Outcome 3 Pharmacology Flashcards
MODULE 3
1
Q
What is pharmacology?
A
Pharmacology is the study of drugs or chemicals and their biological effect(s) on living organism.
2
Q
What do drugs do?
A
Any substance that when administered to living organisms, produces a change in function at the cellular or metabolic pathway level.
3
Q
What is a drug?
A
Any medication that has medicinal or healing properties and is used for treating disease or alleviating symptoms.
4
Q
What are some sources of drugs?
A
Early days
Drugs were obtained from plant or animal sources (e.g. flowers, tissues of any living organism). Some drugs like morphine, digitalis and insulin are still derived from these sources.
Today
Drugs are artificially made in a chemical laboratory.
5
Q
What are two major categories of medicines in North America?
A
- Drugs that can be obtained over the counter (OTC) and
- Drugs that require a prescription or prescription only medication.
6
Q
T or F. Just as there are specialties in medicine or surgery, there are subspecialties in pharmacology.
A
True.
Pharmacology is subdivided into several major areas with each one being an entire area of specialization.
7
Q
Subspecialty: What is chemotherapy?
A
Study of the use of drugs in the treatment of cancer and other diseases.
8
Q
Subspecialty: What is medicinal chemistry?
A
Study of new drug synthesis (process of artificially manufacturing drugs) as well as existing drugs
9
Q
Subspecialty: What is molecular pharmacology?
A
Study of the interaction of drugs and subcellular components
10
Q
Subspecialty: What is pharmacodynamics?
A
What a drug does to the body.
11
Q
Subspecialty: What is pharmacokinetics?
A
What the body does to the drug.
Metabolism - physical and chemical changes to the drug in the body
Absorption - how drugs get into the bloodstream Distribution - how drugs move from the bloodstream to tissues
Excretion - how a drug and its waste products are excreted
MADE
12
Q
Subspecialty: What is toxicology?
A
Study of harmful effects of drugs on living tissue.
13
Q
Subspecialty: What is pharmacy?
A
Preparation and dispensing of medications.
14
Q
Subspecialty: What is pharmacognosy?
A
Study of the physical and chemical properties of animal and plant sources of medication
15
Q
Subspecialty: What is pharmacotherapeutics?
A
The clinical application of pharmacokinetics and pharmacodynamics
16
Q
Subspecialty: What is biopharmaceutics?
A
Examines dosing and drug delivery methods.
17
Q
Every drug has a minimum of ____ names. They are:
A
Three.
- chemical
- generic
- brand
18
Q
T or F: Drugs sold in Canada must be approved and monitored to ensure that the quality is consistent and adverse effects are reported.
A
True.
19
Q
When a drug is discovered or created, it is given a ______ name based on the elements in the drug.
A
Chemical.
20
Q
In Canada, who reviews new drugs for safety and effectiveness?
A
The Therapeutic Products Directorate.
21
Q
In the US, who reviews new drugs for safety and effectiveness?
A
The Food and Drug Administration (FDA)
22
Q
Who approves all drugs that are sold in Canada?
A
The Federal Health Protection Branch. Different from the Therapeutic Products Directorate, which reviews only NEW DRUGS for safety and effectiveness.
23
Q
Who governs the sale, possession, manufacture, and distribution of narcotics and other controlled substances including opium, cocaine and marijuana?
A
The Controlled Drugs and Substances Act
24
Q
Who decides drug pricing in Canada?
A
Patented Medicine Prices Review Board
25
Once new drugs are reviewed by the Therapeutic Products Directorate for safety and effectiveness, it is given a shorter name or ______ name.
Generic.
26
What is a brand/trade/proprietary name?
Name assigned by the **pharmaceutical company** that **manufactured** the drug.
27
New drugs are patent protected for a period of __ years.
20 years.
28
What does it mean when a drug is patent protected?
The *manufacturing company* is **legally protected** from other pharmaceutical companies creating their own generic form for 20 years. After 20 years, *any* company can manufacture a generic copy of that drug.
29
How do drug patents help?
They help recoup the **cost of research and development of new drugs**.
30
What are characteristics of brand/trade/proprietary names?
Brand names are **capitalized**, easier to **remember**, easier to **pronounce**, **shorter**.
CR(A)PS
31
What are characteristics of generic names?
Spelled using **lower case**.
32
What are characteristics of chemical names?
