Pharmacology Exam 1 Flashcards
Substances that produce responses within the body, they are synthesized by cells of the human body, animal cells, or microorganisms
Ex: Insulin
Biologics
Treatments that consider the health of the whole person and promote disease prevention, natural, not drugs or medicine
Ex: herbs, acupuncture, massage, meditation
Complementary and Alternative Medicines
Major differences between prescription and OTC drugs
Prescription: need written order from a doctor
OTC: doesn’t need a prescription, has lower dosage and safer
Role of the FDA in the drug approval process
Reviews drugs that have worked and gone through the New Drug Application (NDA) process. Once they approve it, the drug is put on the market
US agency responsible for the evaluation and approval of new drugs
FDA
Federal law enforcement agency that combats drug smuggling and monitors controlled substances
Drug Enforcement Administration (DEA)
4 phases of the drug approval process
- preclinical investigation: drugs are tested on animals or human cells
- clinical investigation: tests on healthy human volunteers as well as people with a disease
- New Drug Application: completed if the drug appears to work and reviewed by the FDA
- Post marketing surveillance: drug is marketed but still monitored
Method for organizing drugs on the basis of their clinical usefulness, tells you exactly what the drug is going to do in the body
Ex: raises your BP
Therapeutic classification
Method for organizing drugs on the basis of their mechanism of action (at the molecular & body system levels)
Pharmacologic classification
Well understood model drug with which other drugs in a pharmacologic class may be compared
Prototype drug
Strict chemical nomenclature used for naming drugs established by the IUPAC, used in the lab
Chemical name
Nonproprietary name of a drug assigned by the government, stays the same throughout all companies
Generic name
Proprietary name of a drug assigned by the manufacturer, also called the brand or product name, usually easier to understand, most patients know this name
Trade name
Drug product with more than one active generic ingredient
Combination drug
The ability of a drug to reach the bloodstream and its target tissues
Bioavailability
The continued drive to use a substance despite its negative health and social consequences
Addiction
Strong physiological or psychological need for a substance.. associated with tolerance, you will keep needing more
Dependence
A drug placed into one of the five categories based on its potential for misuse or abuse
Scheduled drug
How a drug produces its physiological effect on the body
Drug’s mechanism of action
Description and example of a SCHEDULE 1
No medical use, very high potential for abuse
Ex: heroine, LSD, marijuana
Description and example of a SCHEDULE 2
High potential for abuse
Ex: morphine, methadone
Description and example of a SCHEDULE 3
Potential for abuse, but less than schedule 1 and 2
Ex: codeine
Description and example of a SCHEDULE 4
May cause dependence
Ex: benzodiazepine
Description and example of a SCHEDULE 5
Very limited potential for dependence
Ex: codeine
The process of moving a drug across the body’s membranes from the spot of administration
Absorption
The process of transporting drugs through the body, tissues, heart, kidneys, brain, usually through the blood stream
Distribution
The total of all biochemical reactions in the body, or biotransformation
Metabolism
The process of removing drugs or substances from the body
Ex: by the kidneys through the urine
Excretion
What are the 4 phases of pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
The study of how drugs are handled in the body
Pharmacokinetics
Factors affecting absorption
Oral medication has to dissolve first so it takes a lot longer
Syrups are faster then tablets
IV drugs don’t need absorbed
Depending on the food that’s already in your stomach it could take longer for the medication to absorbed
Blood flow to the digestive tract is important
The amount of drug required to produce a therapeutic effect
Minimum effective concentration
The level of drug that will result in serious adverse effects
Toxic concentration
The dosage range or serum concentration that achieves the desired drug affect, between the minimum effective concentration and the toxic concentration
Therapeutic range
The length of time for the plasma concentration of a medication to decrease by half after the administration
Plasma half life
Large dose given at the beginning of treatment to rapidly obtain the therapeutic effect of a drug
Loading dose
Dose that is less than the loading dose to keep the plasma drug concentration continuously in the therapeutic range
Maintenance dose
Time it takes for a therapeutic effect of a drug to appear, when it starts working/kicking in
Onset of drug action
When its the highest amount of drug in the bloodstream, the strongest affect before dropping off
Peak of plasma level
The length of time that the therapeutic drug lasts before you need to give them another dose of medicine
Duration of drug action
A drug that is capable of binding to receptors, does the action of a natural substance, and induce a cellular response
Agonist
A drug that blocks the response of another drug, prevents chemicals from acting
Antagonist
Medication that produces a weaker, or less efficient response than an agonist, such as pain meds
Partial agonist
