Pharmacology Flashcards
High abuse potential but with legitimate medical purpose
Schedule 2
Examples of schedule 2 drugs
Fentanyl, methylfenidate (ritalin), cocaine
Example of schedule 1 drugs
Heroin, marijuana, LSD
Diazepam & lorazepam are schedule ___ drugs
4
Hydrocodone, ketamine, and APAP w/ codeine are schedule ___ drugs
3
Schedule ___ drugs may not be prescribed, dispensed, used, or administered for medical use
1
Versed (midazolam), Valium (diazepam), and Ativan (lorazepam), are schedule ___ drugs
4
Fentanyl and morphine are schedule ___ drugs
2
The biological and physiologic effects, and mechanism of action of a medication
Pharmacodynamics
The action of the body on a medication
Pharmacokinetics
___ medications work by binding a cell receptor site in order to induce a particular response
Agonist
___ medications work by binding a cell receptor site in order to block a particular action from another chemical
Antagonist
Ability of a medication to bind with a particular receptor site:
Affinity
Alpha 1 receptor agonists cause:
Vasoconstriction
Insulin restriction, glucagon secretion, and inhibition of norepinephrine release are the agonist effects of what type of receptors?
Alpha 2
Agonist effects on ___ receptors causes increased hr, increased myocardial contractility, increased myocardial conduction, and renin secretion for untnory retention
Beta 1
Airway smooth muscle relaxation, insulin secretion, uterine relaxation, and arterial dilation are caused by agonist binding of ___ receptors
Beta 2
Agonist binding of ___ receptors causes vasodilation of mesenteric arteries
Dopaminergic
Agonist binding of ___ receptors allow ach to stimulate muscle contraction
Nicotinic
Agonist binding of ___ receptor sites in the heart are activated by ach to offset SNS stimulation (decreased hr, contractility, and conduction velocity)
Muscurinic-2
Agonist binding of ___ receptors produce analgesia, euphoria, respiratory depression, and other effects
Opioid
Medication concentration required to initiate a cellular response:
Potency
As a medications potency increases, the ___ decreases
Required dose/concentration
A medications ability to initiate or alter cell activity in a desired manner
Efficacy
The ___ of a medication is lower for medications with a higher potency
Threshold Dose
___ meds bind with receptor sites to prevent a cellular response by agonist chemicals
Antagonist
___ antagonists temporarily bind with receptor sites to displace agonist chemicals
Competitive
The efficacy of competitive antagonists is directly related to:
Its concentration near receptor sites
Noncompetitive antagonists work by:
Permanently binding receptor sites and preventing action by agonist chemicals
___ drugs effectively lower the efficacy of other agonist chemicals
Partial agonist
Drugs in pregnancy risk category _ have shown to have little to no risk to the fetus during the first trimester and only remote possibility of fetal harm
A
Drugs in Pregnancy risk category __ have either no control study in humans or show an adverse effect that was not confirmed in first trimester studies
B
Drugs in Pregnancy risk category __ should only be given if the potential benefit justifies the potential fetal risk
C
Drugs in pregnancy risk category __ show positive evidence of fetal risk i and should only be given in life threatening situations or when safer drugs cannot be used or are ineffective
D
Drugs in pregnancy risk category __ have shown evidence of fetal abnormalities or risk or both and risk to the pregnant woman clearly out weighs any benefit
X
Representation of the relationship between a medication dose & efficacy:
Dose-response curve
Formula for ideal weight of a male:
Ideal weight (kg) = 50 + (2.3 x pts height in inches above 5 ft)
Formula for ideal weight of a female
Ideal weight (kg) = 45.5 + (2.3 x pts height in inches above 5 ft)
% Of RBC’s in the intravascular space
Hematocrit
