Pharmacology Flashcards
Aa
Of each
Ac
Before meals
AD
Right ear
Ad lib
As desired
Amt
Amount
Aq
Water
AS
Left ear
AU
Both ears
Bid
Twice a day
BSA
Body surface area
C
With
Caps
Capsules
D/c, dc
Discontinue
Disp
Dispense
Dl
Deciliter
Elix
Elixir
Emul
Emulsion
Et
And
Fl
Fluid
Hr
Hour
Hs
Hour of sleep
K
Potassium
Mcg
Microgram
N
Normal
NaCl
Sodium chloride
NPO
Nothing by mouth
OD
Right eye
Ophth
Instill in eye
OS
Left eye
OTC
Over the counter
Otic
Instill in ear
OU
Both eyes
P
After
Pc
After meal
Per
By, with
PO
By mouth
Prn
As needed
Q
Each
Qh
Every hour
Q2h
Every 2 hours
Q6h
Every 6 hours
Qid
4 times a day
Qs
Quality sufficient
Rx
Prescription
S
Without
Sig
Label
Ss
1/2
STAT
Immediately
Tid
3 times a day
Pure food and drug act
1906
-first drug law passed in United States
-ensure consumer quality
-require label to include ingredients and warnings
-sets U.S. standards for making drugs
-united states pharmacopeia and national drug standards
—source approved medication and chemical formulas for approved drugs
Federal food, drug, and cosmetic act
1938
- law gives food and drug administration authority to oversee safety of drug
- FDA agency of Department of Health and Human service
- new products must be FDA approved
- prescription and non-prescription drugs must be shown effective and safe
- drug utilization review is required
- regulation to prevent tampering
- accurate labels with generic name included
- requires warning labels
Controlled substance act
1970
- enacted to help reduce abuse of legal and illegal drugs
- prescriber must register with Drug Enforcement Agency, obtain a DEA registration number, renew annually
- law is enforced by DEA through Department of Justice
Controlled drugs
- require an Rx due to potential for dependence, abuse, addiction
- medical facility on site responsibility: maintain 2 year inventory of controlled drug transaction
- securely store rx form at facility
- keep current drug reference book available at all times
- keep controlled substance locked securely
Physical dependence
Patient reliance on medication to relieve shaking, pain or other symptoms
Psychological dependance
Patient reliance on medication to relieve anxiety, stress, tension, other undesirable mental state
Drug schedule
Department of justice place drugs into specific categories (schedule) according to potential for abuse and dependance
Schedule I
Drugs with
- high abuse, addiction potential
- no medicinal use, no accepted safety for use
- heroin, mescaline, LSD
Schedule II
- high abuse, addiction potential
- medicinal use
- registered DEA license provider must sign Rx
- Rx must be furnished to pharmacy within 72 hours
- if stored at facility: must be locked, routinely counted, inventoried, dispensing record kept for 2 years
- cocaine, morphine, methadone, codeine, Nembutal, percodan, tylox
Schedule III
- lower physical dependance, high psychological dependance potential
- rx handwritten
- no DEA number required
- up to 5 refills in 6 months
- narcotics, amphetamine-like substance: barbiturates, amphetamine compounds, paregoric, fiorinal
Schedule IV
- lower abuse potential
- mild tranquilizer, hypnotic: diazepam, Librium, Valium, ambien
- rx may be written by MA, RN but signed by MD
- up to 5 refills in 6 months, may be refilled by phone
Schedule V
Drugs require written or oral Rx
- lomotil, robitussin, A-C
- may be written by MA, RN but signed by MD
- up to 5 refills in 6 months
United States Parmacopeia and national formulary (USP-NF)
- official source of information for drugs approved by FDA
- describe drug identification, strength, quality, purity
- updated every 5 years
United States pharmacopeia dispensing information (USP-DI)
-electronic version updated each quarter
-contains 2 volumes:
—volume 1: for prescribers, contains industry respected drug information
—volume 2: advice for patient, written in lay person language, explains proper use of medication, description, precautions, side effects
Physician Drug reference (PDR)
-most comprehensive, widely used reference