Receptors bind to drugs, whether they are good or bad, but drugs can stop these receptors, causing inihibition
Receptors & Drug action
List in order the steps of the nursing process
- Assessment
- Nursing diagnosis
- Planning goals and outcomes
- Implementing
- Evaluating
The part of the nursing process where you gather information and collect data about your patient
Assessment
Clinical judgement part of the nursing process made about the patient’s health within the nurse’s scope of practice, so what the nurse is able to control, two basic ways of of analyzing the patient would be by deficient knowledge and noncompliance
Nursing Diagnosis
The phase of the nursing process in which nurses prioritize their diagnosis, educate the patient about it, and formulate goals/outcomes
Planning
The part of the nursing process when the patient reassesses the patient and comes up with the nursing interventions that would allow the patient to move forward such as re administering a drug
Implementing
The part of the nursing process that compares the patient’s current health with the desired, continues to modify the care plan
Evaluating
A drug or other agent that causes developmental birth defects because a fetus or embryo was exposed to it and it caused damage
Teratogen
The taking of multiple drugs at the same time
Polypharmacy
Changes in enzyme structure and function due to the encoding gene, so changes in DNA
Genetic polymorphism
The area of pharmacology that examines the role of genetics in drug responses
Pharmacogenetics
Treatments that consider the health of the whole person and promote disease prevention, often safer than medications
Complementary Alternative Medicine (CAM)
What are the 5 categories of teratogenic drug classification
A: No risk to the fetus
B: No risk in animal studies, well controlled
C: Animal studies indicate there is a risk
D: A risk has been proven
X: The risk is greater and outweighs the benefits (an X classification will definitely harm the fetus)
Differences that a nurse should be aware of when administering medications to children
They have decreased and slower gastrics
Their liver and kidneys are immature
They have a lower blood pressure
You should administer drugs in a non-traumatic way
Differences that a nurse should be aware of when administering medications to adults
They have slower gastric emptying times
They have decreased blood flow through the liver and kidneys
They have decreased and slower GI mobility
Explain the roles of complementary and alternative medicine in promoting patient wellness
Focuses on treating patients as individuals
Considers the health of the whole person
Emphasizes the integration of mind and body
Promotes disease prevention, selfcare, and self healing
Recognizes the role of spirituality and health in healing
Why are drugs important in the context of emergency preparedness
They are the most powerful tool available to the medical community for bioterrorism and world wide epidemics
Program designed to ensure the immediate deployment of essential medical materials to a community in the event of a large scaled chemical or biological attack
Strategic National Stockpile (SNS)
Caused by the bacterium Bacillus antracis which causes severe disease and high mortality in humans, normally effects domestic and wild animals
Anthrax
Removing poison from the stomach
Gastric lavage
A carbon based drug that is used to absorb poisons
Activated charcoal
Considered for potentially toxic ingestion of sustained release or enteric coated drugs, removing poisons from the bowels
Whole bowel irrigation
Identify the divisions of the peripheral nervous system
Made up of Motor Neurons & Sensory Neurons
Motor Neurons are made up of the Somatic and Autonomic nervous systems
The Autonomic Nervous System is made up of the Parasympathetic (Cholinergic) and Sympathetic (Adrenergic)
The sympathetic is also made up of alphas and betas
This system prepares the body for stressful or energetic activity, activating the fight-or-flight response
Sympathetic
The system dominates during the time of rest-and-digest and it also directs maintenance activities
Parasympathetic
The system where the brain and the spinal cord both receive and process information then initiate actions
Central Nervous system
The system of all the nerves and tissues outside of the CNS which transmits signals between CNS and the rest of the body
Peripheral Nervous system
Activates involuntary responses over the contractions of smooth and cardiac muscle, glands, and organs
Autonomic Nervous system
Activated under the conditions of the fight or flight response
Sympathetic division of the Autonomic Nervous system
Activated under the nonstressful conditions and produces a rest and digest response
Parasympathetic division of the Autonomic Nervous System
Stimulate the sympathetic division (fight-or-flight) and are made up of Alpha and Beta receptors. can also be selective or non selective
Adrenergic receptors
Stimulate the parasympathetic division (rest-and-digest) and are nerves that release acetylcholine which stimulates smooth muscle, gland secretion, and a decreased heart rate
Cholinergic receptors
What are the autonomic nervous system’s 2 primary neurotransmitters…
Norepinephrine
Acetylcholine
These STIMULATE the sympathetic nervous system and what responses we would get such as fight or flight, decreased heart rate
Sympathomimetics
These INHIBIT sympathetic nervous systems, opposite the sympathomimetics
