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My Patho/Pharm > Pharm Unit 1 > Flashcards

Pharm Unit 1 Flashcards

0
Q

what criteria would the perfect drug have?

A 
highly potent
100% selective for the part of the body being treated
no side effects
no drug interation
universally affordable
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1
Q

What is MOA

A

Mechanism of Action (how the drug works)

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2
Q

what is another name for the class of a drug

A

MOA (mechanism of action)

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3
Q

basic pharmaceutical profile for drugs in a particular class?

A 
absorption
degradation & elimination
potential drug-drug interactions
monitoring requirements
use in subpopulations (like pediatrics or pregnancy)
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4
Q

special patient populations to consider with drug selections

A 
age
sex
reproductive status
culture
polypharmacy
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5
Q

patient education with certain drugs may include:

A 
name of drug (brand name & generic)
dose & dose interval
length of treatment (acute or chronic)(refills?)
need for monitoring and followup care
signs & symptoms of toxicity
goals of treatment
help patient understand condition
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6
Q

change biologic functioning via chemical action on cells

A

drugs

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7
Q

study of how chemicals interact with living systems

A

pharmacology

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8
Q

drugs that are chemicals that our own bodies produce

A

endogenous substances

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9
Q

drugs administered to a person

A

exogenous substances

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10
Q

drug use in humans in order to treat and prevent disease, recreation, or religion/culture

A

pharmacotherapy

aka applied pharmacology, medical pharmacology, &pharmacotherapeutics

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11
Q

undesirable effects of chemicals on living systems

A

toxicology

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12
Q

harmful drugs and/or inorganic toxins

A

poisons

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13
Q

poisons of biological origin

A

toxins

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14
Q

what is the smallest part of matter?

A

atom

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15
Q

what is made up of only one type of atom?

A

element

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16
Q

what is made up of more than one type of atom?

A

molecule (compound)

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17
Q

total atomic weight of all atoms in a molecule

A

molecular weight (MW)

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18
Q

three states of matter that are determined by ambient temperature and pressure

A

solid
liquid
gas

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19
Q

what are the five elements that all ORGANIC COMPOUNDS are comprised of?

A 
Carbon
Hydrogen
Oxygen
Nitrogen
Sulfur (some)
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20
Q

a solid substance that is dissolved in a liquid

A

solute

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21
Q

liquid (water) in which substances are dissolved

A

solvent

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22
Q

electrically charged particles in solution

A

ions

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23
Q

positively charged ion

A

cation

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24
Q

negatively charged ion

A

anion

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25
Q

ions in living systems are called . . .

A

electrolytes

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26
Q

what is something without an electrical charge?

A

neutral

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27
Q

scale that measures the acid in a solution

A

pH scale

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28
Q

chemicals that can accept a hydronium ion (H+) in solution

A

bases

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29
Q

chemical made up of a conjugate base and a hydronium ion (H+)

A

acid

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30
Q

what does the route of drug administration depend upon

A

physical state of the drug (chemical)

inhaled, oral, injected

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31
Q

type of drug that has a right or left orientation

A

racemic (aka chiral, isomers, dimers)

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32
Q

what is it called when one chemical attaches or associates with another?

A

bonding

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33
Q

kind of bond that is strong and usually not reversible

less common in drugs

A

covalent bonds

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34
Q

type of bond that is weaker in nature and is more reversible as drugs can dissociate away after initial bonding

A

weak bonds

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35
Q

two types of weak bonds

A

electrostatic bonds

hydrophobic bonds

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36
Q

type of substance that does not form bonds

A

inert substance

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37
Q

name of the concept that causes solute to passively diffuse from areas of high concentration to areas of low concentration with out any energy being required

A

Concentration Gradient

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38
Q

name for a water soluble substance

A

hydrophilic

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39
Q

name for a lipid soluble substance

A

lipophilic

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40
Q

substance that is both water and lipid soluble

A

amphiphilic

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41
Q

in the body, what is the “water compartment” that water soluble drugs travel through?

A

plasma in the bloodstream

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42
Q

what do lipid soluble drugs have to get through to get out of the bloodstream and into the tissues?

A

phospholipid cell membrane

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43
Q

type of protein that helps carry a drug across the cell membrane

A

transporter protein

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44
Q

what type of drug (by solubility) can cross the Blood Brain Barrier

A

lipophilic

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45
Q

two things that help to create the blood brain barrier

A

neuroglia

tight juctions

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46
Q

astrocyte cells that are supporting cells of the brain that help make up BBB

A

neuroglia

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47
Q

what areas of the brain do not have the BBB and why?

