Module 3 Video Flashcards
Pharmacology (definition)
how drugs interact with the body- side effects, contraindications, effectiveness
Pharmacokinetics (definition)
how drugs move through the body- ADME
Pharmaceutics (definition)
how drugs are created- tablet, capsule, suppository
What does ADME stand for?
Absorption, Distribution, Metabolism, Excretion
What does Absorption refer to? (ADME)
The process by which drugs are absorbed into the bloodstream in order for them to produce an effect, especially in the GI tract
What does Distribution refer to? (ADME)
the process by which drugs are taken to their site of action
Distribution primarily takes place in the ____
bloodstream
3 factors that may affect distribution:
Drug’s solubility, size and protein binding
What does the M in ADME stand for?
Metabolism
What does Metabolism refer to? (ADME)
the process by which drugs are changed by enzymes in order to become active, inactive, or for elimination
What are enzymes?
Complex proteins that speed up or slow down chemical reactions
Metabolism is primarily done by the ____
liver
What is a Metabolite?
the substance resulting from the body’s transformation of an administered drug
What does Excretion refer to? (ADME)
The process by which drugs are removed from the body
How can drugs be removed from the body? (naturally)
Renally in urine, or in stool
What does equivalence mean? (what is an equivalent medication)
a situation where a medication may not be available so an alternative must be chosen/ used
What are the three common types of equivalents?
Therapeutic equivalent, Pharmaceutical equivalent, Pharmaceutical alternative
What is a therapeutic equivalent?
when two medications contain the same active ingredient as well as the same pharmacokinetic principles as the reference drug
What is a pharmaceutical equivalent?
medications that contain the same active ingredient, however may differ in inactive ingredients or their release properties
Are pharmaceutical equivalents freely interchangeable?
NO!- it will change how the medication affects the patient
What is a Pharmaceutical alternative?
Medications that may have the same main active ingredient, but could vary in its salt form or other characteristic
Are pharmaceutical alternatives freely interchangeable?
NO! The effects of the medications are not the same
What is an active ingredient?
Ingredients that exhibit a therapeutic effect
What is an inactive ingredient?
An ingredient holding little to no therapeutic value
Advantages of solid dosage forms-
Precise dosing, convenience, easy packaging, storing and dispensing
Explain what a tablet is (dosage form)
Powdered active and inactive ingredients compressed into a small solid form
What is “immediate release”
Available for the body to absorb as soon as the patient takes the medication
What is “extended release”
Modified to only release some of the medication over a long period of time
What is enteric coating?
A coating that prevents the drug from breaking down in the stomach, waiting until it gets to the small intestines
Can you cut ER or enteric coated medications?
No, unless manufacturer explicitly says you can do so
Can you crush ER or enteric coated medications?
No, unless manufacturer explicitly says you can do so
What is a capsule?
A medication in which the active ingredient is enveloped in a hard or soft gelatin shell
How do you use sprinkles?
You’re meant to sprinkle them on food
What is another word for Lozenge?
Troches
What is a lozenge?
Hard, sugary, candy-like dosage form
What is a powder?
Ground combination of drug and inactive ingredient (often to be mixed with liquid and consumed)
What are some examples of semi-solid dosage forms?
Ointments, creams, lotions, gels, pastes, suppositories
Semi-solid dosage forms are typically meant to be ingested (T or F)
False, they are typically to be used topically
What is an ointment?
A topical dosage form that consists of a small amount of water in a large, oily base
What is a cream made of?
A small amount of oil in a water base
Are creams heavier/thicker than ointments?
No, they are lighter than ointments and can be easily rubbed into the skin
What is a cream?
A topical dosage form consisting of a small amount of oil in a water base
Creams can be used for rectal use (T or F)
True
Which are thinner- creams or lotions?
Lotions are thinner
Order the semi-solid dosage forms in order from thinnest to thickest
Lotions, creams, ointments/ gels/ pastes (tied)
Do liquid dosage forms have quicker or slower absorption than solid dosage forms?
Liquid dosage forms have quicker absorption
Is it easy to adjust doses of liquid medications?
Yes
What is a solution?
An evenly distributed mixture of dissolved medications, or solutes in a liquid base, or solvent
Remember- solvent- “disSOLVED IN”
Like Kool-Aid
Aqueous solutions vs Alcoholic solutions
Aqueous is water, Alcoholic is with Alcohol
What is a hydroalcoholic solution?
