Unit One Exam Flashcards
____-OSIN STANDS FOR WHICH DRUG
ALPHA BLOCKERS
Cholinergic/Parasympathetic Saliva
Liquid
Placental Barrier
Spontaneos abortion
tertogenesis
Adrenergic/sympathetic ALPHA 1 LOCATION
arterioles
prostate
bladder
eyes
Adrenergic/sympathetic Bronchi
dilation
Cholinergic/Parasympathetic Eyes
ACCOMMODATION FOR:
Near vision miosis
Nervous system has two main divisions
Central
peripheral
Free Drug
Active drug
able to exit the blood vessels and reach their sit of action causing a pharmacologic response
WET SYMPTOMS
DECREASED:
-BP & HR
INCREASED:
BLOOD FLOW (STOMACH, INTESTINES, KIDNEYS)
BLADDER TONE (URINARY SPHINCTER RELAXATION)
SALIVATION
PERISTALSIS (DIGESTIVE SECRETIONS)
PUPIL CONSTRICTION (NO DILATION W/ GLAUCOMA)
Cholinergic
Rest and Digest
Nonmaleficence
DO NO HARM
Cultural Considerations:
Communication Styles
Spatial Preference
Perception of Time
Environmental Control
Social Organization
Biologic Variations
Blood Brain Barrier
Lipid soluble
low molecular weight
IM, Sub Q, Intrathecal onset
several minutes
Additive Interactions
like-drugs
1+1=3
Adrenergic/sympathetic CNS
increased
drive
alertness
Problems assoc. with OTC drugs
-mask signs/symptoms of disease
-can interact with Rx drugs
-can be taken in larger quantities than recommended dose
PARASYMPATHETIC AGONIST
BRADYCARDIA
HYPOTENSION
SALIVATION
URINATION
DIARRHEA (DEFECATION/GI MOTILITY)
MICTURITION (URNARY URGE)
PUPIL CONSTRICTION (OK FOR GLAUCOMA)
BRONCHOSPASMS (BAD WITH ASTHMA)
(S.L.U.D.(G).(E).)
Brand/trade name
-Selected by the company
-protected by copyright
-designed for clinicians and patients to recall and pronounce easily
onset of action
affected by absorption rate
WET SIDE EFFECTS (S.L.U.D.(G).(E).)
S- SALIVATION
L- LACRIMATION
U- URINATION
D- DEFECATION
(G)- (GASTRIC UPSET)
(E)- (EMESIS)
CHOLINERGIC CRISIS
Cholinergic/Parasympathetic Bronchi
Constriction
increased
secretion
oral/transdermal onset
30-60mins
Adrenergic/sympathetic BETA 1 ACTION
Increased:
Cardiac output
HR
Force of heart contractility
BP (renin release)
Socio-Cultural Considerations
Cultural values
Med Beliefs
Diet
Tobacco Use
Economic Factors
Language Expressions
Language Barrier
Spiritual Beliefs
Adrenergic/sympathetic ENZYME FOR DEGREDATION
Monoamine oxidase
Enteric coated/ Sustained Release
DO NOT CRUSH/CHEW
scoured tablets may be split
Exipients
inert fillers
______-OLOL STANDS FOR
PURE BETA BLOCKER
Black Box Label
The drug carries significant, life threatening risks
Schedule 4
Low potential for abuse/dependence
-acceptable medicinal use
-RX required
Xanax, Valium, Ativan
Off Label Use
Use of a drug for a purpose outside the scope of the drug’s approved uses
Autonoy
Ability to make reasonable decisions
Disintegration is the precursor to
Dissolution
Plasma Proteins
Albumin
Lipoproteins
Alph-1-Acid Glycoproteins (AGP)
Drugs can replace/act as substitutes for missing chemicals
neurotransmitters
hormones
Cholinergic/Parasympathetic GI Tract
Increased
secretion
peristalsis
Decreased
Sphincter tone
Parasympathetic NS (Cholinergic)
Craniosacral
Acetylcholine (NT)
Enzymatic Breakdown:
-acetylcholinesterase
Interfere with functioning of foreign cells
