safe and don’t require periodic monitoring Over the Counter, RX (Prescription), Dietary Supplements

Over the Counter

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

FDA

▪ Clinical Trials Goal: Drug is SAFE AND EFFECTIVE DEA, FDA

FDA

? - Categories A through X Pregnancy New method or Old method

Old method

? - Labeling Pregnancy New method or Old method

New method

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

Old method

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

Old method

New method Registry, risk summary, clinical considerations, data Lactation, Pregnancy, Females and Male of Reproductive Potential

Pregnancy

New method | Risk summary, clinical considerations, data

Lactation

New method | Pregnancy/Infertility

Females and Male of Reproductive Potential

No risk to human fetus Cat. B, A, D, X, C

Cat A

No risk to animal fetus, information for humans unavailable

Cat B

ADE to animal fetus, information for humans unavailable

Cat C

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

Cat D

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

Cat X

Which method focus on labeling pregnancy risk New method or Old method

New method

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

f. All

Which Rems Drug Antipsychotic- lowers Absolute Neutrophil Count (ANC) Clozapine- Clozaril® Isotretinoin (Accutane®)

Clozapine- Clozaril®

Which Rems Drug Used to Treat: Acne Clozapine- Clozaril® Isotretinoin (Accutane®)

Isotretinoin (Accutane®)

Which Rems Drug ◦ =increased risk for infection Clozapine- Clozaril® Isotretinoin (Accutane®)

Clozapine- Clozaril®

Which Rems Drug ◦ Pregnancy Category: X (highly teratogenic!) Clozapine- Clozaril® Isotretinoin (Accutane®)

Isotretinoin (Accutane®)

Called iPLEDGE ?

Rems Drugs

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)

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

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. 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)

(sold without prescription) Over the Counter, RX (Prescription), Dietary Supplements

Over the Counter

(need prescription) Over the Counter, RX (Prescription), Dietary Supplements

RX (Prescription)

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

DEA

The 5 schedules are categorized based on: a. Abuse potential, b. SUD, misuse c. Medical use d. Dependency potential e. None f. All

f. All

▪These drugs are commonly referred to as: a. Controlled Substances, b. Scheduled Drugs c. Narcotics d. None e. All

e. All

Marijuana, Heroin, LSD Schedule 1-5? Abuse Potential? Medical Use? Dependency Potential?

Schedule 1 High None Severe

Codeine with APAP (acetaminophen) Schedule 1-5? Abuse Potential? Medical Use? Dependency Potential?

Schedule 3 Less than 2 Accepted Moderate to low

``` Codeine, oxycodone, cocaine, hydrocodone with APAP (acetaminophen) ``` Schedule 1-5? Abuse Potential? Medical Use? Dependency Potential?

Schedule 2 High Accepted Severe

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

Schedule 4 Less than 3 Accepted Limited

Most cough medications containing an opioid Schedule 1-5? Abuse Potential? Medical Use? Dependency Potential?

Schedule 5 Less than 4 Accepted Limited

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

True

Schedule III- (C III)- NO REFILLS True or False

False Schedule II (C II)

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

True

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

both

Increased risk of pediatric deaths due to Tramadol and Codeine T or F

T

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

▪PHARMACOGENETICS-

▪ Genetic Polymorphisms PHARMACOGENOMICS or PHARMACOGENETICS

▪PHARMACOGENETICS-

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

▪PHARMACOGENOMICS-

Codeine is a Pro-Drug T or F

T

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

All

Pediatric deaths when prescribed Codeine Indirect or Direct

Direct

Infant deaths when Mother is breastfeeding while taking Codeine Indirect or Direct

Indirect