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N232 > Module 1 Part 4: Pharmacology > Flashcards

Module 1 Part 4: Pharmacology Flashcards

1
Q

what is the definition of a drug?

A

any chemical that affects the physiological processes of a living organism

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2
Q

what is the definition of pharmacokinetics?

A

the study of the movement of drugs throughout the body

- also what happens to the drug on it’s journey

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3
Q

what 4 processes does pharmacokinetics include?

A
  1. absorption
  2. distribution
  3. metabolism
  4. excretion
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4
Q

what is the definition of absorption?

A

movement of drugs from the site of admission into the blood

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5
Q

what is the definition of distribution?

A

drug movement from the blood to the interstitial space of tissues

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6
Q

what is another word for metabolism?

A

biotransformation

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7
Q

what is the definition of metabolism?

A

enzymatically mediated alteration of drug structure

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8
Q

what is the definition of excretion?

A

movement of drugs and their metabolites out of the body

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9
Q

what are the 3 ways to cross the cell membrane?

A
  1. passage through channels or pores
  2. passage with transport system
  3. direct penetration of the membrane itself
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10
Q

what is P-Glycoprotein pump (PGP)?

A

multi-drug transporter

- transports drugs out of the cell

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11
Q

Where is the PGP found?

A

in kidney, liver, placenta, intestines, capillaries of brain

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12
Q

what does the rate of absorption determine?

A

how soon the effects will take place

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13
Q

what does the amount of absorption determine?

A

how intense the effect will be

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14
Q

what does large surface area mean in terms of absorption?

A

absorption happens faster

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15
Q

where does absorption inc.?

A

where blood flow is HIGH

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16
Q

what type of drugs can cross the cell membrane FASTER?

A

lipid soluble drugs

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17
Q

what are the two common routes of administration?

A
  1. enteral

2. parenteral

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18
Q

what is enteral?

A

via the GI tract

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19
Q

what is parenteral?

A

outside the GI tract (injections)

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20
Q

what is the faster route in terms of absorption?

A

intravenous (IV)

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21
Q

what are the barriers to IV?

A

none; they are bypassed d/t being injected directly into blood stream

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22
Q

what are the patterns of IV?

A
  1. instantaneous (enters directly)

2. complete (all goes into blood, none is lost during metabolism

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23
Q

what are the advantages of IV? (4)

A
  • rapid onset
  • concise control
  • permits use of large fluid volumes
  • permits use of irritant gloves
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24
Q

what are the disadvantages of IV? (6)

A
  • high cost, difficult, inconvenient
  • irreversible (can’t go back after injected)
  • fluid overload
  • infection
  • embolism (BV blockage)
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25
Q

what are the barriers of IM? (1)

A

capillary wall (easy to pass)

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26
Q

what is the pattern of IM drugs?

A

rapid with water soluble drugs

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27
Q

what are the advantages of IM? (2)

A
  • permits use of poorly soluble drugs

- permits depot prepreration

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28
Q

what are the disadvantages of IM? (3)

A
  • possible discomfort
  • inconvenient
  • potential for injury
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29
Q

which route has all the same characteristics as IM?

A

subcutaneous

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30
Q

what are the barriers of the oral route?

A
  • lining of GI tract

- capillary wall

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31
Q

why can you not crush slow/extended release drugs?

A

the beads that were meant to prolong the distribution in the body will crush and give a toxic dose

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32
Q

what is the pattern of oral admin.?

A

slow & variable

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33
Q

what are the advantages of the oral route? (5)

A
  • easy
  • inexpensive
  • ideal for self-administration
  • potentially reversible
  • convenient
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34
Q

what are the disadvantages of the oral route?

A
  • inactivation of same drugs
  • possible nausea/vomiting
  • pt must be conscious
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35
Q

what are the 3 major factors related to distribution?

A
  1. blood flow to tissues
  2. the ability of a drug to exit the vascular system
  3. the ability of drugs to enter the cell
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36
Q

what can effect drug distribution?

A

tumors and abscesses

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37
Q

what is an abscess? what cannot reach here?

A
  • a ball of puss

- antibiotics cannot reach here

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38
Q

how do drugs exit?

A

through capillary walls

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39
Q

what is the blood-brain barrier (BBB)?

A

the unique anatomy of capillaries in the CNS

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40
Q

how does the BBB prevent drug passage?

A

tight junctions between cells that compose the walls of capillaries so tight that they block passage

41
Q

what is the advantage of the BBB?

A

protects brain from injury of potentially toxic substances

42
Q

what are the disadvantages of the BBB? (2)

A
  • obstacle for certain CNS therapy

- not developed at birth (dangerous for infants)

43
Q

what is the placental drug transfer?

A

membranes separate maternal and fetal blood but DO NOT give absolute barrier to drugs

44
Q

what can get into fetal blood?

A

lipid soluble, non-ionized compounds

45
Q

what drugs cannot get into the fetal blood?

A

ionized, highly polar, or protein bound

46
Q

how are the drugs returned back to the mother’s circulation?

A

the PGP pump

47
Q

what is protein binding?

A

drugs can form reversible bonds with proteins in the body

48
Q

what is the most common protein drugs bind with?

A

plasma albumin

49
Q

where does the most metabolism take place?

A

in the liver

50
Q

what preforms metabolism in the liver?

