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N112 > The MIDDY! > Flashcards

The MIDDY! Flashcards

1
Q

the time it takes for half the drug concentration to be eliminated from the body

A

Half life

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2
Q

What measures the rate drugs are removed from the body

A

Half life

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3
Q

Also known as:
what the BODY does to the DRUG

A

PharmacoKINETICS

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4
Q

What are the 4 processes of pharmacokinetics

A

Absorption
Distribution
Metabolism
Excretion

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5
Q

What is the movement of a drug from the site of administration, into the blood stream

A

Absorption

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6
Q

What is the movement of the drug into the cells

A

Distribution

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7
Q

The method by which drugs are inactivated (biotransformed) by the body

A

Metabolism

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8
Q

Where does metabolism primarily occur?

A

The liver

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9
Q

Biotransformation refers to which pharmacokinetic process?

A

Metabolism

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10
Q

What refers to the elimination of a drug from the body?

A

Excretion

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11
Q

What factors affect absorption?

A

GI Function
Route
Dosage
Lipid Solubility
Blood Flow
Surface Area

(GI.R.D.L.B.S)
Gee I. Really. Dont. Like. Bull. Shit.

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12
Q

What factors affect distribution?

A

Protein Binding
Blood Flow to the tissues
Solubility

(P.B.S)
PBS “distributes” (broadcasts) TV shows

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13
Q

What is the INITIAL biotransformation (metabolism) of a drug that produces altered pharmacologically active molecules?

A

First Pass Effect

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14
Q

What is the most common route of excretion?

A

Urine

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15
Q

What is the rate at which drug molecules disappear from the circulatory system?

A

Clearance

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16
Q

What enzyme system is key to liver metabolism

A

The P450 system

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17
Q

Drugs circulate in the plasma either bound or unbound to plasma proteins

A

Protein binding

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18
Q

What protein contributes to most of the the body’s protein binding

A

Albumin

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19
Q

Drugs given by what route may be extensively metabolized before reaching the systemic circulation.
Give an example.

A

PO
Nitroglycerin
(First pass effect)

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20
Q

What INCREASES metabolism and excretion

A

Inducers

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21
Q

What are 2 examples of inducers

A

Tobacco
St. John’s Wort

There was a TOBACCO farmer named St. JOHN who’s pregnant wife had to be INDUCED while on the farm!! 😨

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22
Q

Clearance is affected by factors such as ______.

A

Gender

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23
Q

What DECREASES metabolism and excretion

A

inhibitors

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24
Q

What are 2 examples of inhibitors

A

Benadryl
Grapefruit

Ben was a Grapefruit. Idk make it work lol

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25
Q

Drugs given by what route, bypass the liver and prevent first pass effect

A

IV
IM
IN
subcut
ntg
inhaln
mucosa
transdermal

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26
Q

When 2 highly protein bound drugs displace one another this is called

A

Displacement
They fight for protein binding

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27
Q

What is highly selective and nearly impermeable

A

The blood brain barrier

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28
Q

When bound to a protein, a drug is unable to pass through what? (causing it to have no effect)

A

Capillary walls

  • because when the drug molecule is bound to a protein, the bound drug molecule is so big that it can’t fit passed the capillary wall. Thus, it can’t make it to the target cell to have an effect until the molecule becomes unbound
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29
Q

What causes drug molecules to become free from their protein bonds

A

When these bonds dissolve
- a drop in serum drug level

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30
Q

What do you call drug molecules that are not protein bound?

A

Active

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31
Q

Drugs administered by what route take longer to be absorbed?

A

Orally

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32
Q

Which route of med administration is absorbed more rapidly;
Enteral or Parenteral?

A

Parenteral

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33
Q

Which liquid meds are absorbed the fastest?

A

Elixirs
Syrups

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34
Q

Which type of oral medication is absorbed the slowest?

A

Enteric coated

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35
Q

Drugs cause their effects by interfering with what system?

A

The enzyme cascade system

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36
Q

Think about it:
Liver damage causes what?

A

Higher levels of ACTIVE drug
More Toxicity

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37
Q

What labs do you monitor for liver damage?

A

ALT
AST
Albumin
Total Protein

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38
Q

What do you assess for with liver damage?

