NUR 118 - Lect. #3 Intro to Pharmacology Flashcards
What is an Enteral medication?
DIRECTLY into stomach/intestines via a TUBE
- For patients who cannot swallow
What is a Transmucosal medication?
List sub-types
Through mucus membranes
Sublingual - Placed under tongue; no chewing, allow to dissolve
Buccal - Placed between gum and inner cheek, allow to dissolve
What is a Topical medication? List the 4 sub-types
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)
What is a Parental medication? List the 7 sub-types
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
What are the 4 processes of Pharmacokinetics”
-“ADME”
- Absorption, Distribution, Metabolism, Excretion
Define Absorption in Pharmacokinetics
What affects absorption?
Movement of drugs from site of administration into the bloodstream/circulation
Effects of absorption depend on:
- Administration route
- Drug solubility
- Blood supply/circulatory capabilities
Define Distribution in pharmacokinetics
What is it? When does it begin/end?
How drugs are transported/delivered through the body
Begins when: the drug enters the circulatory system/bloodstream, until it reaches location
Define metabolism in pharmacokinetics
When does it begin?
What affects metabolism?
What to be wary of?
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
Define Excretion in Pharmacokinetics
The removal of drugs from the body
Commonly occurs through: Kidneys; urine, GI Tract; stool
What is the Onset of Action?
Time required for drug concentration to reach effectiveness
Define “Peak” in Pharmacokinetics; when is this level drawn?
Drug concentration is at its highest level in the bloodstream
- 2 hours after the dose is given
Define “Trough” in pharmacokinetics; when is that level drawn?
Drug is at its lowest concentration level, next dose may be due
- 30 minutes before administration
Define “therapeutic level” in pharmacokinetics
The drug causes the desired effect, without toxicity
Define Half-life
The time it takes for half of the drug to be eliminated
Onset of PO (Oral) Medication
1 hour
Define Pharmacokinetics
The movement of drugs in the body
Onset of IM (Intra-muscular) Medication
30 minutes
Onset of IV (Intravenous) medication
15 minutes
What affects pharmacokinetics?
AGE
SEX -
BODY MASS – Affects how much you need
PREGNANCY
ENVIRONMENT
ROUTE & TIMING OF ADMINISTRATION
FLUIDS
PATHOLOGICAL STATE
GENETICS
PSYCHOLOGICAL FACTORS
Define pharmacodynamics
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
What is the primary effect of a drug?
Predicted, desired, intended effect
- Also therapeutic effect
What is a palliative effect?
Give an example
Not treating a disease process, treating a symptom
ex: morphine for pain from cancer
What is a supportive effect?
Administered alongside something for a disease
ex: Acetaminophen for fever for patient with infection
What is a substitutive effect?
Give an example
Replacing something the patient lacks/body can’t produce
- Insulin to a diabetic pt
What is a chemotherapeutic effect?
Antibiotics (for infection)
- Destroy disease-causing microorganisms or cells
What is a restorative effect?
Vitamins, minerals (supplements)
- Return body to, or maintain body at optimal health
Define Secondary Effects of a drug
Unintended of non-therapeutic effects
- All effects that’re different from what’s intended
What are types of secondary effects of a drug?
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
Describe the drug interaction: Agonist
1+1=2
Desired combined effects / both provide desired effect
Describe the drug interaction: Antagonistic
1+1=1
One drug limits or blocks the effects of another
Drug interactions: Synergistic
1+1=3
There is an additive effect, both drugs together are greater than individually
Drug interactions: Potentiating
A+B=AAAAAA
One drug enhances the other to point of toxicity
Drug interactions: Incompatibilities
1+1=0
Mixed drugs cause chemical deterioration
- Mixed solution take on changed appearance
ex: clear IV fluid gets cloudy
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?
- Allergic reaction
- Dose-related adverse reaction
- Toxic reaction
- Anaphylactic reaction
1) This is correct. Urticaria (HIVES) and pruritus (ITCHING)
are considered mild allergic reactions.
What are the classifications of drugs?
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
What are the most common side effects for most medications?
Constipation/Diarrhea
Nausea/Vomiting
Drowsiness/Dizziness
Which patients would have an issue with excretion of medications?
Renal failure
Kidney stones
Bowel obstruction
Restrictive lung disease
