PHARMA 1ST EXAM Flashcards
the study of drugs and their actions on the body. It is defined as
the science that studies the interaction of the chemical substances with live
organisms, drugs administration for treatment and prophylaxis of various diseases
and pathological processes
Pharmacology
It evaluates the pharmacological action of drug preferred
route of administration and safe dosage range in human by clinical trials
Clinical Pharmacology
chemicals that alter functions of living organisms
Drugs
also called Pharmacotherapy): It is the use of drugs to prevent,
diagnose, or treat signs, symptoms, and disease processes.
Drug therapy
Term usually used if drugs given are for therapeutic purposes.
Medications
It is the science of identification, selection, preservation, standardization,
compounding, and dispensing of medical substances or drugs. The word also refers
to the place where drugs are prepared and dispensed
Pharmacy
The study of the biological and therapeutic effects of drugs
harmacodynamics
Study of the absorption, distribution metabolism and excretion
(ADME) of drugs.
Pharmacokinetics
: It deals with the proper selection and use of drugs for the
diagnosis, prevention, suppression, and treatment of disease.
Pharmacotherapeutics
It is the science of poisons or biologic toxins. Many drugs in larger
doses may act as poisons. Poisons are substances that cause harmful, dangerous
or fatal symptoms in living substances
Toxicology
It is the study of drugs in their original unaltered state. (e.g.
penicillin from penicillium which is a fungi)
Pharmacognosy
It deals with the dosage of the drug required to produce a therapeutic
response; or simply the drug dosage
Posology
It studies the influence of heredity on the
pharmacokinetic and pharmacodynamic response of the drug
Pharmacogenetics
: It describes the use of genetic information to guide the choice
of drug therapy on an individual basis. It discovers which specific gene variations
are associated with a good or poor therapeutic response to a particular drug.
Pharmacogenomic
It’s the effect of drugs upon microorganisms, parasites and
neoplastic cells living and multiplying in living organisms.
Chemotherapy
It is a medical reference summarizing standards of drug purity.
strength, and directions for synthesis
Pharmacopoeia
The process of altering DNA, usually of bacteria, to produce
a chemical to be used as a drug
Genetic engineering
clinical science that serves as a backbone of the clinical calling as medications forms the foundation of treatment in human ailments.
pharmacology
the oldest source of drugs and in fact where most drugs in the ancient times were derived
Plants
used to replace human chemicals that fail to produce as a result of disease or genetic problems.
Animals
solid inorganic substance of natural occurrence.
Minerals
Most notable antibiotics are produced from various from this
Microorganisms
This source is obtained when the nucleus of the drug from natural source is retained but its chemical structure is altered such as that of semi-synthetic human insulin (pork insulin).
Semi-synthetic source
This source is obtained when the nucleus of the drug from natural source as well as its chemical structure is altered.
Synthetic source
hard or soft gelatin shells that contain the drug in a powder, in sustained-release beads, or in a liquid form.
Capsules
a drug that’s been compressed to form a certain shape.
tablet
have a thin coating that allows the tablet to pass through the stomach and disintegrate or dissolve in the small intestine, where the drug is absorbed.
Enteric-coated tablets
release the drug through a single tiny hole in the tablet.
Osmotic pump tablets
distribute the drug through a honeycomb-like material made of wax.
Wax matrix tablets
usually given orally or parenterally
Liquid medications
drugs mixed in a sugar-water solution
Syrups
finely divided drug particles suspended in a suitable liquid medium
Suspensions
hydroalcoholic drug solutions
Tinctures
hydroalcoholic solutions that contain glycerin, sorbitol, or other sweeteners.
Elixirs
a term that literally means outside the intestines
Parenteral
bottles sealed with a rubber diaphragm that contain a single dose or several doses
Vials
glass containers with a thin neck that’s typically scored so it can be snapped off easily
Ampules
a single dose of a drug contained in a plastic bag or a prefilled syringe.
Prefilled system
deliver medications in a solid base that will melt at body temperature. They can be administered rectally or vaginally.
Suppositories
are drugs that are administered in powdered or liquid form using the respiratory route. absorbed by the rich supply of capillaries in the lungs.
Inhalants
a scientific name that precisely describes the drug’s atomic and molecular structure
chemical name
an abbreviation of the chemical name. It is the common general name assigned to the drug; differentiated from trade name by initial lowercase letter; never capitalized.
generic, or nonproprietary, name
also known as the brand name or proprietary name) is a drug name selected by the drug/ pharmaceutical company responsible in manufacturing and selling the drug. protected by copyright.
trade name
In what year did the federal government mandated the use of official names so that only one official name would represent each drug.?