A

Jaundice
Enlarged liver
Ascites

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39
Q

The liver changes drugs from ______ soluble to _______ soluble?

A

From FAT soluble to LIQUID soluble

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40
Q

The kidneys can only excrete drugs when they are _____ soluble?

A

Liquid

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41
Q

Think about it:
Kidney diseases cause what?

A

Decreased effectiveness of drug excretion
Increased risk for adverse drug reactions

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42
Q

What are 2 major modes of drug clearance?

A

Hepatic metabolism
Renal excretion

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43
Q

Who’s gonna rock this middy?!

A

You!
Lol keep going!

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44
Q

What labs do you monitor for Renal diseases?

A

BUN
Cr
Medication Drug Levels

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45
Q

Constipation does what to drug contact time?
Leading to what kind of effects?

A

It increases drug contact time (poop traffic)
Because there’s a poop blocking the way 💩🚧

Leading to increased drug effects / toxicity ☣️

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46
Q

In regards to ABSORPTION
Explain Geri’s gastric mobility

A

Slow gastric mobility- unpredictable rates of absorption

💡 Geri is an old woman. And everything about Geri low or slow

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47
Q

In regards to ABSORPTION
How is Geri’s gastric pH?

A

High
Less acidic
(More alkaline)

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48
Q

In regards to ABSORPTION
How is Geri’s peristalsis?

A

Slow

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49
Q

In regards to ABSORPTION
How is Geri’s blood flow in her GI tract?

A

Reduced
(Low/slow)

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50
Q

The attraction between albumin and drug is represented by what?

A

Percentages

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51
Q

PROTEIN BINDING:
89% and above is considered to

A

Highly bound

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52
Q

PROTEIN BINDING:
60-89% is considered to be:

A

Moderately bound

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53
Q

PROTEIN BINDING:
Less then 30% is considered to be:

A

Low bound

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54
Q

Nutritional status effects what?
(think liver)

A

Protein binding

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55
Q

A patients diet needs to have?

A

Adequate protein

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56
Q

In regards to DISTRIBUTION:
Geri’s blood brain Barrier is?

A

Less effective

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57
Q

In regards to DISTRIBUTION:
Geri’s Lean body mass is:

A

Decreased

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58
Q

In regards to DISTRIBUTION:
Geri’s total body water content is:

A

Reduced

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59
Q

In regards to DISTRIBUTION:
Geri’s protien binding sites are?
And why?

A

Reduced
Due to aging liver

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60
Q

In regards to DISTRIBUTION:
Geri’s fat content is:

A

INCREASED!
Remember Geri also put on some lbs with age 😅

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61
Q

In regards to METABOLISM:
Geri’s liver?

A

Decreased in size/mass

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62
Q

In regards to METABOLISM:
Geri’s liver blood flow?

A

Decreased

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63
Q

In regards to METABOLISM:
Geri’s overall metabolism is?

A

Decreased

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64
Q

In regards to EXCRETION:
Geri’s renal filtration rate is?

A

Decreased

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65
Q

In regards to EXCRETION:
Geri’s renal blood flow is?

A

You guessed it
Decreased

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66
Q

In regards to EXCRETION:
Geri’s nephron levels are?

A

Decreased

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67
Q

Aging leads to a greater incidence of

A

Toxicity

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68
Q

What is the USP-NF?

A

United States Pharmacopoeia National Formulary

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69
Q

What does the USP-NF do?

A

Sets high drug standards used in the US

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70
Q

How often is the USP-NF standards revised?

A

Every 5 years

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71
Q

What kind of agency is the USP?

A

NOT a Government agency

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72
Q

The USP does what?
The Federal Government does what?

