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Pharm Week 2 Flashcards

1
Q

Describe the three phases of drug activity: (think pharmaceuticals)

A
  1. Pharmaceutical
  2. Pharmacokinetic
  3. Pharmacodynamics
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2
Q

Describe the physiochemical processes mediating drug
action.

A

Describe the physiochemical processes mediating drug
action.

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3
Q

Explain the client variables that influence the rate and extent of Absorption, Distribution, Metabolism,
and Elimination.

A

Absorption, Distribution, Metabolism,
and Elimination.

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4
Q

Definitions! Chemical/Generic/Trade name

A

Definitions! Chemical/Generic/Trade name

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5
Q

drug actions: (recept the enzyme or be nonspecific)

A
  • drug receptor interaction
  • drug-enzyme interaction
  • nonspecific drug interaction
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6
Q

drug-enzyme interaction

A

drug-enzyme interaction

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7
Q

nonspecific drug interaction

A

nonspecific drug interaction

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8
Q

Pharmaceutical - Dosage form determines the rate (not absorption, but close)

A

drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract). goes from solid and breaks down in gut
🞑 Enteric-coated tablets
🞑 Extended-release form

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9
Q

Pharmacokinetic

A

Pharmacokinetic

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10
Q

Pharmacokinetic (body kinetetics changes a drug)

A

The study of what the body does to the drug
- Absorption
- Distribution
- Metabolism
-Excretion

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11
Q
  • drug receptor interaction
A
  • drug receptor interaction
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12
Q

Absorption (absorb the bupe into your bloodstream to your sore muscles)

A

the movement from administration into the bloodstream for distribution to the tissues

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13
Q

Distribution

A

Distribution

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14
Q

Metabolism,

A

Metabolism,

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15
Q

elimination

A

elimination

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16
Q

Use Nursing Assessments to identify unusual
and adverse effects of drug therapy.

A

Use Nursing Assessments to identify unusual
and adverse effects of drug therapy.

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17
Q

Drugs do not confer any new functions on a
tissue or organ in the body; they only

A

modify
existing functions.

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18
Q

Drugs in general exert multiple actions rather
than

A

a single effect.

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19
Q

Drug action results from a physiochemical
interaction between the (just the drug and a specific molecule - makes sense)

A

drug and a
functionally important molecule in the body

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20
Q

Pharmaceutics (the suits control the dosage and how it affects the body)

A

the study of how various dosage forms influence the way in which the drug affects the body

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21
Q

Pharmacodynamics involves..(the drug and receptor are dynamic)

A

drug-receptor relationship.
the mechanism of drug actions in living tissues

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22
Q

Pharmacokinetics is the study of what the…(kinetics is a rush) WHICH includes AD ME

A

body does to the drug.
- Absorption
- Distribution
- Metabolism
-Excretion

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23
Q

pharmaceutics -Dosage form determines the rate of (not absorption, but close)

A

drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract).

Enteric-coated tablets
🞑 Extended-release forms

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24
Q

pharmokinetics (kinetics is down with O/P/D)

A

A drug’s time to Onset of action, time
to Peak effect, and Duration of action

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25
Q

pharmokinetics is the study of what happens to a drug from the time it is put into the body until the (parents are kin)

A

the parent drug and all metabolites have left the body

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26
Q

pharmacokinetics: absorption - (absoption goes from admin to bloodstream)

A

Movement of a drug from its site of administration into the bloodstream for distribution to the bioavailability and first pass

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27
Q

absorption (compare theabsportionw/onsetandduration)

A

A comparison of drug Onsets and Duration of Action by Route of Administration. Fastest is IV - bypasses the liver.

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28
Q

A drug’s route of administration affects the (and types of routes - PET the route)absorption????

A

the rate and extent of Absorption of that drug
🞑 Enteral (GI tract)
🞑 Parenteral
🞑 Topical

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29
Q

enteral routes

A

The drug is absorbed into the systemic circulation
through the oral or gastric mucosa or the small
intestine

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30
Q

examples of enteral routes (enteral BROS)

A
  • Oral
  • Sublingual
    -Buccal
    -Rectal (can also be topical)
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31
Q

types of parenteral routes (VAAT D MC)

A

Intravenous (fastest delivery into the blood circulation)
Intramuscular
Subcutaneous (insulin)
Intradermal
Intraarterial
Intrathecal (in spinal column)
Intraarticular (into joint)

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32
Q

topical route (LEEN RVS are topical) start with skin, then top of head - eyes, etc.)