antibodies
Therapeutic
-analgesic
-antipyretic
Schedule 2
High potental for abuse and dependence
-some medical properties
Vicodin, Cocaine, Meth
Schedule 3
Moderate potential for abuse/dependence
-acceptable med properties
-Rx required
Tylenol with Codeine, Ketamine, Steroids
Adrenergic/sympathetic GI Tract
Increase
Sphincter tone
Decrease
peristalsis
blood flow
Adrenergic/sympathetic ALPHA 1 ACTION
Vasoconstriction
Pupil Dilation
Decrease
-GI Smooth muscle motility
Autonomic functions
Regulates:
Cardiac tissue
Exocrine Glands:
-sweat
-salivary
-gastric
Smooth muscle in:
-bronchi
-vessels
-GI tract
Drugs can increase/stimulate certain cellular activities
Metabolism
protein synthesis
smooth muscle
Metbolism (primary site)
Liver
enzyme
-cytochrome P450 (many subclasses)
HEPATIC FIRST PASS
Adrenergic/sympathetic BETA 2 ACTION
Dilate bronchi
promotes skeletal muscle blood flow
GI and Uterine relaxation
Glycogenolysis
Adrenergic/sympathetic ANTAGONIST DRUGS BLOCK/EFFECTS/PREVENTS A RESPONSE
BLOCKS
Synthesis
Release
Degredation
Bind/block post synaptic receptor
Adrenergic/sympathetic BETA 1 LOCATION
heart
blood vessels
kidney
Fidelity
Keep Promises
CHOLINERGIC ANTAGONISTS (BLOCKERS)
BLOCK ALPHA AND BETA RECEPTOR SITES
DIRECTLY (OCCUPYING RECEPTORS)
INDIRECTLY (INHIBITING RELEASE OF NT’S)
IV, Intra-arterial, inhalation onset
within one minute
Distribution
Protein Binding
Blood Flow
Barriers:
-Blood Brain Barrier
-Placental Barrier
FAT SOLUBLE STORAGE!!
Protein Binding
Competative binding is a major cause of
Drug-Drug interactions!
adding a med
-may increase original medication therapeutic effect
stopping a med
-may decrease remaining med effect
Low Therapeutic index
-narrow therapeutic range
Justice
Treating People Fairly
Incompatibilities
I dont like you
precipitates
Lipid soluble meds
Rapidly pass through membrane
Adrenergic/sympathetic Liver
Glycogenesis
glucose release
unintended effects
weight gain
tooth decay
REST AND DIGEST RESPONSE RESULTS IN
WET SYMPTOMS (CHOLINERGIC CRISIS)
ADRENERGIC/SYMPATHETIC ANTAGONISTS BLOCK:
BLOCK THE EFFECTS OF ADRENERGIC NEUROTRANSMITTERS
-ALPHA
-BETA
-SELECTIVE VS NONSELECTIVE
BLOCK ALPHA AND BETA RECEPTOR SITES
DIRECTLY
-OCCUPYING RECEPTORS
INDIRECTLY
-INHIBITING RELEASE OF NT’S
Paraenteral
Not into GI tract
Intramuscular (IM)
Intravenous (IV)
Subcutaneous (SQ)
Intradermal
Define side effects
Predictable
CHOLINERGIC/PARASYMPATHETIC ENZYME FOR DEGRDATION
ACETYLCHOLINEASTERASE
PARASYMPATHETIC NERVOUS SYSTEM
REST AND DIGEST
WOKS IN OPPOSITION OF SNS (TO CREATE HOMEOSTASIS)
DECREASES HR
Fight or flight response results in
Increased:
BP & HR
Blood flow to (brain, heart, skeletal muscles)
muscle glycogen (for energy)
Blood Sugar
Rate of coagulation
Pupil dilation
duration action
affected by half life point of lowest concentration
Pharmacologic Class
Family
-non steroidal
-anti inflammatory
Adrenergic/sympathetic BETA 2 LOCATION
Lungs
arterioles
liver
CHOLINERGIC/PARASYMPATHETIC NEUROTRANSMITTER(S)
ACETYLCHOLINE
Cholinergic/Parasympathetic Heart
Decreased
HR & BP
FDA Pregnancy Categories
A- adequate evidence to show no risk to fetus
