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Nurs Yr 1 Winter > Quiz 1 > Flashcards

Quiz 1 Flashcards

1
Q

what is pharamacology?

A

the study of medicines

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2
Q

what is pharmacon?

A

medicine/drugs

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3
Q

what is the purpose of pharmacone?

A

cure/relieve symptoms

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4
Q

what is pharmacotherapeutics?

A

utilization of medicine to heal or manage pain

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5
Q

what are the 3 types of pharmacotherapeutics?

A
  1. drugs, 2. biologic, 3. Natural health product
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6
Q

what is included under drugs?

A

chemical agents

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7
Q

what’s included under biologic?

A

naturally produced in animal cells - hormones/antibodies

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8
Q

what’s included in natural health product?

A

naturally occuring - minerals, vitamins

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9
Q

what organization monitors/evaluates drugs in canada?

A

Health canda in collaboration with canadian pharmaceutical assocaition

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10
Q

what is the process of approving new pharmacotherapeutic drugs?

A
  1. pricinical
  2. clinical trial - 3 phases
  3. new drug submission to health canada
  4. review & approval
  5. NOC & DIN issued
  6. Health canada continues monitoring
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11
Q

how can bias be eliminated in research?

A

by conducting 2 blinded search where the groups don’t know whether the treatment the patient is receiving the drug or placebo

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12
Q

what are the categories of pharmacotherapeutics drug classes?

A
  1. therapeutic
  2. pharmacological
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13
Q

what do therapeutic names specify?

A

name specifies treatment/therapy

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14
Q

What does pharmacological do?

A

based on the mechanism of action of drug

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15
Q

give examples of therapeutic drugs & their uses

A
  1. anti-coagulant = inhibits clotting
  2. anti-hypersensitive = lowers blood pressure
  3. anti-inflammatory = decreases inflammation
  4. anti-emetic = decreases vomiting
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16
Q

give examples of pharmocological drugs & their uses

A
  1. beta blockers = blocks beta receptors
  2. calcium channel blockers = blocks calcium channels
  3. Inhibits seratonin’s re-absorbtion at the synapse
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17
Q

what are the 3 types of pharmacotherpeutics drugs names?

A
  1. chemical
  2. generic
  3. brand/trade
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18
Q

what does chemical drug name ential?

A

the chemical composition of the drug

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19
Q

what does generic chemical drug name entail?

A

drug without a proprietery affiliation

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20
Q

what does brand/trade ential?

A

named by the manufacturing company

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21
Q

what’s the main differences between a brand name & generic name?

A
  1. cost is the main difference - generic is cheaper, brand is more expensive
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22
Q

what is prototype drug?

A

selection of a single drug form from a drug class to serve as a reference, usually the original drug of that kind

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23
Q

what are drug schedules?

A

these are classifications on where patients can access drugs, and who has the ability to dispense them

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24
Q

what is drug schedule 1 & what is included in this category?

A

available only via prescription
includes controlled drugs, narcotic drugs

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25
Q

what is drug schedule 2 & what is included in this category?

A

available only from a pharmacist, must be obtained in an area with no public access

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26
Q

what is schedule 3?

A

available via open access in a pharmacy

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27
Q

what is unscheduled drugs?

A

can be sold in any store without professional supervision

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28
Q

what category under nursing plan does pharmacotherapeuitcs fall under?

A

falls under intervention

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29
Q

what does the assessment process in nursing process include?

A
  1. subjective/objective data
  2. chief concern
  3. personal/social history
  4. review of systems in health history
  5. physical exam
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30
Q

what does the diagnosis process in nursing plan include?

A

synthesis of data - history & physical exam - lab & imaging results

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31
Q

what does the planning process in nursing plan include?

A

respond to the diagnosis - using interventions like pharmacotherapeutics, other therapeutics, surgery

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32
Q

what does implementing process in nursing plan include?

A

activating the plan & monitoring

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33
Q

what does evaluation process in nursing plan include?

A

review of diagnosis - reases

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34
Q

what factors affect choice of drug administration routes?

A
  1. drug to target tissues
  2. clinical setting
  3. medical situation
  4. drug dynamics
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35
Q

what is the characteristics of administering drugs via oral?

A
  1. it can be liquid, tablet, powder
  2. called enteral (passes through the gi tract)
  3. systemic effect
  4. challenge - acidic environmnet & undergoes 1st pass metabolism
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36
Q

what is the characterisitics of administering drugs via sublingual?

A
  • under tongue
  • capillary absorption into blood stream
  • systemic effect
  • bypasses 1st pass metabolism
  • faster than PO
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37
Q

what are the characteristics of administering drugs via intranasal?

A
  • into the nasal cavity
  • capillary absorption
  • localized or systemic effect
  • difussion across mucosa & distribution along CNS nerve network
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38
Q

what are the characteristics of administering drugs via inhalation?

A
  • breathed into lungs
  • pulmonary capillary network = rapid effects
  • localized or systemic (anesthesia drugs)
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39
Q

what does endotracheal administration entail?

