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PCP > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

drug sources

A 
Plants:
morphine & codeine from poppy plant
Digitalis is from the purple foxglove 
Quinine is from cinchona tree bark
Paclitaxel is from the yew tree

Animals:
Insulin is obtained from pigs
Growth hormone is obtained from the pituitary glands

Bacteria:
Cephalosporins and ahminoglycosides

Chemical synthesis:
Most drugs today
Fentanyl

Minerals: vitamins

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2
Q

drug classification

A

Drugs that produce birth defects, such as thalidomide, are known asteratogens

Drugs that promote the growth of cancerous tumours are calledcarcinogens.

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3
Q

drug safety

A

Should be in therapeutic range

(TI) therapeutic index LD50/ED50 lethal dose, effective dose

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4
Q

what are drugs

A

chemical substance that produces a change In body function

Has specific chemical structure which means they have chemical and biological properties

Affect the functions of cells

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5
Q

side effects

A

More of a nuisance than they are harmful

Occur at minimal doses

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6
Q

adverse effects

A

Undesired effects that may be harmful

Reduction of stage or switching to an alternative drug often will avoid or minimize these consequences

Occur at high doses

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7
Q

toxic effects

A

Drug poisoning

Life threatening

Occur at very high doses

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8
Q

site of action

A

The location within the body where the drug exerts its therapeutic effect

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9
Q

drug forms

A

Aqueous Preparations - syrups, water and sugar combined with drug remove bitter taste of many drugs

Alcoholic preparations - elixirs are drugs dissolved in various concentrations of alcohol usually 5-20%

Solid and semisolid preparations - suppositories

Powders - drugs or drug extracts that are dried and ground into fine particles

Tablets - drug powders in convenient swallowing form and disintegrate in the stomach rapidly

Troches and lozenges - flattened tablets that dissolve in the mouth

Capsules - gelatin capsules used to administer drug powders or liquids, dissolve in the stomach

Delayed release products - tablets or capsules with a special coating so that various portions of the drug that will dissolve in certain rates, they usually contain 2-3 single dose units

Enteric coated products - drugs coated with an acid resistant substance that will dissolve in less acidic portions of the intestines, these drugs should be taken on an empty stomach with water 1 hour before meals or 2 hours after meals

Suppositories - drugs mixed with a substance that will melt at body temperature administered through the urethra, vagina or rectum

Ointments - soft, oily substances containing a drug that is applied to the skin or eye

Transdermal products - bandage/patch system provides continuous source of the drug over 24 hours

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10
Q

routes of administration

A 
Oral - safest
Sublingual 
Buccal 
Rectal 
Transdermal 
Subcutaneous 
Intramuscular
Intravenous - fastest
Intraarterial
Intreathecal
Inhalation -fastest 
Topical 
Vaginal
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11
Q

pharmacokinetics (dame)

A

study of the process of drug absorption, distribution, metabolism and excretion

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12
Q

lipid solubility

A

Most drugs are water soluble and only partially lipid soluble

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13
Q

ionization

A

Many water soluble drugs are weak acids or bases that can form charged particles (ionization)

Absorption is influenced by the degree of ionization

Most drugs exist in 2 forms ionized or unionized

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14
Q

drug formulation

A

Drugs must be in a solution to be absorbed

Lipid medications are absorbed faster then solids (smaller particles get absorbed faster)

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15
Q

drug distribution

A

Plasmas protein binding, blood flow and the presence of specific tissue barriers affect how much drug reaches a certain organ

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16
Q

plasma protein binding

A

Only unbound or free drug molecules can exert a pharmacological effect

When 2 drugs compete for one plasma protein binding site one may displace the other resulting in an increased free drug concentration which can lead to adverse effects

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17
Q

blood flow

A

Liver, kidneys, and brain have largest blood supply therefore are exposed to the largest amount of a drug

Fat has low blood supply but is high in lipids so lipid soluble drugs can enter fat easily

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18
Q

half life

A

amount of time it takes for the drug blood concentration to drop by half of its original level

