๐- Pharmacology Terminology Test Flashcards
Misfeasance
Negligence
Wrong drug/wrong dose
Pharmacology
The study of medicine (drugs)
Nonfeasance
Omission
Omitting a drug dose
Malfeasance
Giving the correct drug via the wrong route
U.S pharmacopoeia
Established in 1820
Set of drug standards used in the United States
4 stages of drug approval
- Preclinical investigation
- Clinical investigation
- Review of NDA (new drug application)
- Postmarketing studies
Phase 1 of clinical investigation
To determine human dosage range based on healthy subjects and identify pharmacokinetics
(Safe dose to give to people)
Phase 2 of clinical investigation
To demonstrate safety and efficacy of drug in subjects with disease to be treated
(Does it work)
Phase 3 and 4 of clinical investigation
To demonstrate safety and efficacy of drug for well client population; to include long term data if a chronic regimen
(Gather info; side effects)
Is the preclinical investigation performed on humans or animals
Animals
What does IRB stand for and what do they do
Institutional review board ; to test drugs on humans
List 5 advantages of prescription drugs
- proper drug ordered
- amount and frequency controlled
- instructions on use and side effects
- can be monitored
- patient education
Disadvantages of prescription drugs
- maybe more expensive if you donโt have insurance
- people may not seek medical help due to cost or inconvenience
Over the counter drugs
Donโt require a physicians order and have a greater margin of safety
Advantages of OTC drugs
- easily obtained
- may be less expensive
Disadvantages of OTC drugs
- delay in professional diagnosis and treatment
- no monitoring of underlying condition
- symptoms maybe masked
- potential for overdose
- drug interactions
- polypharmacy
Therapeutic drug classification
Usefulness
Pharmacological drug classification
Mechanism of action
Prototype drug classification
An original; well understood drug by which others in its class are compared
Chemical name
Describes the drugs chemical structure
What the drug is made of
Generic name
Is the official nonproprietary name for the drug
Nonproprietary
Means the name is not owned by any drug company and is universally accepted
Brand (trade) name
Aka proprietary name
Is chosen by the drug company and is usually a registered trademark owned by that specific company
Schedule I drugs
Limited or no therapeutic use
Example: heroin, lsd, marijuana
Schedule II drugs
Used therapeutically with prescription, some are no longer used therapeutically
Example: Demerol, morphine, PCP, cocaine, hydrocodone, dilaudid (hydromorphone), oxycodone, etc
Schedule III drugs
Used therapeutically with prescription
Ex: anabolic steroids, codeine and hydrocodone with aspirin or Tylenol
Schedule IV drugs
Used therapeutically with prescription
Ex: darvon, talwin, Valium and Xanax
Schedule V drugs
Used therapeutically without prescription
Ex; OtC cough medicines with codeine
Pharmaceutics phase
The drug becomes a solution so that it can cross the biologic membrane
On the drug schedule scale the lower the number suggests what ?
The higher the risk of dependency
When drugs are administered parenterally by subQ IM or IV routes which phase in how drugs work is skipped
Pharmaceutic phase
Disintegration of the pharmaceutic phase
Drugs in solid form (tablet or capsule) must disintegrate into particles to dissolve
Dissolution of pharmaceutic phase
Small particles dissolve in the GI fluid before absorption
Rate limiting
Is the time it takes the drug to disintegrate and dissolve to become available for the body to absorb it
Pharmacokinetics
The process of drug movement to achieve drug action
What are the 4 parts of pharmacokinetics
Absorption
Distribution
Metabolism
Excretion
Absorption
Movement of drug from site of administration to the target cells
Passive absorption
- mostly by diffusion
- drug does not require energy to move across the membrane
Active absorption
- requires a carrier such as an enzyme or protein
- moves drug against a concentration gradient
- energy is required
Pinocytosis
Type of absorption
Process by which cells carry a drug across their membrane by engulfing the drug particles
Distribution
How drugs are transported throughout the body/the process by which the drug becomes available to body fluids and body tissues
What 3 things influence drug distribution
Blood flow
Affinity to the tissue
Protein-binding effect
Metabolism
Process whereby drugs are made less or more active/process by which the body inactivates or biotransforms drugs
Excretion
The process by which drugs are removed from the body
Bioavailability
Is a subcategory of absorption
The percentage of the administered drug dose that reaches the systemic circulation
When does bioavailability occur in the oral route of drug administration
After absorption and first-pass metabolism
What is the percentage of bioavailability for the oral route
Always less than 100%
What is the percentage of bioavailability for the IV route
100%
What is the percentage of bioavailability for an oral drug that has a high first-pass hepatic metabolism
20% to 40%
To obtain the desired drug effect is it safe or unsafe to give an oral dose higher than drug dose for IV
Safe
What are the 5 factors that alter bioavailability
1 drug form
2 route of administration
3 GI mucosa and motility
4 food and other drugs
5 changes in liver metabolism caused by hepatic dysfunction or inadequate hepatic blood flow
First-pass effect
The process in which the drug passes to the liver first then to systemic circulation
How are drugs absorbed during first-pass effect
Absorbed in the intestinal lumen and then go to the liver via the portal vein
What are the 3 things that can happen to a drug while in the liver during the first-pass effect
- Some drugs are metabolized to an inactive form that is then excreted , reducing the amount of active drug
- Some drugs are metabolized to drug metabolite , which maybe equally or more active than the original drug
- Some donโt undergo metabolism at all
Drugs with a larger volume of drug distribution have a longer or shorter half-life ?
