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Pharmacology: Pharmacology Basics > Pharmacologic Principles > Flashcards

Pharmacologic Principles Flashcards

0
Q

adverse drug event

A

any undesirable occurrence related to administering or failing to administer a prescribed medication

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1
Q

additive effects

A

drug interactions in which the effect of combination of two or more drugs with similar actions is equivalent to the sum of the individual effects if the same drugs given alone (e.g. 1 + 1 = 2 [compare with synergistic effects])

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2
Q

adverse drug reaction

A

any unexpected, unintended, undesired, or excessive response to a medication given at therapeutic dosages (as opposed to overdose)

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3
Q

adverse effects

A

a general term for any undesirable effects that are a direct response to one or more drugs

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4
Q

agonist

A

a drug that binds to and stimulates the activity of one or more receptors in the body

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5
Q

allergic reaction

A

an immunologic hypersensitivity reaction resulting from the unusual sensitivity of a patient to a particular medication; a type of adverse drug event

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6
Q

antagonist

A

a drug that binds to and inhibits the activity of one or more receptors in the body (antagonists are also called inhibitors)

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7
Q

antagonistic effects

A

drug interactions in which the effect of a combination of two or more drugs is less than the sum of the individual effects of the same drugs given alone (1 + 1 = <2); it is usually caused by an antagonising (blocking or reducing) effect of one drug on another

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8
Q

bioavailability

A

a measure of the extent of drug absorption for a given drug and route (from 0% to 100%)

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9
Q

biotransformation

A

one or more biochemical reactions involving a parent drug (biotransformation occurs mainly in the liver and produces a metabolite that is either inactive or active; also known as metabolism)

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10
Q

blood-brain barrier

A

the barrier system that restricts the passage of various chemicals and microscopic entities (e.g. bacteria, viruses) between the bloodstream and the central nervous system whilst still allowing the passage of essential substances (e.g. oxygen)

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11
Q

chemical name

A

the name that describes the chemical composition and molecular structure of a drug

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12
Q

contraindication

A

any condition, especially one related to a disease state or patient characteristic, including current or recent drug therapy, that renders a particular form of treatment improper or undesirable

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13
Q

cytochrome P-450

A

the general name for a large class of enzymes that play a significant role in drug metabolism and drug interactions

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14
Q

dependence

A

a state in which there is a compulsive or chronic need, as for a drug

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15
Q

dissolution

A

the process by which solid forms of drugs disintegrate in the gastrointestinal tract and become soluble before being absorbed into the circulation

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16
Q

drug

A

any chemical that affects the physiologic processes of a living organism

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17
Q

drug actions

A

the process involved in the interaction between a drug and body cells (e.g. the action of a drug on a receptor protein); also called mechanism of action

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18
Q

drug classification

A

a method of grouping drugs; may be based on structure or therapeutic use

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19
Q

drug effects

A

the physiologic reactions of the body to a drug; they can be therapeutic or toxic and describe how the body is affected as a whole by the drug; the terms onset, peak and duration are used to describe drug effects (most often referring to therapeutic effects)

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20
Q

drug-induced teratogenesis

A

the development of congenital anomalies or defects in the developing fetus caused by the toxic effects of drugs

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21
Q

drug interaction

A

alternation in the pharmacologic or pharmacokinetic activity of a given drug caused by the presence of one or more additional drugs; it is usually related to effects on the enzymes required for metabolism of the involved drugs

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22
Q

duration of action

A

the length of time the concentration of a drug in the blood or tissues is sufficient to elicit a response

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23
Q

enzymes

A

protein molecules that catalyse one or more of a variety of biochemical reactions, including those related to the body’s physiologic processes as well as those related to metabolism

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24
Q

first-pass effect

A

the initial metabolism in the liver of a drug absorbed from the gastrointestinal tract before the drug reaches systemic circulation through the bloodstream

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25
Q

generic name

A

the name given to a drug by ___; also called the nonproprietary name

the generic name is much shorter and simpler than chemical name and is not protected by trademark

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26
Q

glucose-6-phosphate dehydrogenase (G6PD) deficiency

A

a hereditary condition in which red blood cells break down when the body is exposed to certain drugs