Based on the **elements** in the drug which are usually **difficult and complex**.
33
acetaminophen \> Tylenol
generic name \> brand name
34
ibuprofen \> Advil
generic name \> brand name
35
Ativan \> lorazepam
brand name \> generic name
36
What is the difference in the quality, purity, effectiveness and safety between generic drugs and brand name drugs?
**None**. Both generic and brand name drugs are subject to the same standards. Each product must meet regulations established by the **Food and Drug Act**.
37
T or F. Manufactures must prove to the Provincial Ministries of Health that active ingredients in brand medicine are as ___________ as the original product.
True.
Quality Purity Safety - Dissolve (at same rate) Effectiveness Absorption
QPS-DEA
38
What is the difference in price between brand and generic drugs?
Generic drugs cost **40-50% less** than brand name drugs.
39
What is a narcotic?
A drug that **dulls sensibility**, **relives pain**, and **causes sleepiness**.
40
T or F. Most narcotics are not addictive.
False. Most narcotics are **addictive**.
41
What is a newer term used for a narcotic?
**Opioid analgesic**.
42
What are 3 rules that help regulate narcotic use?
1. Narcotics must be kept **locked away** at all times.
2. A **record** must be kept of the a. **name of person receiving, prescribing** and **administering** the the narcotic, b. **date** the prescription was filled, c. **amount of drug** remaining.
3. Loss or theft of any narcotic must be **recorded** and **reported to the government** within **10 days of discovery**.
LRG - N(rpa)DA
Locked, Record, Government
Name (receiving, prescribing, administering), Date, Amount of drug
43
What is the most imporant Canadia reference book for prescription drugs?
The Compendium of Pharmaceuticals and Specialties (CPS). The Compendium of Nonprescription Products (CNP).
44
What is the Compendium of Pharmaceuticals and Specialties (CPS)?
**Annual alphabetical compilation** of drugs also available in electronic form called the **e-CPS**.
45
Who produces the CPS?
The Canadian Pharmaceutical Association.
46
What is the most significant factor in the speed of drug action?
The **route** of drug administration.
47
What are the most common routes of drug administration?
**Oral** and **parenteral** (injection or infusion).
48
List the 6 methods of drug administration.
1. Oral
2. Parenteral
3. Sublingual
4. Rectal
5. Inhalation
6. Topical
O SPRIT!
oral \> sublingual \> parenteral \> rectal \> inhalation \> topical
49
What is the safest and most convenient method of administering drugs?
Oral administration
50
Oral administration usually requires ____ minutes before significant absorption.
30-60 minutes
51
With oral administration, absorption occurs in the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
gastrointestrinal tract
52
How does food affect drug absorption when drugs are orally administered?
Food and water **minimize gastric irritation**, **delays drug absorption**, and **prolongs the onset of drug action**.
53
T or F. Drugs taken orally can be removed within the first few hours by gastric lavage/induced vomiting in case of drug overdose or accidental poisoining.
True.
54
What is done in a parenteral drug administration?
Drugs are given by **injection** from a **needle/syringe** or a **needle/intravenous tubing**.
55
List the eight routes of parenteral administration.
1. Subcutaneous
2. Intradermal
3. Intramuscular
4. Intravenous
5. Intrathecal
6. Intracavitary
7. Intracardiac
8. Intracapsular/Intraarticular
sub, dermal, muscle, venous, thecal, cavitary, cardiac, capsular/articular
VTAMDS - CCC
vitameds - ccc
venous, thecal, articular, muscular, dermal, subcutaneous, cavitary, cardiac, capsular
56
What is the fastest route of parenteral administration and why?
**Intravenous injection (IV)** is the fastest route of parenteral administration because drugs enter the **bloodstream** immediately.
57
Intravenous injections are injected directly into a ____ and given when a drug can't be injected into other \_\_\_\_\_\_\_.
Vein, tissues.
58
Which parenteral administration is used for spinal anesthesia and treatment of leukemia?
**Intrathecal** or **intraspinal** injection.
59
What is the injection site for intrathecal injection?
**Below the meninges** (protective padding surrounding the brain and spinal cord).
60
What is the most frequently used injection in parenteral administration and why?
61
Which muscles are usually injected in an intramuscular injection?
Muscle of a **buttock** or an **upper arm**. Also the **thigh** muscle for epinephrine administration.