A

The USP reviews meds and sets standards
The FEDs enforce and control those standards

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73
Q

The time it takes to reach minimum effective concentration
(MEC)

A

Onset

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74
Q

The time it takes to reach highest blood or plasma concentration

A

Peak

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75
Q

The length of time the drug has pharmacological effect

A

Duration

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76
Q

Where the drug is at highest level concentration

A

Peak

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77
Q

Where the drug is at lowest level concentration

A

Trough

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78
Q

Thick, sugary liquid- PO med

A

Syrup

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79
Q

Clear, Liquid- PO med

A

Elixir

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80
Q

Suspension solutions, usually oily

A

Emulsion

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81
Q

What liquid PO meds absorb 2nd fasted to Syrups and Exlixirs

A

Emulsions

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82
Q

TID

A

3 times a day

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83
Q

BID

A

2 times a day

84
Q

What time is breakfast

A

0800

85
Q

What time is lunch

A

1200

86
Q

What time is dinner

A

1700

87
Q

1 tsp= x mL

A

5 mL

88
Q

3 tsp = x tbsp

A

1 tbsp

89
Q

1 tbsp= x mL

A

15 mL

90
Q

1 oz = x tbsp

A

2 tbsp

91
Q

1 oz = x mL

A

30 mL

92
Q

1 cup = x oz

A

8 oz

93
Q

1 cup = x mL

A

240 mL

94
Q

1 pint = x cups

A

2 cups

95
Q

1 pint = x oz

A

16 oz

96
Q

1 quart = x pint

A

2 pint

97
Q

1 quart = x oz

A

32 oz

98
Q

1 quart = x cups

A

4 cups

99
Q

1 gallon = x quarts

A

4 quarts

100
Q

1 gram = x milligrams

A

1000

101
Q

1 kilogram= x grams

A

1000 grams

102
Q

1 kilogram = x lbs

A

2.2 lbs

103
Q

1 milligram = x micrograms

A

1000

104
Q

1 liter = x mL

A

1000 mL

105
Q

1 mL = x cc

A

1 cc

106
Q

1 grain (gr) = x mg

A

60 mg

107
Q

Who can prescribe meds?

A

HCPs:
NP
PA
MD
Dentist
Dermatologist

NP,PA,MD,D,D

108
Q

Drug names that are capitalized

A

Trade/ Brand name

109
Q

Drug names that are lower case

A

generic

110
Q

Drug names that sound alike

A

Trade/Brand names

111
Q

Drugs that are usually more expensive

A

Trade/ Brand names

112
Q

Drugs that have the “circled R” symbol

A

Trade/ brand

113
Q

Drugs that are more affordable

A

Generic names

114
Q

What are core pt variables

A

Culture
Health status
Inherited traits
Life span
Diet
Life style
Environment
Habits
Gender

C.H.I.L.D. L.E.H.G
(Child leg) 🤷‍♂️

115
Q

The desired, therapeutic effect of the drug

A

Pharmacotherapeutics

116
Q

What the BODY does to the DRUG
The change that occurs to the DRUG when it is inside the BODY

A

Pharmacokinetics

117
Q

What the DRUG does to the BODY
The effects of the DRUG on the BODY

A

Pharmacodynamics

118
Q

Conditions under which the drug must be carefully monitored

A

Precautions

119
Q

Conditions under which the drug should not be used at all

A

Contraindications

120
Q

Effects that may occur when the drug is given along with another drug, food, or substance

A

Drug interactions

121
Q

The unintended and usually undesired effects that may occur with the use of the drug

A

Adverse/ side effects

122
Q

Basic teaching to pt and family

A

Reason for prescription
Adverse effects
Intended effect
Drug name

R.A.I.D
you want to raid the room to teach the pt

123
Q

Digoxin toxicity s/s

A

Visual disturbances (seeing Halos, usually blue/green)
Bradycardia
Anorexia
Abdominal pain
n/v

124
Q

Established official standards and requirements for accurate labeling

A

1906
Pure Food Drug acts

125
Q

Strengthened 1906 law, prohibiting fraudulent therapeutic claims of drug effectiveness

A

1912
Shirley Amendment

Shirley sure was a fraud
And had 12 kids

126
Q

Required that drugs must meet standards of purity and strength; labeling requirements established- penalties for fraudulent claims and misleading labels

A

1938
Food, Drug, and Cosmetics Act

127
Q

FDA was established and charged with enforcing the law; gave FDA control over drug safety

A

1938
Food, Drug, and Cosmetics Act

128
Q

Designated that drugs must be prescribed by a licensed HCP and dispensed by a pharmacist

A

1951
Durham-Humphrey Amendment

These guys were both pharmacists who liked to hump 🤷‍♂️
And they were both 51 years old