B- No human studies to show safety (animal studies found no harm)
C- Caution Advised, No adequate human studies (animal studies found harmful effects)
D- Clear evidence of risk to fetus (benefits outweigh potential risk)
X- Clear evidence shows TERATOGENESIS (risks outweigh benefits)
Schedule 5
Lowest potential 4 abuse/dependence
-acceptable medicinal properties
RX required (fewest refill restrictions)
Lomotil, Motofen, Lyrica
ADRENERGIC/SYMPATHETIC BLOCKERS
ANTAGONISTS
Adrenergic/sympathetic bladder
Increase
Sphincter tone
decrease
Detrusor muscle
Enteral Administration-
GI TRACT (80%)
oral
gasric
Nurse Practice Acts:
Laws nurses must abide by
NURSING PROCESS
-assess
-plan
-Intervention
-evaluation
Drugs Depress/Slow/block cellular activities
nerve transmission
peristalsis
immune response
Metabolism (process)
Chemically changes drugs into a form that can be excreted
Pharmacogenetics
The study of Genetic factors that influence an individual response to specific drugs
BETA 2 RECEPTORS EFFECT
LUNGS
Chemical Name
Scientific name
Adrenergic/sympathetic Skeletal muscle
increase
Blood flow
glycogenosis
High Therapeutic Index
Wide therapeutic range
Drug Half Life (T 1/2)
The time it takes to eliminate 50% of the medication
half life determine dosing interval
STEADY STATE REACHED AFTER 4 HALF-LIFE DOSES
Excretion
Elimination from the body
Kidneys/urine (water soluble)
Lungs
Gi Tract, Sweat, Saliva, Tears, Breast Milk
CHOLINERGIC/PARASYMPATHETIC RECEPTORS
MUSCORINIC (MAIN RECEPTOR)
POST-GANGLIONIC
Adrenergic
Fight or Flight sympathetic response
therapeutic index
relationship between the
-effective dose
-toxic dose
BETA 1 RECEPTORS EFFECT
HEART
Adrenergic/sympathetic Fat tissue
lipolysis
fatty acid liberation
synergistic Interactions
unlike drugs
1+b=3
Adrenergic/sympathetic NEUROTRANSMITTERS
Norepinephrine
Epinephrine
Dopamine
Adrenergic/sympathetic Heart
Increase
HR
Pump force
BP
Adrenergic/sympathetic Saliva
DRY MOUTH
ALPHA 1 RECEPTORS EFFECT
BLOOD VESSELS AND PROSTATE
Cholinergic/Parasympathetic Skin
Sweat
CHOLINERGIC/PARASYMPATHETIC MUSCORINIC RECEPTORS LOCATED:
EYE
LUNGS
HEART
BOOD VESSELS
GU SYSTEM (BLADDER AND URINARY SPHINCTERS)
GI TRACT (SALIVARY GLANDS, GASTRIC SECRETIONS, INTESTINAL TONE/MOTILITY)
SWEAT GLANDS
SEX ORGANS (ERECTION)
Bound Drug
Inactive drug
CHOLINERGIC/PARASYMPATHETIC
REST AND DIGEST
FEED AND BREED
health literacy
Capacity to obtain, process, and understand basic health information needed to make health decisions
Adrenergic Fight or Flight Response
Increase
-HR & BP
Shunting blood AWAY from skin and viscera
-to skeletal muscle
Dilating the bronchi
Dilating Pupils
Mobilizing stored energy
antagonistic Interactions
opposite
1+1<1
Metabolism (interactions)
Enzyme inhibition
-decreases
Enzyme induction
-increases
Liver Function (LFT’s)
topical onset
one hour
Adrenergic/sympathetic Eyes
Pupillary dilation
Adrenergic/sympathetic AGONIST DRUGS CAUSE/EFFECT/RESPONSE
Increased
NT Synthesis
NT Release
Destroy Enzyme of Degredation
Attach to post synaptic receptors
blocks reuptake of NT
Intended Effects
Situation-
mood elevation
hunger relief
PARKINSONS SYMPTOMS (S.M.A.R.T.)
