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Pathopharm > Pharmacodynamics and Adverse Effects > Flashcards

Pharmacodynamics and Adverse Effects Flashcards

1
Q

What is pharmacodynamics?

A

The study of what drugs do to the body and how they do it

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2
Q

What is a therapeutic effect and why is that the goal?

A

It’s a positive change in a faulty physiological system

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3
Q

Why do we need to know pharmacodynamics?

A

We as nurses must be able to EDUCATE our patients, make PRN DECISIONS, be able to EVALUATE our patients and COMMUNICATE with prescribers

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4
Q

What determines the MEC of a drug?

A

The dose-response relationship

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5
Q

What determines the maximum response a drug can elicit?

A

The dose-response relationship

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6
Q

What determines toxic level

A

The dose-response relationship

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7
Q

What are you thinking about when you decide to increase the dosage to produce an increase in response?

A

The dose-response relationship

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8
Q

As a dose increases does the response increase or stay the same?

A

It increases

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9
Q

How do you find the desired intensity of response?

A

You start with a dose and change it up or down till you find the right amount

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10
Q

What is maximal efficacy?

A

The largest effect that a drug can produce (the peak)

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11
Q

What may happen if a drug’s maximal efficacy is very high?

A

It could become toxic

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12
Q

Why is the relative potency not an important characteristic?

A

Only important when a lack of potency forces inconveniently large doses

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13
Q

What are drugs?

A

Chemicals that produce effects by interacting with other chemicals

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14
Q

What are receptors?

A

Special chemicals in the body that most drugs interact with to produce effects

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15
Q

What does every cell have that receives a signal to elicit a response?

A

Receptors

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16
Q

What is a receptor?

A

A receptor is any functional macromolecule in a cell to which a drug binds to produce its effects

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17
Q

What do receptors normally receive signals from?

A

Hormones, neurotransmitters, and other regulatory molecules

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18
Q

What are the body’s normal points of control?

A

Receptors

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19
Q

Under physiologic conditions, what are receptors functions regulated by?

A

Molecules supplied by the body

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20
Q

What are the only two things drugs can do to the body?

A

Mimic or block the regulatory molevules

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21
Q

T/F Can drugs give cells new functions?

A

NO

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22
Q

What are receptor interactions?

A

The joining of the drug molecule with a receptor site on the surface of a cell or tissue

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23
Q

What is affinity?

A

The degree of attachment and binding, how much it wants the receptor

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24
Q

What are enzyme interactions?

A

Either inhibits or enhances the action of a specific enzyme

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25
Q

What is a nonselective interaction?

A

The drug does not interact with a receptor or enzyme

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26
Q

What is an agonist?

A

A drug that does the same action as an enzyme, there is a response

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27
Q

What is a partial agonist?

A

A drug that does the same thing as an enzyme but to a lesser extent

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28
Q

What is an antagonist?

A

A drug that blocks enzymes, there is no response

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29
Q

What are endogenous regulators (hormones) considered? Agonists or antiagonists?

A

Agonistis

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30
Q

Do adonists have affinity and intrinsic activity?

A

Yes and yes

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31
Q

Do antagonists have affinity and intrinsic activity?

A

Yes and no

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32
Q

Is morphine an agonist or antagonist?

A

Agonist

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33
Q

Is naloxone (Narcan) an agonist or antagonist?

A

Antagonist

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34
Q

What is the pharmacologic effect of an antagonist?

A

They prevent the activation of receptors by agonists

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35
Q

If there is no agonist will the antagonist have an observable effect?

A

No

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36
Q

What do noncompetitive antagonists do?

A

Bind IRREVERSITBLY, REDUCE the max response that an agonist can elicit (fewer receptor spots)

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37
Q

What do competitive antagonists do?

A

Bind REVERSIBLY, have equal affinity with agonists

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38
Q

Why is it that the more a cell tolerates a drug the less responsive it is?

A

The number of receptors on the cell surface and the sensitivity to agonists can change

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39
Q

When a drug binds to a receptor will it increase or decrease the rate of physiologic activity normally uncontrolled by that receptor?

A

Both

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40
Q

What do drugs use to help the body?

A

They use the body’s preexisting capabilities

41
Q

Does the body have many similar receptors?

A

Yes

42
Q

Will a drug have more or less side effects if it’s more selective?

A

Less

43
Q

What will happen if a cell has continuous exposure to an agonist?

A

It will become desensitized and downregulate

44
Q

What will happen is a cell has continuous exposure to an antagonist?

A

Hypersensitivity

45
Q

What does it mean if a drug does not involve receptors?

A

It has simple physical or chemical interactions

46
Q

What are some examples of receptorless drugs?

A

Antiacids, saline laxatives, chelating agents, antiseptics

47
Q

Does the same dose work for every patient?

A

No there is interpatient variability due to different liver functions, kidneys, metabolism

48
Q

What is the ED50?

A

Effective Dose for a population. The dose that is typically effective, the average starting point

49
Q

What is the LD50?

A

The average lethal dose to 50% of animals treated

50
Q

Is a drug safer if it has a higher or lower therapeutic index?