129
Q

Increased control on drug safety; more extensive testing on new drugs; manufacturers must prove safety and efficiency;

A

1962
Kefauver-Harris Amendment

130
Q

Authorized FDA to establish official names for uniformed nomenclature; gave federal authority to standize drug names

A

1962
Kefauver-Harris Amendment

131
Q

Regulated distribution of narcotics and categorized narcotics according to therapeutic usefulness and potential for abuse

A

1970
Comprehensive Drug Abuse Prevention and Control Act

132
Q

Updated and replaced all previous narcotic laws

A

1970
Comprehensive Drug Abuse Prevention and Control Act

133
Q

Required inclusion of women and minorities in NIH funded research studies

A

1993
NIH Revitalization Act

134
Q

Established federal law that regulates OTC sale of ephedrine, pseudoephedrine, and phenylpropanolamine due to their use in manufacturing methamphetamine

A

2005
Combat Methamphetamine Epidemic Act

135
Q

By way of the intestines

A

Enteral

136
Q

By way OTHER THAN the intestines

A

Parenteral

137
Q

High protein bound drugs have _______ duration

A

Longer

138
Q

Low protein bound drugs have _______ duration

A

Shorter

139
Q

High protein bound drugs have _______ affinity to proteins

A

High

140
Q

Low protein bound drugs have _______ affinity to proteins

A

Low

141
Q

What happens to normal cell function, when a single step in the enzyme cascade function is blocked?

A

The normal cell function is disrupted

142
Q

How can we maximize therapeutic results of drugs

A

Administer drug in a way that promotes absorption
Administer drug at the appropriate time
Monitor lab values

143
Q

How can we minimize adverse effects of drugs

A

Allergies
Discontinue or withhold if needed
Administer safely
Monitor pt and labs
Contraindications
Assessment to detect onset of adverse effects
Report adverse effects
techniques: crushing pills, etc

A.D.A.M. C.A.R.T.

144
Q

7 rights of drug administration

A

Right patient
Right drug
Right dose
Right route
Right time

Right reason -6
Right documentation -7

145
Q

How many time do you check the 5 rights before administering

A

3x
When pulling meds
After pulling meds
Before administration

146
Q

7 Elements of a medication order

A

Pt name
Drug name
Drug dose
Drug route
Drug frequency
Provider signature
Date and time ordered

147
Q

How much air do you draw into the syringe before drawing from a vial

A

Equal to the amount of liquid you are drawing out of the vial

148
Q

Electrolytes to check for digoxin

A

K
Mag
Ca

149
Q

Electrolytes to check for flurosemide

A

Na
Cl
Ca
K
Mag

150
Q

Electrolytes to check for enoxaparin

A

None

151
Q

Electrolytes to check for insulins

A

Glucose

152
Q

Time frame to give meds

A

0900-2200

153
Q

How long before or after the scheduled time may you administer medication

A

30 min before or after the scheduled time
30 min before meals or after meals is best unless indicated otherwise

154
Q

Where do you administer enoxaparin

A

Subcut
Love handles
(Lateral abdomen)

155
Q

How do you know if digoxin working?

A

Decreased severity of HF
Increase in cardiac output

156
Q

How do you know if furosemide is working?

A

Urine output
Decreased BP
Decreased edema

157
Q

What do you assess for with digoxin?

A

Apical pulse for 1 before administration
- to make sure HR is above 60 BPM
Electrolyte/dig levels
BUN/Cr
ALT/AST
Input & output

158
Q

What do you assess for with furosemide?

A

Daily weight
Input & output
SBP > 100
Electrolyte levels
BUN/Cr
ALT/AST

159
Q

Refers to the progressive increase in the pre-meal or night time insulin dose, based on pre-determined blood glucose ranges

A

Sliding scale

160
Q

What approximates daily insulin requirements

A

Sliding scale. Insulin regimens

161
Q

When using a sliding scale, how should you regulate your carbohydrate intake with each meal?

A

Eat the same amount of carbohydrates at each meal

162
Q

Which insulins are you able to mix?

A

Regular and NPH

163
Q

When mixing insulins, which insulin do you draw up first?

A

Regular

164
Q

Where is the best site to administer insulin

A

Abdomen
Must rotate sites

165
Q

Why must you rotate insulin sites?

