Review Questions Handout (9/23 JK) Flashcards
What is the leading cause of patient safety errors in healthcare?
Medication errors
What are the 4 types of names for a drug? Give an example
Chemical - 7 chloro-1,3-dihydro-1,methyl-5-phenyl-2h-1
Generic - Diazepam
Official - diazepam, USP
Brand - Valium
4 principle sources of current drugs
- animals
- minerals
- plants
- synthetic
Sources of drug information
USP (US Pharmacopeial Convention), PDR (Physician Desk Reference), AMA Drug Evals, EMS Field Guides
Pure Food Act of 1906
Improved quality and labeling of drugs and made USP the official source
Harrison Narcotic Act of 1914
Regulated import, sale and use of opium and cocaine
Federal Food, Drug, and Cosmetic Act of 1938
Empowered the FDA to enforce and set premarket safety for drugs
Durham Humphrey Amendment to 1938 Act
Required pharmacies to have verbal or written Rx from MD to dispense drugs
Comprehensive Drug Abuse Prevention Act 1970
Replaced the Harrison Act and set. 5 schedules of drugs
Name the 5 schedules of drugs
- high abuse potential w/o accepted medical use (heroine, LSD)
- high abuse potential and may lead to severe dependance (opium, cocaine, morphine, oxycodone)
- May lead to moderate or low dependance, limited opioids in combination with other substances (tylenol with cosine)
- Low abuse potential (valium, phenobarbatol)
- Lowest abuse potential, limited opioids often for cough
Executes the provisions of the Federal Controlled Substances Act
DEA
Describe the special drug rating scale for pregnant women
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
Who monitors drug advertising?
FTC
8 reasons pediatric patients need special consideration when considering drug intervention
- Reduced metabolic activity
- May metabolize meds faster
- GI tract may have slower rate of absorption and elimination
- Increased surface area
- More pervious blood brain barrier
- Increased water %
- Skin is more permeable
- Decreased protein, therefore increased free drug (more drug is avail to effect the body)
Define pharmacokinetics
The absorption, distribution, biotransformation, and elimination of a drug in the body
Define absorption
How a drug finds its way to the site of action
Define Bioavailability
How much of a drug is available once it reaches its target tissue
T or F
A lipid soluble drug will cross the cells lipid membrane, but if ionized it will not.
True
T or F
The stomach is highly acidic and the duodenum is highly alkaline
True
ASA absorbs well through the stomach because…
it is a weak acid and will ionize in an alkali environment
Define Affinity
How well a drug binds to its receptor
Define Efficacy
How well the drug produces its response
What is down regulation?
refers to the decreased responsiveness of a cell to a drug b/c of decreased receptor #s or decreased sensitivity
What is up regulation?
increased target cell sensitivity to a drug or hormone
Define Agonist
bind to the receptor and initiate a response
Define Antagonist
bind, but do not cause the expected response (blocks the desired response)
What is referred to as an Agonist/Antagonist?
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
What is meant by the term “Competitive Antagonist”?
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
What is meant by the term “Noncompetitive Antagonist”?
an agonist cannot overcome an antagonist b/c antagonists permanently bind with receptor sites until new receptor sites or new cells are created
What is Irreversible antagonism?
Antagonist permanently binds to the receptor site
Define biotransformation
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
Describe a phase I biotransformation reaction
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.
Describe a phase II biotransformation reaction
A conjugation reaction occurs with the attachment of a polar molecule to further increase the water solubility
Describe the first-pass effect
When a drug is given orally it is absorbed by the hepatic system and rendered inactive
Define Elimination as it related to pharmacology
How a drug is excreted from the body
What is the definition of an enteral route of drug administration? Give examples
A drug administered enterally delivered into the GI tract
ex. oral, orogastric, nasogastric, sublingual, buccal, rectal
What is the definition of a parenteral route of drug administration? Give examples
A drug administered parenterally is delivered by a route other than the GI tract.
ex. IV, ET, IO, IM, SQ, umbilical, inhalation, topical
What are the different solid forms of a drug taken enterally?
Pills, powders, suppositories, capsules, tablets
What are the different liquid forms of a drug taken enterally?
- Solutions - water or oil based
- Tinctures - alcohol extraction process
- Suspensions - solid doesn’t dissolve in solvent
- Emulsions - suspension with oily substance in solvent
- Spirits - solution of volatile drug in alcohol
- Elixirs - alcohol and water solvent with flavoring
- Syrup - sugar water and drug solution
What are 4 things that determine the extent of a drugs action on an individual?
- The individual
- Dose
- Route
- The drugs metabolism
List the route of drug administrations from fastest to slowest the speed at which a drug is absorbed.
iv/io>respiratory>im>po>across intact skin
What are percutaneous routes of drug administration?
Absorption through the skin or mucus membrane
ex. Transdermal, Pulmonary, Mucus Membrane (SL, Buccal, Nasal)
Name the 4 mechanisms of a drug action?
Drugs act by…
- binding to a receptor site
- changing physical properties of a cell
- chemically combine with other substances
- alter a normal metabolic pathway