A

 Skin (including transdermal patches)
 Eyes
 Ears
 Nose
 Lungs (inhalation)
 Rectum
 Vagina

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33
Q

distribution (distribute from the blood to the worksite)

A

The transport of a drug by the bloodstream to its
site of action

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34
Q

types of distribution (distribute the protein, water, and bbb)

A

 Protein-binding
 Water-soluble vs. Fat-soluble
 Blood-brain barrier

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35
Q

distribution - Areas of rapid distribution - the basic organs (HLK B rapid)

A

Heart, Liver, Kidneys, Brain (if you are in trauma, body will wall off heart, lungs and brain - most important)

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36
Q

distribution - Areas of slow distribution (MS F is slow)

A

Muscle, Skin, Fat

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37
Q

Distribution - A loading dose is administered to…

A

reach a therapeutic response level rapidly. Maintenance
doses are administered at prescribed intervals to
maintain a therapeutic drug response.

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38
Q

distribution - Maintenance doses are administered at

A

prescribed intervals to maintain a therapeutic drug response.

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39
Q

metabolism/biotransformation (transform into active)

A

*The biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite, or a less active metabolite

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40
Q

organs involved in metabolism/biotransformation (I’LL SKP biotransformation)

A

 Liver (main organ)
 Skeletal muscle
 Kidneys
 Lungs
 Plasma
 Intestinal mucosa

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41
Q

Factors that decrease metabolism (metabolism goes down when my heart and kidneys are starving. Also when I’m yellow from acetylate or ketoconazale)

A

 Cardiovascular dysfunction
 Renal insufficiency
 Starvation
 Obstructive jaundice-Yellow skin, eyes,, Liver CA, blocked Bile (also overdose of asprin)
 Slow acetylator-Liver can’t detoxify becomes toxic
 Ketoconazole therapy- tx for fungus or yeast infections

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42
Q

Factors that increase metabolism (metabolism goes up during BAR PH (ight)

A

already outlined

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43
Q

excretion is (excrete that drug)

A

The elimination of drugs from the body

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44
Q

organs involved in excretion (excretion is BBBLEK (bleak) (don’t need to know all of this)

A

 Kidneys (main organ)
 Liver
 Bowel
🞑 Biliary excretion
🞑 Enterohepatic recirculation
Biliary recycling

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45
Q

half life

A

 The time it takes for one half of the original
amount of a drug to be removed from the body…
 A measure of the rate at which a drug is
removed from the body
 Most drugs considered to be effectively removed
after about five half-lives
 Steady state- constant drug level- 2, 4, 5X 1/2L

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46
Q

bioavailability Refers to the (my percent in bio met the target)

A

percentage of active drug substances absorbed and available to reach the target tissues following drug administration

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47
Q

Drug actions (the actions just occur on a cellular level)

A

The cellular processes involved in the drug and cell interaction

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48
Q

Drug effect (chiva effect is OD or O/P/D)

A

 The physiologic reaction of the body to the drug
 Includes onset, peak, and duration of action

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49
Q

Onset (onset is therapeutic)

A

The time it takes for the drug to elicit a therapeutic response

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50
Q

Peak (the peak is the max)

A

The time it takes for a drug to reach its maximum
therapeutic response

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51
Q

Duration (duration is therapy)

A

The time a drug concentration is sufficient to elicit a
therapeutic response

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52
Q

therapeutic drug monitoring - Peak level

A

Highest blood level

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53
Q

therapeutic drug monitoring - lowest blood level (the trough is low)

A

Trough level

54
Q

Pharmacotherapeutics / Pharmaceutics

Therapeutic index represents the**Need to know for test) (theaputic is lethal)

A

ratio between two factors:
▪Lethal dose (LD50)
▪Effective dose (ED50)

TI = LD50/ED50

55
Q

drugs w/ a narrow therapeutic index (PLAD VW is very narrow)***Know for TEST (amen w/ dog drooling over phentanyl at war w/ valerie)

A
  1. Aminoglycosides (Gentamicin®)
  2. Digoxin (Lanoxin®)
  3. Lithium (Lithobid®)
  4. Phenytoin (Dilantin®)
  5. Valproic Acid (Depakote®)
  6. Warfarin (Coumadin®)
56
Q

Pharmacodynamics:
Mechanisms of Action (REN took action)

A

 Receptor interactions-

 Enzyme interactions-

 Nonselective interaction-

57
Q

Receptor interactions- (receptors are on the surface and inside)

A

reactive site on cell surface or inside cell

58
Q

Enzyme interactions-

A

catalyst most biochemical rx in cell

59
Q

Enzyme interactions-

A

catalyst most biochemical rx in cell

60
Q

Nonselective interaction (just doesn’t do the other 2 things)

A

No Rx with receptors or enzymes.