A

Lipodystrophy: condition when fat either breaks down or builds up under the skin; causing lumps or indentations that can interfere with insulin absorption

166
Q

What must you do when giving an insulin that is a HIGH ALERT med

A

Have another nurse check!

167
Q

Subcut needle size

A

25-30 G
3/8 - 1 inch (most common 3/8- 5/8)

168
Q

IM needle size

A

20-25 G
5/8-1.5 inch

169
Q

Drugs should be ordered by what name?

A

generic

170
Q

What categorizes drugs by the disease state that they are used to treat

A

Therapeutic classification

171
Q

Categorizes drugs based on the drugs mechanism of action (MOA)

A

Pharmacological classification

172
Q

What kind of environment do drugs love?

A

Acidic environments

173
Q

What are the stages of tablet breakdown

A

Tablet > disintegration > dissolution

174
Q

How many half lives are needs to achieve steady state?

A

4-5 half lives

175
Q

BETA 1 receptors are located in the _______.

A

Heart

176
Q

BETA 2 receptors are located in the ________.

A

Lungs

177
Q

Calcium channel receptors are located in the _____.

A

Heart/ blood vessels

178
Q

Drugs ending in __pine do what

A

Slow the movement of calcium into the heart and blood vessels

179
Q

What is the difference between the effective dose and the therapeutic dose?

A

Therapeutic index

180
Q

What is located between the peak and trough, an average range

A

Therapeutic index

181
Q

Unusual response to a drug and may be the opposite of what is anticipated

A

Idiosyncratic response

182
Q

Response specific to an individual person and sometimes has genetic cause

A

Idiosyncratic response

183
Q

Study of drugs that alter functions of living organisms

A

Pharmacology

184
Q

Pharmacology include what 3 aspects

A

Pharmacotherapy
Pharmacodynamics
Pharmacokinetics

185
Q

Theory that describes the way drugs exert their effects by binding with receptors

A

Receptor theory

186
Q

Binding either stimulates or inhibits normal cell functions (agonist vs. antagonist)

A

Physiochemical reaction

187
Q

Changes in the permeability of cell membrane to one or more ions

A

May open or close ion channels (calcium channel antagonists -pine)

188
Q

Modify the synthesis, release, or inactivation of
Neurohormones that regulate physiologic processes (acetylcholine, norepi):

A

Direct acting vs. indirect acting drugs

189
Q

Nonreceptor drug actions

A
  • Anti acids: act chemically
  • Drugs structurally similar to nutrients required by the body: Interfere with normal cell function
    Osmotic diuretics: increase osmolarity
    Metal chelating agents: combined with toxic metals to be more readily excreted
190
Q

How is the PNS subdivided

A

Somatic nervous system (voluntary)
Autonomic nervous system (involuntary)

191
Q

s/s of SNS and PSNS

A

SNS: fight or flight
PSNS: rest and digest

192
Q

Identify neurotransmitters of the sympathetic nervous system

A

Norepinephrine

193
Q

Identify neurotransmitters of the parasympathetic nervous system

A

Acetylcholine

194
Q

What is the function of norepinephrine

A

Increases HR
Increases BP

195
Q

What is the function of Acetylcholine

A

Contracts muscles
Dilates blood vessels
Slows HR

196
Q

What are the receptors of the sympathetic nervous system

A

Adrenergic receptors

197
Q

What are the receptors of the PSNS?

A

Cholinergic receptors

198
Q

Are adrenergic receptors agonists or antagonists?

A

Agonist receptors

199
Q

Are cholinergic receptors agonists or antagonists?

A

Antagonist receptors

200
Q

What is the function of adrenergic receptors?

A

Bring about the effects of SNS

201
Q

What is the function of cholinergic receptors?

A

Bring about the effects of the PSNS

202
Q

Variables that effect drug action?

A

Dosage- serum drug level
Route
Drug-diet
Pt related variables

203
Q

What are pt related variables

A

Age
Race
Culture
Weight
Genetics
Gender
Preexisting conditions
Psych factors

Pg2craw

204
Q

What drugs have adverse effects

A

All drugs

205
Q

Strongest warning from the FDA

A

Black Box Warning

N112 (13 decks)

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