A

pituitary
hypthalamus
pineal
-because the brain needs to sample the body’s internal environment for regulation of body function

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48
Q

name some substances that can easily pass through the BBB

A

lipophilic substances (alchohol, and anesthetics)
water
gases (such as carbon dioxide)

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49
Q

name three things that have difficulty passing through the BBB

A

proteins
electrolytes
many therapeutic drugs

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50
Q

expected benefits of a drug

A

target outcome

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51
Q

the drug that should work the best, be the first-line therapy, have the least toxicity to the patient, and be effective when used alone

A

Drug of Choice (DOC)

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52
Q

a drug that is effective when it is used alone is called

A

monotherapy

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53
Q

the reason or medical condition that the drug is being used

A

indication

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54
Q

this is what the FDA has legally determined to be the clinical condition for which a drug should be used

A

label indications (label approved)

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55
Q

when a clinician prescribes drugs that are not label approved for a specific condition due to clinical evidence that it will work based on the science of the drug

A

Off label use

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56
Q

possible reasons such as age, sex, reproductive status, allergies or comorbidities to NOT use a drug on a particular patient

A

contraindications

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57
Q

when a patient is to NOT be given a certain drug under any circumstances

A

absolute contraindications

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58
Q

when the need for a drug is greater than the possibility of an adverse drug reaction, and a risk-benefit decision has to be made by the provider and the patient

A

relative contraindication

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59
Q

two classes of legal drugs

A

prescription

over the counter (OTC) and behind the counter (BTC)

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60
Q

book that is published by the FDA listing all approved drugs in the USA

A

The “Orange Book”

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61
Q

drugs that are further regulated by the Drug Enforcement Administration (DEA) due to their abuse potential are called . . .

A

controlled substances

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62
Q

another name for controlled substances that refers to the time constraints put on to how often a certain drug may be prescribed to or purchased by a single person

A

“Schedule drugs”

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63
Q

class of licit drugs that can be safely administered by a lay person who can also understand the directions, indications, and contraindications. they do not represent potential for loss of life, limb, or eyesight.

A

Over the Counter (OTC)

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64
Q

drugs that do not require a prescription, but are not kept out in the open because they still have to be regulated and have purchase limits.

A

Behind the Counter (BTC)

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65
Q

a drug that requires a prescription from a licensed provider in order to be obtained from a pharmacist

A

legend drug

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66
Q

a drug name that follows nomeclature rules

A

generic names

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67
Q

an FDA approved drug name that is owned by a drug company and used for marketing

A

brand name

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68
Q

who determines schedules for schedule drugs?

A

Drug Enforcement Agency (DEA)

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69
Q

this particular schedule of drug is considered illicit and is illegal in the USA

A

Schedule I

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70
Q

Schedules of drugs that are considered licit (legal) and require additional prescriptive authority from the federal government

A

Schedules II-V

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71
Q

a drug law that was passed in 1970

A

Controlled Substance Act

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72
Q

What does the term illicit mean?

A

use is subject to legal penalties (illegal)

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73
Q

schedule number of the drug that has a high potential for abuse, lack of safety for use in treatment, and no accepted medical use in treatment in the USA.

A

C-1

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74
Q

schedule of drugs with high potential for abuse that may lead to severe psychic or physical dependence

A

C-2 (vicodin, lortab, oxycodone, methadone…)

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75
Q

what schedule of drug to different depressants and stimulates fall under?

A

C-4

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76
Q

what class of drug has the lowest risk for abuse

A

C-5

77
Q

what is a DEA code number?

A

4-digit number assigned to each CS (controlled substance)

78
Q

two types of safe drug disposal

A

trash-mixed with non-drug substances

flushed down the toilet

79
Q

kind of nutrition that maintains a healthy body and helps prevent illness

A

preventive nutrition

80
Q

type of nutrition that is designed to help cure illness and alleviate symptoms

A

prescribed nutrition

81
Q

what is it called when nutrition is prescribed and therefore charted?

A

Medical Nutrition Therapy (MNT)

82
Q

food which is formulated to be consumed or administered enterally under the supervision of a physician and which is intended for the specific dietary management of a disease.