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19
Q

bioavailability

A

the % of the drug absorbed into the blood stream

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20
Q

parasympathetic nerves

A

CN 3, oculomotor 7,9, and 10 vagus - supply the internal organs and glands of the head, thoracic cavity and upper portion of the abdominal cavity

S2-S4 - supply the lower portion of the abdominal cavity and the pelvic cavity

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21
Q

parasympathetic neurotransmitter

A

Acetylcholine (ACH) is the neurotransmitter released at the ganglion and at the post ganglionic nerve ending

Nerves that release (ACH) are known as cholinergic nerves

Cardiac and smooth muscle membrane sites where neurotransmitters act are known as cholinergic receptors

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22
Q

parasympathetic system roles

A

rest and digest

Theparasympatheticnervous system restores the body to a calm and composed state and prevents it from overworking

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23
Q

sympathetic nerves

A

T1-L3

Thoracic nerves supply the internal organs and glands of the head and the thoracic cavity and upper abdominal cavity

Lumbar nerves supply the lower portion of the abdominal cavity and the pelvic cavity

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24
Q

sympathetic neurotransmitters

A

(ACH) is released at the ganglion but norepinephrine (NE) is released at the post ganglionic nerve endings

Nerves that release (NE) are known as adrenergic nerves

Cardiac and smooth muscle membrane sites where neurotransmitters act are known as adrenergic receptors (2 types alpha and beta)

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25
Q

sympathetic nervous system is known as…

A

fight or flight system

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26
Q

peripheral (efferent) nerves

A

are branches of cranial and spinal nerves that travel to cardiac + smooth muscle of the internal organs

Composed of many neurons travelling together to the same destination

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27
Q

T/F

In ANS nerve 2 groups of neurons are linked together via synapses as the nerve travels from the spinal cord to the internal organ

A

T

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28
Q

pre ganglionic nerve fibre

A

neurons that emerge from the CNS to the ANS release neurotransmitter in post ACH released

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29
Q

post ganglionic nerve fibre

A

neurons that travel from the ganglion to the internal organ NE released

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30
Q

collection of synapses is called a…

A

ganglion

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31
Q

Norepinephrine

A

parent drug for the alpha drug class

must be administered by injection

short duration of action

contraction of smooth muscle

increases heart rate and blood pumping from the heart. It also increases blood pressure

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32
Q

Epinephrine

A

drug of choice fro immediate treatment for allergic reactions

subcutaneous administration is preferred

epi pen

also used in surgeries with local anesthetics to produce vasoconstriction

produced in adrenal medulla

not recommended for asthma because of cardiac stimulation

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33
Q

adrenergic receptors

A

alpha1 and alpha2

beta1 and beta2

some organs contain more then 1 receptor

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34
Q

alpha 1

A

smooth muscle

when stimulated by E/NE they contract

provides more blood to organs

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35
Q

alpha 2

A

located on adrenergic nerve endings

activate negative feedback

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36
Q

beta 1

A

smooth/cardiac muscle

when stimulated increase HR and force of contraction

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37
Q

beta 2

A

produce vasodilation, bronchodilation

increase blood flow to skeletal muscle and heart delivers more O2 to the lungs

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38
Q

alpha adverse effects

A

irritation to nasal sinuses and eyes

increased BP

cardiac arrhythmias

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39
Q

beta adverse effects

A

cardiac arrhythmias

restlessness

tremors

anxiety

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40
Q

albuterol

A

beta 2

bronchodilator

inhalant, tablet, syrup

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41
Q

dopamine

A

alpha

beta 1

circulatory shock

IV

42
Q

epi table 6.4

A

alpha

beta

allergy

bronchodilator

SC, IM inhalant

43
Q

chemical name

A

chemical or molecular structure

44
Q

generic

A

nonproprietary

assigned by manufacture

45
Q

trade name

A

proprietary

46
Q

types of solutions

A

weight in weight
weight in volume
volume in volume

47
Q

2 neurotransmitters in 2 ANS systems

A

acetylcholine

norepinephrine

48
Q

2 types of adrenerdic receptors

A

beta (1/2) and alpha (1/2)