Administration of Several smaller doses of a med intended to produce the same clinical effects as a single, larger dose:
Cumulative action
Undesired clinical effects caused by a medication that may Cause some degree of harm ordiscomfort:
Untoward/adverse effects
Adverse effects that are Unexpected, uncommon, or not previously known to occur with a particular Med:
Idiosyncratic reactions
Process involving a mechanism that reduces available receptors for a particular med:
Down-regulation
Resistance to a drug in the same class as another to which an individual has had repeated exposure
Cross-tolerance
Intolerance caused by repeated doses of a drug within a short time
Tachyphylaxis
Chemicals which cause transient increases in physical mental, or emotional performance:
Stimulants
Chemicals which reduce CNS & SNS functioning
Depressants
Abnormal tolerance to therapeutic or adverse effects of a substance due to repeated exposure
Habituation
Physical, emotional, or behavioral need for a substance in order to maintain “normal” function:
Dependence
Undesirable medication interactions
Medication interference
Combination of 2+ medications with similar effects that combine to equal the sum of effects
Summation/addition
2 medications with similar effect combine to produce effects greater than the sum of the medications effects
Synergism
Enhancement of one medication by another
Potentiation
Large quantities of unbound drug due to either reduced body protein, or protein that is saturated with another drug, can cause ___
Toxicity
Main plasma protein used in absorbing drug particles
Albumin
Percentage of unaltered/unchanged medication that reaches systemic circulation
Bioavailability
A drug’s bioavailability is altered by all administration routes except:
IV
Drugs administered by IV have ___% bioavailability
100
In addition to GI motility, pH, and presence of food/liquid, GI medications are subjected to ___
First pass metabolism
GI medications pass from the GI tract into the ___ and then to the ___
Portal vein; liver
Alteration of a medication via metabolism within the GI tract before it reaches systemic circulation
First-pass effect
Most bio transformation occurs in the ___
Liver
Enzyme-based process of altering chemical structure of meds or other chemicals in the liver
Cytochrome p-450 system
___ is the amount of time needed in an average Person to metabolize or eliminate 50% of a substance in plasma
Half-life
“Ignition switches” in the sympathetic nervous system:
Alpha & beta receptors
Beta 1 receptors are found in the:
Heart
Beta 2 receptors are located in the:
Lungs
All Beta agents have a ___ effect on the heart.
Stimulant
Alpha agents trigger ___ in arteries
Vasoconstriction
Beta agents trigger ___ in arteries
Vasodilation
In the lungs, alpha agents cause:
Minor bronchoconstriction
In the lungs, Beta adrenergic agents trigger:
Significant broncodilation
Drugs that have alpha or beta sympathetic properties are called:
Sympathomimetics
A pure beta agent will cause (systemic):
Increased heart rate, force, automaticity; bronchodilation; arterial vasodilation
A pure alpha agent will cause: (systemic)
Slight broncho-constriction, arterial vasoconstriction
Norepinephrine is primarily a ___ agent, and will cause ___
Alpha; vasoconstriction
Albuterol is a specific ___ agent
Beta-2
A beta-2 agent will cause:
Bronchodilation
Drugs that act primarily on cardiac beta receptors:
Beta-1 adrenergic agonists
Drugs that act primarily on pulmonary beta receptors:
Beta-2 adrenergic agonists
Class of drugs that block the action of sympathetic agents:
Sempatholytic/sympathetic blockers
Another name for sympatholytic blockers;
Beta blockers
Parasympathetic blocker that opposes the vagus nerve to speed up the heart after excessive vagal stimulation/firing has caused bradycardia
Atropine
Parasympathetic agent used primarily to induce vasoconstriction & increase bp
Norepinephrine
Sympathetic agent having a primary vasoconstrictor effect.
