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Pharmacology > Pharmacology Lesson 2 > Flashcards

Pharmacology Lesson 2 Flashcards

0
Q

What is a chemical name?

A

Drug’s chemical composition and molecular structure.

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1
Q

What are three classifications of drug nomenclature?

A
  • Chemical
  • Genetic
  • Trade
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2
Q

What is a genetic name?

A

Non-proprietary name assigned by the United States Adopted Name Council.

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3
Q

What is a trade name?

A

Proprietary name given by the developers of the drug. Drug trade names have a registered trademark.

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4
Q

What is the difference between drug action and drug effect?

A
  • Drug action–>cellular level (drug/cell interaction)

- Drug effect–>whole body (overall effect on the body)

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5
Q

What are the 4 pharmacologic principles of pharmacokinetics?

A

(ADME)

  • Absorption
  • Distribution
  • Metabolism
  • Elimination
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6
Q

What is pharmacokinetics?

A

What the body does with the drug.

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7
Q

What is pharmacodynamics?

A

What the drug does to the body.

Biochemical and physiological effect of the drug on body tissue and microorganisms in/on the body

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8
Q

What is pharmacotherapeutics?

A

The use of drugs and the clinical indications for drugs to prevent and treat diseases.

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9
Q

What is absorption?

A

Movement of a drug from its site of administration into systemic circulation (blood).

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10
Q

What are the factors that affect drug absorption?

A
  • Status of patient’s circulation
  • Co-administration of food or fluids
  • Bioavailability of drug
  • Route of administration
  • Type of membrane transport
  • Acidity of the stomach
  • Status of GI motility
  • Dosage form
  • Concentration of drug
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11
Q

What is distribution?

A

Delivery of drug from the blood to the end target.

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12
Q

Drug moves from blood to ____ ______?

A

End target

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13
Q

What areas of distribution will result in higher concentration of drug?

A

Areas of more RAPID distribution will result in higher concentration of drug.

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14
Q

What are 3 major factors affecting distribution?

A
  • Protein-binding properties
  • Water soluble vs fat soluble
  • Blood-brain barrier
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15
Q

What are the 4 distribution patterns of pharmacokinetics?

A
  • Drug stays within vascular system
  • Drug distributes throughout body water
  • Drug concentrates in specific tissue
  • Drug distributes throughout body and tissue
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16
Q

What are 2 factors that affect drug distribution?

A
  • Rate of distribution

- Extent of distribution

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17
Q

What affects the rate of distribution?

A
  • Membrane permeability

- Blood perfusion

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18
Q

What affects the extent of distribution?

A
  • Lipid Solubility
  • Plasma pH
  • Plasma protein binding
  • Intracellular binding
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19
Q

Protein binding may be reversible or irreversible? (True or False)

A

True

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20
Q

In what 2 forms do drugs exist in plasma?

A
  • Bound

- Unbound (free)

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21
Q

Only the unbound form of a drug has therapeutic action. This is known as ___________?

A

Bioavailability

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22
Q

Only the unbound form of a drug will be metabolized and/or excreted. (True or False)

A

True

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23
Q

What does reversible protein binding maintain for active drugs?

A

State of equilibrium

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24
Q

What are some variables affecting the unbound fraction of drugs

A
  • [ ] of drug given
  • Amount of plasma proteins
  • Quality of plasma proteins
  • Concomitant administration of other protein binding drugs
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25
Q

97% of the anticoagulant Warfarin is protein bound. What percent of Warfarin is biologically active and will be metabolized and/or excreted?

A

3%

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26
Q

What are 4 plasma proteins that drugs bind to?

A
  • Serum albumin (most significant)
  • Lipoprotein
  • Glycoprotein
  • Globulins
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27
Q

Diminished quantity of plasma proteins may lead to excess free (unbound) drug. (True or False)

A

True

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28
Q

When a drug concentration is too high or number of plasma proteins are too low, all binding sites on protein become _____________.