A

the hepatic microsomal enzyme system (or P450 system)

51
Q

what are the 6 consequences of the hepatic drug metabolizing enzymes?

A
  1. accelerated renal excretion
  2. inc. therapeutic action
  3. activation of “pro drugs”
  4. inc. toxicity
  5. dec. toxicity
52
Q

how does metabolism differ in children?

A
  • in infants, it is limited

- about 1 years old is when the liver can metabolize

53
Q

what is a special consideration for older adults?

A

dosages may need to be dec. to avoid toxicity

54
Q

what are inducers?

A

inc. rates of metabolism

55
Q

what are inhibitors?

A

act on liver to dec. metabolism

56
Q

what is the “first pass effect”?

A

rapid hepatic inactivation of certain oral drugs

57
Q

what happens if the capacity of the liver is too high?

A

drugs can be inactivation

58
Q

what happens if the pt is malnourished?

A

drug metabolism is compromised

59
Q

what is the most common organ for excretion?

A

the kidneys

60
Q

what does renal excretion limit?

A

the duration of action on drugs

61
Q

how does renal failure affect the excretion of the drug?

A

may inc. the duration and action of drug

62
Q

what are the 3 steps in renal excretion?

A
  1. glomerular filtration
  2. passive tubular reabsorption
  3. active tubular secretion
63
Q

what are the 3 factors that modify excretion?

A
  1. pH dependant ionization
  2. competition for active tubular transport
  3. age
64
Q

what are the 2 non-renal routes of excretion?

A
  1. breast milk

2. feces - bile leaves body via feces

65
Q

what is the minimum effect concentration?

A

(MEC) plasma during level below which therapeutic effects will not occur

66
Q

what is the toxic concentration?

A

plasma level where toxic effects begins

67
Q

what is the therapeutic range?

A

the range between MEC and toxic concentration

68
Q

what is the objective of drug dosing?

A

to get it into therapeutic range

69
Q

what is the def’n of drug half-life?

A

amount of time for the amount of drugs in the body to dec. by 50%

70
Q

what does the half-life determine?

A

the dosing interval

71
Q

what is the definition of the plateau?

A

when amount of drug elimination = dose administered

average drug levels will remain constant

72
Q

What is the peak concentration?

A

highest level conc.

73
Q

what is the trough concentration?

A

lowest level conc.

74
Q

what is the definition of pharmacodynamics?

A

study of biochemicals and physiologic effects of drugs on the body and the molecular mechanisms they produce

75
Q

why are pharmacodynamics important for nurses?

A
  • educates pt
  • make prn decisions
  • evaluate patients for beneficial and harmful drug effects
76
Q

what is maximum efficiency?

A

the largest effect a drug can give

77
Q

what is relative potency?

A

amount of drug needed to elicit the effect

78
Q

what are drug receptors?

A

any functional macromolecule in a cell to which a drug binds to produce its effect
- (on-off switch)

79
Q

what are the 4 drug receptor families?

A
  1. cell membrane
  2. ligand-gated ion channels
  3. G protein-coupled systems
  4. transcription factor
80
Q

what are agonist drugs?

A

drugs that mimic the body’s own regulatory molecules

activate receptors

81
Q

what are antagonist drugs?

A

block action of endogenous regulatory molecules

prevents receptor activation

82
Q

what is an example of an antagonist drug?

A

narcan

83
Q

what is a partial agonist drug?

A

mimic the actions of endogenous regulatory molecules but they produce response of intermediate intensity
(prevent activation)

84
Q

what is interpatient variability?

A

describes how the dose requirements vary from patient to patient

85
Q

what is the definition of the average effective drug dose (ED50)?

A

the dose of drug that produces a therapeutic response in 50% of the population = standard dose

86
Q

what is the definition of the therapeutic index?

A

safety of the drug

- ratio of drug’s ED to LD

87
Q

what is LD50?

A
  • lethal dose

the amount of the drug that would kill 50% of the population

88
Q

when do drug interactions take place?

A

when the patient is on two or more drugs

89
Q

what are the 3 consequences of drug interactions? `

A
  1. intensify effects
  2. inc. therapeutic effect
  3. inc. adverse effects
90
Q

what are the 4 basic mechanisms of drug to drug interactions?

A
  1. direct chemical or physical attraction
  2. pharmacokinetic interaction
  3. pharmacodynamic interaction
  4. combined toxicity
91
Q

what happens in drug-dug interactions with a narrow therapeutic range?

A

produces an inc. in drug levels that could lead to toxicity

92
Q

what happens when you mix food with drug?

A

depends on the drug

- could lead to either inc. or dec. absorption

93
Q

what is the grapefruit juice effect?

A

inhibits the metabolism of certain drugs, therefore raises the drug levels

94
Q

what happens with tyramine food?

A

oxidase inhibitor mixed with BP can raise to fatal level

95
Q

what is the time frame of “administering of an empty stomach?

A

1 hour BEFORE meal or 2 hours AFTER

96
Q

what is the placebo effect?

A

prep that is devoid of intrinsic pharmacologic activity

97
Q

what does it mean if the patient has an effect on the placebo?

A

it is all psychological

98
Q

what is the definition of bioavailability?

A

amount of active drug that reaches the systemic circulation from site of administration

99
Q

what are the 3 ways that genes can play a factor in drugs?

A
  • accelerate or slow metabolism
  • inc. toxicity
  • alter receptors

N232 (9 decks)

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