Have a longer half-life and stay in the body longer
Name 2 drugs that shouldnโt be given via mouth because of a high first-pass effect
Nitro and lidocaine
Protein binding effect
Drugs that need a protein receptor to get to target cells
Is the portion of the drug that is bound to protein active or inactive
Inactive ; because it is not available to receptors
Free drugs
(Drugs not bound to protein)
Are active and can cause a pharmacologic response
What can occur when 2 highly protein-bound drugs are given concurrently
They compete for protein binding sites, causing more free drug to be released into circulation
Leading to drug accumulation and possible toxicity
Prodrugs
Aka metabolites
Are drugs that break down into equal or more active substances
Where do prodrugs become active
In the liver
Half-life
Is the time it takes for one half of the drug concentration to be eliminated
What are 2 things that affect the half-life of a drug
Metabolism and elimination
How does liver or kidney disease affect the half-life of a drug
The half-life is prolonged and less drug is metabolized and eliminated
A drug has to go through several half-lifeโs before more than what percentage of the drug is eliminated
90%
Microsomial enzyme system
Drugs are broken down by the liver enzymes which are usually inactive forms of the drugs which are more easily excreted
Excretion
Is the process by which drugs are excreted from the body
Name 6 ways (other than the kidneys) that drugs are excreted from the body
Bile Feces Lungs Saliva Sweat Breast milk
Acidity of urine in excretion
Acidic urine promotes elimination of weak base drugs
Alkalinity of urine in excretion
Alkaline urine promotes elimination of weak acid drugs
How does kidney disease affect excretion
Drug excretion is slowed or impaired leading to drug accumulation and possible toxicity
Pharmacodynamics
Is the study of the way drugs affect the body / the process by which drugs Influence cell physiology
Dose response
The relationship between the minimal versus the maximal amount of drug dose needed to produce the maximal drug response
Maximum drug effect
All drugs have a maximal efficacy
Ex: no matter how much tramadol you give the pain relief provided by morphine is greater
Desired effects
The expected therapeutic response to a drug
Onset of action
The time it takes to reach the minimum effective concentration (MEC) after a drug is administered
When it reaches a therapeutic level
Peak action
Occurs when the drug reaches its highest blood or plasma concentration
Maximum effectiveness
Duration of action
The length of time the drug has a pharmacologic effect
How long the therapeutic effect lasts
Receptor theory
Drugs act through receptors by binding to the receptor to produce (initiate) a response or to block (prevent) a response
Drug-binding sites are primarily located where
On proteins
The better the drug drug fits at the receptor site , means what ?
The more biologically active the drug is
Nonspecific drug effect
Drugs that affect various cholinergic receptor SITES and have properties of nonspecificity
Name the 6 cholinergic receptor sites
Bladder โค๏ธ Blood vessels Stomach Bronchi Eyes
Nonselective drug effect
Drugs that affect various RECEPTORS and have properties of nonselectivity
Epinephrine acts on which 3 receptors
Alpha1
Beta1
Beta2
What are the 4 categories of drug action
- Stimulation or depression
- Replacement
- Inhibition or killing of organisms
- Irritation
Stimulation or depression related to drug action
Cell activity or function is increased or decreased
Replacement related to drug action
Replace essential body compounds
Ex: insulin
Inhibition or killing of organisms related to drug action
Interfere with bacterial cell growth
Irritation related to drug action
Laxatives irritate the inner wall of the colon, thus increasing peristalsis and defecation
The length of action of a drug depends on what
The half-life of that drug
Half-life is used to determine what
The dosing schedule
Drugs with a long half are usually given how many times a day
Once
Drugs with a short half-life are usually given how many times a day
Several
Potency
Aka strength
The amount of drug required to produce a given percentage of its maximal effect / amount of drug needed to elicit effect
Efficacy
The ability of the drug to produce a more intense response as its concentration is increased
Therapeutic index
Estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose ED in 50% of people and the lethal dose LD in 50% of people
Therapeutic index
Estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose ED in 50% of people and the lethal dose LD in 50% of people
In the therapeutic index , the closer the ratio is to 1 the greater the what ?
Danger of toxicity
In the therapeutic index , the closer the ratio is to 1 the greater the what ?
Danger of toxicity
Drugs with a low therapeutic index have a narrow or wide margin of safety ?
Narrow
Drugs with a low therapeutic index have a narrow or wide margin of safety ?
Narrow
Drugs with a high therapeutic index have a narrow or wide margin of safety
Wide and less danger of producing toxic effects
Drugs with a high therapeutic index have a narrow or wide margin of safety
Wide and less danger of producing toxic effects
If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often
More often
If the therapeutic index is narrow does the plasma drug level need to be monitored more often or less often
More often
Therapeutic range (window)
Concentration of a drug between the minimum effective concentration and the minimum toxic concentration
Therapeutic range (window)
Concentration of a drug between the minimum effective concentration and the minimum toxic concentration
Loading dose
- given when immediate drug response is needed to achieve a rapid response
- after a large initial dose, a prescribed dose per day is ordered
Loading dose
- given when immediate drug response is needed to achieve a rapid response
- after a large initial dose, a prescribed dose per day is ordered
Digitalization as associated with loading dose
Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time
Digitalization as associated with loading dose
Is the process by which the minimum effective concentration level for digoxin is achieved in the plasma in a short time
Peak drug levels
Highest plasma concentration at a specific time
Indicates the rate of absorption
Peak drug levels
Highest plasma concentration at a specific time
Indicates the rate of absorption
Trough drug level
Is the lowest plasma concentration of a drug
Indicates the rate of elimination