A

Saturated

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29
Q

Excess drug remains unbound (free) and ____________.

A

Biologically active

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30
Q

What are 4 contributing factors to reduced plasma protein?

A
  • Malnutrition
  • Renal disease
  • Liver disease
  • Catabolic state
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31
Q

What is displacement?

A

When one drug pushes another drug off of the binding site on a protein.

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32
Q

Administering two or more protein-binding drugs together can dramatically alter the _____________ effect of one or more drugs.

A

Therapeutic

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33
Q

Majority of drugs are ___________, in turn creating continuous state of equilibrium.

A

Reversible

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34
Q

Acid drugs will generally bind to what kind of protein?

A

Albumin

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35
Q

Basic drugs will generally bind to what kind of proteins?

A

Glycoproteins and globulins

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36
Q

Drug metabolism is also know as ____________?

A

Biotransformation

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37
Q

What 3 things can drug metabolism biologically transform a drug into?

A
  • Inactive metabolite
  • More soluble compound
  • More potent metabolite
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38
Q

What is bioavailability?

A

The fraction of unchanged drug (therapeutically active) that reaches systemic circulation and is available at target site.

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39
Q

What is the main site of drug metabolism?

A

Liver

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40
Q

What does decreased drug metabolism result in?

A
  • Accumulation of drugs

- Prolonged action of the effects of the drugs

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41
Q

What does increased drug metabolism result in?

A

Diminished pharmacologic effects

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42
Q

What factor might affect increase and/or decrease of drug metabolism?

A

Drug/drug interaction

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43
Q

What is the definition of First-Pass Effect?

A

Metabolism of a drug by the liver and its passage from the liver into the circulation.

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44
Q

A specific drug can be given orally and through IV. Which route bypasses the liver and avoids First-Pass effect?

A

IV

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45
Q

What administration routes avoid First-Pass effect?

A
  • Sublingual
  • Buccal
  • Intramusvular
  • Intravenous
  • Subcutaneous
  • Intranasal
  • Inhalation
  • Transdermal
  • Intraosseous
  • Vaginal
46
Q

Which route has a “special situation”?

A

Rectal route

47
Q

Drugs administered to the ________ portion of the rectum are absorbed directly into the ________ _____ _____ and avoid ______ _____ thus avoiding First-Pass effect.

A

Lower; inferior vena cava; portal veins

48
Q

Drugs administered to the ________ portion of the rectum are absorbed rapidly into the ______ ____ and undergo a higher degree of First-Pass Metabolism.

A

Upper; Portal veins

49
Q

Drugs given via oral route may be ___________ ___________ before reaching the systemic circulation. (High first-pass effect)

A

Extensively metabolized

50
Q

Extensive (increased) drug metabolism results in a diminished bioactive drug effect. (True or False)

A

True

51
Q

Decreased drug metabolism results in what 2 things?

A
  • Accumulation of drugs

- Prolonged action of the effects of the drug (potentially toxic)

52
Q

What is the definition of excretion?

A

Elimination of drugs from the body

53
Q

what is the main organ involved in excreting drugs?

A

The kidneys

54
Q

What is another way drugs are excreted?

A

Breast milk

55
Q

Increased metabolism = ___________ bioactive effect

A

Decreased

56
Q

Decreased metabolism = ___________ concentration of drug; Which in turn will __________ bioactive effect.

A

Increased; Increase

57
Q

Majority of drugs excreted through _________ system.

A

Renal

58
Q

What is the main factor affecting renal drug clearance?

A

Adequacy of renal function

59
Q

What are 2 major conditions that impair kidney (renal) function?

A
  • Hypertension

- Diabetes

60
Q

How can renal function be tested prior to prescribing drugs?

A

Serum creatinine OR urine creatinine clearance

61
Q

What is creatinine clearance?

A

Volume of serum or plasma that is cleared of creatinine in one minute via urinary excretion.

62
Q

What is the formula used to calculate creatinine clearance?