62
Which parenteral administration is used mainly for skin testing allergies and tuberculosis testing (Mantoux test)?
**Intradermal**.
63
Intradermal injections are injected within the layers of the \_\_\_\_.
Skin.
64
Subcutaneous injections are injected beneath the ____ into the ______ usually in th outer surface of the arm.
Skin, subcutaneous layer
65
How are subcutaneous and intradermal injections different?
Subcutaneous injections are injected into the **tissue layer** between the skin and the muscle while intradermal injections are injected *within* the layers of skin (dermis).
66
Which parenteral administration is injected into a body cavity?
Intracavitary injection.
67
List two examples of intracavitary injections.
1. Peritoneal dialysis injection
2. Some types of chemotherapy
68
Which parenteral administration is injected directly into the heart?
Intracardiac injection.
69
GIve an example of an intracardiac injection.
Epinephrine can be injected into the heart after cardiac arrest in an effort to bring back blood pressure.
70
Which parenteral administration is injected into a joint?
Intracapsular or intraarticular injection
71
Give an example of intracapsular injection.
Anti-inflammatory drugs can be injected in the shoulders, elbows, wrists, ankles (as in gout), knees, and hips
72
During sublingual administration of drugs, a tablet is placed under the _____ and allowed to dissolve.
Tongue.
73
Give an example of a drug that works well when administered sublingually.
**Nitroglycerin** a vasodilator and muscle relaxant that relieves angina pectoris pain **almost instantly**.
74
When are drugs usually rectally administrated?
If the physician has the ordered a patient to have **NPO** (nothing by mouth) or the patient **cannot swallow**.
75
What are suppositories and enemas?
The shape or form of a drug administered rectally. Suppositories are **cone shaped tablets** meant to dissolve in the rectum/vagina while enemas are **liquids or gases** injected into the rectum.
76
What are the most common types of drugs given rectally?
Sedatives, antiemetics, and antipyretics.
SEP
77
What are two ways to administer drugs by inhaling?
1. Spray or Mist -- inhaled as **droplets** such as **nebulizers** for asthmapatients, **vaporizers** or **nasal spray bottles**
2. Gases -- **nitrous oxide**, an anesthetic inhaled for general anesthesia ex. wisdom teeth extraction.
78
What are two types of topical application?
**Dermal** applications and **mucous membrane** applications.
79
What is the difference between a cream and an ointment?
If skin is **wet**, use **cream**, if skin is **dry**, use **ointment**.
80
What is a liniment?
A **medicated liquid** used to counteract an inflammation or irritation
81
What are **mucosal membrane applications**?
Drugs in the form of **sterile liquid** applied by **drops**. ex. eye, ear, and nose drops
82
What does drug action mean?
Describes how the body **manages drugs** after they have been absorbed in the **blood stream**
83
What is individual variation?
An identical drug and/or dosage may produce an intense response in one individual and no observable effect in another. Variation occurs as the result of several factors \>
84
List the factors that influence individual variation.
1. Age
2. Weight
3. Gender
4. Emotional State
5. Placebo Effect
6. Presence of Disease
AW PEG D!
age weight placebo emotional state gender disease
85
Why are infants and children much more sensitive to the effects of drugs?
The **inability to metabolize drugs** related to **immature enzyme systems** in the liver.
86
T or F. In the elderly, decreased liver enzymatic activity and reduced renal function results in a decreased ability to metabolize and to excrete drugs. therefore, dosages in the elderly are usually reduced.
True.
87
How are dosages determined for children?
By consideration of the child's **age** or **weight**
88
T or F. Most adult dosages are calculated for the average adult height.
False. Weight.
89
T or F. Because of a higher percentage of body fat, males may experience a greater drug effect than females because a higher concentration of drugs will be exposed to the more active tissues.
False. Females experience a greater drug effect.
90
T or F. Some individuals who are excited or extremely anxious requires the same dose of tranquilizer or hypnotic as an individual who is not emotionally stimulated.
False. People who are emotionally stimulated may require a **larger dose**
91
What is the placebo effect?
The **influence of one's mind** on the course of treatment.
92
T or F. Patients with liver or kidney disease suffer a greater incident of adverse drug effects because they are unable to effectively eliminate drugs properly.
T.
93
What is drug absorption?
Drug absorption refers to the **entrance of a drug into the bloodstream**.