49
Q

Cholinergic receptors

A

muscarinic and nicotinic

parasympathetic

50
Q

muscarinic receptors

A

located on the cell membranes of visceral organs and glands

51
Q

nicotinic receptors

A

nerves (NN) located on the cell membranes of visceral organs and glands on p/s systems

muscles (NM) located on cell membranes of skeletal muscle

52
Q

adrenergic drug classes

A

sympathomimetics - stimulates the SNS

sympatholyics - antagonize the SNS

53
Q

beta blockers are…

A

selective and non selective

54
Q

atropine

A

tablet, parental injection

antidote for cholinesterase inhibitor poisoning, anticholinergic effects

opthalmic examinations

55
Q

ipratropium

A

aerosol, inhaler

bronchodilator

56
Q

anticholine drug adverse effects

A

dry mouth

visual disturbances

urinary retention

constipation

57
Q

diancephalon includes…

A

the thalamus and the hypothalamus

58
Q

the brainstem includes…

A

the midbrain, pons, medulla oblongata

59
Q

limbic system

A

controls emotional behaviour/mental health

60
Q

GABA

A

gamma aminobutyric acid

inhibitory neurotransmitter

accounts for 50% of the inhibitory activity of the brain and spinal cord

regulates the chloride channel

when gaba enters everything relaxes

Once gaba hits target cell it opens ion channel and allows more chloride to go into the cell

Chloride enters the cell and deactivates

when bound to GABAa receptor Cl channel opens

61
Q

alcohol

A

most widely used non prescription sedative hypnotic and anti anxiety agent

62
Q

alcohol pharmacology effects

A

depresses CNS

dilates vessels

stimulates secretion of saliva and gastric juice = increased appetite

gastritis

decreases renal absorption

lack of vitamins and amino acids

63
Q

benzodiazepines

A

-class of drugs used to treat anxiety and sleep disorders

64
Q

benzodiazepines MOA

A

-decrease excitibility/functional activity of certain areas of the brain and spinal cord (CNS)
-hyper polarization
-neuronal depression
increases inhibitory action of GABA which results in CNS depression

65
Q

benzodiazepines adverse effects

A
  • drowsiness
  • confusion
  • ataxia
  • minor GI disturbances
  • hangover effect
  • insomnia
66
Q

lorazepam

A

-anticonvulsant
-anti anxiety
-acts on the CNS to produce calming effect
-short duration (short acting)
-oral/iv/im
tonic clonic
-drug of choice for epilepticus

67
Q

diazepam

A
  • oral/iv/im
  • anticonvulsant
  • anti anxiety
  • rapid onset
  • long duration (long acting)
  • alcohol withdrawl
  • tonic clonic
68
Q

long vs short acting benzos

A
  • long acting half life of 20+ hours/from metabolites
  • short acting half life of 5-20 hours/ metabolites dont contribute to the therapeutic affect
  • metabolized by the liver
69
Q

flumazenil

A
  • antagonist of benzos
  • IV
  • reverse respiratory/CNS depression effects/OD
  • may cause seizures
  • reverse effects of midazolam in surgeries
70
Q

midazolam

A
  • preoperative sedation induction
  • increase saliva and bronchospasm
  • rapid onset
  • drug of choice when parental is required
  • IV/rectal
  • potent short acting CNS depressant
  • also used for induction of general anesthesia
  • chosen because of its short half life and non active metabolites
71
Q

pathways for pain

A
  • start on nocireceptors
  • travel through spinal cord through dorsal horn then to the appropriate vein to interpret intensity and quality of the pain
72
Q

opioid clinical indications

A
  • front line therapy for pain and pain associated procedures

- no increased risk of bleeding!

