Pharmacology Flashcards
1
Q
MEDICATION vs DRUG
A
Medication refers to a substance used to treat an illness or condition.
Drug is any substance that produces a physiologic effect (whether therapeutic or not) when used in a clinical sense.
EVERY MEDICATION IS A DRUG, NOT EVERY DRUG IS MEDICATION.
2
Q
PHARMACOLOGY
A
Scientific study of how various substances interact with or alter the function of a living organism.
3
Q
Pure Food and Drug Act (1906)
A
Prohibited altering or mislabeling medications
4
Q
Opium Exclusion Act (1909)
A
Opium was prohibited from being imported
5
Q
Harrison Narcotics Act (1914)
A
Restricted the use of various opiates and cocaine
6
Q
Food, Drug, and Cosmetic Act (1938)
A
FDA was given enforcement authority for rules requiring that new drugs were safe and pure
7
Q
“off-label”
A
purpose not approved by the FDA
8
Q
Controlled Substances Act (1970)
A
classifies certain medications with the potential of abuse into five categories (schedules)
9
Q
Schedule I
A
may not be prescribed, dispensed, used, or administered for medical use. High abuse potential; no recognized medical purpose
10
Q
Schedule I Examples
A
Heroin, Marijuana***, LSD
***CONTROVERSIAL
11
Q
Schedule II
A
High abuse potential; legitimate medical purpose
12
Q
Schedule II Examples
A
Fentanyl (sublimaze), methylphenidate (ritalin), cocaine
13
Q
Schedule III
A
lower potential for abuse
14
Q
Schedule III Examples
A
Hydrocodone (vicodin), acetaminophen with codeine (tylenol with codeine #3), ketamine
15
Q
Schedule IV
A
lower potential for abuse than Schedule III
16
Q
Schedule IV Examples
A
diazepam (valium), lorazepam (ativan)
17
Q
Schedule V
A
lower potential for abuse than Schedule IV drugs
18
Q
Schedule IV Examples
A
narcotic cough medicines
19
Q
Sources of Medication
A
Plant
Animal
Microorganism
Mineral
Synthetic (made in laboratory setting)
Semisynthetic (made from chemicals derived from P, A, or M sources then modified in lab setting)
Genetic Engineering
20
Q
Plant Sourced Medications
A
Atropine, aspirin, digoxin, morphine
21
Q
Animal Sourced Medication
A
Heparin, antivenom, thyroid preparations, insulin
22
Q
Microorganism Sourced Medications
A
streptokinase, numerous antibiotics
(bacteria, fungi, mold)
23
Q
Mineral Sourced Medications
A
iron, magnesium sulfate, lithium, phosphorus, calcium
24
Q
Class of Medication
A
grouping to which a medication belongs
25
Three names of medication
Chemical, Generic, Brand
26
Indication
a sign/symptom; reason for giving a medication
27
Mechanism of Action
the way in which a medication produces the intended response
28
Onset
estimated time it will take for medication to take effect
29
Peak
estimated amount of time it will take for medication to have greatest effect
30
Duration
estimated amount of time that the medication will have an effect
31
Medication Monograph
profile including medication information
32
Affinity
ability of a medication to bind with a particular receptor site
33
Efficacy
ability to initiate of alter cell activity in a desired manner
34
Harmful environmental effects to medication
direct sunlight, extreme heat or cold, physical damage
35
Pharmacodynamics
process of a medication altering a function or process of body
36
Side Effect vs Adverse Effect
Side Effect usually expected reaction to medication
Adverse Effect an unexpected/undesired response to a medication
37
Pharmacodynamics
biochemical and physiologic effects and mechanism of actions of a medication
38
Pharmacokinetics
activity of medications in the body over time, such as absorption, distribution, and elimination
39
Processes of Medication Administration
* Absorption
* Distribution
* Biotransformation (metabolism)
* Elimination
40
Agonist Medications
initiate or alter a cellular activity by attaching to a receptor site
(prompts cell response)
41
Antagonist Medications
prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity
(BLOCKS a certain response)
42
Beta 1
*One Heart*
43
44
P-450
alters the chemical structure of a medication
(mainly liver)
45
Define Pharmacology
scientific study of how various substances interact with/alter the function of living organisms
46
Define Medication
substance used to treat an illness or condition
47
Paramedics are likely to carry and administer which schedules of drugs
Schedule II and Schedule IV
48
Medications are either _____ or _____ (pertaining to sources)
synthetic or semisynthetic
49
Semisynthetic medications are derived from (4 things)
plants, animals, minerals, microorganisms
50
Med names are either ____ (3 names)
Generic, chemical, brand
51
Define Indication
circumstance that points to/shows cause, pathology, treatment, or issue of an attack or disease
*albuterol is indicated for broncho-constriction*
52
Define Mechanism of Action
way in which a medication produces the intended response
53
Define Contraindicated
any condition, especially a disease, that renders some particular line of treatment improper or undesirable
54
Most basic concern regarding medication storage is the \_\_\_\_\_\_
integrity of the medication container
55