-organized into 5 categories
—section 1: white-manufacturers index
—section 2: pink-alphabetical arrangement of generic and brand name index
—section 3: blue-classification index
—section 4: gray-manufacturers photographic index displaying medication
—section 5: white-production information
—section 6: white-controlled substance categories, poison control center, drug information centers, sound-alike, look-alike drug names
PDR section 5
Provides detailed information for each drug
- Action: cellular change result from drug use, principal organ site of action
- cautions: particular risk of using drug, adversity reaction, other side effects, warnings when to discontinue use
- contraindication: condition which drug administer would be improper, undesirable
- indication: condition for drug is meant to be used
- interaction: other drug/food cause interaction alter drug effects, type of drug interaction
Antogonism
Type of drug interaction
-occur when presence of 1 drug decrease intensity or shortens duration of another drug effect
Potentiation
Type of drug interaction
-occur when 2 drugs taken together, 1 of them exaggerates action of another
Synergism
Type of drug interaction
-if 2 drugs taken together are similar in action, combined effect is greater than effect produced if each taken separately
Hypoglycemic
- use to lower blood glucose level of diabetic patient
- interacts: alcohol, sulfonamide antibacterial drug
- interaction results: further lowering blood sugar level, severe risk of hypoglycemia
Depressant of central nervous system
- sedatives, narcotic, analgesics, antihistamine, alcohol
- substance: any CNS depressant listed at left
- result: dangerous over sedation, respiratory failure
Anticoagulants
- substance: aspirin, non-steroidal, anti-inflammatory, drugs, alcohol, antibiotics
- result: increase anti-coagulant, effect and risk of abnormal bleeding
Certain type of tetracycline antibiotic
- substance: iron supplement, milk, antacids
- result: reduce effectiveness of antibiotic if taken within 1 hour before, 2 hours after antibiotic
Oral contraceptives
- substance: barbiturates, some types of antibiotic
- result: reduced effectiveness of contraceptive, increase risk of pregnancy
Monoamine, oxidase inhibitor, antidepressant
- substance: meperidine, decongestant, amphetamines, cheese, bananas, red wine, beer, yeast extract, chocolate
- result: dangerous rises in BP, risk of seizures, brain hemorrhage
Generic or official
- Common, general name given when drug is first produced
- usually based on chemical name
- name not protected by trademark
- drug less costly
Trade or brand name
- name, on FDA approval, manufacturer gives the drug
- name protected by trademark
Chemical
- scientific molecular structure of drug
- long and complicated
Local
Drug acts on limited area, which it is administered
Systemic
General effect
-drug is transported through bloodstream, carried to 1 or more tissues
Absorption
-drug moves into bloodstream from site of administered
-rate which drug passes from intestine into blood stream, amount of drug passing into bloodstream depends on
—drug form, pH of medication, drug concentration, amount of food in stomach, depth of breathing for inhalants
Distribution
- drug leaves bloodstream, pass into tissue space, cell bodies
- may pass across blood-brain barrier, placenta into fetus
Metabolism
- drug breakdown to another chemical within liver
- usually result inactivation of drug
- sometimes convert to active form after liver absorption
Elimination
- excrete in urine
- small amount via saliva, sweat, stool, breast milk, breathing, tears
Curative
Kill cause factor of condition or disease
Therapeutic
Relieve symptoms of disorder or disease
Destructive
Eliminate tumor or organism
Palliative
Provide patient comfort, no cure, relieve pain or other symptoms
Prophylactic
Lessen severity of disease or prevent condition or disease
Replacement
Replace missing substance normally found in body
Diagnostic
Test for allergies (antigen sera) Radiographic studies (dye injection)
