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patho-pharm > Week 1: intro and cells/immune system > Flashcards

Week 1: intro and cells/immune system Flashcards

1
Q

generic name-where is it categorized and what is it, example

A

-in pharmacies, this is how it is categorized
-medicine’s active ingredient that makes it work
-nonproprietary
-ex. ibuprofen

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2
Q

trade name

A

name of company
- proprietary name
- advil

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3
Q

what are the 3 types of drug names

A

chemical
generic
trade

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4
Q

what are the 5 pharmacological priniciples

A

pharmaceutics
pharmacokinetics
pharmacodynamics
pharmacotherapeutics
pharmacognosy

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5
Q

what are the 3 phases of drug activity

A

pharmaceutical phase
pharmacokinetic phase
pharmacodynamic phase

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6
Q

what occurs during the pharmaceutical phase

A

disintegration of dosage form

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7
Q

what occurs during the pharmacokinetic phase

A

absorption, distribution, metabolism, excretion

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8
Q

what occurs during the pharmacodynamic phase

A

drug-receptor interaction

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9
Q

why is drug absorption generally slower in young and the elderly

A

less gastric juices

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10
Q

what can increase and decrease absorption depending on the situation

A

food

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11
Q

pharmacokinetics…determines what and when it is

A

determines how it goes up/down and how fast it goes into you
*whenever you are told to take something with food

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12
Q

drug absorption of various oral preparations…fastest to slowest

A

liquids, elixirs, syrups
suspension sol’n
powders
capsules
tablets
coated tablets
enteric-coated tablets

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13
Q

pharmacokinetic phase is the process of…and what are the 4 things

A

drug movement to achieve drug action
1. absorption
2. distribution
3. metabolism
4. excretion

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14
Q

pharmacokinetic phase: absorption. this is the process of

A

the drug leaving the site of administration and becoming available

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15
Q

what is the main purpose of the pharmacokinetic phase, what does it require, what is most important here

A

-wants meds to be available
-requires food and fluids
-rate of blood flow to the small intestines and the acidity of the stomach is most important here

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16
Q

what factors affect absorption: pharmacokinetic phase(examples and were is it absorbed)

A

*most oral drugs are absorbed into the surface area of the small intestine
- how drug was delivered
-the food and fluids that were given with the drug
- dosage formulation
- status of the absorptive surface
- rate of blood flow to the small intestines
-acidity of the stomach
- status of GI motility

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17
Q

first pass effect…what is it, where, practical application

A
  • anything that comes into the body goes through the liver and it potentially metabolized
  • only occurs when the GI tract is involved
  • the reason why ppl get such a high dose of drugs is because the majority of the medication is metabolized by the liver. more drug you give, the faster the liver gets rid of it
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18
Q

official definition of first pass effect

A

the metabolism of a drug and its passage from the liver into the circulation

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19
Q

ways to bypass the liver-pharmacokinetic phase

A

sublingual
buccal
rectal
intravenous
intranasal
transdermal
vaginal
intramuscular
subcutaneous
inhalation

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20
Q

when bypassing the liver what route undergoes a higher degree of first-pass effects

A

rectal

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21
Q

when do you use the various methods of bypassing the liver: rectal

A

helpful when pl can’t swallow

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22
Q

when do you use the various methods of bypassing the liver: intranasal

A

mostly recreational

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23
Q

when do you use the various methods of bypassing the liver: transdermal

A

patch: slow process
24-48 hours before the drug will work

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24
Q

when do you use the various methods of bypassing the liver: sublingual

A

used commonly for panic attacks, short term solution, quick acting

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25
Q

when do you use the various methods of bypassing the liver: intramuscular and subcutaneous

A

gives diff flow of meds

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26
Q

when do you use the various methods of bypassing the liver: inhalation

A

delivers drugs you want to the place the injury is, gets less side effects because you don’t need as many meds

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27
Q

when do you use the various methods of bypassing the liver: subcutaneous

A

subcutaneous port: for pain pump, pain relief long term if the patient can’t handle oral