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27
Q

half-life

A

in pharmacokinetics, the time required for half of an administered dose of drug to be eliminated by the body, or the time it takes for the blood level of a drug to be reduced by 50% (also called elimination half-life)

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28
Q

idiosyncratic reaction

A

an abnormal and unexpected response to a medication, other than an allergic reaction, that is peculiar to an individual patient

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29
Q

incompatibility

A

the characteristic that causes two parenteral drugs or solutions to undergo a reaction when mixed or given together that results in the chemical deterioration of at least one of the drugs

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30
Q

intraarterial

A

within an artery (e.g. intraarterial injection)

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31
Q

intraarticular

A

within a joint (e.g. intraarticular injection)

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32
Q

intrathecal

A

within a sheath (e.g. the theca of the spinal cord, as in an intrathecal injection into the subarachnoid space)

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33
Q

medication error

A

any preventable adverse drug event involving inappropriate medication use by a patient or health care professional; it may or may not cause patient harm

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34
Q

medication use process

A

the prescribing, dispensing, and administering of medications, and the monitoring of their effects

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35
Q

metabolite

A

a chemical form of a drug that is the product of one or biochemical (metabolic) reactions involving the parent drug

active metabolites are those that have pharmacologic activity of their own, even if the parent drug is inactive

inactive metabolites lack pharmacologic activity and are simply drug waste products awaiting excretion from the body (e.g. via the urinary, gastrointestinal, or respiratory tract)

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36
Q

onset of action

A

the time required for a drug to elicit a therapeutic response after dosing

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37
Q

parent drug

A

the chemical form of a drug that is administered before it is metabolised by the body’s biochemical reactions into its active or inactive metabolites

a parent drug that is not pharmacologically active itself is called a prodrug; a prodrug is then metabolised to pharmacologically active metabolites

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38
Q

peak effect

A

the time required for a drug to reach its maximum therapeutic response in the body

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39
Q

peak level

A

the maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring

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40
Q

pharmaceutics

A

the science of preparing and dispensing drugs, including dosage form design

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41
Q

pharmacodynamics

A

the study of the biochemical and physiological properties of drugs and their pharmacologic interactions with body receptors

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42
Q

pharmacoeconomics

A

the study of economic factors impacting the cost of drug therapy

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43
Q

pharmacogenetics

A

the study of the influence of genetic factors on drug response, including the nature of genetic aberrations that result in the absence, overabundance, or insufficiency of drug-metabolising enzymes

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44
Q

pharmacognosy

A

the study of drugs that are obtained from natural plant and animal sources

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45
Q

pharmacokinetics

A

the study of what happens to a drug from the time it is put into the body until the parent drug and all metabolites have left the body

pharmacokinetics represent the drug absorption into, distribution and metabolism within, and excretion from the body

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46
Q

pharmacology

A

the broadest term for the study or science of drugs

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47
Q

pharmacotherapeutics

A

the treatment of pathologic conditions through the use of drugs

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48
Q

prodrug

A

an inactive drug dosage form that is converted to an active metabolite by various biochemical reactions once it is inside the body

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49
Q

receptor

A

a molecular structure within or on the outer surface of a cell; receptors bind to specific substances (e.g. drug molecules ), and one or more corresponding cellular effects (drug actions) occurs as a result of this drug-receptor interaction

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50
Q

steady state

A

the physiologic state in which the amount of drug removed via elimination is equal to the amount of drug absorbed with each dose

51
Q

substrates

A

substances (e.g. drugs or natural biochemicals in the body) on which an enzymes acts

52
Q

synergistic effects

A

drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum if the individual effects of the same drugs given alone (e.g. 1 + 1 is > 2 [compare with additive effects])

53
Q

therapeutic drug monitoring

A

the process of measuring drug levels to identify a patient’s drug exposure and to allow adjustment of dosages with goals of maximising therapeutic effects and minimising toxicity