Factor affecting drug action: age
—newborn: immature, geriatric: deteriorating-both sensitive to medication
—geriatric: metabolism gastrointestinal function, drug sensitivity, circulation are dosage consideration
—adult patient: dosage calculation based on age, weight
—child patient: dosage calculated basis of mg of drug/kg of body weight, body surface area considered in calculation
Factors affect drug action: body weight
Same dose of same drug will have lesser effect on patient weighing more, than weighing less
Cumulation
Accumulation of drug in body result in toxicity
- drug has greater effect and toxic side effects
- due to lack of elimination between administration
- other factors are weight, age, sex, environment, psychological, genetics, allergies
Factor affect drug action: Disease
Kidney, liver disease affect drug action
-drug action may begin the disease process affecting body organs
Factor affecting drug action: drug-drug interaction
One drug may potentially or lessen action of another drug
Factor affecting drug action: immune response
May cause body to develop antibodies, any future administration of same drug produce allergic reaction
Factor affect drug action: sex
Pregnant women, other women, men all affected differently by drugs
- IM medication are absorbed more quickly by men than women
- caution must be used with drug administration to pregnant women, so not to affect fetus
Factor affect drug action: tolerance
Reduce responsiveness to drug
-may be inherited or acquired by use of drug over length of time
Adverse reaction
Include ototoxicity, tinnitus, photosensitivity, nephrotoxicity
Toxic effects
Poisonous effect result of idiosyncrasies, single overdose, accumulation in blood level over time
Side effects
- predictable reaction to drug, can be expected to occur due to way drug work on different tissues
- are inevitable for most type of drugs
Angiotensin-converting enzyme inhibitors side effects
Dizziness, dry mouth, vomiting, cough, rash
Antibiotics side effects
Diarrhea , thrush, rash
Anticholinergic drugs side effects
Blurred vision, dry mouth, urine retention
Antidepressant side effect
Drowsiness, dry mouth, blur vision, constipation
Antihistamines side effects
Dizziness, drowsiness, clumsiness
Barbiturates side effects
Dizziness, drowsiness, clumsiness
Benzodiazepines side effect
Dizziness, drowsiness
Beta blockers side effects
Wheezing, cold hand/feet, impotence
Cytotoxic anti-cancer drug side effects
Hair loss, diarrhea, vomiting, sore in mouth
Narcotic analgesic side effects
Constipation, nausea, vomiting, drowsiness
Nonsteroidal anti-inflammatory drug side effects
Indigestion, nausea, diarrhea, black bowel movement
Thiazide diuretics side effect
Sensitive to light, impotence
Vasodilator Side effect
Dizziness, fainting, ankle swelling
Tylenol with codeine
Analgesic
- generic name: acetaminophen and codeine
- used for: pain reliever, antipyretic
Endocet
Analgesic
- generic name: oxycodone/APAP
- action: pain reliever, narcotics
Aleve
Analgesic
- generic name: naproxen
- action: non opioid pain reliever, NSAID, antipyretic
Novocaine
Analgesic
- generic: procaine
- use: numbing local topical area
Xylocaine
Analgesic
- generic: lidocaine 0.5% injection
- use: localized numbing
Oxycontin
Analgesic
- generic: oxycodone
- use: chronic, moderate, severe pain relief of more than few days
Percocet, roxicet
Analgesic
- generic: oxycodone/acetaminophen
- use: pain reliever, narcotic
Ultram
Analgesic
- generic: tramadol hydrochloride
- use: moderate pain relief, non-narcotic
Allegra
Anti allergy agents
- generic: fexofenadine
- use: seasonal allergy rhinitis, chronic idiopathic, urticaria, anti-histamine
Atarax
Anti-allergy agent
- generic: hydroxyzine hydrochloride
- use: antihistamine, antiemetic
Clarinex
Anti allergy agents
- generic: desloratadine
- use: seasonal allergy, H1 histamine antagonist
Hydrocodone
Anti-allergy agents
- generic: hydrocodone, bitartrate
- use: a Titus I’ve for nonproductive dry cough, narcotic
Zyrtec
Anti-allergy agents
- generic: cetirizine