A

Higher, more space

51
Q

What is a side effect?

A

Could be THERAPEUTIC, EXPECTED, DON’T HINDER the effect of the drug, MILD

52
Q

What is an adverse effect?

A

Usually HARMFUL, HINDER the effect of the drug, more COMPLICATIONS, UNEXPECTED, SEVERE

53
Q

What is a carcinogenic effect?

A

Causes cancer

54
Q

What is an allergic reaction?

A

An immune response

55
Q

What is a teratogenic effect?

A

Can cause birth defects

56
Q

What is a QT interval interference?

A

Messes with the heart rhythm

57
Q

What is ADR?

A

Adverse drug reactions

58
Q

What are side effects?

A

unavoidable secondary effects at therapeutic doses

59
Q

What is a side effect of morphine?

A

Makes you sleepy

60
Q

What is toxicity?

A

ADR is caused by excessive dosing

61
Q

What is an allergic reaction?

A

An immune response, mild to severe

62
Q

What is an idiosyncratic effect?

A

A reaction completely unexpected, even opposite

63
Q

What is a teratogenic effect?

A

Drugs capable of causing birth defects

64
Q

What is a positive drug-drug interaction?

A

An intended and desired interaction between drugs

65
Q

Why do patients take multiple different drugs?

A

To treat ONE disorder, MULTIPLE disorders, OVER-THE COUNTER drugs (caffeine, nicotine, alcohol)

66
Q

What are the three possible consequences of drug-drug interactions?

A

Intensification, reduction, or unique response

67
Q

What is an example of an intensification of therapeutic effects with drug-drug interactions?

A

Sulbactam and ampicillin- antibiotics, a synergistic effect

68
Q

What is an example of increased adverse effects with drug-drug interactions?

A

Aspirin and warfarin- Blood thinners

69
Q

What is an example of reduced effectiveness with drug-drug interactions?

A

Propranolol and albuterol- shrink airways and open airways (INHIBITORY)

70
Q

What is an example of reduced adverse effects with drug-drug interactions?

A

Naloxone to treat morphine overdose

71
Q

What is an example of a unique response to drug-drug interactions?

A

Alcohol with disulfiram- makes you vomit

72
Q

What are the four basic mechanisms drugs can interact with?

A

DIRECT chemical or physical interaction, PHARMACOKINETIC, PHARMACODYNAMIC, combined TOXICITY

73
Q

Your 80-year-old patient tells you they keep all of their pills in one container, what should you say?

A

They shouldn’t do that because they could chemically react with each other

74
Q

Your pt has multiple IV lines, should you run them together?

A

Only after you establish compatibility

75
Q

What is precipitation with IVs?

A

When it forms crystals

76
Q

What are the four things that effect pharmacokinetic interactions?

A

Altered ABSORPTION, DISTRIBUTION, EXCRETION, METABOLISM

77
Q

What drug elevates gastric pH?

A

Antacids

78
Q

What drug alters absorption?

A

Laxatives

79
Q

What drug depresses peristalsis?

A

Opioids

80
Q

What drug induces vomiting?

A

Ipecac

81
Q

What is an absorbent drug?

A

Activated charcoal

82
Q

What causes altered distribution?

A

Competition for protein binding

83
Q

When a drug is bound to a protein is it active or inactive?

A

Inactive

84
Q

When you increase the dose is there more or less active drug

A

More

85
Q

How does the risk for serious drug interaction relate to the number of drugs a patient is taking?

A

It’s directly proporitonate

86
Q

Why is drug-drug interaction especially important for drugs with low therapeutic indices?

A

Because it’s easy to over dose

87
Q

How can you minimize adverse drug-drug interactions?

A

MINIMIZE the number of drugs the pt takes, drug HISTORY, ILLICIT drug use, adjust the DOSE, or TIMING, MONITOR the pt

88
Q

Does milk increase or decrease absorption for tetracycline?

A

Decrease

89
Q

Does fiber increase or decrease the absorption of digoxin?

A

Decrease

90
Q

Does high-calorie meals increase or decrease the absorption of saquinavir?

A

Increase

91
Q

What does grapefruit juice do to drugs?

A

Inhibits the metabolism or raises the drug blood levels

92
Q

What drugs are affected by the cheese effect?

A

MAOIs (antidepressants)

93
Q

Should you have theophylline and caffeine?

A

No it could lead to drug toxicity

94
Q

Should you have potassium-sparing diuretics and salt substitutes?

A

No, it could lead to drug toxicities

95
Q

Should you have warfarin and foods rich in vitamin K?

A

No, warfarin is a blood thinner, and vitamin K aids in clotting

96
Q

Can conventional drugs interact with herbal preparations?

A

Yes

97
Q

What does St. John’s wort do?

A

Induces drug-metabolizing enzymes and reduces the blood levels of many drugs

98
Q

If there is no previous exposure to a drug, how long can an allergic reaction wait to happen?

A

Several days as the body must make antibodies

99
Q

What should you keep in mind as a nurse related to allergic reactions?

A

pt TEACHING, PREVENTION, EMERGENCY management, EPI

Pathopharm (8 decks)

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