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28
Q

when do you use the various methods of bypassing the liver: intravenous

A

terrible for chronic pain because its fast acting

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29
Q

pharmacokinetics: distribution, what is it, what is it influenced by and why is it important

A

-drugs are distributed throughout the body by the bloodstream (circ system)
- influenced by: blood flow, affinity to the tissues, protein-binding, volume of drug distribution
- differential blood flow can change the effectiveness of the drug

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30
Q

pharmacokinetics: metabolism, where, whats it called and what enzyme

A

liver, biotransformation
cytochrome P-450 enzymes

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31
Q

what does the p-450 do

A

makes it easy for the body to find it and get rid of it
makes it water soluble

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32
Q

what are hepatics biotransformations

A

variations of p-450

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33
Q

when do people use renal dosing

A

for ppl in renal failure bc it will stay in their body, bc they can’t eliminate

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34
Q

pharmacokinetics: excretion, what does it mean, what organ, other routes

A

-elimination of drugs from body
- kidney-main organ
-liver, bile feces, lungs, saliva, sweat and breast milk

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35
Q

pharmacokinetics: half life of a drug…what effects it, what is it useful for, how it is determined

A

-metabolism and elimination affects it
- useful for determining ‘steady state’
- determined on how fast your liver works/how effective your kidney is

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36
Q

after 5 half-lifes what does that mean for the drugs

A

that there is effectively 0 drugs

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37
Q

what is a steady state, why is it important, used for what

A

-for chronic meds
- same amount of drug floating around at the same time (drug eliminated=drug absorbed)
-achieve a therapeutic effect

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38
Q

pharmacodynamics…what is it

A

what the drug does to people

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39
Q

pharmacodynamics: mechanisms of actions

A

-receptor interaction: reactive site allows (agonist) or blocks (antagonist) physiological response
- enzyme interaction: drug inhibits/alters physiological response of an enzyme
- non-specifics interaction: drugs interfere with or chemically alter cellular/metabolic processes

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40
Q

pharmacotherapeutics: nursing responsibility-assessment

A

current meds, pregnancy, illnesses, allergies, sensitivities, contraindications

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41
Q

pharmacotherapeutics: nursing responsibility- implementation

A

intent of the therapy, psycho-motor skill of administering

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42
Q

pharmacotherapeutics: nursing responsibility-monitoring

A

client’s condition (therapeutic effect), side effects, adverse effects/rxns, toxic effects: all drugs capable, interactions

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43
Q

most important things while monitoring

A

charting
monitoring drug-drug interactions bc once you get past 3 drugs interacting you have no clue what will happen next

44
Q

monitoring drug-drug interactions…types of effect

A

additive effects: 2 drugs that work the same given together
synergistic effect: combined effects greater than if drug was given alone
antagonistic effect: effects that are less than if the drugs given separately
incompatibility: 2 parenteral drugs dont mix and chemical deterioration occurs

45
Q

3 other drug related effects

A

teratogenic: all done in animals then observed in humans
mutagenic: causes a change as you go along
carcinogenic

46
Q

what is a controlled substance

A

anything that has street value for recreational/not approved use

47
Q

3 categories of over-the-counter drugs and example

A
  1. restricted access drug-ask pharmacist ex. insulin
  2. pharmacy only, antihistamines
  3. general retail- acetaminophen
48
Q

criteria for OTC status

A
  • consumer can diagnose conditions, easy use, easy monitor
  • limited drug interaction profile, low misuse potential, favourable adverse affect profile
49
Q

for prescription drugs regarding refills

A

can’t do refills on controlled substances/narcotics only discretionary changes in how you treat it

50
Q

cellular adaptation…cells can adapt by

A

increasing/decreasing in size, number, structure

51
Q

cell adaptation: atrophy
what is it, why does it occur

A

decrease in size of cells
-shrink down due to lack of stimulation
- physiologic, pathologic, disuse, decreased protein synthesis, increased protein catabolism or both
-any muscles with no innervation then it’ll atrophy

52
Q

for cellular adaptation pathologic what is it

A

results from decreases in workload, use, pressure, blood supply, nutrition, hormonal stimulation, and nervous stimulation

53
Q

cell adaptation: hypertrophy, what is it, why is it, casued by?