54
Q

therapeutic effect

A

the desired or intended effect of a particular medication

55
Q

therapeutic index

A

the ratio between the toxic and therapeutic concentrations of a drug

56
Q

tolerance

A

reduced response to a drug after prolonged use

57
Q

toxic

A

the quality of being poisonous (i.e. injurious to health or dangerous to life)

58
Q

toxicity

A

the conditions of producing adverse bodily effects due to poisonous qualities

59
Q

toxicology

A

the study of poisons, including toxic drug effects, and applicable treatments

60
Q

trade name

A

the commercial name given to a drug product by its manufacturer; also called the proprietary name

61
Q

trough level

A

the lowest concentration of drug reached in the body after it falls from it’s peak level, usually measured in a blood sample for therapeutic drug monitoring

62
Q

An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognises that this woman has experienced which type of reaction or effect?

A. allergic reaction
B. idiosyncratic reaction
C. mutagenic effect
D. synergistic effect

A

B. idiosyncratic reaction

63
Q

While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur?

A. absorption
B. distribution
C. metabolism
D. excretion

A

C. metabolism

64
Q

A patient who has advanced cancer is receiving opioid medications around the clock to “keep him comfortable” as he beats the end of his life. Which term best describes this type of therapy?

A. palliative therapy
B. maintenance therapy
C. supportive therapy
D. supplemental therapy

A

A. palliative care

65
Q

The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. The nurse knows that the factor that most influences the decision about which route to use is the patients’s:

A. altered biliary function
B. increased glomerular filtration
C. reduced liver metabolism
D. diminished circulation

A

D. diminished circulation

66
Q

A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement?

A. “take the tablet with 2 to 3 ounces of orange juice”
B. “avoid taking all other medications with any enteric-coated tablets”
C. “crush the tablet before swallowing if you have problems with swallowing”
D. “be sure to swallow the tablet whole without chewing it”

A

D. “be sure to swallow the tablet whole without chewing it”

67
Q

Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last.

A. enzymes in the liver transform the drug into an inactive metabolite
B. drug metabolites are secreted through passive glomerular filtration into the renal tubules
C. a drug that binds to the plasma protein albumin and circulates through the body
D. a drug moves from the intestinal lumen into the mesenteric blood system

A

A. 3
B. 4
C. 2
D. 1

68
Q

A drug that delivers 500 mg has a half-life of 4 hours. How many milligrams of drug remain in the body after 1 half-life?

A

7.250 mg

69
Q

pharmaceutical phase

A

disintegration of dosage form; dissolution of drug in body

70
Q

pharmacokinetic phase

A

absorption, distribution, metabolism, excretion

71
Q

pharmacodynamic phase

A

drug-receptor interaction

72
Q

drug absorption of various oral preparations from fastest to slowest

A 
oral disintegration, buccal tablets, and oral soluble wafers
liquids, elixirs, and syrups
suspension solutions
powders
capsules
tablets
coated tablets 
enteric-coated tablets
73
Q

dosage forms: enteral

A

tablets, capsules, oral soluble wafers, pills, timed-released capsules, times-release tablets, elixirs, suspensions, syrups, emulsions, solutions, lozenges or troches, rectal suppositories, sublingual or buccal tablets

74
Q

dosage forms: parenteral

A

injectable forms, solutions, suspensions, emulsions, powders for reconstitution

75
Q

dosage forms: topical

A

aerosols, ointments, creams, pastes, powders, solutions, foams, gels, transdermal patches, inhalers, rectal and vaginal suppositories

76
Q

intravenous (IV) advantages

A

provides rapid onset (drug delivered immediately to bloodstream); allows more direct control of drug level in blood; gives option of larger fluid volume, therefore diluting irritating drugs; avoids first-pass metabolism

77
Q

intravenous (IV) disadvantages

A

higher cost; inconvenience (e.g. not self-administered); irreversibility of drug action in most cases and inability to retrieve medication; risk of fluid overload; greater likelihood of infection; possibility of embolism