94
In order for absorption to occur, the drug must be dissolved within the \_\_\_\_\_\_\_\_.
Body fluids.
95
Drugs must pass through the membranes of the ________________ and __________ before they gain access to the blood. With the exception of __________ and _________ administration.
gastrointestinal lining and blood vessels. With the exception of intravenous or intra-arterial administration
96
What factors affect drug absorption of oral medications?
1. **Time** required to **empty** the stomach
2. **Acidity** of the stomach
3. **Presence** of **food** in the stomach
4. **Other ingredients** in the tablet
TEA POI
time to empty stomach, acidity, presence of food, other ingredients
97
After a drug gains access to the blood, it is distributed to the various _____ and \_\_\_\_\_.
Tissues and organs.
98
List the 3 factors that determine what **percentage** of a drug will reach any one particular organ or area of the body.
1. Plasma Protein Binding
2. Blood Flow
3. Blood Brain Barrier
peanut butter, boyfriend, body butter
plasma protein binding, blood flow, BBB
99
T or F. Many drugs are attracted to proteins such as albumin and globulins.
True.
100
Tor F. Some drug molecules blind to plasma protein while a portion of drug molecules remain unbound or free in circulation.
True.
101
T or F. There is competition between drugs or other plasma substances for the same plasma protein-binding side, where one drug may displace another.
True.
102
In some cases of plasma protein binding, the competition causes the free drug concentration to ______ which can lead to adverse effects similar to overdose.
Increase.
103
Which organs in the body have the largest blood supply and are exposed to the largest amount of the drug?
The brain, liver and kidney.
104
Adipose or fat tissue don't accumulate large amounts of most drugs because they receive a poor amount ob blood supply. What type of drugs enter adipose tissue easily?
Highly lipid-soluble drugs
105
An **additional lipid barrier** that **protects the brain** by **resisting the passage** of microorganisms and other **water-soluble molecules**.
What is the blood brain barrier (BBB)?
106
T or F. A drug **must** have a certain degree of **lipid solubility** if it's to penetrate the BBB and gain access to the brain.
True.
107
\_\_\_\_\_\_\_\_\_\_ refers to the **chemical alteration of various substances** (e.g. drugs, foreign compounds) within the body.
Metabolism.
108
What is the purpose of **drug metabolism**?
Either
1. **Inactivate** a drug for the purpose of **excretion**
2. **Activate** the drug to produce a **therapeutic effect** or **prolong the drug action**
Inactivate for excretion
Activate for therapeutic effect
Activate to prolong the drug action
109
The ______ is the main organ involved in drug metabolism.
Liver.
110
T or F. Within the cells of the liver are a group of enzymes that function to **metabolize foreign (drug) subtances**. These enzymes take **lipid soluble drugs** and chemically alter them so they become **water-soluble compounds**.
True.
111
The ____ can excrete water-soluble compounds whereas lipod-soluble compounds are repeatedly reabsorbed back in the blood.
Kidneys.
112
What are the common pathways of drug excretion?
Through urine, feces, and exhaled gases. Some drugs are also excreted through sweat, saliva, and breast milk.
113
The _____ is the most important organ for drug metabolism but the _____ are the most important organs for drug excretion.
Liver, kidneys
114
T or F. The respiratory system plays a significant role in drug excretion.
False. There are however some drugs that are metabolized to products that *can* be exchanged from the blood into the respiratory tract.
115
What organ excretes general anesthetic gases?
The lungs.
116
Drug action terminology: The action of drugs can be **enhance, diminished, or inactivated** under certain circumstances.
Drug interaction.
117
Drug action terminology: A sudden or delayed, **unexpected or dangerous reaction** to a drug.
Adverse reaction
118
Drug action terminology: The action of r**epeated doses of drugs that are not immediately eliminated** from the body. Results in high accumulation of the drug in the body.
Cumulative action
119
Drug action terminology: Acquired **need** for a drug that may produce **psychological and/or physical symptoms** of withdrawal when the drug is discontinued.
Dependence.
120
Drug action terminology: The combined effect of two drugs **equal to the sum of their individual effects**. Used to combat side effects.
Additive action.
a + b = a or b
121
Drug interaction terminology: When the combined effect of two drugs is **less** than the effect of each drug alone. Often used to reverse an overdose or a toxic effect.