A mix of alcohol and water
What is aromatic water?
Water and oil (or other volatile substance)
What is an Elixir?
A dissolved medication in water and ethanol
What is a syrup?
A sugar based solution
What is an extract?
A powder derived from animal or plant after solvent is evaporated
What is a Tincture?
An alcoholic or hydroalcoholic liquid that contains plant extract
What is a spirit?
An alcoholic or hydroalcoholic liquid with volatile, aromatic ingredients
What is an irrigating solution?
A liquid used for cleansing the body
What is a parenteral solution?
A sterile liquid with intention of being administered by injection
What is a suspension?
A liquid in which the drug DOES NOT dissolve in the base, leaving small solid particles floating in the liquid base
These medications may need to be reconstituted (mixed with water) before dispensing
ALWAYS SHAKE SUSPENSIONS WELL
What auxiliary label do water suspensions need?
“Shake well”
What is depo therapy/ depot injections?
A type of medication injected into the muscle that slowly releases the medication over time (can be a suspension)
What is an Enema?
A liquid medication used to deliver medication rectally in order to bypass the GI tract
What is an aerosol?
A medication that is given as a very fine liquid or solid spray in a gas propellant
What is a spray?
A medication contained in a pump-type dispenser that when pushed dispenses a fine release of liquid, solid or gas particles
Can be a variety of bases, including alcohol or water
Aerosol vs Spray
Aerosol is better for lower respiratory, spray is better for upper respiratory, such as a sore throat
What is a transdermal patch?
(trans- to go through/change, dermal- skin)
Medication that is housed in a “reservoir” and slowly allowed to be released from the patch to the skin
Transdermal patches eliminate the need for frequent dosing (T or F)
True
What is a route of administration?
The way in which a medication will be taken
What are some common routes of administration?
Oral, sublingual, buccal, rectal, vaginal, ocular, otic, nasal, inhalation, topical, intramuscular, subcutaneous, intravenous, and intrathecal
What is the oral route of administration?
Medications that are to be taken by mouth
What is the first pass effect?
Before drugs are transported to their site of action they pass through the wall of the intestines and are transported through the liver to the bloodstream
Some drugs are completely metabolized in the liver before they can reach the bloodstream
What is the sublingual route of administration?
Medications placed under the tongue
What is the buccal route of administration?
Medications placed between the cheek and gums
What is the rectal route of administration?
Medications inserted into the rectum
What is the vaginal route of administration?
Medications inserted into the vagina
What is ocular route of administration?
Medications to be placed in the eye
What is the otic route of administration?
Medications to be placed in the ear
What is the nasal route of administration?
Medications to be inhaled through the nose
What is the inhalation route of administration?
Medications to be inhaled into the lungs
Does the inhalation route of administration avoid the first pass effect?
Yes
What is the topical route of administration?
Medications that are applied externally (typically to the skin)
What does the abbreviation AAA stand for?
Apply to Affected Area
Does the topical route of administration have a fast or slow onset of action?
Slow
What is the transdermal route of administration?
Medications that are to be diffused THROUGH the skin (typically patches)
Does the transdermal route of administration avoid the first pass effect?
Yes
What is the intramuscular route of administration?
Medications to be injected into the muscle
What is the subcutaneous route of administration?
Medications which are injected under the skin
What are some common abbreviations for subcutaneous medications?
SC, SubQ, or SQ
What is the intravenous route of administration?
Medications directly injected into the veins
Why do IV medications have the quickest onset of action?
They go straight into the bloodstream
What is the intrathecal route of administration?
Medications injected around the spinal cord into the spinal canal
What are “side effects”?
Unintended effects of a medication
What is a common oral medication side effect?
GI discomfort
What is a common topical/ transdermal medication side effect?
Skin irritation
What is a common side effect of injectable medications?
Injection site pain
What are the important 3 NSAID adverse (side) effects?
Ulcers/Stomach Bleeding- they disrupt the production of the fluid that protects the stomach from acid
Serious Kidney Damage
Increased risk of having a blood clot
What are some more common side effects of NSAIDs?
Heartburn, gas, stomach pain, constipation, diarrhea
What is one of the main serious adverse effects of depressants/sedatives? (when overtaken)
Respiratory depression (slowed breathing)
What are more common side effects of depressants/ sedatives?
Forgetfulness/ amnesia, drowsiness, dizziness
What are some signs of respiratory depression?
Slurred speech, blue lips or extremities
What are a few common depressants/ sedatives?