Epinephrine
Sympathetic agent used to increase renal perfusion, increase HR & myocardial contractility, and constrict peripheral vessels
Dopamine
Sympathetic beta-2 agents that act on the lungs to induce bronchodilation
Albuterol, isoetharine, terbutaline
Sympathetic beta-blocker used to slow HR in certain tachydysrhythmias, decrease pain from chronic angina, & depress irritability of the heart
Propranolol
Administration of an alpha agonist will result in
Vasoconstriction
___ blockers will reduce HR & BP.
Calcium-channel
Diltiazem is a drug in the class;
Calcium-channel blocker
Furosemide is a___
Diuretic
Atorvastatin is a___
Cholesterol synthesis inhibitor
Dexamethasone is a___
Corticosteroid
Hydrocortisone is a___
Glucocorticoid
Acetylcysteine is a ___
Mucolytic agent
Aspirin is a ___
Platelet inhibitor
Clopidogrel (plavix) is a ____
Platelet inhibitor
Sertraline and paroxetine are ____
SSRI’s
Ach binds with ___ receptor sites
Nicotinic
Neuromuscular blocking agents (agonize/antagonize) Ach
Antagonize
Onset/duration time of succinylcholine:
30-60 sec/ 3-8 min
Rare, but immediately life-threatening side effect of succinylcholine
Malignant hyperthermia
Onset/duration of rocuronium
1-3 min/15-60 min
Selective beta-2 agonist used in prehospital for treatment of acute bronchospasm
Albuterol
Naturally occurring beta-2 agonists in the body:
Epi/norepi
___ antagonizes muscarinic receptors to Cause bronchodilation and decreased mucus production
Ipratropium bromide
Chemicals thought to be more potent at causing bronchoconstriction than histamines:
Leukotrienes
___ medications specifically target cells in the heart to suppress ectopic foci
Antidisrhythmic
Antidysrhythmic meds are classified using;
Vaughan- Williams classification scheme
___ is used to treat desthythmias, but not included in VW classification
Adenosine
During Cardiac cycle phase __, cardiac cells are at rest
4
Na and Ca+ slowly enter the cell during phase __
2
Depolarization occurs after/during phase ___ of the cardiac cycle
0
During phase ___, sodium ions rapidly enter the cell thru sodium channels in cardiac cells
0
___ exits the cardiac cell during phase 1
Potassium
Period during which cardiac myocytes are unable to fire or conduct an impulse
Refractory period
Class __ antidisrhythmics slow movement of sodium thru ion channels in certain cardiac cells
1
___ is a class 1 antidesrhythmic that blocks sodium channels in the purkinje fibers & ventricles
Lidocaine
antidysrhythmics Class ___ is composed of beta-adrenergic blocking agents
2
Antidysrhythmic Class ___ medications increase the duration of phases 1,2,3 of the cardiac cycle
3
Class __ antidysrhythmics are comprised of calcium channel blockers
3
Calcium channel blockers slow conduction at the ___
AV node
___ causes marked reduction in the cardiac conduction velocity
Adenosine
Patients taking alphanadrenergic receptor agonist meds at home are often more prone to ___
Orthostatic hypotension & tachycardia
Alpha-blockers generally work to _____
Lower BP & decrease systemic vascular resistance
Ach activates receptors in the heart to produce:
Bradycardia & conduction delays
Competitive muscarinic receptor agonist
Atropine sulfate
___ is used to treat bradycardia caused by vagal stimulation
Atropine
Stimulation of alpha-2 receptors suppresses:
Release or norepinephrine
First sign of IV occlusion:
Decreasing drip rate or presence of blood in tubing
The ___ contains epithelial cells that form a continuous barrier to medication absorption
Urinary tract
___ is an anticholinergic drug derived from plant sources
Atropine
You should suspect altered medication metabolism in a pt with:
HX of Chronic alcoholism
IM administered medications have a bioavailability of:
75-100%
Administration of ___ is indicated in eclampsia when seizures do not respond to Mag sulfate
Diazepam (valium)
___ can be administered to suppress preterm labor, which may be necessary in case of cord prolapse
Terbutaline
___ is useful in treating hyperemesis gravidarium
Diphenhydramine