A

(140-age in yrs) (weight in kg) / (72 x serum creatinine in mg/dL)

Multiply weight by 0.85 for women

63
Q

What are the normal creatinine levels for men and women?

A

Men: 91 - 137 ml/min

Women: 88 - 128 ml/min

64
Q

What is the definition of half-life?

A

The time it takes for 1/2 of the original amount of the drug to be removed from the body.

65
Q

Half-life is a measure of the rate of _____ _________ from the body.

A

Drug elimination

66
Q

Half-life is significant when considering what 3 factors?

A
  • Steady state of drug
  • Toxicity of drug
  • Sub-therapeutic drug levels
67
Q

What is mechanism of action (MOA)?

A

The ways by which drugs produce therapeutic effects

68
Q

What is the definition of onset?

A

Time needed for the drug to elicit a therapeutic response

69
Q

What is the definition of peak?

A

Time needed for a drug to reach its maximum therapeutic response.

70
Q

What is the definition of duration?

A

Length of time that a drug concentration is sufficient to elicit a therapeutic response.

71
Q

what are the 6 types of therapy and what do they mean?

A
  • Acute therapy: right now or very serious
  • Maintenance therapy: ongoing
  • Supplemental therapy: addition to
  • Palliative therapy: controlling symptoms
  • Supportive therapy: psychotherapy
  • Prophylactic therapy: preventive
72
Q

What is the significance of drug treatment?

A

The more the patient knows and understands about how to take the medication and why it is prescribed… The greater the chances that the drug treatment will be successful.

73
Q

What are the 3 main factors of drug monitoring?

A
  • Evaluating the effectiveness of drug therapy
  • Observing for any adverse drug effects
  • Making adjustments as needed
74
Q

What are the 6 considerations in drug monitoring?

A
  • Therapeutic index
  • Drug concentration
  • Patient’s condition**
  • Tolerance and dependence
  • Interactions
  • Side effects/adverse drug effects
75
Q

What is therapeutic index?

A

The ratio between a drug’s therapeutic benefits and its toxic effects.

76
Q

What is the definition of tolerance?

A

A decreasing response to repetitive drug doses.

77
Q

What is the definition of dependence?

A

A physiologic or psychological need for a drug.

78
Q

_______ _____ ______ are human medication errors that result in patient harm. All are ___________.

A

Adverse drug events; Preventable

79
Q

________ _____ _______ are any unexpected drug reaction that is NOT desired that occurs with normal therapeutic dose. These are ____ __________.

A

Adverse drug reactions; Not preventable

80
Q

What are the 4 adverse drug reactions?

A
  • Idiosyncratic (unusual)
  • Hypersensitivity
  • Drug/drug interactions
  • Drug/food interactions
81
Q

What are some drug/drug interactions to consider?

A
  • Other prescribed drugs
  • OTC medications
  • Herbal therapies
82
Q

What are the 4 different ways drug interactions can effect the body?

A
  • Additive effect: Possibly toxic
  • Synergistic effect: Drugs that work well together
  • Antagonistic effect: Drugs negate each other
  • Incompatibility effect: One drug might alter the effect of another drug
83
Q

What is the definition of side effects?

A

Expected well-known reactions that result in little or no change in patient management.

84
Q

what is the definition of iatrogenic responses?

A

Unintentional adverse effects that are treatment induced.

85
Q

What are some other drug-related unwanted effects?

A
  • Teratogenic: Effect baby during pregnancy
  • Mutagenic: Can alter DNA
  • Carcinogenic: Can cause cancer
86
Q

How are drug forms classified?

A

By physical state (liquid, solid) and chemical composition.

87
Q

What influences rate of dissolution and absorption?

A

Drug form

88
Q

Why are some tablets enteric-coated?

A

To protect the gastric mucosa.

89
Q

How do buffered tablets prevent stomach irritation?

A

By combining drug with a buffering agent that decreases acidity of drug.