61
Q

drug-receptor interactions - agonist

A

drug binds to the receptor; there is a response

62
Q

drug-receptor interactions - partial agonist

A

drug binds to the receptor; the response is diminished compared to agonist

63
Q

drug-receptor interactions - antagonist

A

drug binds to the receptor: there is no response. drug prevents biding of agonists.

64
Q

drug-receptor interactions - competitive antagonist

A

drug competes w/ agonist for binding to the receptor: if binds, there is no response.

65
Q

drug-receptor interactions - non-competitive antagonist

A

drug combines with different parts of the receptor and inactivates it; agonist then has no effect.

66
Q

agonists (mimic the agonist)

A

• Mimics action of the receptor
• A drug that has high affinity and intrinsic activity-(ability of drug to be bound to receptor)

67
Q

antagonist

A

• Blocks action of the receptor
• Acts to prevent receptor activation by
endogenous(internal origin) regulatory
molecules and agonist
drugs

68
Q

Pharmacotherapeutics:
Types of Therapies - ON TEST (MSS PPE therapy)

A

 Maintenance therapy
 Supplemental/replacement therapy
 Palliative therapy
 Supportive therapy
 Prophylactic therapy
 Empiric therapy

69
Q

contraindications

A

 Any characteristic of the patient, especially a
disease state, that makes the use of a given
medication dangerous for the patient
 It is important to assess for contraindications!
(ex. pregnant women can’t take tylenol)

70
Q

monitoring - must be familiar with what?

A

 Evaluating the clinical response of the patient to
the treatment
 One must be familiar with the drug’s:
• Intended therapeutic action (beneficial)
• Unintended but potential adverse effects
(predictable, adverse drug reactions)

71
Q

monitoring 2

A

 Therapeutic index- ratio TI=LD50/ED50
 Drug concentration
 Patient’s condition-infection/CV/GI/Stress/ depression/anxiety
 Tolerance and dependence-I
is physiological or psychological response to repeated doses
 Drug interactions (additive effect, synergistic
effect, antagonistic effect, incompatibility)- action
of one drug by another
 Adverse drug events-
( Additive effect= 1+1=2, Synergistic effect= 1+1>2, Antagonistic effect= 1+1 < 2 ,
Incompatible effect= Chemical deteriorated & precipitates )

72
Q

monitoring 3

A

Adverse drug reactions
 Pharmacologic reactions, including adverse effects-
(drug too effective dec BP)
 Hypersensitivity (allergic) reaction
Pt immune sys, histamines cytokines-
rash- airway
 Idiosyncratic reaction- unexpected rx
 Drug interaction-
2 or more drugs together in body
cause unusual effect

73
Q

other drug related effects (TMC is all genic)

A

Teratogenic

Mutagenic

Carcinogenic

74
Q

drug effects (SAAD side effects)

A

• Side Effects
• Adverse Effects
• Allergic Effects
• Drug Induced Reaction

75
Q

 Side effects are usually

A

predictable
secondary effects such as anorexia, nausea, vomiting, dizziness, drowsiness, dry mouth, abdominal gas or distress, constipation, and diarrhea.

76
Q

adverse effects are

A

unintended, undesirable, and
often unpredictable drug effects that range from
mild to fatal.

77
Q

Drug-Induced Reactions

A

Drug-Induced Reactions: (you have these definitions in your cards)
 Tolerance
 Tachyphylaxis
 Cumulative effect
 Idiosyncrasy
 Drug dependence
 Drug interaction
 Drug antagonism
 Summation
 Synergism
 Potentiation

78
Q

cultural assessment

A

 Languages spoken
 Health beliefs and practices
 Past uses of medicine
 Herbal treatments, folk remedies, home remedies
 Over-the-counter drugs and treatment

79
Q

cultural assessment 2

A

 Usual response to illness
 Responsiveness to medical treatment
 Religious practices and beliefs
 Support from the patient’s cultural community
 Dietary habits

80
Q

legal nursing considerations

A

 State and federal legislation- FDA, DEA, CA Board of Nursing, DPH
 Nurse practice acts
oScope of nursing practice-
oExpanded nursing roles
oEducational requirements
oStandards of care
oMinimally safe nursing practice
oDifferences between nursing and medical practice
(Nursing= Caring Medical= Curing)
Only MD, APN, NP, OD, Dentist, Podiatrist can prescribe Drugs.