- use: seasonal/perennial allergic rhinitis, chronic idiopathic urticaria, pruritus reduction, hives
Amoxicillin
Antibiotics
- generic: amoxicillin
- use: anti-infective, systemic chronic/acute infections
Amoxil
Antibiotics
- generic: amoxicillin
- use: anti-infective, acute/chronic systemic infections, anti ulcers, ENT infection
Augmentin
Antibiotic
- generic: amoxicillin clavulanate
- use: soft tissue infection, moderate/severe bacterial infection, otitis media, sinusitis, UTI
Bactrim
Antibiotic
- generic: trimethoprim-sulfamethoxazole
- use: UTI, URI, otitis media
Biaxin
Antibiotic
- generic: clarithromycin
- use: mild-moderate URI, chronic bronchitis, uncomplicated skin infection
Cefzil
Antibiotic
- generic: cefprozil
- use: streptococcus, staphylococcus: cause URI and skin infection
Cipro
Antibiotic
- generic: ciprofloxacin
- use: UTI, URI, bone/joint infection, otitis media, skin infection
Aspirin
Anticoagulants
- generic: aspirin/ASA
- use: blood thinner, analgesic, antipyretic
Coumadin
Anticoagulants
- generic: warfarin
- use: clotting disorders, myocardial infarction, chronic atrial fibrillation, blood thinner
Dilantin
Anti-arrhythmic agents
- generic: phenytoin
- use: anticonvulsant
Lanoxin
Anti-arrhythmic agent
- generic: digoxin
- use: slow/ strengthens heartbeat, hypertension
Paxil
Antidepressant
- generic: paroxetine hydrochloride
- use: depression, anxiety, panic disorders
Wellbutrin XL
Antidepressant
- generic: bupropion hydrochloride
- use: depression
Zoloft
Antidepressant
- generic: sertraline hydrochloride
- use: depression, obsessive compulsive disorder
Avandia
Anti diabetic agents
- generic: rosiglitazone maleate
- use: NIDDM (type 2 diabetics)
Glucophage
Anti-diabetic agents
- generic: metformin
- use: NIDDM (type 2)
Glucotrol XL
Anti-diabetic agents
- generic: glipizide
- NIDDM (type 2)
Diflucan
Antifungal agents
- generic: fluconazole
- use: oropharyngeal, vaginal/systemic candidiasis
Mycostatin
Anti-fungal agent
- generic: nystatin
- use: candida-skin/mucous membrane infection
Lipitor
Anti-hyperlipidemic agents
- generic: atorvastatin calcium
- use reduction of cholesterol levels
Pravachol
Anti-hyperlipidemic agents
- generic: pravastatin sodium
- use: reduce cholesterol levels
Accupril
Anti-hypertensive agents
- generic: quinapril hydrochloride
- use: hypertension, CHF, ACE inhibitor
Cozaar
Anti-hypertensive agent
- generic: losartan potassium
- use: hypertension
Lasix
Anti-hypertensive agents
- generic: furosemide
- use hypertension, CHF, diuretic for edema
Lotensin
Anti-hypertensive agent
- generic: benazepril hydrochloride
- use: hypertensive
Norvasc
Anti-hypertensive agent
- generic: amlodipine besylate
- use: hypertensive, angina, calcium channel blocker
Prinivil
Anti-hypertensive agent
- generic: lisinopril
- use: hypertension, ACE inhibitor, CHF
Toprol XL
Anti-hypertensive agent
- generic: metoprolol succinate
- use: hypertension, aging pectoris
Zestril
Anti-hypertensive agent
- generic: lisinopril
- hypertension, ACE inhibitor, CHF
Aleve
Anti-inflammatory agent
- generic: neproxen
- use: arthritis, dysmenorrhea
Celebrex
Anti-inflammatory agent
- generic: celecoxib
- use: pain associated with arthritis
Prevacid
Anti-ulcer agents
- generic: lansoprazole
- use: short term treatment for active duodenal ulcer, gastric ulcer, erosive esphagitis
Prilosec
Anti-ulcer agent
- generic: omeprazole
- use: gastric/duodenal ulcer, GERD
Aminophylline
Bronchodilators
- generic: theophylline ethylenediamine
- use: bronchospasm prevention and symptom relief
Epi-EZ pen, primatene mist suspension
Bronchodilators
- generic: epinephrine
- use: temp relief of bronchospasm from asthma, anaphylactic reaction
Proventil HFA
Bronchodilators
- generic: albuterol
- use: prevent bronchospasm associated with asthma/bronchitis
Flonase
Corticosteroids
- generic: fluticasone
- use: seasonal/perennial allergic/non allergic rhinitis
Nasonex
Corticosteroids
- generic: mometason furoate
- use: steroid-dependent asthma, seasonal/perennial allergic rhinitis
Climara
Hormones
