Quiz 1 Flashcards

1
Q

clinical pharmocology

A

the study of drugs and their interactions with living systems

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2
Q

therapeutic objective

A

the objective of drug therapy is to provide maximum benefit with minimum harm
since drugs are not ideal, skill and care must be exercised if treatment is to result in more good than harm
nurses have a CRITICAL responsibility in achieving the therapeutic objective

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3
Q

MEC

A

minimum effective concentration
the plasma drug level at which a decrease will cause the drug to show no therapeutic effects
a drug must be present at a level at or above the MEC but below the toxic concentration
- toxic concentration- plasma drug level at which toxic effects begin

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4
Q

plateau/ steady state

A

the evenly distributed concentration of a drug, occurs when the amount of drug eliminated equals the dose administered
this state is approx. achieved in four to five half-lives

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5
Q

half life

A

the time needed for the plasma concentration of a drug to be reduced by 50%
very imp. b/c it determines frequency of dosing, dosing interval
drugs w/ a shorter half life need short dosing intervals
drugs w/ a longer half life need long dosing intervals, careful to not lose the therapeutic effect

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6
Q

drug selectivity

A

elicits ONLY the response for which it is given

unfortunately, there is not such thing as a selective drug

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7
Q

BUN

A

blood, urea, nitrogen test

checks for kidney function

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8
Q

GFR

A

glomerular filtration rate

checks for kidney function and how well they can excrete waste

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9
Q

creatinine clearance

A

a kidney function test
creatin is a chemical waste product which is used to supply energy to the muscle
creatinine is the end product of that energy being used which is then excreted in the kidneys
creatinine varies due to muscle size

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10
Q

drug schedules

A

schedule I- high abuse potential, no accepted medical use
schedule II- high abuse potential, accepted medical use
schedule III- less abuse potential than II, moderate dependence liability
schedule IV- less abuse potential than II drugs, limited dependence liability
schedule V- less abuse potential and very limited dependence

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11
Q

affinity

A

strength of attraction b/w a drug and its receptor
high affinity drugs have a strong attraction for receptor sites
- drugs w/ a high affinity are very potent
drugs w/ a low affinity have to be present in the body in high concentration to elicit a response

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12
Q

intrinsic activity

A

the ability of a drug to activate a receptor upon binding
drugs w/ a high intrinsic activity have maximal efficacy
- maximal efficacy- the largest effect that a drug can produce
these drugs have the ability to produce an intense response

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13
Q

agonists

A
activate receptors
have a high affinity
have a high intrinsic activity
they mimic the action of endogenous regulators
- i.e. hormones, neurotransmitters
they do not give cells new actions
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14
Q

antagonists

A

prevents receptor activation by endogenous molecules and drugs
has a high affinity
has no effect on its own so that our own receptors don’t react to it
binds to receptors and blocks them from other drugs or molecules :. prevents activation of receptors by antagonists

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15
Q

competitive antagonists

A

binds reversibly to receptors
competes w/ agonist for receptor sites
produces receptor blockades
receptor site will be occupied by whichever agent [agonist or antagonist] has a higher concentration or a higher affinity

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16
Q

non-competitive antagonists

A

bind reversibly to receptors
- rarely used therapeutically
reduces the maximal response that an agonist can produce
only way their effect is stopped is when the cell it is bound to dies or it is replaced

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17
Q

partial agonist

A

an agonist w/ moderate intrinsic activity
maximal effect is lower than a full agonist
not used therapeutically b/c it can act as an agonist or an antagonist

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18
Q

pregnancy categories of medications

A

category A- least dangerous
category B, C, D- progressively more dangerous than category A
category X- most dangeous

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19
Q

steps of nursing process in drug therapy

A

assessment [pre-administration]
- ID core drug ad pt. variables
– variables- health status, life span, gender, ethnicity, lifestyle, etc.
- hx taking, health status, drug hx, physical exam
analysis/ nursing dx
- compare and contrast drug and pt. variables
- judge the appropriateness of therapy, ID potential health problems, formulate nursing dx
planning
- maximize therapeutic effects and minimize adverse effects
- individualized
intervention
evaluation

20
Q

administration of two or more drugs

A

intensification of effects
- potentiative- when taking 2 med.’s, one drug may intensify effects of the other drug
– the effect of only ONE of the two drugs is increased
- it either will increase the therapeutic effect or increase the adverse effect
reduction of effects
- inhibitory- interactions result in reduced drug effect
– it either will reduce therapeutic effect or reduce adverse effects

21
Q

idiosyncratic response

A

it is an unusual, abnormal or peculiar response to a drug
sometimes this response is referred to as a paradoxical response
these responses are thought to occur b/c genetic enzymes deficiencies can alter the drug’s metabolism

22
Q

additive effects

A

this occurs when two or more “like” [like in terms of effects] drugs are combined, and the result is the sum of the individual drug’s effects

23
Q

synergistic effect

A

this occurs when two or more “unlike” [unlike in terms of effects] drugs are used together to produce a combined effect and the outcome is a drug effect greater than any either drug’s activity alone

24
Q

antagonistic interaction

A

it is an interaction that is the opposite of synergism
it results in a therapeutic effect that is less than the effect of either drug alone b/c the second drug either diminishes or cancels the effect of the first drug

25
Q

theoretical principle of idealness

A

ideal drugs exist in theory only
the three most imp. characteristics that any drug can have are: effectiveness, safety, and selectivity
additional properties include reversible action, predictability, ease of administration, freedom from drug interactions, low cost, chemical stability, possession of a simple generic name

26
Q

imp. characteristics of any drug

A
effectiveness
- elicits the response for which it is given
safety
- goal: minimize risk of adverse effect
- no such thing as a safe drug
selectivity
- elicits ONLY the response for which it is given
- no such thing as a selective drug
27
Q

use of drugs in pharmacology

A

to prevent, diagnose, relieve, treat and cure a disease, illness, etc.

