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Pharmacology 1 > module 1 > Flashcards

module 1 Flashcards

1
Q
  1. Define pharmacology:

2. Name the steps in the approval of drugs in the US:

A
  1. The study of the biological effects of chemicals
  2. Preclinical Trials animal testing

Phase 1 (testing on human with the disease)

Phase 2 (tested on humans with the disease and comorbidities)

Phase 3 (drug used in a large clinical market)

Phase 4 (drug goes on market, but is continuously evaluated).

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2
Q
  1. Brand name drugs begin with ………….case letter, where as generics begin with …………case letter
  2. What is the therapeutic index?
A
  1. Upper, lower

2. the margin of safety of the drug and is a ratio between the therapeutic dose and the lethal dose

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3
Q
      1. Name the 3 types of adverse reactions/side effects:
      1. Name the types of drug allergies:
  3. how does a hypersensitivity differ from an allergic reaction?
A
  1. Primary Actions
    Overdose; extension of the desired effect
  2. Secondary Actions
    Undesired effects produced in addition to the pharmacologic effect
  3. Hypersensitivity Reactions
    Excessive response to primary or secondary effect of drug
  4. Anaphylactic Reaction
    Know Signs and Symptoms of anaphylaxis:
    SOB, Blood pressure changes (may be high initially, then low), rash, itch, tachycardia, severe anxiousness
  5. Cytotoxic Reaction:
  6. Serum Sickness Reaction:
  7. Delayed Allergic Reaction:
  8. allergy must involve the immune system - antibody, antigen reaction
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4
Q
      1. Name the types of drug induced tissue and organ damage:
  2. What happens in poisoning?
A
  1. dermatological reactions: most serious is Steven Johnson’s syndrome
  2. Stomatitis: inflammation of mucous membranes, canker sores etc
  3. Superinfections: think yeast infections or infections that come as an overgrowth of bad bugs from destruction of normal flora
  4. Blood Dyscrasia: bone marrow suppression (most common in chemo and malaria treatment) so blood cells are suppressed.
  5. Liver damage: always check lab work. Fever, nausea, jaundice (late sign), change in color of stool or urine, elevated liver enzymes ALT and AST
  6. Kidney damage: elevated BUN and creatine, change in urinary pattern.
  7. Poisoning occurs when an overdose of a drug damages multiple body systems.
    Damage to multiple systems can lead to a fatal reaction.
    Treatment varies accordingly with drug
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5
Q
  1. What can happen to patients on corticosteroids?
  2. What is hypokalemia or hyperkalemia, and why is this such an important electrolyte to watch?
  3. What is target end artery damage?
A
  1. hyperglycemia
  2. too little or too much potassium. Affects cardiac rhythm
  3. damage of sensory organs, ocular and auditory toxicity (8th cranial nerve has tendency to get damaged and tinnitis or loss of balance is the first clue this is happening).
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6
Q

1.- 4. What are some neurological effects and their symptoms:

A

1, General CNS: altered levels of consciousness

  1. Atropine-like (anticholinergic): dry mouth urinary retention, blurred vision.
  2. Parkinson-like: muscle tremors and gait changes. Motor symptoms. Discontinue use
  3. Neuroleptic Malignant Syndrome: anesthetic reactions. Unexplained high fevers.
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7
Q
  1. pharmacodynamics:

2. pharmacokinetics and the 4 pharmacokinetic processes:

A
  1. what drugs do to the body

2. what the body does to drugs (absorption, distribution, metabolism, and excretion)

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8
Q
  1. What is the nursing process?