- generic: estradiol
- use: contraceptive, HRT
Humulin N insulin
Hormones
- generic: isophane insulin, human rDNA
- use: hyperglycemia, IDDM (type I)
Premarin
Hormone
- estrogen
- use: imbalance: breast/prostate, osteoporosis, menopausal symptoms
Synthroid
Hormone
- generic: levothyroxine
- use: hypothyroidism, cretinism, myxedema
Ambien
Hypnotic/sedative
- generic: zolpidem tartrate
- use: insomnia
Lunesta
Hypnotic/sedative
- generic: exopiclone
- use: insomnia
Fosamax
Supplemental / replacement
- generic: alendronate
- use: treat/prevent osteoporosis in postmenopausal women
Klor-con
Supplement/replacement
- generic: potassium chloride
- use: hypokalemia, electrolytes supplements
Levoxyl
Supplement/replacement
- generic: levothyroxine
- use: treat low thyroid function
Right dose
Check amount of drug and correct strength
Right drug
- check label 3 times
- on removal from storage
- while preparing
- on return to storage
Right technique
Admitted drug using correct method, at correct site
Right route
Administer drug using correct route: oral, topical, parenteral, optic, ophthalmic
Right time
Administer drug correct time, some patient should be told when next dose is due
Right patient
Know patient when drug is to be administered, verify name and DOB
Right documentation
- patient name
- date/time administer
- drug name/dosage
- route used, site if injected, any complication
- any adverse reaction
- reason for not administering
- signed by medical assistant
Prescription components
- written by MD, filled by pharmacy
- indicate medication needed, include all direction for pharmacist and patient
- name of drug, dosage, when given, how given, how many times given, date of order, signature of MD who wrote it
Inscription
Name of drug, dosage, form, strength
Superscription
Patient name, address, date, symbol Rx
Subscription
Number of doses dispensed and quanitities
Signature
Direction for taking drug, usually preceded by term sig.
Oral administration
Convenient, safe, relatively inexpensive
Most drug taken 1-2 hours after meal
Caplet
solid form
Shape like capsule, but consistency of tablet
Capsule
solid form
Two part container
Shell dissolve in gastrointestinal tract
Drug-imbedded powder or beds contain inside
Tablet
solid form
Compressed powder
Various shapes, colors, may be enteric coated, scored or layered
Elixir
Liquid form
Solution contain sugar, alcohol, water
Emulsion
Liquid form
Fine droplets of fat globules in water
Solution
Liquid form
- liquid homogeneous preparation contain 1 or more substance
- combo made of solute ( dissolved substance), solvent (liquid in solute is dissolved
Spirit
Liquid form
Solution contain alcohol
Suspension
Liquid form
Drug particles suspend within liquid, not dissolved
Syrup
Liquid containing sugar
Tincture
Liquid form
Solution of drug dissolved in alcohol with or without water
Liniment
Topical
Drug mix with oil, soap, water, alcohol
-used externally on skin to produce warmth in area where drug is needed
Lotion
Topical
- suspension/emulsion preparation
- externally on skin in area where drug is needed
Ointment
Topical
- salve with fatty base
- petroleum jelly, lanolin, lard
- applied externally on skin where needed
Transdermal
Typically contain in adhesive patch or disk attach to skin
-allow for slow control delivery through skin to deeper tissue or circulation system
Suppository
Melt after insertion
- rectally, vaginally, urethra
- pt should be in sim’s position
Eye ointment
Tip allow dispensing small stream into bottom eyelid
Eye drops
Placed in center of lower conjunctival sac
Buccal
Meds in tablet or gum form
- absorption through gum and cheek
- do not chew
Sublingual
Placed under tongue, dissolve and absorbed
Inhalation
Nasal/mouth membrane delivery occur through atomizer or inhaler
-suspenses as tiny droplets in aerosol form
Otic (ear)
Drop form is common for otic med instillation
-drop instillation: pull pinna up and back for adults; pull lobe down and back for child less than 3 years old
Parenteral injection
