Pharm Basics Flashcards
What is pharmacokinetics?
What our body does to the drug
What is pharmacodynamics?
How the drug affects our body
What is the difference between therapeutic and pharmacologic drug classifications?
Therapeutic: usefulness in treatment; how the drug treats
Pharmacologic: physiological effect on molecular/tissue level; how the drug works
Difference between chemical, generic, and brand/trade names of drugs.
Chemical: structure
Generic: name of actual medication (important for tests/NCLEX)
Brand: name given to drug by the pharmaceutical company
Process in which drugs are developed and come to market.
Preclinical phase: tested on lab animals
Phase I: tested on healthy human volunteers
Phase II: tested on clients with disease
Phase III: large sample size approved by FDA
Phase IV: usually 2+ years post market, new or adverse affects — recall
What are the responsibilities of the Food and Drug Administration (FDA)?
Protects public health by ensuring safety, efficiency, and security of drugs, biological products & medical devices.
— Also includes safety of food supply, cosmetics & products that emit radiation
Function of the DEA (Drug Enforcement Agency)
Regulates manufacturing, distribution, and dispensing of drugs with known abuse potential (controlled substances).
*Nurses must be familiar with regulations and standard of practice.
Schedule I drugs:
— high abuse potential
— not for medical use
Ex: heroin
Schedule II drugs:
— high abuse potential
Ex: narcotics
Schedule III drugs:
— moderate
— less abuse
Ex: sedatives
Schedule IV drugs:
— moderate
— less abuse
Ex: anxiety agents
Schedule V drugs:
— limited abuse
Ex: codeine
What is a teratogenic drug?
Drugs that can cause birth defects
— cross placental barrier
Primary adverse effect:
Overdose; extension of desired effect
Secondary adverse affect
Undesired effect, must be tolerated
— undesired effect produced in addition to pharmacologic effect
How does toxicity effect the liver?
Fever, nausea, jaundice
How does toxicity affect the kidneys?
— oliguria
— increased BUN
— increased creatinine
How does toxicity effect the nervous system?
Change in LOC, cognition & behavior
What is happening to the body during an allergic reaction?
Anaphylaxis: bronchoconstriction, response to histamine
— delayed allergic reactions can also occur
What are contradictions in drug therapy?
Example: having a bleeding disorder is a contradiction for taking aspirin due to excess bleeding
Drug-food interactions:
— acid production: speeds breakdown of drug
— milk products: calcium binds to drug, decreases absorption
— chemical reaction: iron binds with tetracycline
— liver enzymes: grapefruit juice (48hr after ingesting), enzyme inhibitor: toxic drug effects
What are the 6 rights of medication administration
Right:
Drug, dose, route, time, patient, documentation
What are the four phases of pharmacokinetics?
- Absorption: drug to blood
- Distribution: drug to tissue
- Metabolism: breaking drug down
- Excretion: getting drug out of body
What are factors that alter absorption of an oral drug?
— composition of drug is too big, cannot pass thru membrane
— highly lipid soluble drugs: dissolve before absorbed correctly
— foods and fluids (binding)
— multiple drugs (interaction)
— enteric coating tablets
What factors alter drug distribution?
— blood flow to tissue
— ability to cross blood-brain barrier
— protein binding: albumin; molecule gets too big
— water-soluble: stays in blood stream
— lipid-soluble: rapidly passes membrane and deposits into adipose tissue
Explain the “first pass effect”
Oral drug—absorbed across intestinal mucosa—enters portal circulation, travels to liver—drug is metabolized to less active form—leaves liver to distribute to tissues
*less active
What is the liver’s role in metabolism of drugs?
— transforms drug into active form
— breakdown drug for excretion
— hepatic microsomal enzyme system
— metabolism
What organs are primarily involved with excretion of drug byproducts?
Kidneys
Explain therapeutic response
Response after treatment of any kind, usually a useful and favorable response
What is onset, peak, and duration of drugs?
Onset: time for drug to elicit a therapeutic response
Peak: time for drug to reach maximum therapeutic response
Duration: time of drug concentration sufficient to therapeutic response
What is an agonist?
Causes the same activity of a natural chemical
Ex: insulin, beta-agonist
What is an antagonist?
Blocks normal stimulation of receptor
Ex: beta-blockers, anti-histamines
What is peak and trough?
Trough: lowest drug level needed to reach therapeutic range; lowest level of drug in bloodstream
— drawn 1hr prior to start of next medication
Peak: highest level of drug in bloodstream
— drawn 1hr after infusion is completed
What information should be included in patient education?
— name of drug
— dosing
— action
— timing
— storage and prep
— measuring
— what to avoid
— monitoring symptoms and vitals
— adverse effects
— toxicity
— warnings
— special considerations
*verify patient understanding
What is the difference between medication error and adverse effect?
Adverse drug effect: side effect; anticipated or unanticipated
Medication error: error in process that leads to adverse effect
— ex: higher than acceptable dose given; drug-drug interaction
What are the functions of the sympathetic nervous system?
— “fight or flight”
— decreased urination (retention)
— decreased digestion
— increased feelings of stress, anxiety, & danger
— system’s activity increases
What receptors are involved in the sympathetic nervous system?
Adrenergic AGONIST: sympathomimetic; used for cardiac + respiratory
— tachycardia
— vasoconstriction
— bronchodilation
— decreased GI activity
— glycogenolysis (increased blood glucose)
— constricts bladder sphincter
Adrenergic ANTAGONIST: blocking normal action; Adrenergic blocking, alpha-beta blocker; used for HTN
— slows HR
— decreases BP
— bronchoconstriction
— hypoglycemia
— urinary incontinence
What are the functions of the parasympathetic nervous system?
— “rest and digest”
— decreases HR
— constricts bronchioles
— increases digestions
— increases urination
What receptors are involved with the parasympathetic nervous system?
Cholinerigic AGONIST: mimics acetylcholine; used for Alzheimer’s
— increased saliva production
— deceased HR
— constricts bronchioles
— increases digestion
— increased urination
ANTAGONIST: anti-cholinergic; cholinergic blocking; used for bowel & bladder disease, Parkinson’s, and asthma
— decreased saliva
— increased HR
— relaxes bronchioles
— slows digestion
— decreased urination