90
Q

Buffered and/or enteric-coated tablets can be crushed and/or dissolved. (True or False)

A

FALSE: Buffered and enteric-coated tablets should NEVER be crushed or dissolved.

91
Q

What type of tablet can be cut in half?

A

Only scored tablets

92
Q

_________________ capsules dissolve at a predetermined rate over longer period of time.

A

Sustained-release (SR)

93
Q

What are suspensions?

A

Insoluble drug contained in a liquid.

94
Q

What is needle length/gauge based on for parenteral medications?

A

Based on drug characteristics and individual factors

95
Q

What is syringe size/length based on for parenteral medications?

A

Type and amount of medication.

96
Q

What are specialty syringe units (Epi-pen, Novo-pen) designed for?

A

Quick and easy administration of drug in emergency and/or self-injection.

97
Q

What are the 3 major categories of drug routes?

A
  • Enteral: Drug absorbed into systemic circulation through alimentary canal (mouth to anus)
  • Parenteral: Needle and/or catheter required for administration
  • Topical: Drug applied to skin or mucosa or inhaled
98
Q

What are the 6 types of enteral routes?

A
  • Oral: swallowing
  • Sublingual: under tongue
  • Buccal: between tongue and cheek
  • Via nasogastric tube
  • Via gastrostomy feeding tube
  • Rectal: inserted into rectum
99
Q

What is an advantage or sublingual and buccal?

A

Rapid absorption –> fast onset

100
Q

What is an example of oral administration?

A

Cost lower compared to other parental routes.

101
Q

What are some disadvantages to oral route?

A
  • Subject to first-pass effect
  • Effect too slow for emergencies
  • Can’t use in unconscious patients
102
Q

What are some advantages of the rectal route?

A
  • Patients with nausea/vomiting
  • Patients who are unconscious
  • Infants/young children who can’t swallow pills
103
Q

No single method of drug administration is ideal for all drus in all circumstances. (True or Flase)

A

True

104
Q

What are the 7 parenteral routes?

A
  • Intravenous ** fastest delivery to blood stream
  • Intramuscular
  • Subcutaneous
  • Intradermal
  • Intrathecal
  • Intraarticular
  • Intraosseous
105
Q

What are some advantages to Intravenous (IV) route?

A
  • Avoids first-pass (100% bioavailability)
  • Rapid onset
  • Precise and accurate dosing
  • Can give large quantities of meds
  • No pain of repeated injections
106
Q

What are some risks with IV route?

A
  • Infection
  • Fluid overload
  • Electrolyte imbalance
  • Phlebitis (irritaion/inflammation without infection)
  • Extravasation (accidental infusion of IV meds/fluids into surrounding tissue instead of vein)
  • Embolus (Air, blood, or catheter)
107
Q

What are some advantages to Intramuscular (IM) route?

A
  • Avoids first-pass
  • Avoids GI side effects
  • May be appropriate for non-compliant patients
  • Can inject fairly large amount of meds (in larger muscles)
108
Q

What are the 5 IM injection sites?

A
  • Deltoid
  • Dorsogluteal (Gluteus Medius)
  • Ventrogluteal (Gluteus Medius)
  • Rectus femoris
  • Vastus lateralis
109
Q

What IM administration site should you avoid in infants?

A

Gluteals… Because the muscle is not well-developed until they have been walking for one full year.

110
Q

What IM administration site is best for infants and young children?

A

Vastus Lateralis… Because it is well-developed and there are no large blood vessels or nerves.

111
Q

What are some advantages to subcutaneous (SubQ) route?

A
  • Site easily accessed
  • Can be self-administered
  • Wide selection of sites
  • Relatively convenient and portable
  • Emergency administration of epinephrine anywhere
112
Q

What is an advantage to Intradermal route?

A

Provides a wide field for allergy testing

113
Q

What are the 6 ares of topical routes?

A
  • Skin
  • Eyes
  • Ears
  • Nose
  • Lungs (inhaled)
  • Vagina

Pharmacology (6 decks)

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