Unit 1

Question 1

Pharmacokinetics

Answer 1

describes the four stages a drug goes through in the body: absorption, distribution, metabolism, and excretion

Question 2

the process a drug goes through in our body is?

Answer 2

ADME: absorption, distribution, metabolism, and excretion

Question 3

Pharmacodynamics

Answer 3

refers to the effects of drugs in the body and the mechanism of their action

Question 4

Drug bioavailability

Answer 4

the ability of a drug or other chemical to be taken up by the body and made available in the tissue where it is needed

Question 5

Pharmacogenetics

Answer 5

the study of how people’s genes affect their response to medicines

Question 6

Pharmacognosy

Answer 6

the study of natural products and their potential for medicinal use

Question 7

Toxicology

Answer 7

the study of how chemicals, substances, and situations can harm living organisms and the environment

Question 8

Pharmacoeconomics

Answer 8

measuring costs and outcomes associated with the use of pharmaceuticals in health-care delivery

Question 9

Where does a medication get distributed after consumed orally?

Answer 9

It goes through stomach -> liver -> portal circulation

Question 10

The first pass effect

Answer 10

the inactivation of orally or enterally administered drugs in the liver and intestines by enzymes

Question 11

What is the transdermal route of medication delivery beneficial for?

Answer 11

medication that must be administered over a longer period of time to control symptoms

Question 12

Side effect

Answer 12

anticipated, well-known consequence of the drug targeting other cells rather than just its target cell

Question 13

Adverse effect

Answer 13

unanticipated effect of a drug that may be harmful to the patient

Question 14

Free/unbound drug

Answer 14

the portion of the drug that is dissolved in plasma water

Question 15

T/F: only free and unbound drugs will pass from the bloodstream to tissues where drug-receptor interactions will occur.

Answer 15

True. The protein-bound portion of the drug is inactive.

Question 16

Blood-brain barrier

Answer 16

tightly woven mesh of capillaries that protect the brain from potentially dangerous substances, such as poisons or viruses

Question 17

What can get through the blood-brain barrier?

Answer 17

Only certain medications made of lipids (fats) or those with a “carrier” can get through the blood-brain barrier

Question 18

Everything that enters the bloodstream is metabolized by ______

Answer 18

the liver

Question 19

Biotransformations

Answer 19

chemical metabolizing done by the liver

Question 20

Phase I-III biotransformations

Answer 20

Phase I - change an inactive drug -> active called a prodrug. Prodrugs improve a medication’s effectiveness.
Phase II - couple the drug molecule with another molecule in conjugation to change it from active -> inactive again to be excreted.
Phase III - may also occur after Phase II, but not always. This is where conjugates & metabolites are excreted from cells.

Question 21

Disruptions of drug metabolism:

Answer 21

depot binding and enzyme induction

Question 22

Depot binding

Answer 22

the coupling of drug molecules with inactive sites in the body, resulting in the drug not being accessible for metabolism

Question 23

Enzyme Induction

Answer 23

Enzymes are induced by repeated use of the same drug, so the body becomes accustomed to the constant presence of the drug and compensates by increasing the production of the enzyme necessary for the drug’s metabolism. This contributes to a condition referred to as tolerance and causes clients to require ever-increasing doses of certain drugs to produce the same effect

Question 24

What is the most common route of drug excretion?

Answer 24

The kidneys

Question 25

Drugs that share metabolic pathways may inhibit metabolism because....

Answer 25

they can “compete” for the same binding sites on enzymes, thus decreasing the efficiency of their metabolism.

Question 26

Mechanism of action (MOA)

Answer 26

describes how a medication works in the body

Question 27

Agonist drug

Answer 27

binds tightly to a receptor to produce a desired effect

Question 28

Antagonist drug

Answer 28

competes with other molecules and blocks a specific action or response at a receptor site

Question 29

Generic drugs

Answer 29

the drug names we will want to study for NCLEX. They have (by FDA law) the same chemical formula as brand name drugs, but different additives

Question 30

Steady state

Answer 30

refers to the point at which the amount of drug entering the body is equal to the amount of drug being eliminated, resulting in a stable drug concentration

Question 31

Half-life

Answer 31

the time it takes for the amount of a drug's active substance in your body to reduce by half

Question 32

Therapeutic window

Answer 32

window between the (minimally) effective concentration and the toxic concentration where the safest and most effective treatment will occur

Question 33

Peak and trough labs

Answer 33

A peak drug level is drawn after the medication is administered and is known to be at the highest level in the bloodstream. A trough level is drawn when the drug is at its lowest in the bloodstream, right before the next scheduled dose is given

Question 34

Therapeutic index

Answer 34

a quantitative measurement of the relative safety of a drug.