1962
Drugs that share similar characteristics are grouped together as what?
pharmacologic class (or family).
medication that is not considered to be a depressant or a stimulant and is not considered addictive or with a potential for abuse. may include over-the-counter medication or prescription medication
Noncontrolled medication
medication that is tightly controlled by the government because it may be abused or cause addiction. It include opioids, stimulants, depressants, hallucinogens, and anabolic steroids.
Controlled medication
Drugs that currently do not have accepted medical use, have a high potential for abuse, and lack accepted safety measures for use (i.e., LSD, peyote, heroin).
Schedule I
Drugs that have medical use and a high potential for abuse; those that tend to cause severe dependence (i.e., morphine, secobarbital, amphetamines (Ritalin), methadone).
Schedule II
Drug used in medical practice with less potential for abuse than schedule II drugs; those that tend to cause moderate or low physical dependence or high psychological dependence (i.e., nalorphine, drug combinations containing small amounts of narcotics such as codeine).
Schedule III
Drugs that have medical use and lower potential for abuse than schedule III drugs; those that tend to cause limited physical or psychological dependence (i.e., meprobamate, chlordiazepoxide, diazepam).
Schedule IV
Drugs that have medical use and lower potential for abuse than schedule IV drugs; those that tend to cause less physical or psychological dependence (i.e., mixtures of limited quantities of narcotics such as cough syrups containing codeine).
Schedule V
rules set to assure consumers that they get what they pay for. The law says that all preparations called by the same drug name must be of uniform strength, quality, and purity.
Drug Standards
Must be physically pure in that it only contains the ingredients stated.(very few drugs are available in a truly pure state – THINK…what impact might this have on drug administration?)
Purity
Strength of the drug, measured by standardization of weight of ingredients.
Potency
The degree to which a drug can reach its site of action in the body.
Bioavailability
The effectiveness of the drug in achieving the desired biological change.
Efficacy
The frequency and severity of adverse drug reactions (ADR) determines safety. No chemical is free of adverse effects
Safety
chemicals tested which may have potential as a new drug
Investigational drugs
is the discovery, use, and management of information in the use of medications. It covers the gamut from identification, cost, and pharmacokinetics to dosage and adverse effects.
Drug information
refers to all the printed information included with any dietary supplement, over-the-counter medicine, or prescription drug.
drug label
The strength indicates the amount or weight of the medication that is supplied in the specific unit of measure. This amount may be per capsule, tablet, milliliter, and so on.
DOSAGE STRENGTH
indicates how the drug is supplied. Such aa; tablets, capsules, liquids, suppositories, and ointments.
FORM
how the drug is to be administered.
ROUTE
a written direction furnished by a prescribing practitioner (a doctor or a nurse practitioner) for a specific medication
A drug or medication order
If the drug order is written on a special pad and done for a client in an outpatient setting it is known as
prescription order
written by the health care provider and apply indefinitely until another order is written to discontinue or alter the first one.
Standard written orders
written for medications that must be given immediately to treat an urgent client problem.
STAT order
a drug order written for a medication that is given only once
Single order
(Latin pro re nata, meaning as needed or as occasion arises) is a drug order prescribed to be administered “as necessary”
PRN order
given within 2 hours of being written and carried out on schedule
Routine orders
(aka protocol order) is a drug order written in advance and is carried out under specific circumstances or established guidelines for treating a particular disease or set of symptoms.
Standing order
medication orders that are given orally in urgent situations
Verbal orders
verbal orders prescribed over the telephone. This type of drug order is usually only given in urgent situations
Telephone orders
prescription drug
* can be dispensed if with prescription order; with specific name of drug & dosage regimen to be used by client
* determined unsafe for over-the-counter purchase because of possible harmful side effects if taken indiscriminately; includes birth control pills, antibiotics, cardiac
Legend drug
One of the most widely used references for drugs in currentuse
Physicians’ Desk Reference (PDR)
Portable reference which comprehensive, concise, and complete pharmacologic details and nursing management of drug.
