Pharmacy Flashcards
What are prescription drugs?
- Require to be written by an ACREDITED PRESCRIBER PROVIDER
- Legal document that contains info required to dispense
- CHCS, hand written scripts only, NO FAX’d prescriptions
** What is the DOD form to prescribe meds? **
DD 1289
- Used for all controlled drugs, unless directed by CO or Higher Authority
What is the POLY-prescription form?
NAVMED 6710/6
** What are all of the ways providers can submit prescriptions? **
CHCS
DD 1289
NAVMED 6710/6
** What information must be written in ink, indelible pencil, or typewritten on prescriptions? **
- Pt’s full name
- Date script was written
- Patient’s DOB
- Full drug name, form of drug, dosage size/strength in METRIC, quantity dispensed, and written generically
- Directions for PT
- Legible signature of provider
- refill authorization
How can IDC’s give meds without the DD 1289/NAVMED6710/6?
Proper SOAP Note documentation including drug administered
What are the General Principles of Pharm?
(1) The factors that affect the actions of drugs.
(2) Factors that affect drug reactions.
(3) Various types of drug interactions.
(4) Factors influencing drug response interactions.
What is Pharmacokinetic?
- Activities of drugs after it enters the body
- study of drug absorption, distribution, metabolism, and excretion
- fundamental concept: drug clearance, elimination of drugs from the body
What are the different types of drug absorption in the body?
- Active Absorption
- Passive Absorption
- Pinocytosis
- Bioavailability
What is active absorption?
Carrier Molecule such as a protein or enzyme activity moves the drug across the membrane
What is passive absorption?
Diffuse across membrane from area of higher concentration to area of lower concentration
- Water Soluble Drugs
What is Pinocytosis?
- Cells engulf the drug particle across cell membrane
- Pacman
What are the factors that alter BIOAVAILABILITY?
- drug form (tabletm capsule, sustained release, liquid, trans-dermal, patch, inhalation, etc.)
- route
- changes in liver metabolism caused by dysfunction
- GI Mucosa and motility
- food and drugs
- solubility: I.E. fat soluble are absorbed faster than water soluble
** What is bioavailability? **
- subcategory of absorption
- percentage of drug dose that reaches systemic circulation
- oral meds are only usable when metabolized/absorbed by liver
- Oral meds have 20-40% bioavailability
- IV meds have 100% bioavailability
How does distribution of drugs in the body work?
Movement of a drug throughout the body typically by proteins known as ALBUMIN
Where does metabolism of drugs happen?
Liver kidneys lungs plasma intestinal mucosa
WHat is excretion?
Elimination of drugs from the body
- kidneys excrete inactive compounds through urine
What is half-life?
- Time required for the body to eliminate 50% of the drug
- organ disfunction/ age, disease can increase risks of toxicity
WHat is Pharmacodynamics?
Drugs actions and effects within the body
- primary = desired effect
- secondary (side effects) = desired/undesired
Psychological dependence?
Compulsion to use substance to obtain a pleasurable experience
Pharmacogenetic disorder?
genetically determined abnormal response to normal dose of a drug
receptor?
specialized macromolecule that binds to the drug molecule, altering function of the cell and producing the therapeutic response
What are the alterations in Cellular Environment?
A drug that alters cellylar function can INCREASE OR DECREASE the PSYCHOLOGIC Functions of the cell
- Example: Increased HR - Decreased BP
Therapeutic Response - Alteration of cell to achieve desires response
Agonist: Drug that binds with receptor to produce therapeutic response
** What is an Antagonist? **
Drug binds to receptor stronger than agonist thus producing pharmacologic effect
- Narcan is antagonist to morphine
What is an adverse reaction?
Undesirable drug effects
What is allergic reaction?
- drug reaction when individuals immune system views drug as foreign substance
Drug idiosyncrasy?
AN unusual/abnormal reaction to a drug that a patient can have
- do not occur in the vast majority of patients taking the same drug
Drug Tolerance?
- Decreased response to a drug
- requires increase in dosage to achieve desires effect
Cumulative Drug Effect?
drug effect that occurs when the body has not fully metabolized a dose of a drug before the next dose is given
** Toxic? **
Harmful drug effect if it is delivered in high dose or when blood concentration levels exceed therapeutic level
- may be reversible
- you have to know signs and symptoms of toxicity for drugs you are giving
Pharmacogenetics Reactions?
inherited traits that cause abnormal metabolism of the drug
- G6PD patient taking aspirin or sulfonamides will have hemolysis of their RBC’s
Pharmaceutic phase?
dissolution of a drug
- applied to breakdown of tablets
Drug Interactions ?
When one drug interacts with/interferes with action of another drug
- antacid with oral tetracycline decrease effectiveness of tetracycline
** Additive drug reaction? **
A reaction that occurs when the combined effect of two drugs is equal to the sum of each drug given alone
** Synergism? **
A drug interaction that occurs when drugs produce an effect that is greater than the sum of their separate actions
Antagonist drug reaction:
WHen one drug interferes with action of another, causing neutralization or a decrease in the effect of one drug
- Protamine sulfate completely neutralizes the effects of heparin
Drug-Food Interactions?