Question 35

High vs low therapeutic index

Answer 35

High = safe Low = not as safe and should be titrated

Question 36

Drug selectivity

Answer 36

the separation between the desired and undesired effects of the drug

Question 37

Duration of action (DOA)

Answer 37

how long the drug works for before you need to give the drug again

Question 38

Additive effects

Answer 38

Drug 1 + Drug 2 = work together to make something

Question 39

Synergistic effects

Answer 39

Drug 1 + Drug 2 = enhance each other and produce greater effect than alone.

Question 40

Antagonistic effects

Answer 40

Drug 1 + Drug 2 = work against each other and may cancel out effects

Question 41

Adverse drug events (ADEs)

Answer 41

any injury caused by taking a medication

Question 42

What is the most common ADE?

Answer 42

medication error

Question 43

What age groups should we pay special attention to when administering drug doses?

Answer 43

Pediatrics (infants, neonates, school age) - underdeveloped systems like livers and kidneys that cannot metabolize drugs as quickly as adults, resulting in higher concentrations of the drug in the bloodstream Pregnant & breast-feeding women - hardly any drugs tested on pregnant women, so they may harm the fetus. Many drugs can also be passed in breastmilk to the newborn, and that's not safe. Elderly patients - polypharmacy ; cognitive decline making medication instructions hard to follow correctly ; decreased function in body systems (muscle mass, protein carriers, liver & kidneys)

Question 44

CSA Drug Schedules

Answer 44

Schedule 1 - no accepted legal medicinal use and very high risk for addiction/abuse. (heroin, LSD, GHB, MDMA, marijuana, etc). Schedule 2 - Restricted legal medicinal use. High potential for physical and/or psychological dependence. High risk for addiction/abuse. (cocaine, codeine, morphine, opium, etc). Schedule 3 - Accepted legal medicinal use. Lower potential for physical dependance, but high potential for psychological dependence specifically. Moderate risk for addiction/abuse (anabolic steroids, ketamine, vicodin, testosterone, etc). Schedule 4 - Accepted legal medicinal use. Low potential for physical and/or psychological dependence. Low risk for addiction/abuse (ambien, ativan, rohypnol, xanax, etc). Schedule 5 - OTC. Legal without prescription.

Question 45

Drug diversion

Answer 45

transferring a legally prescribed controlled substance from the individual for whom it was prescribed to another person for any illicit use

Question 46

What is the worst form of drug diversion?

Answer 46

Tampering (taking medication out of syringes or prepared packages and replacing it with a fake like saline)

Question 47

Maleficence vs beneficence

Answer 47

Maleficence - the intentional act of causing harm to another person Beneficence - the obligation to do good and promote the well-being of patients

Question 48

8 Rights of Med Administration:

Answer 48

1. Right patient: Check using two patient identifiers 2. Right medication 3. Right dose 4. Right route 5. Right time 6. Right documentation: Always verify any unclear or inaccurate documentation prior to administering medications. 7. Right reason: If signs and symptoms no longer warrant administration of the prescribed medication, notify the prescribing provider. 8. Right response: The prescribing provider should be notified if expected outcomes are not achieved or if adverse effects occur

Question 49

Common medication errors:

Answer 49

- Error prone abbreviations (BID, PRN, etc - most of these are written out now to avoid miscommunication on them) - Do Not Crush Meds (it’s really important not to crush meds that can’t be crushed like extended releases! If you’re not sure, look it up) - Look-Alike and Sound-Alike Drugs (Adderall and Inderal , etc) - Boxed Warnings (pay attention to those Black box warnings and take care to their effects and the way they must be administered_

Question 50

APINCH

Answer 50

Black Box drugs. A - antimicrobials (the -mycin family and amphotericin) P - Potassium & other electrolytes (injections of concentrated electrolytes) I - Insulin N - Narcotics (opioids, anesthetics, and sedatives) C - Chemotherapeutic agents (methotrexate, etc) H - Heparin and other anticoagulants (Warfarin, etc).

Question 51

Which ways can drugs be excreted?

Answer 51

renal, glandular, pulmonary, and fecal

Question 52

T/F: Blood flow to the liver decreases with age

Answer 52

True

Question 53

Do newborns have more fat than water?

Answer 53

No, they have more water than fat (75% water).