Adrenergic antagonists
These STIMULATE the parasympathetic nervous system, producing the rest and digest response
Parasympathomimetics
These INHIBIT the parasympathetic nervouse system, they are cholinergic blocking agents
Anticholinergics
Having a large drop in blood pressure as you stand up, making you dizzy and sometimes causing falls. This is a side effect of raking Prazosin (minipress) which is used to lower blood pressure
Orthostatic hypotension
Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care provider, patient, or consumer
Medication Error
Name the organizations involved with medication safety
Food & Drug Administration (FDA)
U.S. Pharmacopoeia (USP)
Institute for Safe Medication Practices (ISMP)
Joint Commission
Oversees the safety of consumer products, such as medicines, biologics, cosmetics, food, and medical devices
FDA
Creates a system of standards and quality, also only admits drugs that meet the guidelines, heparin labeling situation
US Pharmacopoeia
A nonprofit, independent watch dog, safe medicines and error prevention, collects info on errors, research, and educate patients
Institute for Safe Medication Practices
Improves safety in health care institutions, provides accreditation, the goal is to reduce the risk of bad outcomes
Joint Commission
What are the 3 different delivery systems
Unit dose
Multiple dose
Automated medication dispensing system (AMD)
Medications packaged individually like the ones we use in lab
Unit dose
Medications with more than one dose in a container so like a bottle of pills
Multiple dose
Medications that come from a computer storage and dispensing system like the one in lab
Automated medication dispensing system
What are the 6 rights of medication administration
Patient Drug Dose Route Time Documentation
What are the 3 times you check the medication before administering
When collecting the medications
Before entering the patient’s room
At the bedside
Describe point-of-care barcode technology and how it improves the accuracy of medications
- Scan the patients ID bracelet barcode
- Scan medication barcode and the computer will say if its a match
This improves accuracy of medication administration and reduces the # of drug-related errors
Proper method of administering oral drugs
wash hands check for allergies check label 3 times make sure the drug is appropriate for the patient make sure the head is elevated give a sip of water to make sure they can swallow do not give if nauseous or vomiting open unit dose at the bedside pour liquid at eye level follow with water
What are the 6 different types of medication orders
Routine meds Standing meds PRN (as needed) One time/single order ASAP or Now STAT
What are the 5 components of a medication label
The chemical composition The disease or disorder that the drug treats Prescribing guidelines Known drug reactions and interactions Warnings and cautions about the drug
What are some different types of solid medications
Tablets Capsules Granules Chewable Coated Effervescent Modified release Multilayer Orally disintegrating Soluble Troche Lozenge
What are some different types of liquid medications
Solutions Suspensions Emulsions Elixirs Syrups
Identify the major types of anxiety disorders
Generalized anxiety Panic Disorder Phobia Social anxiety Obsessive Compulsive disorder Post traumatic stress disorder
Stress disorder where you’re always worried, nervous, symptoms, lasting more than 6 months
Generalized anxiety disorders
Stress disorder with intense panic, attacks lasting 10 min, interferes with daily activities
Panic disorder
Stress disorder where you get anxiety from speaking in front of people, not wanting to be with people at all
Social anxiety
Stress disorder where you repeat behaviors, hand washing, light switches
Obsessive compulsive disorder
Stress disorder that happens after a traumatic event/natural disaster
Post traumatic stress disorder
Region of the brain associated with feelings of stress and anxiety
Limbic system (middle of the brain)
Region of the brain associated with high alertness, you’re not drowsy, not sleepy
Reticular formation (connects with hypothalamus)
Region of the brain associated with wakefulness
Reticular activating system (RAS)
What are the classes of medication used to treat anxiety and sleep disorders
Antidepressants: Lexapro
Benzodiazepines: Ativan
Barbituates
Non benzo/non barbituates: Ambien
Requires different classes of drugs that cause loss of sensation to the entire body, usually resulting in loss of consciousness
General anesthesia
Loss of sensation to a limited part of the body
Local anesthesia
5 types of local anesthesia
Epidural Infiltration Nerve block Spinal Topical
Injection into the skin immediately at the surgical site
-blocks a specific amount of small nerves
Infiltration
Injection into tissue that may be distant from the operation site (regional)
-blocks sensation into a limb or a large area like the face
Nerve block
Multiple/combination of drugs are used to rapidly induce unconsciousness, allow muscle relaxation, maintain anesthesia
3-5 drugs combined so you don’t get the side effects of just one drug
Balanced anesthesia
A genetically inherited problem, reaction to the anesthetic agent when you have a rapid increase in body temperature
Malignant hypothermia
Inhibits the amount of seratonin so that it’ll stay in the system longer..?
Selective seratonin reuptake inhibitors (SSRI)