Drug Cards
A reference for drugs used by nurses and nursing students
Nursing Drug Reference
This is a medical reference summarizing standards of drug purity, strength, and directions for synthesis
Pharmacopeia
the expected response of a medication
Desired action
known and frequently experienced, expected reaction to drug
Side effects
unexpected, unpredictable reactions that are not related too usual effects of a normal dose of the drug
Adverse reaction
enhances the specialized tissues
STIMULATION
diminished functional activity of specialized tissues
DEPRESSION
either stimulate or depress non-specialized tissues
IRRITATION
replaces what is sufficient and deficient
REPLACEMENT THERAPY
entails the use of anti-microbial agents
ANTI-INFECTIVE
Topically applied, and action is just on the area itself
LOCAL
produces a systemic effect even if you just apply it on you on your skin; sprayed or injected
SYSTEMIC
increases bowel movement increases bowel movement
Cathartic
for constipated patients
Laxative
induces sleep
Hypnotic
increases urination
Diuretic
has buffering actions; neutralizes HCl
Antacid
relaxed vascular smooth muscles (Ca 2+ blocker)
Vasodilator
It involves the disintegration of dosage form (generally water soluble) and dissolution of active ingredients of the drug (lipid soluble)
Pharmaceutic phase
what the body does to the drug
Pharmacokinetic phase
what the drug does to the body
Pharmacodynamic phase
The rate and extent to which a drug substance or its active
Bioavailability
A pharmacokinetic process by which the drug becomes available to body fluids and body tissues
Distribution
A phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation; oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown
First-pass effect
Drugs that are not bound to protein but are active and can cause a pharmacologic response
Free drugs
Refers to the time required for the body to eliminate 50% of the drug.
Half-life
The amount of an initial dose of a certain drug needed to reach a target plasma concentration
Loading dose
The amount of a certain drug needed to achieve a steady target plasma concentration
Maintenance dose
Refers to the time interval that starts when the drug is administered and ends when the therapeutic effect actually begins.
Onset of action
The process of engulfing substances and moving them into a cell by extending the cell membrane around the substance
Endocytosis
What are two kinds of endocytosis
pinocytosis and phagocytosis
a documented effect of the mind on drug therapy; if a person perceives that a drug will be effective, the drug is much more likely to actually be effective
Placebo effect
It refers to a drug losing part or its entire efficacy over time as the body becomes tolerant or counter regulatory processes occur
Tachyphylaxis
The ratio of the dose that produces the desired therapeutic effect to the dose that produces a toxic effect
Therapeutic Index
Refers to a decreased responsiveness to a drug as a result of repeated drug administration
Tolerance
the study of the drug mechanisms that describes biochemical or physiologic actions and effects of drugs in the body.
Pharmacodynamics
an approximate assessment of the safety of the drug. It compares the therapeutically effective dose to the toxic dose of a pharmaceutical agent. It is expressed as the ratio of the median lethal dose and the median effective dose
therapeutic index
therapeutic index also called as
therapeutic window or safety
usually calculated as the ratio of the toxic dose to 1% of the population (TD01) to the dose that is 99% effective to the population (EDD99)
Margin of Safaty (MOS)
graphical representations of the relationship between the dose of the drug and the effect it achieves.
Graded dose-response curves
refers to the relative amount of a drug required to produce a desired response.
Drug potency
a useful parameter that indicates the degree to which a change in dose results in a change in effect. When it is shallow, it suggests a greater chance of overlap between desired effects and side-effects
Slope
the maximum effect/response achievable from a drug. This is where the dose response curve reaches a plateau.
Maximum or the Emax
The branch of medicine that deals with doses is called
POSOLOGY
The dose of the drug which can cause death
Lethal dose
The quantity of the drug needed to produce the therapeutic effect
Therapeutic dose
The smallest dose of the drug required to produce the desired therapeutic effect
Minimum dose
The largest dose of the drug that can be safely given to a client without producing harmful effects
Maximum dose
The dose of the drug which produces undesirable effects in majority of the clients.
Toxic dose
The dose that is suitable for most of the clients
Fixed dose
Single large dose of drug which is given at the beginning of the treatment or series of quickly repeated drug doses given to rapidly attain target concentration.
Loading dose
A tolerance where some species show less sensitivity to some drugs.
Natural tolerance
A tolerance that is developed on repeated administration of the drug.
Acquired tolerance
: A disadvantage of loading dose is that clients may be exposed to high concentration of drug which may result in
toxicity
The degree of biological activity is proportional to the amount of active drug/receptor complexes
Potency and Efficacy
(strength) refers to the amount of drug needed to produce an effect (for example, relief of pain or reduction of blood pressure).
