SECOND EXAM REVIEW (CH. 10) Flashcards

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1
Q

the scientific study of how various substances interact with or alter the function of living organisms.

A

Pharmacology

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2
Q

organization that approves new medications and removes unsafe medications from use

A

FDA

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3
Q

The United States has a comprehensive system of medication and drug regulation

A

The Food, Drug, and Cosmetic Act (1938)

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4
Q
  • A purpose not approved by the FDA
  • At doses different from the recommended doses
  • By a route of administration not approved by the FDA
A

off-label

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5
Q

Classifies certain medications with the potential of abuse into five categories (schedules)

A

Controlled Substances Act of 1970

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6
Q

Schedule I drugs

A

heroin, marijuana, LSD

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7
Q

Schedule II drugs

A

fentanyl (Sublimaze), methylphenidate (Ritalin) cocaine

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8
Q

Schedule III drugs

A

Hydrocodone (Vicodin), acetaminophen with codeine, ketamine

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9
Q

Schedule IV drugs

A

Diazepam (Valium), lorazepam (Ativan)

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10
Q

Schedule V drugs

A

Narcotic cough medicines

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11
Q

heroin, marijuana, LSD

A

Schedule I drugs

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12
Q

fentanyl (Sublimaze), methylphenidate (Ritalin) cocaine

A

Schedule II drugs

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13
Q

Hydrocodone (Vicodin), acetaminophen with codeine, ketamine

A

Schedule III drugs

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14
Q

Diazepam (Valium), lorazepam (Ativan)

A

Schedule IV drugs

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15
Q

Narcotic cough medicines

A

Schedule V drugs

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16
Q

what are schedule I drugs?

A

high abuse potential with no recognized medical purpose

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17
Q

what are schedule II drugs?

A

high abuse potential with a legitimate medical purpose

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18
Q

Made completely in a laboratory

A

Synthetic

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19
Q

Made from chemicals derived from plant, animal, or mineral

A

Semisynthetic

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20
Q

What variables do pharmaceutical companies control?

A

Concentration
Purity
Preservatives
Other ingredients

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21
Q

medication name used during development

A

chemical name

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22
Q

medication name used to promote consistency and avoids duplication

A

nonproprietary name

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23
Q

medication name selected for marketing

A

brand name

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24
Q

Unites States Pharmacopeia-National Formulary (USP-NF)

Physicians’ Desk Reference (PDR) are sources that provides this type of medical profile

A

medication monograph

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25
Q

medication package inserts contain this information?

A

dosing, route of information, contraindications and adverse effects

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26
Q

Provides detail about medication selection and administration

A

AMA Drug Evaluations

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27
Q

Important factors to consider about medication storage

A
  • Must provide adequate protection
  • Must be convenient for quick access
  • Must prevent physical damage
  • Should be placed in protective bins
  • Should facilitate quick and accurate identification
  • should also avoid extreme sunlight, temperature, and physical damage
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28
Q

what is pharmacodynamics

A

how a medication affects process and function of body

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29
Q

the process of medication administration

A

absorption
distribution
biotransformation
elimination

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30
Q

pharmacokinetics

A

action of the body on a medication

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31
Q

ability of a medication to bind with a particular receptor site

A

affinity

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32
Q

level at which initiation of alteration of cellular activity begins

A

Threshold level

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33
Q

concentration of medication required to initiate a cellular response

A

Potency

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34
Q

ability to initiate or alter cell activity in a therapeutic or desired manner

A

Efficacy

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35
Q

Illustrates the relationship of medication concentration and efficacy

A

Dose-response curve

36
Q

medications can alter cell function without interacting with receptors and are engineered to target microorganisms, lipids, water, and exogenous toxic substances

A

drug action

37
Q

May target specific substances present in the cell walls of a bacteria or fungi

A

Antimicrobials

38
Q

Bind with heavy metals.

Sodium bicarbonate

A

Chelating agents

39
Q

Create osmotic changes and alter distribution of fluids and electrolytes

A

diuretics

40
Q

change concentration and distribution of ions in cells and fluids throughout the body

A

electrolyte based medications

41
Q

factors affecting response to medications

A
choice of medication
dose
route
timing
manner of administration
monitoring
42
Q

percentage of body fat in infants compared to adults

A

lowest in infants; increases in adults

43
Q

percentage of body water in infants compared to adult s

A

highest in newborns; decreases throughout life

44
Q

percentage of body proteins in relation to infants compared with adults

A

varies throughout life span

45
Q

hyperthermic environment has this effect on medications

A

may increase metabolism of drugs and may reduce amount of drug returned to circulation