USP-NF recommended temp range for medication storage is…
15-30 degrees C
56
Define Absorption
process by which molecules of substance are moved from the site of entry/administration into systemic circulation
57
Define Distribution
movement and transportation of a medication throughout the bloodstream to tissues and cells, and ultimately to its target receptor
58
Biotransformation
process with 4 possible effects of how a medication can be absorbed into the body
59
Define Elimination
ability of a medication to bind with a particular receptor site
60
Define Affinity
ability of a medication to bind with a particular receptor site
61
Threshold Level
concentration of medication at which initiation or alteration of cellular activity begins
62
Define Potency
concentration of medication required to initiate a cellular response
63
Define Efficacy
ability to initiate/alter cell activity in a therapeutic/desired manner
64
Diuretic
chemical that increases urinary output
65
Agonist Medication
initiate/alter cellular activity by attaching to receptor sites
66
Partial Agonist
binds to receptor site but do not initiate as much cellular activity or change as do other agonists
67
Full agonist
binds to a receptor site and initiates all activity the receptor is responsible for
68
Antagonist
binds to receptor site to prevent a cellular response to agonist chemicals
## Footnote
**block a certain response**
69
Competitive Antagonist
TEMPORARILY bind with cellular receptor sites, displacing agonist chemicals
70
Noncompetitive Antagonist
PERMANENTLY bind with receptor sites and prevent activation by agonist chemicals
71
Effects of noncompetitive antagonist medication continue until \_\_\_\_
new receptor sites or new cells are created
72
Define analgesia
state of being insensible to pain while still conscious
73
\_\_\_\_\_ (drug we give) is an opiate antagonist
Narcan (Naloxone)
74
Alpha 1 effects…
vasoconstriction of arteries and veins
75
Beta 1 effects…
Heart
* increased heart rate (chronotropic effect)
* increased myocardial contractility (lontropic effect)
* increased myocardial conduction (dromotropic effect)
* renin secretion from urinary retention
76
Beta 2 effects…
lungs
* bronchus and bronchiole relaxation
* insulin secretion
* uterine relaxation
* arterial dilation in certain key organs
77
Dopaminergic receptor effects…
vasodilation of renal and mesenteric arteries
78
Nicotinic receptor
present at neuromuscular junction, allowing ACj to stimulate muscle contraction
79
Muscarinic receptor
present in the heart, activated by ACj to offset stimulation of the sympathetic nervous system.
decreases HR, contractility, and electrical conduction velocity
80
Opioid receptor
present in CNS and PNS, bowels, and various tissues.
activated by opioid substances to produce analgesia, euphoria, respiratory depression
81
Most prominent opioid receptor
Mu
82
Factors affecting response to medications
* age
* weight
* environment
* genetics
* pregnancy
83
FDA Pregnancy Category A
controlled studies in women fail to demonstrate a risk to the fetus in the first trimester, possibility of fetal harm appears remote
84
FDA Pregnancy Category X
studies in animals and humans have demonstrated fetal abnormalities. risk of the use of the drug cleary outweighs the benefit
85
Define Cumulative Action
several smaller doses of a particular medication capable of producing the same clinical effects as a single larger dose of the same med
86
Define Untoward effects
a clinical change caused by a medication that causes harm or discomfort to a Pt
## Footnote
**AKA adverse effect**
87
Define Stevens-Johnson Syndrome
a severe, possibly fatal reaction that mimics a burn
may be due to a medication
88
Define Therapeutic Index
the relationship between the median effective dose and the median lethal dose OR median toxic dose
## Footnote
**AKA therapeutic ration**
89
Define Tolerance
condition that develops following repeated use by a PT of a medication that results in decreased efficacy or potency
90
Define Habituation
the unusual tolerance to the therapeutic and adverse clinical effects of a medication or chemical
91
Define Dependence
the physical, behavioral, or emotional need for a medication or chemical to maintain “normal” physiologic function
92
Addition or Summation
2 meds with a similar effect combine to produce an effect equal to the sum of the individual effect of each med
93
Synergism
2 meds with a similar effect combine to produce an effect greater than the sum of one of the meds effect
94
Potentiation
effect of 1 med is greatly enhanced by the presence of another med, which doesn't have the ability to produce the same effect on its own
95
96
Altered Absoption
the action of 1 med may increase or decrease the ability of another med to be absorbed by the body
97
Altered Metabolism
the action of one medication increases or decreases the metabolism of another medication within the body
98
Altered Distribution
the presence of one medication alters the area available for the distribution of another medication in the body
99
When would altered distribution become important?