POTENCY
a drug’s capacity to produce an effect regardless of dose (such as lowering blood pressure).
EFFICACY
Most of the drugs act by interacting with a cellular component called
receptor
protein molecules present either on the cell surface or with in the cell
Receptors
used in the treatment of peptic ulcer disease act by non-receptor mechanism by neutralizing the gastric acid.
Aluminum hydroxide and magnesium trisilicate
the ability of a drug to produce an effect at a receptor.
Efficacy or intrinsic activity
Categories of Drug Action
- Stimulation
- Replacement
- Inhibition
- Irritation
measure of the tendency of a drug to bind to its receptor o Most drug-receptor bonds are reversible
Drug affinity
the degree to which a drug activates receptors after binding and triggers a cell response
Drug efficacy
the lifespan of a drug-receptor complex
Residence time
drug that has a similar effect to that of the endogenous receptor activator
Agonist
a drug that binds to a receptor and prevents its activation. It blocks a receptor and therefore blocks the action of the endogenous transmitter
Antagonist
The agonist and the antagonist competes to bind to the same receptor.
Competitive antagonist
The drug binds at a site other than the agonist-binding site (also called allosteric site), changes the structure of the agonist binding site, and decreases the affinity of the agonist. As a result, the efficacy of the agonist is decreased
Non-competitive antagonist
In this type of antagonism, two different molecules working through separate receptors produce physiologically opposite effects.
Functional (physiological) antagonist
a substance that has some agonistic action at a receptor but does not elicit the complete response of a true agonist.
Partial agonist
Binds to the same receptor as an agonist, but not to the same active site. It elicits a response that is opposite to the agonistic response and has a negative efficacy.
Inverse agonist
Binds at a different site than the agonist and initiates conformational changes that induce modulation of ligand-binding.
Allosteric modulator
Binds at a site other than the agonist-binding site (also called allosteric site) and changes the structure of the active binding site to increase affinity to the substrate.
Allosteric activator
can cause an increase or decrease in the potency of a drug or result in additional side effects
Drug interactions
takes place when 2 drugs are given together & double the effect is produced.
Alcohol + aspirin= Pain relief
Additive effect
takes place when 1 drug interferes with the action of another drug.
Antagonistic effect
takes place when 1 drug replaces another at the drug receptor site, increasing the effect of the 1st drug
Displacement effect
occurs when 2 drugs mixed together in a syringe produce a chemical reaction so they cannot be given. e.g. Protamine sulfate & vitamin K
Incompatibility
occurs when 1 drug promotes the rapid excretion of another, thus reducing the activity of the 1st
Interference
takes place when the effect of 2 drugs taken at the same time is greater than the sum of each drug given alone. E.g. combining diuretics & adrenergic blockers to lower the BP
Synergistic effect
the study of drug movement in the body, that mainly involves the processes of absorption, distribution, metabolism, and elimination of the drug. Basically, it is the movement of drugs INTO, WITHIN and OUT of the body.
Pharmacokinetics
It describes the pharmacokinetic processes which follow a given dosage regimen
LADME
the release of the drug from its dosage form
Liberation
the movement of drug from the site of administration to the blood circulation
Absorption
the process by which drug diffuses or is transferred from intravascular space to extravascular space (body tissues).
Distribution
the chemical conversion or transformation of drugs into compounds which are easier to eliminate.
Metabolism
the elimination of unchanged drug or metabolite from the body via renal, biliary, or pulmonary processes
Excretion
Movement of a solute through a biological barrier from the phase of higher concentration to phase of lower concentration. No need of energy e.g . highly lipid soluble drug
Simple diffusion
the process by which water soluble drug of relatively low molecular weight crosses the plasma membrane e.g. urea and ethyleneglycol
Filtration
It means the passage of drug across the bilogical membrane along the concentration gradient by the prote in carrier mediated system also called as carrier mediated diffusion.
Faciliatated diffusion
The process by which drugs pass across the biological membrane most often against their concentration gradient with the help of carriers along with the expenditure of energy e.g. alpha methyl dopa, levodopa, 5fluoro-uracil, 5 bromouracil
Active transport
It is the process by which the large molecules are engulfed by the cell membrane and releases them intracellularly
Endocytosis
describes the rate and concentration at which the drug appears in circulation. It is expressed as a percentage of the dose that was initially administered.