A

medical foods

83
Q

actions of drugs on the body

A

pharmacodynamics

84
Q

actions of the body on drugs (referring to the detoxification, inactivation, and excretion of drugs)

A

pharmacokinetics

85
Q

strength of a drug to bind to a specific receptor

A

affinity

86
Q

a chemical that binds to a receptor is called a _______

A

ligand

87
Q

drugs that bind and activate the receptor to produce the desired biologic effect

A

agonists

88
Q

when body’s endogenous substances inhibit or block the effect of an agonist, and they are competing for the same cell receptor binding site

A

antagonist

89
Q

this means to speed up a reaction

A

catalyze

90
Q

the name of an enzyme always ends in ___.

A

-ase

91
Q

a sequential series of chemical reactions catalyzed by enzymes

A

metabolic pathway

92
Q

prevent normal physiologic activity of cell pumps

A

pump poisoners

93
Q

affects the water balance of the body’s compartments

A

osmotic effects

94
Q

when a drug has affects on the body beyond what is expected from its MOA

A

pleiotropic effects

95
Q

these naturally restore the balance of bacterial flora in the body

A

probiotics

96
Q

drugs that are designed in a lab and are engineered to act at the micro-molecular biochemical level

A

designer drugs

97
Q

results of placebo-controlled, double-blind, cohort matched randomized control trials tell us if drug claims are really true

A

evidence based medicine (EBM)

98
Q

steps of the EBP process

A 
Assess the patient
Ask the question
Acquire evidence
Appraise the evidence
Apply by talking with the patient
Self evalutaion
99
Q

substance given to a patient with no known drug effect

A

placebo

100
Q

when a patient reports improvement or even objectively measured data improves even though they have not actually taken a drug

A

placebo effect

101
Q

when both the investigator and the patient are unaware regarding who is receiving active drugs or placebos

A

double blind

102
Q

when an investigator and their patients are aware of the therapy and know that they have received a placebo

A

open-label drug trial

103
Q

trial of two drugs in the same class to see which one is better

A

head-to-head trial

104
Q

comparison of generic drugs to brand name

A

bioequivalence

105
Q

type of drug that requires a very consistent blood level and is therefore not allowed to be substituted with its generic brand

A

critical dose drug

106
Q

medical conditions that the drug is FDA approved to treat

A

label indications

107
Q

when a drug is label approved for one condition and then prescribed to treat another, with the support of a scientific basis

A

off-label prescribing

108
Q

drugs that have limited uses for very rare diseases

A

orphan drugs

109
Q

organization that aims to provide drug information to consumers with websites for drugs

A

Center for Drug Evaluation and Research (CDER)

110
Q

summary of chemical and biological information on a drug, inlcluding data from RCT’s, warnings, prescribing guidance, how it’s supplied, dosing, ect.

A

Prescribing Information

111
Q

where are vaccine-related injuries and/or adverse effects reported to?

A

Vaccine Adverse Effects Reporting System (VAERS)

112
Q

put at the very top of the Prescribing Information for the drug to highlight a serious adverse effect risk

A

Black Box Warning (BBW)

113
Q

what is it called when a patient just takes a medication as it is prescribed?

A

compliance

114
Q

what is it called when a patient takes a medication as it is prescribed and follows through on other elements of the management plan (like diet and exercise)

A

adherence

115
Q

when the continued administration of a drug results in decreased response to the same dose, thus a higher dose will be needed to achieve the same drug effect

A

tolerance

116
Q

what is it called when tolerance develops rapidly?

A

tachyphylaxis

117
Q

when a drug stops and a withdrawal syndrome developes

A

physical dependence

118
Q

drugs in the same class that are used to prevent or relieve symptoms of withdrawal from another drug in the same class

A

cross-dependence (cross tolerance)

119
Q

feeling of satisfaction and desire to repeat drug experience despite knowing that the drug us causing harm

A

psychologic dependence (addiction)

120
Q

episodic drug use without dependence, often practiced within rituals & in company of others

A

recreational drug use

121
Q

when drugs are marketed by a pharmaceutical company in a combined form (tablet, capsule) and a prescriber can use the combination of these two drugs with one prescription

A

fixed-drug (fixed-dose) combination

122
Q

when all cell receptors are occupied by a drug

A

maximal response

123
Q

dose at which 50% of the population studied will show the toxic effect

A

median toxic dose (TD50)

124
Q

dose at which 50% of the population studied will die

A

median lethal dose (LD50)

125
Q

drugs that are added to the primary drug to allow use of primary drug at lower dose to decrease toxicity