A
  • uses tube in ER/ICU
  • use of epinephrine
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40
Q

what are the characteristics of administering drugs via topical route?

A
  • applied directly to skin
  • local effect
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41
Q

what are the characteristics of administering drugs via transdermal route?

A
  • use of patch
  • dermal capillary absorption
  • sytemic effect
  • long acting - slow & steady release absorption
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42
Q

what are example of transdermal patches?

A
  • nitroglycerine patch
  • nicotine patch
  • morphine patch
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43
Q

what are the characteristics of administering drugs via rectal route?

A
  • inserted into the lower GI, rectum
  • local & systemic effect
  • low 1st pass metabolism
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44
Q

what are the characteristics of administering drugs via intravenous route?

A
  • requires needle-catheter into a vein
  • immediate absorption = fast on-set of action
  • dose given = dose reaching the tissue
  • systemic effect
45
Q

what are the characteristics of administering drugs via intramascular route?

A
  • needle injection into muscle tissue
  • cappilary bed absorption into bloodstream
  • systemic effect
  • painful
46
Q

what are the sites of injection for intramascular route & where they are located?

A
  1. deltoid - on top of scapula
  2. vastus lateralis and rectus femoris - on top of thigh
  3. ventrogluteal (just below illiac crest)
47
Q

what are the characteristics of administering drugs via subcutaneous route?

A
  • injection into adipose tissue of hypodermis
  • absorption via capillary bed
  • systemic effect
48
Q

what is pharmacokinetics?

A

kinetics = movement
pharma = medicine
- movement across cell membranes via lipid bilayer

49
Q

what are the 4 phases of of pharmacokinetics?

A

A = absorption
D = distribution
M = metabolism
E = excretion

50
Q

what are factors affecting pharmacokinetics?

A
  1. molecular characteristics
  2. membrane transport
51
Q

explain how molecular characteristics affect kinetics?

A
  1. neutral atoms get converted to ionized
  2. base-to-base , acid-to-acid
  3. lipophilicity affects it = likes lipid
  4. hydrophillicity affects it = likes water
  5. size = smaller ones are easier to go across membranes
52
Q

what are the 2 movement used in molecular transport?

A
  1. passive transport
  2. active transport
53
Q

what is included in passive transport?

A
  • passive transport -
  • osmosis -
  • facilitated diffusion
54
Q

what is active transport?

A

movement of a

55
Q

what is the barrier with lipid layer of plasma membrane?

A

it is lipophilic membrane which is impermeable to large molecules, ions, polar molecules

56
Q

what are the 2 general ADME rules?

A
  • for easy absorbtion = it has to be lipophilic, non-ionized, small
  • for easy excretion = it has to be hydrophilic, ionized
57
Q

What is the absorption process of pharmacokinetics?

A

time for drug to reach systemic circulation

58
Q

what factors affect absorption?

A
  1. administration route
  2. molecular characteristics
59
Q

what is the term used for systemic circulation?

A

bioavailability - systemic circulation (plasma) drug concentration

60
Q

how is bioavailability measured?

A

via blood plasma

61
Q

what does titrating to effect mean?

A

adjusting the dose level to achieve desired patient effect

62
Q

what is 1st pass metabolism?

A

drugs absorbed from the stomach & small intestine first travel to the liver, where they may be inactivated before they ever reach their target organs

63
Q

what is the comprehensive flow of first pass metabolism?

A
  1. oral drug administration
  2. drug absorbed across the intestinal mucosa stomach
  3. drug enters hepatic portal vein circulation
  4. travels to the liver (bio-transformed)
  5. on the first pass through the liver. drug is metabolized to less active forms.
64
Q

what are the some drugs with extensive first pass metabolism?

A
  1. morphine
  2. meperidine
  3. diazepam
  4. midazolam
  5. lidocaine
  6. propranolol
  7. ETOH
65
Q

what is therapeutic range?

A

the plasma drug concentration between minimum effective concentration and toxic concentration

66
Q

what is minimum effective concentration?

A

the amount of drug required to produce a therapeutic effect

67
Q

what is toxic concentration?

A

the level of drug that will result in serious adverse effects

68
Q

what does a steady state level on the graph mean?

A

amount of drug administered has reached equilibrium with the amount of drug being eliminated

69
Q

what is the loading dose?

A

give one dose after other without reaching toxic range to reach the therapeutic range rapidly

70
Q

what is maintenance dose?

A

it is the amount given after loading dose to keep the plasma drug concentration in the therapeutic range
- usually regular recommended dose

71
Q

what is the recommended dose?

A

aka ED 50
- this is the amount that elicits a therapeutic effect
- based on clinical trials

72
Q

what is median toxicity dose?

A

dose at which substance is lethal - lethal dose (LD)

73
Q

what is the therapeutic index?

A

difference/ratio between TD50:ED50 = TI (therapeutic index)

74
Q

how is therapeutic index calculated?

A

LD50/ED50

75
Q

what does smaller TI mean?

A

higher risk

76
Q

what examples of drugs with narrow IT?

