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NUR5111 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Pharmacodynamics vs pharmacokinetics

A

Pharmacodynamics: drug action and mechanism
Pharmacokinetics: absorption, distribution, metabolism, excretion

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2
Q

Drug absorption

A
  • Lipid-soluble, polar, ionised drugs pass easily through membranes
  • Water-soluble, non-polar, non-ionised drugs have more difficulty
  • Free molecules can pass through capillary walls, whereas bound are too large
  • Most drugs move across membranes by diffusion (passive transport)
  • Drugs absorbed rapidly where high blood flow
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3
Q

Drug distribution

A
  • Factors influencing distribution:
  • increased blood flow to tissue
  • exiting vasculature
  • BBB –> only allows lipid-soluble drugs
  • placental barrier –> non-selective
  • adipose tissue acts as reservoir for lipid-soluble drugs
  • enterohepatic cycling –> GI tract –> portal vein –> liver –> excrete into bile –> small intestine
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4
Q

Drug metabolism

A
  • drug alteration by cytochrome P450 enzymes
  • increases water solubility for excretion
    LIVER PHASE 1: functionalisation - chemical reactions increase water solubility
    LIVER PHASE 2: conjugation - metabolite joins with polar substance
  • drug doses calculated on First Pass Effect
  • factors affecting metabolism: genetic, environment, disease, age, drug interactions, % bound
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5
Q

Drug excretion

A
  • Kidneys, biliary excretion, respiratory expiration, sweat, saliva, breast milk
  • Kidney - via 3 processes
    1. Glomerular filtration
    2. Passive tubular reabsorption (lipid-soluble)
    3. Active tubular secretion (water-soluble, polar, ionised)
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6
Q

Loading dose

A
  • amount given to reach minimum effective concentration (usually 2x normal dose)
  • maintenance dose given after
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7
Q

Dose-response curves (eg. morphine)

A
  • relationship between size of administered dose and intensity of response produced
  • margin of safety between analgesic effect and respiratory depressive effect
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8
Q

Efficacy

A
  • index of the maximal response a drug can produce

- height of dose-response curve

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9
Q

Potency

A
  • Index of how much drug must be administered to elicit a desired response
  • same effect with lower dose = more potent
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10
Q

Therapeutic index

A
  • Measure of drug safety
  • high TI = more safe drug
  • TI = lethal dose/effective dose
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11
Q

Factors contributing to medication errors

A
  • Poor labelling
  • miscommunication
  • lack of verification (9 rights)
  • incomplete prescriptions
  • inadequate staffing
  • disorganised medications
  • interruptions
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12
Q

9 rights of medication administration

A
  1. Right patient
  2. Right drug
  3. Right dose
  4. Right route
  5. Right time
  6. Right indication
  7. Right documentation
  8. Right response
  9. Right action
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13
Q

VTE prophylaxis

A
  • Pharmacological - eg. Rivaroxaban (anticoagulant)

* Non-pharmacological - eg. TED (thrombo-embolus deterrent) compression stockings

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14
Q

INR

A
  • International Normalised Ratio
  • How long it takes blood to form a clot
  • normally ~1
  • might aim for 2-4 for someone on warfarin
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15
Q

Drug Schedules

A 
Schedule 2: pharmacy medicine
Schedule 3: pharmacy only medicine 
Schedule 4: prescription medicine
Schedule 5: caution
Schedule 6: poisons 
Schedule 7: dangerous poisons 
Schedule 8: controlled drugs 
Schedule 9: prohibited substances 
Schedule 10: substances of such danger to health to warrant prohibition
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16
Q

Schedule 2 drugs

A
  • pharmacy
  • eg. antihistamines, paracetamol
  • may be RN/midwife initiated
17
Q

Schedule 3 drugs

A
  • pharmacy only
  • eg. salbutamol
  • requires pharmacist advice
  • may be RN/midwife initiated
18
Q

Schedule 4 drugs

A
  • prescription only medicine

- eg. antihypertensives, antibiotics, sleeping tablets

19
Q

Schedule 8

A
  • controlled drug
  • eg. morphine, pethidine
  • supply, storage, prescription, and disposal are controlled by law
20
Q

Schedule 9 drugs

A
  • prohibited substances
  • eg. heroin, MDMA, cannabis
  • usage restricted to analytical labs and trials
21
Q

Schedule 11 drugs

A
  • drugs of dependence
  • eg. tramadol, temazepam
  • S4 and S8 medications with potential for abuse
22
Q

High risk drugs

A 
Antibiotics
Potassium
Insulin
Narcotics
Chemotherapy
Heparin & anticoagulants 
System (requires extra processes)
23
Q

Who can check schedule 8 drugs out of a safe?

A

Under Victorian law, one RN must check a schedule 8 drug out of a safe

24
Q

Bioavailability refers to:

A

The amount of drug that reaches the systemic circulation

25
Q

First Pass Effect

A

Phenomenon whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation, particularly when administered orally, due to the fraction lost by absorption and metabolism by the liver, in the stomach.

NUR5111 (14 decks)

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