A

adjunctive drugs

126
Q

dose at which 50% of the population exhibits the desired effect

A

effectiveness (ED50)

127
Q

compares the TD50 (or LD50) with the ED50 to determine the margin of safety for a drug

A

therapeutic index (TI) (aka selective toxicity)

128
Q

dose range that gives a benefit without toxicity

A

therapeutic window

129
Q

a reaction that occurs that is not part of the expected therapeutic response to a drug

A

adverse drug reaction (ADR)

aka adverse event, adverse effect, adverse drug event

130
Q

any mistake made in diagnosis or treatment

A

medical error

131
Q

any mistake made in prescribing, transcribing, dispensing, or administering medication

A

medication error

132
Q

a medical (or medication) error that has not caused harm

A

near miss

133
Q

when a medical mistake causes harm

A

preventable adverse effect

134
Q

three types of ADR’s

A

dose related (toxic)
predictable (side effects)
immunologic or idiosyncratic

135
Q

ADR where as the dose increases, so does the ADR potential

A

dose related (toxic)

136
Q

ADR that is really just a side effect of the drug

A

predictable ADR

137
Q

and ADR that is unrelated to pharmacologic actions

A

idiosyncratic

138
Q

an ADR that is an allergic reaction where an immune response has occured

A

immunologic

139
Q

when serious and potentially life threatening symptoms occur, usually minutes after contact with an allergen

A

anaphylaxis

140
Q

type I hypersensitivity

A

anaphylaxis

141
Q

type III hypersensitivity

A

aka serum sickness

142
Q

type IV hypersensitivity

A

contact dermatitis

143
Q

rash eruptions that are independent of IgE effects

A

cutaneous drug reaction

144
Q

“what the body does to the drug

A

pharmacokinetics

145
Q

pharmacokinetics 4 steps (ADME)

A

absorption
distribution to tissues
metabolization (biotransformation & elimination)
excretion

146
Q

when the response of combined drugs is additive (1+1=2)

A

addition

147
Q

effect achieved by using combined drugs is greater than would be predicted than by simple additive effects often due to complementary effects of the drug MOA (1+1>2)

A

synergism

148
Q

a drug with no effect will enhance the effect of another drug

A

potentiation

149
Q

one drug inhibits the effect of another drug

A

antagonism

150
Q

drug toxicity effect that causes loss of consciousness (LOC) and death.
named for the QT interval prolongation and tachycardia on the EKG

A

Long QT Interval Syndrome (LQTS)

151
Q

amount of time needed for the plasma concentration to drop by 50% after the drug is discontinued. determines how long the drug remains in the system

A

half-life (elimination)

152
Q

strategy to get a higher serum level immediately by using a larger dose for the first dose

A

loading dose

153
Q

3 checks of medicine administration

A

1st: when you receive the med
2nd: when you prepare the med
3rd: when you bring the med to the patient

154
Q

5 rights of medication administration

A 
right patient
right drug
right dose
right route
right time
155
Q

2 newly added rights of med administration

A

right reason

right documentation

156
Q

examples of medication calculation

A

conversion between systems

pediatric dosing based on age, weight and ,surface area

157
Q

dosage calculation formula for IV drips

A

drops/min= (mL of solution prescribed per hour x drops delivered per minute) / (60 min/hr)

158
Q

four pediatric rules of dising

A

Fried’s rule (toddlers)
Young’s rule (children 1-12)
Clark’s rule (newborns & young infants)
body surface area calculations

159
Q

Fried’s rule

child’s dose = ?

A

(age in months x adult dose) / 150

160
Q

Young’s rule (children aged 1-12)

child’s dose = ?

A

(child’s age in years x adult dose) / (child’s age + 12)

161
Q

Clark’s rule (newborns and young infants)

child’s dose = ?

A

(child’s weight in lbs x adult dose) / 150

162
Q

Body surface area calculation (most common way)

child’s dose = ?