Alcohol, Opioid Analgesics, Barbiturates, Benzodiazepines
What are some common side effects of opioid analgesics?
Constipation, Nausea, Vomiting, Itching
What is “tolerance”?
When a patient’s body requires an increased dose of medication to achieve the same effect
Patients will gain tolerance to all effects of opioids except for ________
Constipation
What is one of the main serious conditions that can occur with medications such as SSRIs, SNRIs, and tricyclic antidepressants?
Serotonin Syndrome
What is Serotonin Syndrome?
When the body has too much serotonin
What are some symptoms of serotonin syndrome?
Changes in mood (agitation/confusion), rapid heart beat, high blood pressure, twitching, sweating, rigid muscles
What can happen when a patient on blood thinners gets a cut or falls?
Their blood may be too thin to clot
What are some common side effects of blood thinners?
Bruising, Prolonged Bleeding
What are some more serious side effects of blood thinners that warrants treatment?
Bleeding that won’t stop
Severe headache/stomach ache
Bruising without an injury
Coughing up/ vomiting up blood
What are some common side effects of first generation antihistamines?
Dry mouth, drowsiness, dizziness, blurred vision, confusion, unable to urinate
What are HMG-CoA Reductase Inhibitors commonly referred to as?
the “Statins”
What is the most commonly brought up side effect of HMG-CoA Reductase Inhibitors (statins)?
Muscle pain
Some statins cause worse muscle pain than others (T or F)
True
What could extreme muscle pain be a sign of?
Rhabdomyolysis
What is rhabdomyolysis?
The breakdown of skeletal muscle
What is the most common side effect of ACE Inhibitors?
Non-life threatening cough
In rare instances, ACE Inhibitors can induce _______, which is an emergency
Angioedema
ACE Inhibitors work in the kidneys (T or F)
True
What are some symptoms of low blood pressure?
Dizziness upon standing, changes in vision
What is Angioedema?
Extreme swelling of the deep tissues
What are some common side effects of Anticholinergics?
Dizziness, drowsiness, dry eyes, decreased urination, changes in mood/agitation
What is the saying to help remember the side effects of Anticholinergics?
“Blind as a bat”
“Dry as a bone”
“Full as a flask”
“Mad as a hatter”
^^dizziness/changes in vision, dry eyes, inability to urinate, changes in mood
What is the maximum daily dose of Acetaminophen/Tylenol when taken OTC?
3000 mg (more could lead to liver injury)
What is a common side effect of Magnesium?
(ex. Milk of Magnesia or Magnesium Citrate)
Diarrhea
What is a common side effect of Aluminum?
Constipation
What are two common side effects of Iron?
Constipation, gas/bloating
(Constipated and SAD)
What is a common side effect of Niacin?
Flushing
What are some medications that people are commonly allergic to?
Penicillin antibiotics, Sulfa drugs, Anticonvulsants, NSAIDS, Chemotherapy Meidcations
What are some common mild medication allergy symptoms?
Itching, hives, swelling
What is a life threatening medication allergy symptom?
Anaphylaxis
Mild medication allergies can be treated with a first generation _______
Antihistamine
Life threatening medication allergies can be treated with another medication (T or F)
FALSE- they should be completely avoided and require medical treatment if exposed (ex. some Penicillin allergies)
As drugs travel through the body, they are exposed to anything else in our bloodstream (T or F)
True
What are some things that could cause an interaction with a medication?
Other drugs, diseases, supplements, nutrients, lab tests (can affect the results)
Drug-drug interactions could cause either an additive or detrimental effect (T or F)
True
What are some medications that could cause oral contraceptives to be less effective? (drug-drug interaction)
Carbamazepine, Lamotrigine, Oxcarbazepine, Phenobarbital, Phenytoin, Primidone, Rifampin, Topiramate
What are some medications that could cause HMG-CoA Reductase Inhibitors (statins) to be less effective? (drug-drug interaction)
Amiodarone, Digoxin, Ranolazine, Cyclosporine, Tacrolimus, Diltiazem, Gemfibrozil, Ticagrelor, Itraconazole, Ketoconazole
Do not take Fluoroquinolones, Tetracyclines or Levothyroxine within 2 hours of taking ___________
Any multivitamins, calcium, magnesium, iron or aluminum
What is a common medication that could cause Warfarin to be less effective? (drug-drug interaction)
Aspirin- blood could be further thinned and have increased bleeding risk
