Review Questions Handout (9/23 JK)

Question 1

What is the leading cause of patient safety errors in healthcare?

Answer 1

Medication errors

Question 2

What are the 4 types of names for a drug? Give an example

Answer 2

Chemical - 7 chloro-1,3-dihydro-1,methyl-5-phenyl-2h-1
Generic - Diazepam
Official - diazepam, USP
Brand - Valium

Question 3

4 principle sources of current drugs

Answer 3

1. animals
2. minerals
3. plants
4. synthetic

Question 4

Sources of drug information

Answer 4

USP (US Pharmacopeial Convention), PDR (Physician Desk Reference), AMA Drug Evals, EMS Field Guides

Question 5

Pure Food Act of 1906

Answer 5

Improved quality and labeling of drugs and made USP the official source

Question 6

Harrison Narcotic Act of 1914

Answer 6

Regulated import, sale and use of opium and cocaine

Question 7

Federal Food, Drug, and Cosmetic Act of 1938

Answer 7

Empowered the FDA to enforce and set premarket safety for drugs

Question 8

Durham Humphrey Amendment to 1938 Act

Answer 8

Required pharmacies to have verbal or written Rx from MD to dispense drugs

Question 9

Comprehensive Drug Abuse Prevention Act 1970

Answer 9

Replaced the Harrison Act and set. 5 schedules of drugs

Question 10

Name the 5 schedules of drugs

Answer 10

1. high abuse potential w/o accepted medical use (heroine, LSD)
2. high abuse potential and may lead to severe dependance (opium, cocaine, morphine, oxycodone)
3. May lead to moderate or low dependance, limited opioids in combination with other substances (tylenol with cosine)
4. Low abuse potential (valium, phenobarbatol)
5. Lowest abuse potential, limited opioids often for cough

Question 11

Executes the provisions of the Federal Controlled Substances Act

Answer 11

DEA

Question 12

Describe the special drug rating scale for pregnant women

Answer 12

A - Safe and effective for mom and fetus with good trials
B - Safe and effective in animal trials or human trials fail to show risk
C - Animal trials show risk but no good human trials
D - Human trials indicate fetus risk, but benefits may outweigh risk
X - Animal and human trials show marked risk to fetus and use is contraindicated for pregnant women

Question 13

Who monitors drug advertising?

Answer 13

FTC

Question 14

8 reasons pediatric patients need special consideration when considering drug intervention

Answer 14

1. Reduced metabolic activity
2. May metabolize meds faster
3. GI tract may have slower rate of absorption and elimination
4. Increased surface area
5. More pervious blood brain barrier
6. Increased water %
7. Skin is more permeable
8. Decreased protein, therefore increased free drug (more drug is avail to effect the body)

Question 15

Define pharmacokinetics

Answer 15

The absorption, distribution, biotransformation, and elimination of a drug in the body

Question 16

Define absorption

Answer 16

How a drug finds its way to the site of action

Question 17

Define Bioavailability

Answer 17

How much of a drug is available once it reaches its target tissue

Question 18

T or F

A lipid soluble drug will cross the cells lipid membrane, but if ionized it will not.

Answer 18

True

Question 19

T or F

The stomach is highly acidic and the duodenum is highly alkaline

Answer 19

True

Question 20

ASA absorbs well through the stomach because…

Answer 20

it is a weak acid and will ionize in an alkali environment

Question 21

Define Affinity

Answer 21

How well a drug binds to its receptor

Question 22

Define Efficacy

Answer 22

How well the drug produces its response

Question 23

What is down regulation?

Answer 23

refers to the decreased responsiveness of a cell to a drug b/c of decreased receptor #s or decreased sensitivity

Question 24

What is up regulation?

Answer 24

increased target cell sensitivity to a drug or hormone

Question 25

Define Agonist

Answer 25

bind to the receptor and initiate a response

Question 26

Define Antagonist

Answer 26

bind, but do not cause the expected response (blocks the desired response)

Question 27

What is referred to as an Agonist/Antagonist?

Answer 27

Partial agonists bind to the receptor site but do not initiate as much cellular change as other agonists. Effectively lower the efficacy of other agonists

Question 28

What is meant by the term "Competitive Antagonist"?

Answer 28

enough agonist will overcome antagonist. If the amount of agonists increase or the concentration of the competitive antagonist falls the agonist can resume cellular activity

Question 29

What is meant by the term "Noncompetitive Antagonist"?

Answer 29

an agonist cannot overcome an antagonist b/c antagonists permanently bind with receptor sites until new receptor sites or new cells are created

Question 30

What is Irreversible antagonism?

Answer 30

Antagonist permanently binds to the receptor site

Question 31

Define biotransformation

Answer 31

How a drug or toxin is broken down and metabolized by the body and made more water soluble to increase rate of excretion. How a drug is transformed into active or inactive metabolites

Question 32

Describe a phase I biotransformation reaction

Answer 32

Includes oxidative(-H or +O), hydrolytic(+H2O) or reductive reactions where the polarity of the drug molecule increases to become more water soluble and less active. The metabolites are generated by a hydroxylating enzyme system known as Cytochrome P450.

Question 33

Describe a phase II biotransformation reaction

Answer 33

A conjugation reaction occurs with the attachment of a polar molecule to further increase the water solubility

Question 34

Describe the first-pass effect

Answer 34

When a drug is given orally it is absorbed by the hepatic system and rendered inactive

Question 35

Define Elimination as it related to pharmacology

Answer 35

How a drug is excreted from the body

Question 36

What is the definition of an enteral route of drug administration? Give examples

Answer 36

A drug administered enterally delivered into the GI tract | ex. oral, orogastric, nasogastric, sublingual, buccal, rectal

Question 37

What is the definition of a parenteral route of drug administration? Give examples

Answer 37

A drug administered parenterally is delivered by a route other than the GI tract. ex. IV, ET, IO, IM, SQ, umbilical, inhalation, topical

Question 38

What are the different solid forms of a drug taken enterally?

Answer 38

Pills, powders, suppositories, capsules, tablets

Question 39

What are the different liquid forms of a drug taken enterally?

Answer 39

1. Solutions - water or oil based 2. Tinctures - alcohol extraction process 3. Suspensions - solid doesn't dissolve in solvent 4. Emulsions - suspension with oily substance in solvent 5. Spirits - solution of volatile drug in alcohol 6. Elixirs - alcohol and water solvent with flavoring 7. Syrup - sugar water and drug solution

Question 40

What are 4 things that determine the extent of a drugs action on an individual?

Answer 40

1. The individual 2. Dose 3. Route 4. The drugs metabolism

Question 41

List the route of drug administrations from fastest to slowest the speed at which a drug is absorbed.

Answer 41

iv/io>respiratory>im>po>across intact skin

Question 42

What are percutaneous routes of drug administration?

Answer 42

Absorption through the skin or mucus membrane | ex. Transdermal, Pulmonary, Mucus Membrane (SL, Buccal, Nasal)

Question 43

Name the 4 mechanisms of a drug action?

Answer 43

Drugs act by... 1. binding to a receptor site 2. changing physical properties of a cell 3. chemically combine with other substances 4. alter a normal metabolic pathway