A

(child’s BSA / 1.73) x adult dose

163
Q

reproductive and nursing status for drug administration includes:

A

last menstrual period
birth control
lactation history

164
Q

pregnancy drug categories from least to greatest on risk of fetal harm

A

A, B, C, D, X

165
Q

category that drugs are absolutely contraindicated in pregnancy or women who may become pregnant

A

Category X

166
Q

at what point in her daily lactation cycle should a breastfeeding mother take he medications, just to be sure that it is cleared from her blood before her next feeding

A

30-60 minutes after nursing and 3-4 hours before her next feeding

167
Q

list of medicines that are drug intolerances in children

A 
Benzyl alcohol
BP meds
Arthritis meds
Iron
Aluminum
tetracyclines & quinolone antibiotics
168
Q

geriatric drug concerns may include:

A 
aging physiology
higher fall risk (sedatives)
respiratory depression risk (opiods)
renal toxicity
polypharmacy
169
Q

when multiple drugs are used daily, and there is an increased risk of drug interactions and toxicities

A

polypharmacy

170
Q

what problems to these help reduce?:
medication disclosure
ID drugs by generic name & class
right drug for right reason
know side effects for each
ID risk of adverse effects
eliminate drugs with no benefit or indication
substitute for less toxic drugs if possible
try to avoid prescribing drugs to treat other drug side effects
try to have each drug to one dose per day

A

polypharmacy issues

171
Q

someone with the ability to assess, test, diagnose, generate and implement a plan of care

A

provider

172
Q

examples of medical prroviders

A 
MD (medical doctor)
MO (doctor of osteopthy)
NP (nurse practitioner) 
PA (physician's assistant)
DDS (dentist)
DPM (podiatry)
173
Q

healthcare member who dispenses drugs with an order from a licensed provider

A

pharmacist

174
Q

healthcare member who administers drugs with an order from a provider

A

nurse

175
Q

routes of drug administration

A

oral (withstand stomach acid)
oral disintegrating tablets ( straight to bloodstream)
sublingual
rectal (used in unconscious or vomiting people)
inhalational (lung or nasal sprays)
topical (usually dermatologic or ophthamlmologic)
transdermal (patches)
parenteral (intravenous, intramuscular, subcutaneous)
intrathecal (directly to CSF into brain ventricles)
epidural & spinal (injection to spaces surrounding spinal chord)

176
Q

drug formulation with more rapid onset of action that also lasts a shorter period of time

A

immediate release

177
Q

drug formulation with slower onset of action but more predictable release to body that last for a longer period of time

A

extended release

178
Q

nursing medicinal responsibilities to prevent medication errors

A 
assessment
administration of ordered meds and therapy
assessment of reaction to meds
teaching
assessment of teaching effectivness
179
Q

patient education of the drugs they are prescribed includes:

A 
name
dose
action
administration timing
storage and prep
alternative therapies and drugs to avoid
safety measures
points about drug toxicity
warnings about drug discontiuation
180
Q

special warnings to give about drugs to patients:

A 
drowsy warning
alcohol
diet
drug interactions
pregnancy
refills
181
Q

effect of medication and medical errors on a nurses life

A

“Second Victim Syndrome”

182
Q

5 steps of the nursing process

A 
clinical history assessment
physical exam assessment
nursing diagnosis
intervention (plan of care)
evaluation (was plan of care effective?)
183
Q

Medication Administration Record includes:

A 
patient name
drug name, dosage, frequency & time & route of administration
name of prescriber
time given
date of most recent order
food & drug allergies
184
Q

botanicals, recognized for medicinal effect, that are ingested, inhaled, or massaged into skin

A

herbal medicine (phytomedicine)

185
Q

warnings about herbal medicine

A

may have interactions with OTC drugs
may have issues with purity and dosing variability
may have long term and short term issues
may affect an existing clinical condition
may have organ toxicity
may have an allergic reaction

186
Q

type of juice that inhibits CYP3A4 enzyme path, causing drug to stay in the system for longer than they are supposed to and can cause drug levels to rise dangerously

A

grapefruit juice

187
Q

4 types of food sensitivity reactions

A 
food hypersensitivity & anaphylaxis (common reactions)
food intolerance (gluten, lactose)
food toxicity (poisoning -- additive, microbe toxins)
food idiosyncrasy (MSG reactions)
188
Q

when patients exhibit food reactions to herbal products within the same botanical families
(nuts, citrus, shellfish, melons & ragweed pollen, birch pollen & apples, latex & certain foods)

A

cross reactivity

189
Q

if allergic to latex, one may have cross reactivity to foods such as:

A 
bananas
kiwis
peanuts
avocados
chestnuts
soybeans
190
Q

common food additives that cause reactions

A

sulfites
MSG
dyes

191
Q

5 injection sites

A 
deltoid (upper arm)
rectus femoris (anterior thigh)
ventrogluteal (side hip)
dorsogluteal (back of hip)
vastus lateralis (side thigh)

My Patho/Pharm (7 decks)

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