2. What are the 3 nursing interventions in regard to medications that nurses perform?

A
  1. a framework for making clinical decisions. ADPIE
  2. Drug administration
    Provision of comfort measures
    Patient/family education
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9
Q
  1. what is drug classification?
  2. What is drug category?
  3. What are the rights of safe drug administration (8)?
A
  1. categorizes drugs by the way they act against diseases or disorders
  2. way drugs work at the molecular, tissue, or body system level
3. Right Patient
Right Drug
Right Storage
Right Route
Right Dosage
Right Preparation
Right Timing
Right Documentation
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10
Q
  1. What are the actions of drugs (4)
  2. what is an agonist?
  3. What is an antagonist, and describe the 2 types:
A
  1. substitute for missing chemicals

increase/stimulate certain cellular activities

to depress cellular activities

to interfere with the functioning of foreign cells

  1. agonists are molecules that activate receptors
  2. antagonists prevent receptor activity. Two types: Competitive: compete with agonists at receptor sites, and Noncompetitive: reduce the response by reducing the number of avail receptors
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11
Q
  1. Name 4 types of drugs that don’t involve receptors.
A
  1. antacids, antiseptics, saline laxatives, and chelating agents
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12
Q
  1. critical concentration:
  2. Therapeutic range:
  3. Loading dose:
  4. Half-life. How many half lives does it take to clear a drug from the body?
  5. Drugs that have shorter half-life requires ……. dosing. Drugs with longer half-life requires ….. ……….. dosing.
A
  1. The correct amount of a drug that is needed to cause a therapeutic effect (not toxic or too weak)
  2. quantity of drug in blood to be effective
  3. The initial dose being higher to achieve therapeutic level.
  4. time required for half of the drug to be excreted. Affected by absorption, distribution, metabolism, and excretion. 5
  5. frequent , less frequent
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13
Q
  1. Dynamic equilibrium:

2. Dynamic equilibrium is affected by the four pharmacokinetic processes::

A
  1. the actual concentration that a drug reaches in the body.
  2. Absorption
    Distribution
    Biotransformation
    Excretion
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14
Q
  1. Absorption is affected by what?
  2. What is distribution, and what has an affect on it?
  3. Drugs must be ……… soluable to absorb into tissues (deionized, non-charged). Drugs must be ………… soluble to be easily excreted by the kidneys (ionized, charged). Can drugs switch from deionized to ionized?
  4. How can drugs pass the blood-brain barrier?
  5. Which blood protein is most closely monitored in regard to protein bound drugs?
A
  1. route, food in stomach (for oral meds)
  2. The movement of a drug to the body’s tissues. Protein binding
    Ionization/pH
    Perfusion of the reactive tissue
  3. lipid, water. Yes, depending on the pH around them
  4. must be highly protein-bound
  5. albumin
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15
Q
  1. The ……… is the most important site for biotransformation (metabolism).
  2. Describe the first pass effect:
  3. What is cytochrome P450? Which are the most commonly used within this class?
  4. Why is P450 important?
  5. What do elevated ALT and AST enzymes in the blood indicate?
A
  1. liver
  2. drugs absorbed in digestion circulate first to the liver which acts as a filter allowing only some of the drug through to the circulation. Drugs vary in the amount the liver metabolizes.
  3. a class of enzymes the liver uses to alter the drug and start biotransformation. CYP3A4 and CYP2D6 are most common
  4. Genetic variability in these enzymes may influence a patient’s response (beta blockers and antidepressants). Also, can cause drug-drug interactions, and adverse reactions
  5. liver damage
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16
Q
  1. ……….. play the most important role in excretion of medication
  2. Where else can drugs be excreted other than urine, feces and skin?
  3. What are 3 kidney function tests?
A
  1. Kidneys
  2. breast milk
  3. BUN 7-20 mg/dL, creatinine < 0.8 -1.4 mg/dL, and GFR > 60 ml/min
17
Q
  1. Where in the body do drug-drug interactions take place (5)?
  2. Certain foods interact with drugs. Therefore, drugs are best taken on an ……….. stomach
A 
1. Site of absorption
During distribution
During biotransformation
During excretion
At the site of action
  1. empty
18
Q
  1. what do the feds demand if a drug is to be advertised?
  2. Why can herbals advertise whatever they want?
  3. what are off-label meds?
  4. what is bio-equivalence?
A
  1. Contraindications
    Adverse effects
    Precautions
  2. they aren’t FDA approved/regulated. Can be whatever.
  3. The use of a drug for an indication not approved by the FDA (remember the Avon cream)
  4. the degree to which a generic works the same as brand name drugs.
19
Q
  1. what do NSAIDs (including salicylates) block?
  2. contraindications to nsaids:
  3. Drug to drug interactions:
  4. NSAID adverse effects:
  5. prototype:
A
  1. Prostaglandin synthesis by inhibiting cox 1 and 2 for mild to mod pain
  2. allergy (to nsaid or salicylate), hypertension, peptic ulcer, GI bleeding, pregnancy, lactation, renal or hepatic dysfunction, sulfonamide allergy (celecoxib)
  3. decreased diuretic effect of loop diuretics, decreased effect of beta-blockers, lithium toxicity
  4. nausea, dyspepsia, GI pain, constipation, diarrhea, GI bleed, platelet inhibition, hypertension, bone marrow depression, somnolence
  5. ibuprophen
20
Q
  1. What are salicylate effects?
  2. What are its pharmacokinetics?
  3. contraindications?
  4. drug-drug interactions?
  5. adverse effects?
  6. Prototype salicylate?
  7. Patients at risk for salicylates?
A
  1. platelet inhibitory effect, blocks inflammatory response, antipyretic response, analgesic properties ex: aspirin
  2. Absorbed from the stomach, peak in 5-30 min., metabolized in the liver, excreted in the urine
  3. Known allergy, bleeding abnormalities, impaired renal function
  4. Interact with other drugs by interfering with absorption
  5. nausea, heartburn, epigastric pain, bleeding, dizziness, ear ringing, vomiting, diarrhea,
  6. Aspirin
  7. children, renal disease, bleeding disorders,
21
Q
  1. what are nsaid effects?
A
  1. Provide strong anti-inflammatory, antipyretic, and analgesic effects
22
Q
  1. where are prostaglandins found in high concentration?
  2. what is the link w/ gastric damage?
  3. what is the only NSAID that blocks only cox 2? What group of people could be sensitive to this?
  4. contraindications to NSAIDs:
A
  1. concentration in thegastricmucosa andgastric juice.
  2. when we suppress prostaglandins, we suppress the body’s ability to inhibit acid
  3. celecoxib. People with sulfonamide allergies.
  4. dyspepsia, GI pain and bleed, platelet inhibition
  5. can potentiate bleeding if paired w/ another antiplatelet drug and decreased diuretic effects
23
Q
  1. Describe pregnancy categories A - X
A