81
Q

legal nursing considerations 2

A

 Guidelines from professional nursing groups
 Institutional policies and procedures, state and
federal hospital licensing
 Case law or common law- relies on records of similar
situations/status d/t no official legal code to apply to the
case.
 HIPAA- Privacy Lay for Healthcare records

82
Q

ethical considerations

A

 American Nurses Association (ANA) - Code of
Ethics for Nurses- www.nursingworld.org
 International Council of Nurses (ICN) - Code of Ethics
for Nurses
 Duty
 Breach of Duty
 Causation
 Damage
( Book, page 58, 8th ed.)

83
Q

Tachyphylaxis

A

refers to a quickly developing tolerance that occurs after repeated administration of a drug. (NTG in chest pain)

84
Q

Cumulative effect

A

occurs when the body cannot metabolize one dose of a drug
before another dose is administered. (1+1 = 1.5)

85
Q

Summation (addition or additive effect) occurs when (the sum, 1 + 1 = 2)

A

the combined effect of two drugs produces a result that equals the sum of the individual effects of each agent. (1+1 =2)

86
Q

Tolerance refers to a

A

decreased physiologic response that occurs after repeated
administration of a drug or a chemically related substance

87
Q

Drug Dependence is the (can be both)

A

term preferred over the previous terminology of
“habituation” and “addiction” can be physical or psychological

88
Q

Synergism describes a

A

drug interaction in which the combined effect of drugs is
greater than the sum of each individual agent acting independently. (1+1 =3)

89
Q

Idiosyncrasy is (Ritalin)

A

any abnormal of peculiar response to a drug which may manifest by itself by (benadryl makes a kid hyper)
1)over response or abnormal susceptibility to a drug
2) under response, which demonstrates abnormal tolerance
3) a qualitatively different effect from the one expected, such as excitation after the
administration of a sedative
4) unpredictable and unexplainable symptoms. often from genetic enzymatic
deficiencies

90
Q

Potentiation refers to

A

the concurrent administration of two drugs in which one drug
increases the effect of the other drug. (PI booster in HIV therapy)

91
Q

Which of the following describes the process of the movement of drug molecules from the site of entry into the body?

A

absorption

92
Q

drugs do not confer

A

anything

93
Q

critical care

A

what is white count, infection. Bambis are baby warriors. (band shift)

94
Q

remove old patch and

A

add new patch to a new area

95
Q

cardivascular decreases…

A

metabolism.

96
Q

will be on test

A

The nurse is giving a medication that has a high
first-pass effect. The physician has changed the
route from IV to PO. The nurse expects the oral dose
to most likely be:
1. higher because of the first-pass effect.
2. lower because of the first-pass effect.
3. the same as the IV dose.
4. unchanged.

97
Q

Pharmacotherapeutics: ON TEST
Types of Therapies
 Acute therapy- CC
 Maintenance therapy- Prevent progression of disease, tx;HTN, BC
 Supplemental/replacement therapy- replace substance needed, tx;
Insulin, thyroid
 Palliative therapy- EOL, C/care
 Supportive therapy-recovery post Op or trauma, bld after surgery
 Prophylactic therapy- prevent illness, vaccines
 Empiric therapy- clinical problem- ex: antibx for sepsis

A

Pharmacotherapeutics:
Types of Therapies
 Acute therapy- CC
 Maintenance therapy- Prevent progression of disease, tx;HTN, BC
 Supplemental/replacement therapy- replace substance needed, tx;
Insulin, thyroid
 Palliative therapy- EOL, C/care
 Supportive therapy-recovery post Op or trauma, bld after surgery
 Prophylactic therapy- prevent illness, vaccines
 Empiric therapy- clinical problem- ex: antibx for sepsis

98
Q

Drug polymorphism - ON TEST

A

various drug resistance d/t pt age, gender,
size, body composition

99
Q

Barriers to adequate health care for culturally diverse-

A

Language, poverty, access, pride, belief in medicine, need for
Cultural Assessment