73
Q

opioids

A
  • bind to opioid receptors and mimicking the agonist affects
  • inhibit nocireceptor signals from reaching the spinal cord
  • contract bronchioles
  • when bound to mu receptors Ca channels close
  • K channels open
  • dont give to people with head injuries
74
Q

fentanyl

A
  • chemically synthesized
  • relieves acute and chronic pain
  • preoperative sedation
  • works on mu receptors
75
Q

morphine

A
  • standard opioid analgesic
  • highly addictive
  • wont work on pancreas
76
Q

narloxone

A
  • opioid antagonist
  • do not produce opioid effects
  • bind to receptors so other drugs cannot
  • reverse mu effects
  • life saving drug
77
Q

cyclooxygenase

A
  • family of enzymes required to make postglandins from arachidonic acid
  • COX1 - always available in all cells so homeostasis is balanced
  • COX2 - manufactured in activated microphages in response to injury or damaged local tissues
78
Q

non opioid effects

A
  • Do not depress cardiac function in therapeutic doses
  • Hypotension
  • May increase/decrease CNS
  • GABA may be stimulated creating happy effect
  • Other people may experience dysphoria
  • Nausea/vomiting (not for some)
  • Respiratory depression
  • Moisis
  • Increase smooth muscle tone
  • Block release of ACH
  • Increased pressure in the gall bladder
  • Constrict bronchioles
  • Decrease urine output
79
Q

cholinergic receptor and nerve activity

A
  • Anticholinergic drugs prevent ACH from acting on receptors
  • 2 categories direct/indirect
  • Direct acting drugs bind to receptors and produce effects similar to ACH and increase activity at the cholinergic sites
  • Indirect acting drugs are known as anticholinesterases allow ACH to build up in receptor sites
80
Q

action of non opioid anti inflammatory

A
  • Ease symptoms associated with inflammation due to inhibition of prostaglandin synthesis
  • 2 groups salicylates + NSAIDS and acetaminophen
  • Produce analgesia and antipyresis by affecting the hypothalamus
  • MOA involves blockade of prostaglandin stimulation of the CNS
  • Vasodilators
  • Inhibit COX
81
Q

anti inflammatory adverse effects

A
  • Vertigo
  • Vomiting
  • Confusion
  • Headache
82
Q

salicylates and NSAIDS

A
  • Aspirin (drug of choice for fevers) and salicylic acid (plant based)
  • Oldest and most frequently used
  • Improve minor aches and pains
  • Aspirin shouldn’t be taken while pregnant
  • Children and teenagers recovering from chicken pox/flu shot not use these products due to the risk of
  • Reyes syndrome (swelling in liver and brain)
83
Q

acetaminophen

A
  • Aspirin substitute
  • No proven anti inflammatory activity
  • Drug of choice for fever and cold relief for children
  • Doesn’t irritate the stomach lining like aspirin
  • Tylenol
  • Can contribute to liver failure
84
Q

acetaminophen adverse effects

A
  • Nausea/vomiting
  • Flu like symptoms
  • Liver toxicity
85
Q

non-steroidal inflammatory

A
  • Used for short periods (7 days)
  • Advil
  • Tylenol
  • Asa
86
Q

epi vs norepi in regards to smooth muscle

A
  • epi relaxes smooth muscle

- norepi doesn’t

87
Q

beta blockers suffix

A

LOL

88
Q

phenytoin

A

dilantin works on sodium channels

89
Q

tonic clonic =

A

grand mal

90
Q

alcohol provides a ? effect to the skin

A

cooling

91
Q

reticular fibres

A
  • network of nerve fibres that travel through the brain and spinal cord
  • Composed of excitatory fibres
  • Composed of inhibitory fibres
92
Q

frontal lobe

A

-muscle movement (stroke here will have hard time talking, moving)

93
Q

parietal lobe

A
  • touch

- vibrations

94
Q

temporal lobe

A

-language

95
Q

occipital

A
  • communication
  • coordination
  • vision
96
Q

cerebellum

A
  • body movement

- posture

97
Q

hypothalamus

A
  • body temp

- energy maintenance

98
Q

1 teaspoon =

A

5 ml

99
Q

1 table spoon =

A

15ml or 1/2 oz

100
Q

how many drops is a teaspoon

A

60

PCP (12 decks)

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