A

increase in size of cells
- natural adaptation
- increased work demand
- physiologic, pathologic-heart muscle hypertrophy bad
- reversible, not problematic short term, natural

54
Q

cell adaptation: hyperplasia, what is it and leads to what

A

increase in number of cells (more cell division)
-physiologic (compensatory-organs regenerate, hormonal-replaces/supports new growth), pathologic
- leads to more serious conditions

55
Q

dysplasia: what is it, what is formed, when it is used in the real world

A

abnormal changes in size, shape, and organization of cells
- errors being formed
- precancerous…not cancer yet
- this is what you are looking for in PAP smears and can see it in biopsies

56
Q

cell adaptation: metaplasia, what is it, and examples

A

reversible replacement of one mature cell by another sometimes less differentiated cell type
-reprogramming of stem cells
ex. scar tissue just holds side a to side b, COPD is scar tissue in lings

57
Q

ways to hurt a cell

A

hypoxic: lack of oxygen
anoxia: total lack of oxygen
ischemia: reduced blood supply leading to cellular death

58
Q

what happens if a cell dies

A

necrosis-process of cellular dissolution

59
Q

what happens during necrosis and what is used to make you feel better

A

-when the cells die, membrane disappears and all the stuff it was filled with goes into the blood
-steroids are used with chemo patients to mop up the shit the cells expel so you feel better

60
Q

what is the process of cells dying naturally and what does it do

A

apoptosis: programmed cell death characterized by active cellular self-destruction

61
Q

what is a hematoma and what is the limitation, what happens once it’s drained

A

collection of blood in soft tissues
- you can’t draw up clotted blood
- once a hematoma is drained if it was big enough it can cause a depression in the structures around it

62
Q

contusion, what, where, major cause of bruising in the elderly

A

bruise (ruptured blood vessels without break in the skin)
-interstitial
- when you are old, aspirin (anticoagulant) and thin skin is one of the reasons for major bruising

63
Q

laceration, what is it, why should you close it

A

-tear in the skin
-close it to prevent infection

64
Q

avulsion

A

flap of lacerated skin

65
Q

amputation

A

severed limb/area of the body

66
Q

abrasion, what is it, why is it difficult

A

removal of superficial layers of skin
-this is difficult to clean because they take a long time to heal

67
Q

types of necrosis

A

dry gangrene

68
Q

ways your skin protects itself

A

-skin and epithelial linings
- mucus, sweat, tears, earwax, saliva
- proteins on skin
- normal bacterial flora
- mechanical processes like cough, vomiting or sneezing

69
Q

second line of defence

A

inflammatory response

70
Q

what activates the inflammatory response

A

infection, mechanical damage, oxygen deprivation, chemical agents, temp, radiation

71
Q

types of immune response

A

-non specific immune response
- specific immune response
- humoral response (b cells)
- cell-mediated response (t cells)

72
Q

steps of the inflammatory response

A
  1. damaged tissues release histamines, increasing blood flow
  2. histamines cause capillaries to leak, releasing phagocytes, clotting factors into the wound
  3. phagocytes engulf bacteria, dead cells, cellular debris
  4. platelets move out of the capillary to seal the wounded area
73
Q

inflammation sx-symptoms

A

-increased blood flow results in heat
- increased capillary leakage causes swelling
- increased histamine and other cytokines causes pain and itching

74
Q

humoral mediated (b cell) is also known as

A

antibody mediated immunity

75
Q

stages of humoral mediated immune response

A
  1. activation phase where macrophage engulfs invader and present antigens on their surface
  2. T-helper cells recognize and bond to antigens
  3. effector phase-activated Th cells trigger B cells to proliferate and release antibodies
76
Q

humoral mediated(b cell)-ways different antibodies work

A

-agglutination: makes pathogens clump together
- antitoxins: neutralize the toxins produced by bacteria
- lysis: digests the bacterial membrane, killing the bacterium
- opsonisation: coats the pathogen in proteins that identifies them as foreign cells