Antagonism
A + B = a
122
Drug interaction terminology: Two drugs together cause each one to **produce an effect neither could produce on its own**
Synergism/potentiation
a + b = A
an antihistamine taken with an opiod analgesic intensifies the effect of the narcotic so that less of the opiod is needed
123
What is the difference between drug-drug interaction, drug-food interaction, drug-herb interaction?
**Drug-drug interaction** two drugs administered together can affect the response of either one
**Drug-food interaction** some drugs are **inactivated** when food is present in the stomach
**Drug-herb interaction** some drugs are **enhanced** in the presence of herbal remedies
124
Drug action terminology: an **over responsiveness** to drug action - even to small doses. **Allergic reaction**
Hypersensitivity
125
Drug action terminology: the **side effects** of treatment
Iatrogenic
126
Drug action terminology: An abnormal drug response occuring in individuals who have a **peculiar, often hereditary defect** in their body chemistry which produces an effect totally unrelated to the drug's normal pharmacological action.
Idiosyncrasy
127
T or F. Idiosyncrasy is a form of allergy.
False. Ex. agitation when taking sleeping pills
128
T or F. Overdoses are limited to doses that clearly exceed the normal dosage recommended by the manufacturer.
False. Not limited to excess. The optimal drugs of many drugs varies from person to person. What may be an **average** dose for the majority of individuals will be an overdose for some and an underdose for others.
129
Drug action terminology: A drug-induced **change in the skin** that results in the development of a rash/sunburn when exposed to the **sun or ultraviolet lamps**
Photosensitivity
130
Drug action terminology: Normal, expected, and predictable responses to a drug that **accompanies the intended response** sought in treatment.
Side effects.
131
T or F. Side effects are part of a drug's pharmacological activity and are unavoidable.
True.
132
Drug action terminology: the effect of drugs that produce **birth defects**
Teratogenic effect
133
Drug action terminology: The effects of a given dose of drug diminish as the drug is administered over a period of time; therefore, larger doses must be given. Body tissues become accustomed to the drug's presence and react to it less vigorously
Tolerance
134
When a patient finds that the usual dose of codeine is no longer sufficient to relieve pain and has to increase the dosage (which creates a risk for addiction), this is called \_\_\_\_\_\_\_\_\_.
Harmful tolerance
135
T or F. Tolerance can only be harmful in treatment.
False. Tolerance can be beneficial
136
\_\_\_\_\_\_\_\_\_\_\_\_ is an adverse reaction to the administration of a drug. The drug has become **poisonous** to the body. Goes beyond side effects in that which it produces harmful changes
Drug toxicity
137
T or F. Toxicology can be due to a one time overdose or normal doses given over a period of time
True.
138
Vitamin _ is the antidote for toxic levels of Coumadin.
K
139
Vitamin _ deficiency can cause night blindness and lack of resistance to infections
A
140
Vitamin _ deficiency can cause hemolysis
Vitamin E
141
Vitamin _ deficiency can cause hemorrhages
Vitamin K
142
Minerals make up approximately ___ of body weight, 75% of which are _______ and \_\_\_\_\_\_\_\_.
4%. Calcium and phosphorus.
143
MInerals and vitamins are not used for fuel, they join with other nutrients to ensure __________ of the body cells.
Proper functioning
144
Mineral role: hardness of bones and teeth; blood clotting
Calcium
145
Mineral role: Formation of bones and teeth; energy storage; energy transfer
Phosphorus
146
Mineral role: Proper functioning of the muscles and nerves; bone formation
Magnesium
147
Mineral role: Helps to maintain intracellular osmotic pressure; nerve conduction; muscle contraction
Potassium
148
Mineral role: Essential part of insulin; regulates various body activities such as energy storage
Sulfur
149
Mineral role: Main electrolyte responsible for **water balance**; needed for **neuromuscular function**
Sodium
150
Mineral role: Required for hydrochloric acid formation by stomach glands to aid in digestion
Chlorine
151
before meals
ac
152
after meals
pc
153
ad, as, au
right ear, left ear, both ears
154
c (with bar on top), s (with bar on top)
with, without
155
gt; gtt
drop, drops
156
HS/hs
hour of sleep (bedtime)
157
nothing by mouth
NPO
158
od, os, ou
right eye, left eye, both eyes
159
PR
per rectum
160
PRN vs ad lib
as needed, as desired
161
Sig
label; instructions
162
SC or SUBQ or subq
subcutaneous injection