100
Q

Cultural Assessment

A

 Languages spoken
 Health beliefs and practices
 Past uses of medicine
 Herbal treatments, folk remedies, home remedies
 Over-the-counter drugs and treatment

101
Q

Cultural Assessment - 2

A

Cultural Assessment
 Usual response to illness
 Responsiveness to medical treatment
 Religious practices and beliefs
 Support from the patient’s cultural community
 Dietary habits

102
Q

Legal Nursing Considerations

A

 Guidelines from professional nursing groups
 Institutional policies and procedures, state and
federal hospital licensing
 Case law or common law- relies on records of similar
situations/status d/t no official legal code to apply to the
case.
 HIPAA- Privacy Lay for Healthcare records

103
Q

Ethical Considerations

A

 American Nurses Association (ANA) - Code of
Ethics for Nurses- www.nursingworld.org
 International Council of Nurses (ICN) - Code of Ethics
for Nurses
 Duty
 Breach of Duty
 Causation
 Damage
( Book, page 58, 8th ed.)

104
Q

absorption involves…(absoption is available at first pass)

A

🞑 Bioavailability
🞑 First-pass effect (liver says gimme first, then everything else goes into circulatory)

105
Q
  • Fast acetylator - decrease or increase metabolism?
A

increase

106
Q
  • Barbiturate therapy CNS depressant, Tx Sz, Anesthesia - increase or decrease metabolism?
A

increase metabolism

107
Q
  • Rifampin therapy- TB meds.
  • Phenytoin therapy- Sz - seizures - increase or decrease metabolism?
A

-increase

108
Q

MH - hypothermia - increase or decrease metabolism?

A

increase. - their bodies react - code MH - have to have meds or their temp goes up one degree a minute. Then they get lock jaw.

109
Q

Affinity (seen with agonists)

A

promotes binding (level of degree drug attaches or binds with receptor)

110
Q

• Intrinsic Activity (seen w/ agonists)

A

allows the bound agonist to activate the receptor

111
Q

antagonist - what’s the deal w/ affinity and intrinsic activity

A

• High affinity but no intrinsic activity

112
Q

pharamacotherauptic - Maintenance therapy

A

Prevent progression of disease, tx;HTN, BC

113
Q

 Supplemental/replacement therapy

A

replace substance needed, tx;Insulin, thyroid

114
Q

 Palliative therapy

A

EOL, C/care

115
Q

 Supportive therapy(postop)

A

recovery post Op or trauma, bld after surgery

116
Q

 Prophylactic therapy

A

prevent illness, vaccines

117
Q

 Empiric therapy(clinical problem)

A

clinical problem- ex: antibx for sepsis (like broadspectrum antibiotics)

118
Q

drug related effects - Teratogenic

A

Structural defects to Fetus

119
Q

drug related effects - Mutagenic

A

Permanent change to genetic DNA:
Radiation/virus/chemicals

120
Q

drug related effects - Carcinogenic

A

Cancer causing

121
Q

pharamacokenetics

A

the branch of pharmacology concerned with the movement of drugs within the body

122
Q

metabolism/biotransformation involves what organs or systems? (I’LL SKP biotransformation)

A

 Liver (main organ)
 Skeletal muscle
 Kidneys
 Lungs
 Plasma
 Intestinal mucosa

123
Q

pharmacotherapeutics focuses on (therapy - it’s in the name)

A

clinical use of drugs and how to prevent and treat diseases.

124
Q

can granules be crushed?

A

no

125
Q

remember, inhalers are what form of ingestion?

A

topical

126
Q

parents are kin

A

pharmacokinetics - what happens to the drug between the time of administration until the parent drug and all of its metabolites have left the body

127
Q

first pass

A

if a large amount of drug is absorbed by liver, less amount will be circulated.

128
Q

high first pass rate

A

a large amount of drug is absorbed by liver and less will reach target sites

129
Q

first pass reduces what?

A

the bioavailability

130
Q

how bioavailable are IV drugs?

A

100%, because none is absorbed by the liver

131
Q

what changes absorption of drug after it leaves the liver?

A

stomach acid, food or water or no food or water, changes in intestines

132
Q

short bowel syndrome

A

stomach contents are delivered to intestines more rapidly, resulting in gastric dumping

XIO (393 decks)

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