Bioavailability
Two proprietary preparations of a drug are said to be bioequivalent if they exhibit the same bioavailability when administered in equal doses.
Bioequivalence
the dissolving of the smaller particles in the GI fluid before absorption
Dissolution
the breakdown of a tablet into smaller particles
Disintegration
the penetration of a drug to the sites of action through the walls of blood vessels from the administered site after avsorption
drug distribution
A variable and other significant portion of absorbed
drug may become reversibly bound to plasma proteins.
Protein binding of drug
It represents the drug that is bound to
the plasma proteins (albumins and globulins) and the drug in free form. It is the free
form of drug that is distributed to the tissues and fluids and takes part in producing
pharmacological effects.
Plasma concentration of drug (PC)
Volume of plasma cleared off the drug by metabolism and excretion per unit
time. Protein binding reduces the amount of drug available for filtration at the glomeruli and
hence delays the excretion, thus the protein binding reduces the clearance.
Clearance
There are some specialized barriers in the body
due to which the drug will not be distributed uniformly in all the tissues.
. Physiological barriers to distribution
through which thiopental sodium is easily crossed but not
dopamine.
Blood brain barrier (BBB)
which allows non-ionized drugs with high lipid/water partition coefficient
by a process of simple diffusion to the fetus e.g. alcohol, morphine.
Placental barrier
The concentration of a drug in certain tissues after a
single dose may persist even when its plasma concentration is reduced to low.
Affinity of drugs to certain organs
the process by which drug is converted by the liver to
inactive compounds through a series of chemical reactions
Biotransformation
The rate of metabolism and/or elimination remains constant
and is independent of the concentration of a drug (e.g., metabolism of alcohol)
Microsomal enzymes
The rate of metabolism and/or elimination is directly
proportional to the plasma concentration of the drug (applies to most drugs)
First order kinetics
The transformation of drugs through
oxidation, reduction, and hydrolysis.
Phases of biotransformation
This is a synthetic process which
involves coupling the metabolite with glucuronic acid (most common coupling
reaction), acetyl groups (e.g., metabolism of isoniazid), sulfates, amino acids (e.g.,
glycine), or glutathione
Phase II reactions (conjugation reaction)
passage of unaltered or altered form of drug out of the body. Drug
is converted in water metabolites via the kidneys, liver, lungs, and intestines where the major
processes of excretion occur. Its minor routes are saliva, sweat, tears, breast milk,
vaginal fluid, nails and hair.
Excretion of drugs
measure of the rate of drug elimination. It is defined as the plasma
volume that can be completely cleared of the drug in a given period of time (e.g.,
creatinine clearance)
Drug clearance
the time required for the plasma concentration of a drug to reach half of its
initial value
Half-life (T½)
It is a process, which depends on (1) the concentration of
drug in the plasma (2) molecular size, shape and charge of drug (3) glomerular
filtration rate.
Glomerular filtration
The cells of the proximal convoluted tubule actively
transport drugs from the plasma into the lumen of the tubule e.g. acetazolamide,
benzyl penicillin, dopamine, pethidine, thiazides, histamine
Active Tubular secretion
The reabsorption of drug from the lumen of the distal
convoluted tubules into plasma occurs either by simple diffusion or by active
transport.
Tubular reabsorption
The conjugated drugs are
excreted by hepatocytes in the bile.
Biliary elimination
(primarily in inhaled anesthetic drugs): Drugs that are readily
vaporized, such as many inhalation anesthetics and alcohols are excreted through lungs.
Pulmonary elimination
Unabsorbed protein portion of orally administered drug is
eliminated through fecal matter. e.g. aluminum hydroxide changes the stool into white
color, ferrous sulfate changes the stool into black and rifampicin into orange red.
Gastrointestinal Excretion
A number of drugs are excreted into the sweat either by simple diffusion or active
secretion e.g. rifampicin, metalloids like arsenic and other heavy metals.
Sweat
FACTORS AFFECTING RESPONSES TO DRUGS
- Body weight and composition
- Age
- Gender
- Pathophysiology (how disease affects responses to drugs)
- Acid-Base Imbalance
- Altered Electrolyte Balance
- Tolerance
Non-prescription/non-controlled drug; no purchasing restrictions by the
FDA
OTC - Over the counter
drug intended for the treatment of “rare diseases and conditions”.
Orphan Drug
Stated that drugs should be free of
“adulterants”
Food, Drug and Cosmetic Act, passed in 1938