- used when drug cannot be orally given, by mucous membrane, topically
- surest and fastest method of drug delivery to body
- risk of overdose is higher
- effectiveness is determine by site blood supply
Needle gauges
- determine by size of needle lumen
- higher number, smaller lumen is
Intravenous (IV)
Instantaneous effect
Intradermal (ID)
-bevel up, do not aspirate, use for purified protein derivative (PPD) tuberculin test
Subcutaneous (SC)
- grasp skin form 1 inch fold
- aspirate
- inject slowly
- for insulin: roll vial between palm to mix evenly, do not shake, do not massage after injection (true for imferon and heparin)
Intramuscular (IM)
- stretch skin taut
- aspirate
- inject slowly
- cover site
- massage
Z track injection
- pull skin 1.5 inch away from injection site
- insert 90 degree in dart-like fashion
- aspirate
- inject slowly
- wait 10 seconds before withdrawing, remove needle same angle, release skin
- do not massage
Kilo
1000
Hecto
100
Deka
10
Deci
1/10 of unit
0.1
Centi
1/100 of unit
0.01
Milli
1/1000 of unit
0.001
Micro
1/ 1000000 of unit
0.000001
Milliliter
ML
Liter
L
Cubic centimeter
Cc
Grain
Gr
Microgram
Mcg
Milligram
Mg
Gram
G
Kilogram
Kg
Millimeter
Mm
Centimeter
Cm
Meter
M
Ounce
Oz
Pound
Lb
Teaspoon
Tsp
Tablespoon
Tbsp
Pint
Pt
Quart
Qt
Gallon
Gal
Inch
In
Length
Measure in meters
100 centimeter = 1 meter
Volume
Fluids
Measure in liters
1000 milliliter = 1 liter
Weight
Solids Measure in grams 1000 mcg = 1 mg 1000 mg = 1 g 1000 g = 1 kilogram
Convert metric weight
- mg to g: divide by 1000, move decimal 3 place left
- g to mg: multiply by 1000, move decimal 3 place right
- g to kg: divide by 1000, move decimal point 3 places to left
- kg to g: multiply by 1000, move decimal 3 place to right
Convert metric volume
- L to mL: multiply by 1000, move decimal 3 place right
- mL to L: divide by 1000, move decimal 3 place left
Volume
- 1 teaspoon = 5 mL
- 1 tablespoon = 15 mL
- 1 ounce = 30 mL
- 1 cup = 240 mL
- 1 pint = 500 mL
- 1 quart = 1000 mL, 1000 cc
Weight
- 1 ounce = 30 g
- 16 ounces = 1 pound
- 2.2 lb = 1 kg
Length
2.5 cm = 1 inch
Formula to convert Fahrenheit to Celsius
C = (F-32) x 5/9
Subtract 32 from Fahrenheit, multiply result by 5, divide result by 9
Formula convert Celsius to Fahrenheit
F = 9 x C + 32
Multiply C by 9, divide result by 5, add 32 to results
Dosing calculation
-use ratio proportion method to solve for X
—ratio is way to show relationships between numerator and denominator of fraction
—proportion comparison of 2 ratios
-set up equation to have X represent your unknown
-to left of equal sign, set up equivalent measure you know
-follow same sequence on right side of equal sign, insert X for unknown looking for
-proportion method use term means and extremes
-multiply together known means or extreme
-take answer, divide by 1 known extreme
Ampule
Small profiled glass container, holding sterile solution or powder
-has scored neck, design for 1 use only
Aspirate
Pull back on hypodermic plunger to ensure needle is not in blood vessels
- no blood should be present in needle barrel
- failure to aspirate, may deliver IM or SC injection into IV injection
Average dose
Most effective with minimum toxic effect
Cartridge-needle unit
Hold pre-measured medication, disposed after use
Dispense
Prepare and give medication to patient
Divided dose
Smaller measured portion given at shorter intervals
Enteric coated
Drug form designed to bypass stomach, dissolve in intestine
Initial dose
First dose
Maintenance dose
Amount needed for drug to remain at therapeutic level in bloodstream
Maximum dose
Largest amount given that is safe
Medication unit
Expresses potency of drug too varied in their potency
Minimum dose
Smallest amount will still be effective
Pharmacodynamic
Analysis of drug effect on living organism
Prescribe
Recommended or order therapeutic treatment or use of drug
Toxic dose
Amount cause sign / symptoms of drug poisoning
Vital
Profiled small glass container holding sterile solution or powder, rubber stopper for needle entry
Wheal
Slight elevation of skin
Result of ID injections