when both medication are bound for the same site, such as plasma proteins
100
if proteins are already occupied by one med, ____ of the other med may develop
toxic levels
101
Physiologic Antagonism
2 meds--each producing opposite effects--are present simultaneously, resulting in minimal or no clinical change
102
Neutralization
2 meds bind together in the body, creating an inactive substance
103
Diagnostic Error
* error/delay in diagnosis
* failure to employ indicated tests
* failure to act on results of monitoring or testing
104
Treatment Error
* error in the performance of an operation, procedure, or test
* error in administering treatment
* error in the dose/method of using a drug
* inappropriate care
105
Preventative Error
* failure to provide prophylactic treatment
* inadequate monitoring or follow-up of treatment
106
other medical errors
* failure of communication
* equipment failure
* other system failure
107
First Order Elimination
the rate of elimination is directly influenced by plasma levels of a substance
108
Zero Order Elimination
fixed amount of a substance is removed during a certain period, regardless of the total amount in the body
109
Half-Life
the time needed in an average person for metabolism/elimination of 50% of the substance in plasma
110
Most biotransformation of drugs occurs in the \_\_\_
liver
111
Elimination occurs in \_\_\_\_
the kidneys and excreted into urine
112
10 rights of medication administration
* Right Patient
* Right Medication
* Right Dose
* right route
* right time
* right education
* right documentation
* right assessment
* right evaluation
* right to refuse
113
Angioedema
localized areas of swelling beneath the skin
114
Components of Medication Profiles
* medication name
* category or class
* use/indication
* mechanism of action
* pregnancy risk factor
* contraindications
* available forms
* dosage
* administration/monitoring considerations
* potential incompatibilities
* adverse effects
* pharmacokinetics
115
Anticoagulant
reduce efficacy of clotting factors present in blood
116
Antidysrhythmics
prevent or control various cardiac dysrhythmias
117
Antiemetics
treat or prevent nausea and vomiting
118
Beta-Agonist
bronchodilation
119
Beta-Blocking Agents
reduce heart rate and blood pressure
120
Calcium Channel Blockers
reduce heart rate and blood pressure
121
Cholinergics
activate secretory glands in eyes and GI tract; improve muscle weakness
122
Corticosteroids
decrease inflammation; immunosuppressant
123
Diuretics
promote excretion of urine; manage fluid overload
124
Narcotic Analgesics
relieve pain and relieve/suppress cough
125
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
treat pain and inflammation
126
Class I Antidysrhythmic
slow movement of sodium through channels in certain cardiac cells
127
Class II Antidysrhythmics (Beta Blockers)
competitively inhibit catecholamine activation of beta receptor sites
128
Class III Antidysrhythmic
increase the duration of phases 1, 2, and 3 of the cardiac cycle. These meds prolong the absolute refractory period
129
Class IV Antidysrhythmics (calcium channel blockers)
displace calcium @ certain receptor sites or enter smooth muscle cells in place of calcium. this action relaxes smooth muscle present in the heart, blood vessels, GI tract, and uterus.