A. no risk to fetus in any trimester

B. No Adverse effects in animals; no human studies

C. animal studies have adverse effects. Given only after fetal risk considered

D. Definite fetal risk, yet may be given for a life-threatening condition

X. absolute fetal abnormality. Not to be used at all in pregnancy

24
Q
  1. What are the characteristics of schedule 1 drugs?

2. What are the characteristics of schedule 2 drugs?

A
  1. High potential for abuse. No medical use
  2. High potential for abuse which leads to severe physical /psychological dependence. Has medical use.
  3. Less potential for abuse. Has a medical use. Moderate degree of dependence.
  4. Lower potential of abuse. Has a medical use. similar level of dependence as schedule 3.
  5. Low potential for abuse. Has a medical use. Least level of dependence
25
Q
  1. What factors factors influence drug’s effect (11)?
A
  1. weight, age, gender, physiologic, pathologic, genetic, immunologic, physchologic, and environmental factors, drug tolerance, and cummulative effect
26
Q
  1. What is the purpose of Gold Compounds?
  2. Mechanism of action for gold compounds:
  3. contraindications:
A
  1. antiarthritis treatment
  2. absorbed by macrophages thus inhibiting their action and decreasing tissue damage
  3. allergy, diabetes, CHF, renal or hepatic impairment, blood dyscrasias, pregnancy and lactation
27
Q
  1. What is the mechanism of action of narcotic (agonist) analgesics?
  2. What are the contraindications?
  3. With what should the nurse exercise caution?
  4. What are the adverse reactions?
  5. What is the narcotic agonist analgesic prototype?
  6. Name the drug we use to correct overdose? How does it work?
A
  1. act at specific opioid receptor sites in the CNS. Agonists use mu receptors
  2. allergy, pregnancy, labor, lactation
  3. closely monitor for respiratory dysfunction, GI or GU surgery, ulcerative colitis
  4. cardiac arrest from respiratory depression, constipation, urinary retention, orthostatic hypotension, emesis, and intracranial pressure
  5. morphine.
  6. naloxone (Narcan). It binds the opioid receptor but doesnt stimulate it (antagonist).
28
Q
  1. What is the mechanism of action of narcotic Agonist/antagonist?
  2. are these safe to use in labor/delivery?
  3. prototype?
  4. What is the benefit and drawback of this med type?
  5. Adverse reactions:
A
  1. agonist/antagonists stimulate kappa receptors and depress mu receptors)
  2. yes
  3. Buprenorphine or Pentazocine
  4. Less analgesia than narcotic agonists and have a lower potential for abuse
5. Headache
Dizziness
Psychoses
Anxiety
Hallucinations
Ureteral spasm, urinary retention
29
Q
  1. migraine headaches:
  2. cluster headaches
  3. tension headaches
A
  1. severe throbbing headache on one side of head caused by vasodilation and inflammation of cranial arteries
  2. begin during sleep, sharp, steady eye pain, sweating, flushing, tearing, and nasal congestion
  3. brought on by stress. dull band of pain around entire head
30
Q
  1. What type of drugs treat migraines?
  2. what is the prototype?
  3. mechanism of action:
  4. contraindications:
  5. caution:
  6. adverse effects:
  7. describe ergotism:
A
  1. Ergot derivatives or triptans
  2. Ergotamine
  3. blocks alpha-adrenergic and serotonin rec eptors in brain to constrict cranial blood vessels
  4. allergy, pregnancy, lactation, CAD, HTN, PVD
  5. pruritus, malnutrition
  6. nubmness, tingling of fingers/toes, muscle pain in extremities, tachycardia, bradycardia, ergotism
  7. nausea vomiting diarrhea caused by too much ergot derivative.
31
Q
  1. What is another migraine drug (other than ergot)?
  2. Prototype
  3. mechanism of action:
  4. Adverse effects:
  5. contraindications:
  6. cautions:
  7. drug to drug:
A
  1. Triptans
  2. almsumatriptan (Imitrex)
  3. Bind to selective serotonin 5-HT 1B/1D receptors sites to cause vasoconstriction of cranial vessels.
  4. dizziness, vertigo, weakness, myalgia, BP
    alterations, tightness of chest
  5. allergy, pregnancy, CAD
  6. elderly, lactation
  7. ergot-containing drugs and MAOI’s
32
Q
  1. What is the action of acetaminophen?
  2. Can this be used prophylactically?
  3. contraindications?
  4. adverse reactions:
  5. drug to drug:
A
  1. acts directly on the hypothalmus (thermaregulatory cells) resulting in CNS analgesia
  2. yes, in babies prior to D-tap vaccine
  3. allergy, hepatic dysfunction or alcoholism
  4. Headache, hemolytic anemia, renal dysfunction, skin rash and fever
    Hepatotoxicity assoc with chronic use and overdose
  5. Oral anticoagulants increase bleeding
    Hepatotoxicity with barbiturates, carbamazepine, hydantoins, or rifampin
33
Q
  1. What is the action of tumor necrosis factor blockers?
  2. Name one of the prototypes of this category:
  3. What are these drugs used for?
  4. how do we administer?
A
  1. decreases local effects of the cytokine, TNF which stimulates proinflammatory activity
  2. etanercept (chinese hamster ovary product)
  3. used as a first line treatment to progressive arthritis
  4. IV and SQ

Pharmacology 1 (4 decks)

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