78
Q

intravenous (IV) nursing considerations

A

continuous intravenous infusions require frequent monitoring to be sure that correct volume and amount are administered and that the drug reaches safe, therapeutic blood levels; intravenous drugs and solutions must be checked for compatibilities; intravenous sites are to be monitored for redness, swelling, heat, and drainage - all indicative of complications, such as thrombophlebitis; if intermittent intravenous infusions are used, clearing or flushing of the line with normal saline before and after is generally indicated to keep the intravenous site patent and minimise incompatibilities

79
Q

intramuscular (IM); subcutaneous (SC) advantages

A

intramuscular injections are good for poorly soluble drugs, which are often given in “depot” preparation form and are then absorbed over a prolonged period; insets of action differ depending on route

80
Q

intramuscular (IM); subcutaneous (SC) disadvantages

A

discomfort of injection; inconvenience; bruising; slower onset of action compared to intravenous, although quicker than oral in most situations

81
Q

intramuscular (IM); subcutaneous (SC) nursing considerations

A

use landmarks to identify correct IM and SC sites
IM:
ventral gluteal muscle
1 1/2-inch needle
20- to 25-gauge needle (for aqueous solutions)
18- to 25-gauge needle (for viscous or oil-based solutions)
SC:
90-degree angle
1/2- to 5/8-inch needle
26- to 30-gauge needle

82
Q

oral advantages

A

usually easier, more convenient, and less expensive; safer than injection, dosing more likely to be reversible in cases of accidental ingestion (e.g. through induction of emesis, administration of activated charcoal)

83
Q

oral disadvantages

A

variable absorption; inactivation of some drugs by stomach acid and/or pH; problems with first-pass effect or pre-systemic metabolism; greater dependence of drug action on patient variables

84
Q

oral nursing considerations

A

some medications are to be taken with or without food; taken with fluids; consider other medicines taken at the same time and concurrent use of dairy products or antacids; if given via nasogastric or gastrostomy tubes, placement in the stomach needs to be assessed and the patient’s head is to remain elevated; flushing the NGT with at least 30 to 60 mL of water before and after to maintain potency and prevent clogging

85
Q

sublingual; buccal advantages

A

absorbed more rapidly from oral mucosa and leads to more rapid onset of action; avoids breakdown of drug by stomach acid; avoids first-pass metabolism because gastric absorption is bypassed

86
Q

sublingual; buccal disadvantages

A

patients may swallow pill instead of keeping under tongue until dissolved; pills often smaller to handle

87
Q

sublingual; buccal nursing considerations

A

sublingual route are to be placed under the tongue; once dissolved, the drug may be swallowed; buccal route are placed between cheek and gum; both forms are relatively no no-irritating; drug is usually without flavour and water-soluble

88
Q

rectal advantages

A

provides relatively rapid absorption; good alternative when oral route not feasible; useful for local or systemic drug delivery; usually leads to mixed first-pass and non-first-pass metabolism

89
Q

rectal disadvantages

A

possible discomfort and embarrassment to patient; often higher cost than oral route

90
Q

rectal nursing considerations

A

absorption is erratic and unpredictable; safe alternative when nausea and vomiting prevents oral dosing; patient must be placed on left side so that the normal anatomy of the colon allows safe and effective insertion; suppositories are inserted using a gloved hand and water-soluble lubricant

91
Q

topical advantages

A

delivers medication directly to affected area; decreases likelihood of systemic drug effects

92
Q

topical disadvantages

A

sometimes awkward to self-administer (e.g. eyes drops); can be messy; usually higher cost than oral route

93
Q

topical nursing considerations

A

maximal absorption is enhanced with skin that is clean and free of debris; application must be done carefully and per instructions; gloves help to minimise cross-contamination and prevent absorption of drug into the nurse’s own skin; if patient’s skin is not intact, use sterile technique

94
Q

transdermal advantages

A

provides relatively constant rate of drug absorption; one patch can last 1 to 7 days, depending on drug; avoids first-pass metabolism

95
Q

transdermal disadvantages

A

rate of absorption can be affected by excessive perspiration and body temperature; patch may peel off; cost is higher; used patches must be disposed off safely

96
Q

transdermal nursing considerations

A

transdermal drugs should be placed on alternating sites and on a clean, non-hairy, non-irritated area, and only after the previously applied patch has been removed and that area cleansed and dried