Drug given orally, food may impair or enhance its absorption
- Proton pump inhibitor should be taken 1 hour before meals
** What are the factors influencing drug response? **
- Age
- Weight
- Gender
- Disease
- Route of Administration
- Drug Use and Pregnancy
What are the basic Units for Dosage calculations?
- Weight = micrograms (mcg), Milligrams (mg), Grams (g), Kilograms (kg)
- Volume = Milliliter (mL), Liter (L), 1 mL = 1 cubic cm
Length = Meter (m)
Frequency used unit conversion for dosage?
- 1 kg = 1000 grams
- 1 g = 1000 mg
- 1 mg = 1000mcg
What is the most frequent route of drug administration that rarely causes physical discomfort when taken properly?
oral
*** What are the methods of oral medication administration?
- NG tube
- Buccal route: between cheek allowed to dissolve
- sublingual: Drug is placed or sprayed under the tongue
*** What are the methods of parenteral drug admin?
- Subcutaneous - SC, in between the tissue and muscle
- Intramuscular - IM, direct into the muscle
- Intravenous - IV, direct to blood via needle/catheter inserted into vein, action occurs immediately
- Intradermal - ID, sensitivity tests i.e TB
*** What are the applications of drugs through skin/mucus membranes?
- Topical
- Transdermal = small patch, Nicorette
- Inhalation = Albuterol
Pharmacological profile of Psychotherapeutics?
- Class: Sedatives and Hypnotics
- Sedative hypnotics = class that cause dose-dependent depression of CNS function: sedation, sleep, unconsciousness
- barbiturates, benzodiazepine, melatonin agonists
Barbiturates ACTION?
Action:
(a) Long-acting barbiturates sedative, and hypnotic, have anticonvulsant properties.
Barbiturates depress the sensory cortex, decrease motor activity, alter cerebellar
function, and produce drowsiness, sedation, and hypnosis. In high doses,
barbiturates exhibit anticonvulsant activity; barbiturates produce dose-dependent
respiratory depression.
Use:
(a) Sedation: Used as a sedative
(b) Seizures: Management of generalized tonic-clonic, status epilepticus and partial
Seizures.
Barbiturates ADVERSE EFFECTS?
Adverse Effects: (a) CNS: Somnolence (b) Respiratory: Hypoventilation (c) GI: Nausea (d) CV: Bradycardia (e) Other: Agitation, confusion, nightmares, lethargy, vomiting, diarrhea, and hypotension
Barbiturates CONTRAINDICATION/WARNING/CAUTION?
Contraindication/Warning/Caution: - Hypersensitivity to phenobarbital - barbiturates or any component of the formulation; marked hepatic impairment - dyspnea or airway obstruction; porphyria (manifest and latent) - intra-arterial administration - subcutaneous administration (not recommended) - use in patients with a history of sedative/hypnotic addiction; nephritic patients (large doses).
Barbiturates USES?
Use:
(a) Sedation: Used as a sedative
(b) Seizures: Management of generalized tonic-clonic, status epilepticus and partial
Seizures.
Example:
(a) Phenobarbital
(b) Thiopental (no longer manufactured in the United States or Canada).
Barbiturates CLASS?
SEDATIVES AND HYPNOTICS
`What are the PSYCHOTHERAPUTIC DRUGS?
- Barbiturates
- Anti-Anxiety
- Anti-depressants
- Anti-psychotic
- CNS-stimulants
WHat are the antiemetic drugs?
- Antiemetic
- Anti-nausea
What are the Anesthetic drugs?
- Local
- Induction
What are the Non-Narcotic Analgesics/Anti-inflammatory/Antipyretics?
- Salicylates
- Non-salicylates
- NSAIDS
- Urinary Anesthetic Analgesics
What are the bronchodilator drugs?
- Beta-2 agonist
- Muscarinic Antagonist
- Leukotriene Antagonist and Mast Cell Stabilizer
- Inhaled Corticosteroids
What are the Antihypertensive drugs?
- Ace inhibitors
- beta blockers
- calcium channel blocker
What are the Antihyperlipidemic drugs?
- Carbonic Anhydrase inhibitor
- loop diuretics
- osmotic Diuretics
- Potassium sparing diuretics
- Thiazide
- Hyperlipidemia
What are the Gastrointestinal System drugs?
- Antacids
- Histamine H-2 antagonist
- protein pump inhibitor
- Anti-diarrheal
- anti-flatulence
- hemorrhoid agents
- laxatives
WHat are the Anti-diabetic Drugs?
- Insulin
- Oral Antidiabetics
What are the Profile of Hormone drugs?
- Thyroid
- Male Hormones (testosterone)
- Contraceptives
What are the Antibacterial Drugs?
- Sulfonamides
- Penicillin
- Cephalosporines
- Tetracyclines
- Macrolides
- Fluoroquinolones
- Aminoglycosides
- Carbapenem
- Amebicide/antiprotozoal/nitroimidazole
What are the Skin Disorder Drugs?
- Scabicide
- Topical anti-infective
- antiseptic and germicide
- topical corticosteroid
- keratolytic
- local anesthetic