they also slow conduction through the AV node
130
Define Orthostatic Hypotension
a fall in blood pressure that occurs when moving from a recumbent to a sitting or standing positions
* diastolic falls by 20mmHg
* systolic rises by 10mmHg
* pulse increases by 20bpm
131
Beta Blockers end in…
-olol or -lol
132
ACE inhibitors end in…
-pril
133
Anticoagulants
impair the function of blood clotting or coagulation chemicals in the bloodstream
134
Antiplatelets
reduce platelet aggregation (clumping), preventing new thrombus formation, or the extension of an existing thrombus
135
\_\_\_\_ is a common example of an antiplatelet
Aspirin
136
Inotropic Effect
force of cardiac contraction
137
138
Dromotropic Effect
rate of electrical conduction
139
Chronotropic Effect
change in heart rate
140
Sterile Technique
the destruction of all living organisms and is achieved by using heat, gas, or chemicals
141
Antiseptic
chemicals used to cleanse an area before performing invasive procedure
*ie isopropyl alcohol or iodine*
142
Disinfectant
chemicals used on non-living objects to kill organisms; toxic to living tissues
143
Disposal in…
sharps
144
Crystalloid Solutions
solutions of dissolved crystals (*ie salts or sugars*) in water; contain compounds that quickly dissociate in solution
145
Colloid Solutions
solutions that contain molecules (usually proteins) that are too large to pass out of the capillary membranes and, therefore, remain in the vascular compartment
146
Isotonic Solution
a solution that has the same concentration of sodium as does the cell. water does not shift, and no chance in the cell shape occurs
## Footnote
**0.9% sodium chloride (normal saline), LR**
147
Hypertonic Solution
a solution that has a greater concentration of sodium than does the cell; increased osmotic pressure can draw out water from the cell and cause it to collapse
## Footnote
**3% saline, blood products, albumin**
148
Hypotonic Solution
a solution that has a lower concentration of sodium than does the cell; increased osmotic pressure lets water flow into the cell, causing it to swell and possibly burst
## Footnote
**5% dextrose in water (D50)**
149
Macrodrip Set
an administration set named for the large orifice between the piercing spike and the drip chamber; allows for rapid fluid flow into the vascular system
## Footnote
**10 or 15 gtts/mL**
150
Microdrip Set
an administration set named for the small orifice between the piercing spike and the drip chamber; allows for carefully controlled fluid flow and is ideally suited for medication administration
## Footnote
**60 gtts/mL**
151
152
Initial IV insertion angle: \_\_\_, then drop to \_\_\_
45 degrees, about 15 degrees
153
Helpful hints when giving IV
* allow arm to hang off stretcher
* pat/rub area without being too vigorous
* apply wrapped chemical heat pack for about 60 sec
* if you meet resistance from valve, elevate extremity after 2 misses, let partner try
* never pull catheter back over needle
154
When documenting IV, include:
* gauge
* IV attempts vs success
* the site location
* type of fluid
* rate @ which fluid is running
155
Infiltration
escape of fluid into the surrounding tissue, causes localized edema.
* discontinue IV line and reestablish on opposite extremity or in more proximal location.
* direct pressure over swollen area
156
Occlusion:
Physical blockage of a vein or catheter
* Sign: decreasing drip rate or presence of blood in tubing
* use syringe with clean IV fluid to add pressure to line to disrupt occlusion
157
Thrombophlebitis
inflammation of a vein.
* common in regular IV drug users and Pts who receive long-term IV therapy
* pain/tenderness along the vein and redness/edema @ site
* easier to prevent than treat
158
Hematoma
* accumulation of blood in the tissues surrounding IV site
* blood can be seen rapidly pooling around IV site, leading to tenderness and pain
* if occurs while attempting, stop and apply direct pressure
159
Nerve/tendon Damage
* improper identification of IV site
* Pt will experience sudden and severe shooting pain
* numbness and tingling common
160
Arterial Puncture
* accidentally puncture artery
* immediately withdraw catheter, apply direct pressure for at least 5 min or until spurting stops
161
Pyrogenic Reaction
a reaction characterized by an abrupt temperature elevation (*as high as 106 degrees F [41 degrees C])* with severe chills, backache, headache, weakness, nausea, and vomiting
162
When a medication binds with a receptor site, one of four actions will occur…
1. channels permitting the passage of ions (charged particles) in cell walls are opened or closed
2. a biochemical messenger becomes activated, initiating other chemical reactions within the cell
3. a normal cell function is prevented
4. a normal or abnormal function of the cell begins
163
Endogenous
occurring naturally within the body
164
Exogenous
from outside the body
165
Medications distribute into three primary types of body substances…
water, lipids/fat, protein
166
Medication metabolism in the liver is affected by the…
cytochrome P-450 system
167
Paradoxical medication reaction
patient experiences effects opposite from the intended effect
168
the percentage of EBC/s in the intravascular space is known as…
hematocrit
169
Median Lethal Dose (LD50)
weight-based dose of a medication that causes death in 50% of the animals tested
170
Median Toxic Dose (TC50)
50% of the animals tested had toxic effects at or above this weight-based dose
171
Down-regulation
reduced available cell receptors for a particular medications
## Footnote
**AKA tolerance**
172
Repeated doses of medication within a short time rapidly cause tolerance, making medication virtually ineffective
Tachyphylaxis
173
Two Parts of the Autonomic Nervous System
Sympathetic and Parasympathetic Nervous Systems
174
Mydriasis
Pupil Dilation
175
Neurotransmitter for SNS is…
norepinephrine
176
Neurotransmitter for PNS…
Acetylcholine