S- SHUFFLING GAIT
M- MASK LIKE FACE
A- AKINESIA
R- RIGIDITY
T- TREMOR
Organ Toxicity (drug effects)
Hepatotoxicity
-liver
nephrotoxicity
-kidney
ototoxicity
-eyes
agonist
produces a response
PARASYMPATHETIC ANTAGONIST (BLOCKER)
TACHYCARDIA
HPERTENSION
DRY MOUTH
CONSTIPATION
URINARY HESITENCY (RETENTION)
PUPIL DILATION (NOT FOR PEOPLE W/ NARROW ANGLE GLAUCOMA)
Non-Selective Drugs
Drugs that effect multiple different receptors
antagonist
blocks a response
beneficience
ethical obligation to do good and avoid causing harm
BETA BLOCKER SIDE EFFECTS
BRADYCARDIA
LETHARGY
GI DISTURBANCE
CHF
DECREASED BP
DEPRESSION
sublingual/buccal onset
several mintes
Peripheral Nervous system has two major subdivisions
Somatic
-controls voluntary movements
Autonomic
-Involuntary
Pharmacodynamics
The study of the EFFECT of Drugs on the body
rectal/vaginal onset
15-30 mins
CHOLINERGIC SIDE EFFECTS (L.E.S.S.D.U.M.B.)
L- LACRIMATION
E- EXITATION OF NICOTINIC SYNAPSES
S- SALIVATION
S- SWEATING
D- DIARRHEA
U- URINATION
M- MICTURITION
B- BRONCHOCONSTRICTION
SYMPATHETIC ANTAGONIST (BLOCKER)
BRADYCARDIA
HYPOTENSION (ORTHOSTATIC)
FATIGUE
DEPRESSION
PUPIL CONSTRICTION (OK FOR GLAUCOMA)
BRONCHOSPASMS (BAD WITH ASTHMA)
CHOLINERGIC/PARASYMPATHETIC INDIRECT AGONISTS
TARGET ACETYLCHOLINEASTERASE (DESTROYS)
PREVENTS BREAKDOWN OF NT’S
FDA
protecting public by assuring safety and efficency and security of FOOD (humans/animals), Meds, etc
Also advance PH by speeding innovations to make meds and food safer
Grapefruit juice
Inhibits intestinal enzymes which
decreases drug metabolism so
the juice can Increase potency of some meds
peak action
point of highest concentration
Pharmacokinetics
The process of drug movement throughout the body that is necessary for drug Action
Protein Binding (distribution)
Each drug has a different affinity for plasma proteins
As free drug leaves circulation, protein bound medication is released
drugs in dynamic equilibrium
Sympathetic NS (adrenergic)
Thoraco-lumbar
Norepinephrine (NT)
Enzymatic breakdown
-monoamine oxidase
Autonomic NS Response
Increased
-HR & BP
Shunt blood to muscles
Dilate Bronchi
Mydriasis
Glycogenesis
Cholinergic/Parasympathetic Bladder
Decreased
sphincter tone
Increased
Detrousor
Adrenergic/sympathetic NON SELECTIVE AGONISTS
Epinephrine (A1,B1,B2)
Ephedrine (A1, B1, B2)
Norepinephrine (A1, B1)
Dopamine (A1, B1)
Pseudoephedrine (A1, B1)
Veracity
Tell the truth
water soluble drugs
need carrier
(enzyme/protein)
CHOLINERGIC SYMPTOMS/SIDE EFFECTS:
DRY SYMPTOMS
(CANT PEE, SEE, SPIT, SHIT)
SYMPATHETIC AGONIST
TACHYCARDIA
HYPERTENSION
DRY MOUTH
URINARY RETENTION
HYPERGLYCEMIA
TREMORS
ANXIETY/NERVOUSNESS
PUPIL DILATION
(NOT GOOD FOR PEOPLE WITH NARROW ANGLE GLAUCOMA)
5 Medication Right
Right
-time
-route
-amount
-medication
-patient
Loading Dose
Significantly higher than maintenence dose
given initially to achieve therapeutic levels while reaching “ready state”
Asorption
Into the bloodstream
-across membranes
active/passive transport
concentration/energy/carrier
Interacts with:
-other meds
-GI bacteria
-food
-lifespan
Generic Name
Nonproprietary name
-original name assigned to the drug at the beginning of the evaluation process
BETA BLOCKER ACTION
BLOCKS BETA RECEPTORS IN THE HEART CAUSING:
DECREASED:
-HR
-FORCE OF CONTRACTION
-RATE OF AV CONDUCTION
CHOLINERGIC/PARASYMPATHETIC DIRECT AGONISTS
TARGET PRODUCTION OF NT’S
STIMULATES RECEPTORS (DIRECTLY)
Schedule 1
most potential for abuse and dependence
-no medical properties
Heroin, LSD, Marijuana
