NUR 118 - Lect. #3 Intro to Pharmacology

Question 1

What is an Enteral medication?

Answer 1

DIRECTLY into stomach/intestines via a TUBE
- For patients who cannot swallow

Question 2

What is a Transmucosal medication?
List sub-types

Answer 2

Through mucus membranes
Sublingual - Placed under tongue; no chewing, allow to dissolve
Buccal - Placed between gum and inner cheek, allow to dissolve

Question 3

What is a Topical medication? List the 4 sub-types

Answer 3

Directly to the skin or mucus membrane

Skin - To skin surface

Transdermal - Onto the skin, goes systemically (ex: transdermal patch

Instillation - Directly into body cavity (suppository: gets inserted into rectum, ear drops, nasal drops)

Inhalation - Via inhalation into respiratory tract (ex: anesthesia)

Question 4

What is a Parental medication? List the 7 sub-types

Answer 4

Administered by routes avoiding digestive tract; usually injection

4 Skin, 3 Spinal

INTRAVENOUS – Administered directly into a vein​ (IV fluids)
INTRAMUSCULAR – Administered directly into a muscle​

SUBCUTANEOUS – Administered into the layer of fat and tissue just under the skin​ (insulin, heparin)

INTRADERMAL – Administered into the dermis, just below skin surface (lidocaine)

INTRASPINAL – Administered into spinal canal​

    INTRATHECAL – SUBARACHNOID SPACE AROUND SPINAL CORD​

EPIDURAL – Administered into epidural space surrounding spinal cord

Question 5

What are the 4 processes of Pharmacokinetics”

Answer 5

-“ADME”
- Absorption, Distribution, Metabolism, Excretion

Question 6

Define Absorption in Pharmacokinetics
What affects absorption?

Answer 6

Movement of drugs from site of administration into the bloodstream/circulation
Effects of absorption depend on:
- Administration route
- Drug solubility
- Blood supply/circulatory capabilities

Question 7

Define Distribution in pharmacokinetics
What is it? When does it begin/end?

Answer 7

How drugs are transported/delivered through the body
Begins when: the drug enters the circulatory system/bloodstream, until it reaches location

Question 8

Define metabolism in pharmacokinetics
When does it begin?
What affects metabolism?
What to be wary of?

Answer 8

The chemical breakdown & inactivation of drug
Begins when: drug reaches site of action
What affects metabolism: Liver disease/failure, diabetes
Can result in liver toxicity

Question 9

Define Excretion in Pharmacokinetics

Answer 9

The removal of drugs from the body
Commonly occurs through: Kidneys; urine, GI Tract; stool

Question 10

What is the Onset of Action?

Answer 10

Time required for drug concentration to reach effectiveness

Question 11

Define “Peak” in Pharmacokinetics; when is this level drawn?

Answer 11

Drug concentration is at its highest level in the bloodstream
- 2 hours after the dose is given

Question 12

Define “Trough” in pharmacokinetics; when is that level drawn?

Answer 12

Drug is at its lowest concentration level, next dose may be due
- 30 minutes before administration

Question 13

Define “therapeutic level” in pharmacokinetics

Answer 13

The drug causes the desired effect, without toxicity

Question 14

Define Half-life

Answer 14

The time it takes for half of the drug to be eliminated

Question 15

Onset of PO (Oral) Medication

Answer 15

1 hour

Question 16

Define Pharmacokinetics

Answer 16

The movement of drugs in the body

Question 17

Onset of IM (Intra-muscular) Medication

Answer 17

30 minutes

Question 18

Onset of IV (Intravenous) medication

Answer 18

15 minutes

Question 19

What affects pharmacokinetics?

Answer 19

AGE​
SEX - ​
BODY MASS – Affects how much you need​
PREGNANCY ​
ENVIRONMENT​
ROUTE & TIMING OF ADMINISTRATION​
FLUIDS​
PATHOLOGICAL STATE​
GENETICS​
PSYCHOLOGICAL FACTORS

Question 20

Define pharmacodynamics

Answer 20

The study of how medications obtain their effects in the body and how the body interacts & responds
Pharma = drug
Dynamics = power/potency
Think: How drugs get their strength in body

Question 21

What is the primary effect of a drug?

Answer 21

Predicted, desired, intended effect
- Also therapeutic effect

Question 22

What is a palliative effect?
Give an example

Answer 22

Not treating a disease process, treating a symptom
ex: morphine for pain from cancer

Question 23

What is a supportive effect?

Answer 23

Administered alongside something for a disease
ex: Acetaminophen for fever for patient with infection

Question 24

What is a substitutive effect?
Give an example

Answer 24

Replacing something the patient lacks/body can’t produce
- Insulin to a diabetic pt

Question 25

What is a chemotherapeutic effect?

Answer 25

Antibiotics (for infection)
- Destroy disease-causing microorganisms or cells

Question 26

What is a restorative effect?

Answer 26

Vitamins, minerals (supplements)
- Return body to, or maintain body at optimal health

Question 27

Define Secondary Effects of a drug

Answer 27

Unintended of non-therapeutic effects
- All effects that’re different from what’s intended

Question 28

What are types of secondary effects of a drug?

Answer 28

Side effects - Unintended but predictable–can continue drug

Adverse reactions - Unintended + harmful–must stop drug

Toxic Reactions - Damage tissue

Allergic reaction - Immune system react

Idiosyncratic reactions - unexpected, abnormal

Question 29

Describe the drug interaction: Agonist

Answer 29

1+1=2
Desired combined effects / both provide desired effect

Question 30

Describe the drug interaction: Antagonistic

Answer 30

1+1=1
One drug limits or blocks the effects of another

Question 31

Drug interactions: Synergistic

Answer 31

1+1=3
There is an additive effect, both drugs together are greater than individually

Question 32

Drug interactions: Potentiating

Answer 32

A+B=AAAAAA
One drug enhances the other to point of toxicity

Question 33

Drug interactions: Incompatibilities

Answer 33

1+1=0
Mixed drugs cause chemical deterioration
- Mixed solution take on changed appearance
ex: clear IV fluid gets cloudy

Question 34

A patient develops urticaria and pruritus 5 days after
beginning phenytoin for treatment of seizures.
Which type of reaction is the patient most likely experiencing?

1. Allergic reaction
2. Dose-related adverse reaction
3. Toxic reaction
4. Anaphylactic reaction

Answer 34

1) This is correct. Urticaria (HIVES) and pruritus (ITCHING)
are considered mild allergic reactions.

Question 35

What are the classifications of drugs?

Answer 35

Body System - Where the drug works
(ex: gastrointestinal, cardiovascular)

Therapeutic Use/Clinical Indication - WHY the drug is used
(ex: laxative, antihypertensive)

Chemical/Physical Action - What is the drug made of & made to do?
(ex: stool softener, beta blocker)

Prescription - Requires MD, NP, PA, Pharma

Non-Prescription - OTC

Illegal - Used for non-therapeutic purposes

Question 36

What are the most common side effects for most medications?

Answer 36

Constipation/Diarrhea
Nausea/Vomiting
Drowsiness/Dizziness

Question 37

Which patients would have an issue with excretion of medications?

Answer 37

Renal failure
Kidney stones
Bowel obstruction
Restrictive lung disease