46
Q

hypothermic environment has this effect on medications

A

impairs effectiveness of medications used in traditional cardiac life support

47
Q

how does of pregnancy affect physiology of body

A
  • Cardiac output and intravascular volume increase.
  • Hematocrit decreases.
  • Respiratory tidal volume, minute volumes increase.
  • Inspiratory/expiratory reserve volumes decrease.
  • Gastrointestinal motility decreases.
  • Renal blood flow and urinary elimination increase.
  • Endocrine glands undergo change
48
Q

The relationship between the median effective dose and the median lethal dose

A

Therapeutic index

49
Q

If difference in therapeutic index is large

A

medication is safe

50
Q

If difference in therapeutic index is small

A

patient needs to be monitored

51
Q

: repeated exposure within a particular class has the potential to cause a tolerance to the class

A

Cross tolerance

52
Q

repeated doses within a short time rapidly cause tolerance

A

tachyphylaxis

53
Q

undesirable medication interactions

A

medication interference

54
Q

Duration and effectiveness is determined by

A

Dose
Route of administration
Clinical status of the patient

55
Q

related to absorption and distribution

A

onset and peak

56
Q

related to metabolism and elimination

A

duration

57
Q

percentage of unchanged medication that reaches systemic circulation

A

bioavailability

58
Q

considerations when endotracheal medications have to be given

A
  • administer at least 2 to 2.5 times the IV dose

- follow with a 10- to 15- mL flush with sterile water or normal saline

59
Q

If the IO site is the proximal tibia, what is the vein?

A

popliteal vein

60
Q

If the IO site is the femur, what is the vein?

A

femoral vein

61
Q

If the IO site is the distal tibia, medial malleolus, what is the vein?

A

great saphenous vein

62
Q

If the IO site is the proximal humerus, what is the vein?

A

axillary vein

63
Q

If the IO site is the manubrium, what is the vein?

A

internal mammary and azygos veins

64
Q
Liquid medications are converted into a mist that is sprayed into one or both nostrils.
Absorption is rapid.
Bioavailability is close to 100%. 
unreliable
No risk for needlestick injury
A

intranasal

65
Q

Preferred method in the prehospital setting
Catheter is inserted into a peripheral or external jugular vein
Bioavailability is 100%.
Onset is quick.

A

Intravenous

66
Q

Medication is injected into large muscle.
Bioavailability is from 75% to 100%.
Delayed absorption and onset of action
Confirm that:
Medication is appropriate for IM use
Particular muscle should be used
Particular technique for injection should be used

A

Intramuscular

67
Q

Medication is injected into SC tissue site.
Certain medications are indicated for SC use only.
Slower absorption may prevent adverse cardiovascular effects.

A

Subcutaneous

68
Q

May alter a patient’s clinical presentation or interfere with other medications administered
Deliver a relatively constant dose of mediation during a long period.
Often contain a large quantity of medication

A

Dermal and transdermal

69
Q

Nitroglycerin is often given using this route.
Medication is placed under patient’s tongue.
Bioavailability is low.
Large doses are required.
Patients must be conscious and alert.

A

Sublingual

70
Q

Limited to oxygen and antidote
May assist patients with medications via metered-dose inhalers
Medication may be nebulized.
Potential to cause bronchospasm

A

Inhaled or nebulized

71
Q

Preferred over the oral route
Usually not subject to first-pass metabolism
May have greater than 90% bioavailability
Manufactured in suppository form
Absorption can be unpredictable

A

Rectal

72
Q

blood is pumped through a dialysis machine

A

Hemodialysis

73
Q

distribution of medication is determined by:

A

chemical, physical, patient factors

74
Q

three barriers that can affect the movement of medications through capillary walls

A

blood brain, blood placenta, blood testes barrier

75
Q

describes extent to which a medication will spread within the body

A

volume of distribution

76
Q

medication becomes a metabolite

A

biotransformation

77
Q

capable of pharmacologic activity

A

active metabolite

78
Q

no longer possess the ability to alter a cell process or body function

A

inactive metabolite

79
Q

where does most biotransformation occur? what types of meds, parenteral or enteral? through what system?

A

liver, enteral meds, P-450 system

80
Q

this enzyme system alters the chemical structure of a medication

A

P-450 system

81
Q

other tissues may cause biotransformation?

A

kidney, lungs, GI tract

82
Q

how is medication primarily eliminated?

A

kidneys

83
Q

fixed amount of a substance is removed during a certain period

A

Zero-order elimination

84
Q

rate of elimination is influenced by substance’s plasma levels

A

First-order elimination

85
Q

time needed for metabolism or elimination of 50% of the substance in plasma

A

Half-life

86
Q

half life can be affected by these factors

A

disease states, changes in perfusion, medication interactions