28
Q

drug movment

A

to move throughout the body, drugs must cross cell membrane [wherever they may be moving to/from]
affects all four phases of pharmacokinetics
drugs cross cell membranes 3 ways:
- channels or pores [found w/i capillaries]
- transport systems
– selective depending on the drug structure
- direct penetration of membrane itself

29
Q

drug solubility

A

solubility refers to the ability of a drug to dissolve and form a solution
how drugs can move through cell membranes
drugs must be dissolved to work
lipid solubility
- it is essential for any drug that must diffuse across the cell membrane b/c the membrane is partially composed of lipids
- certain molecules are not lipid soluble and they cannot penetrate membranes
– i.e. polar molecules, ions

30
Q

polar molecules

A

cannot get through lipid layer of cells

they have no net charge and are unable to dissolve in lipid layer of cell membrane :. it should be given IV or IM

31
Q

ions

A

cannot get through lipid layer of cell
molecules that have a net electrical charge
ionized drugs are poorly absorbed b/c they do not diffuse easily across lipid membrane and the opposite is true for non-ionized drugs

32
Q

enteral route

A

adsorption from stomach or small intestine
factors that influence absorption:
- gastric and intestinal pH-ionization
- solubility and stability of drug
- gastric emptying time
- co-administration of other drugs
- drug coating
advantages: easy, convenient, inexpensive, safer than injection, potentially reversible
disadvantages: highly variable, certain drugs can become inactivated, irritation of the GI tract
- variable- diff. to control the concentration of the drug being absorbed at the site of action

33
Q

intravenous route

A

bypasses GI tract and availability of absorption from other areas

advantages: rapid onset and control, use of large fluid volumes, use of irritant med.’s
disadvantages: rapid onset and irreversibility, volume overload, infection, embolism, expensive, difficulty of process, inconvenient

34
Q

intramuscular route

A

absorption factors: water solubility, blood flow to area of administration
advantages: appropriate for viscous or irritating med.’s, depot preparation
- depot prep- drug absorbed slowly over an extended time
disadvantages- discomfort, inconvenience, local tissue injury, nerve damage [avoidable], bleeding

35
Q

distribution of drug

A

factors:
- blood flow to tissues
- - abscesses or tumors reduce regional blood flow
- ability of drug to exit vascular system
- ability of drug to enter cells

36
Q

characteristics of drugs that can pass the blood-brain barrier

A

lipid soluble
possess own transport system
p-glycoprotein pumps drugs back into blood and limits access to brain

37
Q

characteristics of drugs that can pass the placenta

A

lipid soluble

non-ionized drugs

38
Q

hepatotoxicity

A

the liver is highly susceptible to toxicants due to direct exposure to ingested drugs and other toxicants
leading cause of acute liver failure

39
Q

hepatic inducing drugs

A

some drugs act on the liver to increase rates of drug metabolism :. an increase of med. dose is recommended
this occurs b/c the liver synthesizes drug metabolizing enzymes

40
Q

hepatic first pass

A

orally administered drugs [most] are first absorbed through the walls of the small intestine
travels through the portal vein to the liver
travels into systemic circulation to the site of action
some drugs undergo rapid metabolism and are inactivated before reaching the systemic circulation

41
Q

avenues of drug excretion

A

KIDNEY, via
- glomerular filtration- moves drugs from blood to urine through capillary pores
- passive reabsorption- lipid-soluble drugs move back to blood, leaving behind polar and ionized drugs
active transport- pumps drugs from blood to tubular urine
bile
sweat
saliva
expired air
breast milk

42
Q

drug info. to include in pt. education

A
drug name
dosage
schedule
route and technique of administration
expected therapeutic response
duration of treatment
method of storage
adverse effects
interactions
who to contact
43
Q

allergic reactions

A

a hypersensitivity reaction marked by abnormal sensitivity or an exaggerated response by the body to the stimulus of a foreign agent
a drug allergy, or allergic reaction, is marked by increasing reactivity on subsequent exposures to the foreign agent
- reaction depends on the degree of sensitivity
- varies from mild to severe

44
Q

anaphylaxis

A

a systemic reaction caused by contraction of smooth muscles and increased vascular permeability
it is characterized by dyspnea, bronchospasms, laryngeal edema, cardiac dysrhythmias and occasional seizures
it is a medical emergency
it is the most serious of allergic reactions

45
Q

drug toxicity

A

the point where drug accumulation exceeds the amount the body can eliminate through metabolism and excretion
several factors may be responsible for this