A

Diligent - Represents Digoxin (lanoxin)
Wizards - Represents Warfarin (coumadin)
Prefer - Represents Phenytoin (dilantin)
Taking Potions - Represents Tacrolimus (progaf, astagraf)

77
Q

What is involved in the distribution process of pharmacokinetics?

A

involves the transport of drugs to target tissues

78
Q

what are some factors affecting distribution?

A
  1. blood flow to the tissue - cardiac output, brain blood barrier, injury
  2. size of the tissue
  3. molecular characteristics - lipophilicity, size
  4. PBP
79
Q

how does BBB affect distribution?

A

the capillaries within the CNS are lined by specialized endothelial cells that only allow only for selective transport of substance

80
Q

what is the P-glycopreotein pump?

A

this is a pump that only allows selective materials to get into BBB

81
Q

How does PPB affect distribution?

A

some drugs have high affinity for plasma carrier proteins thus binding with these plasma protein molecules with decreases dristribution rates, and space becomes competitive

82
Q

what protein do acidic drugs bind to?

A

albumin

83
Q

which protein do basic drugs bind to?

A

alpha-1-acid glycoprotein

84
Q

what’s the distribution rule for PPB

A

unbound drugs are more effectively distributed compared to bound drugs

85
Q

what are some drugs that are extensively bound?

A

We - Represents Warfarin
Need - Represents NSAID (Ibuprofen & Naproxen)
Fine - Represents Furosemide
Dining - Represents Digoxin

86
Q

what is volume of distribution?

A

this estimates how extensively drug is distributed into tissues

87
Q

how is VD calculated?

A

drug dose/measured drug plasma concentration

88
Q

What is involved in the metabolism process of pharmacokinetics?

A

an enzymatic chemical conversion that prepares drug/substance for excretion

89
Q

where is the primary organ where metabolism happens?

A

liver

90
Q

what are the hepatic microsomal enzymes?

A

metabolism in the liver is accomplished through enzyme complex called the P450 system/microsomal enzyme system - made up of cytochome P450 (CYP)

91
Q

what are the 2 main CYP 450 enzymes?

A

CYP 3A4 + CYP 3A5 = make up 50%

92
Q

what are the 3 types of biotransformation results?

A
  1. active to inactive
  2. active to active
  3. inactive to active (prodrugs)
93
Q

what are the 2 main phases of metabolism?

A
  1. phase 1
  2. phase 2
94
Q

what process is involved in phase 1 of metabolism?

A

hydrolysis, reduction, oxidation
- use of cytochome 450 enzyme
- polar metabolite become ionized

95
Q

what process is involved with phase 2 of metabolism?

A
  • only some drugs require this
  • involves conjugation & polarization
96
Q

explain how acetaminophen is biotransformed?

A

phase 1 = acetaminophen becomes N-acetyl-p-benzoquinoneimine (hepatotoxic)
Phase 2 = N-acetyl-p-benzoquinoneimine becomes inactive metabolite using glutathione enzyme for conjugation

97
Q

What is involved in the excretion process of pharmacokinetics?

A

this is the elimination of inactive substances & metabolites are eliminated

98
Q

what is the primary organ of excretion?

A

kidneys

99
Q

explain the filtration mechanism of kidneys

A
  • uses glomerulus - write how
100
Q

what are factors affecting renal excretion?

A
  1. molecular characteristics (ionization, hydrophilicity, small size)
  2. CO = renal blood flow
  3. renal function
101
Q

how is GFR calculation done?

A
  1. Creatinine - bloodwork lab results
  2. Clearance -(rate of elimination of drug in an hour) requires calculation
102
Q

what are the 2 types of clearance elimination kinetics & their meaning?

A
  1. 1st order = rate of elimination is equal to concentration of drug in the body
  2. zero - order = rate of elimination is constant regardless of drug’s concentration
103
Q

how is the clearance rate for 1st order elimination calculated?

A

CL = elimination/peak plasma concentration

104
Q

what is half life & how does it relate to excretion?

A

this is the amount of time for cmax drug plasma concentration to decrease by one half (by 50%)

105
Q

what’s the formula for total half life?

A

to calculated for 90 % of drugs eliminated use:
4 X t1/2 = 90%

106
Q

List of drugs with zero elimination

A

Every - Represents Ethanol
Artist - Represents Aspirin (ASA)
Paints - Represents Phenytoin (Dilantin)

107
Q

explain how entero-hepatic process works

A

find how

108
Q

List drugs that are absorbed in the stomach

A

All - Represents Alcohol
Artists - Represents Aspirin (ASA)
Create - Represents Caffeine
Wonderful - Represents Warfarin (Coumadin)
Drawings - Represents Dilantin (Phenytoin)

109
Q

list of drugs with first pass metabolism

A

My - Represents Morphine
Mother- Represents Meperidine (Demerol)
Dislikes - Diazopem
Licorice - Represents Lidocaine
Even - Represents Ethanol (ETOH)
Professionally - Represents Propranolol
Made - Represents Midazolam

Nurs Yr 1 Winter (4 decks)

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