97
Q

inhalation advantages

A

provides rapid absorption; drug delivered directly to lung tissues where most of these drugs exert their actions

98
Q

inhalation disadvantages

A

rate of absorption can be too rapid, increasing the risk of exaggerated drug effects; requires more patient education for self-administration; some patients may have difficulty with administration technique

99
Q

inhalation nursing considerations

A

medications are to be used exactly as prescribed and with clean equipment; instructions need to be given to the patient regarding medications to be used as well as proper use, storage, and safe-keeping of inhalers, spacers, and nebulisers

100
Q

first-pass routes

A

hepatic arterial; oral; portal venous; rectal (leads to both first-pass and non-first-pass effects)

101
Q

non-first-pass routes

A

aural (instilled into the ear); buccal; inhaled; intraarterial; intramuscular; intranasal; intraocular; intravaginal; intravenous; subcutaneous; sublingual; transdermal

102
Q

diseases that decrease drug metabolism

A

cardiovascular dysfunction; renal insufficiency

103
Q

conditions that decrease drug metabolism

A

starvation; obstructive jaundice; genetic constitution

104
Q

drugs that increase drug metabolism

A

barbiturates; rifampin (P-450 inducer); phenytoin (P-450 inducer)

105
Q

drugs that decrease drug metabolism

A

ketaconazole (P-450 inhibitor)

106
Q

drug-receptor interactions: agonist

A

drug binds to receptor; there is a response

107
Q

drug-receptor interactions: partial agonist (agonist-antagonist)

A

drug binds to the receptor; the response is diminished compared with that elicited by an agonist

108
Q

drug-receptor interactions: antagonist

A

drug binds to the receptor; there is no response; drug prevents binding of agonists

109
Q

drug-receptor interactions: competitive antagonist

A

drug competes with the agonist for binding to the receptor; if it binds, there is no response

110
Q

drug-receptor interactions: non-competitive antagonist

A

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

111
Q

pharmacotherapeutic types of therapies

A

acute; maintenance; supplemental (or replacement); palliative; supportive; prophylactic (or empiric)

112
Q

common food and drug interactions: leafy green vegetables

A

warfarin (anticoagulant); decreased anticoagulant effect from warfarin

113
Q

common food and drug interactions: dairy products

A

tetracycline, levofloxacin, ciprofloxacin, moxifloxacin (antibiotics); chemical binding of drug leading to decreased effect and treatment failures

114
Q

common food and drug interactions: grapefruit juice

A

amiodarone (antidysrhythmic); buspirone (antianxiety); carbamazepine (antiseizure); cyclosporine, tacrolimus (immunosuppressants); felodipine, nifedipine, nimodipine, nisoldipine (calcium channel blocker); simvastatin, atorvastatin (anticholesterol); decreased metabolism of drugs and increased effects

115
Q

common food and drug interactions: aged cheese & wine

A

monoamine oxidase inhibitors; hypertensive crisis

116
Q

common poisons and their antidotes: acetaminophen

A

acetylcysteine

117
Q

common poisons and their antidotes: organophosphates (e.g. insecticides)

A

atropine

118
Q

common poisons and their antidotes: tricyclic antidepressants, quinidine

A

sodium bicarbonate

119
Q

common poisons and their antidotes: calcium channel blockers

A

intravenous calcium

120
Q

common poisons and their antidotes: iron salts

A

deferoxamine

121
Q

common poisons and their antidotes: digoxin and other cardiac glycosides

A

digoxin antibodies

122
Q

common poisons and their antidotes: ethylene (e.g. automotive antifreeze solution), methanol

A

ethanol (same as alcohol used for drinking), given intravenously

123
Q

common poisons and their antidotes: benzodiazepines

A

flumazenil

124
Q

common poisons and their antidotes: beta blockers

A

glucagon

125
Q

common poisons and their antidotes: opiates, opioid drugs

A

naloxone

126
Q

common poisons and their antidotes: carbon monoxide (by inhalation)

A

oxygen (at high concentration), known as bariatric therapy

Pharmacology: Pharmacology Basics (10 decks)

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