77
Q

what happens when B cells are confronted with an antigen: first and second

A

first: b cells produce memory cells, as well as plasma cells (primary response)
second: memory cells now stick to and destroy antigen

78
Q

primary response: what is, and duration

A
  • Be cells produce memory cells and plasma cells
  • slow response: days/ weeks to recruit enough plasma cells to bring infection under control
79
Q

secondary response: what is it and response time

A
  • quicker response
  • memory cells are used and they stick on and destroy antigens
80
Q

cell meditated (t cell) also known as

A

cytotoxic (killer) t cells

81
Q

what do cytotoxic(killer) t cells do

A

attacks body cells that have been infected by virus, bacteria or fungus

82
Q

where does immune response occur

A

thymus gland, lympth nodes, breast, liver, spleen, lymph nodes

83
Q

wound healing

A
  1. inflammatory phase: rinsed by blood and filled with blood-collagen and fibrin constituents
  2. proliferation phase: resorption of blood-collagen and reepithelialization
  3. maturation and remodeling phase: growth of new epithelial cells
84
Q

what are the physiological signals that make you aware that you are responding to stress

A

Increased heart rate, shallow breathing, muscle tension, sweating, dilated pupils, digestive changes, and cognitive effects signal stress response.
-fight or flight

85
Q

what makes you waterproof

A

carotene

86
Q

what part of the autonomic nervous system is the stress response a part of

A

sympathetic branch

87
Q

what other glands/ system is part of the stress response

A

pituitary and adrenal glands of the endocrine system and the immune system

88
Q

how is the stress response triggered?

A

by actual stressor present in body or perceived by mind

89
Q

what does an aroused SNS cause

A

catecholamines to be released by adrenal gland

90
Q

hypothalamic corticotropin-releasing factor (CRF) stimulates what to release hormones

A

pituitary gland

91
Q

what does adrenocorticotrophic hormones (ACTH) stimulate?

A

adrenal gland or adrenal cortex to release cortisol

92
Q

two types of catecholamines and what does it do

A

epinephrine and norepinephrine
prepares body for fight or flight

93
Q

qualities of epinephrine

A

enhances cardiac motility, heart rate and venous return, dilates skeletal blood vessels, causes transient hyperglycemia, mobilizes free fatty acids and cholesterol

94
Q

qualities of norepinephrine

A

regulates/raises blood pressure by constricting peripheral vessels, inhibits GI activity, dilates eyes

95
Q

importance of cortisol

A

-mobilizes substance needed for cellular metabolism
- increases blood glucose, increase in hormone actions

96
Q

what could high cortisol result in

A

immunosuppression

97
Q

what does cortisol directly influence

A

immune responses to antibodies suppresses inflammatory response

98
Q

what is sodium balance mediated by

A

aldosterone- a mineralocorticoid

99
Q

what synthesizes and secretes aldosterone

A

adrenal cortex

100
Q

what does aldosterone do and where

A

increase the reabsorption of sodium and secretion of potassium by the distal tubule of the kidney

101
Q

what could immune-related conditions be related to

A
  • stress
  • interactions between immune, nervous and endocrine systems
102
Q

central stress response

A

-glucocorticoids (adrenal cortex) due to adrenocorticotrophic hormone (pituitary gland)
- parasympathetic system
- allostasis
- chronic or disregulated allostasis

103
Q

function of parasympathetic system

A

balances the sympathetic nervous system
-influences adaptation/maladaptation to stress

104
Q

allostasis function

A

adaptive physiologic response to stressful events

105
Q

chronic or disregulated allostasis meaning

A

long-term or chronic exaggerated responses to stress
can lead to disease

patho-pharm (3 decks)

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