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
2
Q
trade name
A
name of company
- proprietary name
- advil
3
Q
what are the 3 types of drug names
A
chemical
generic
trade
4
Q
what are the 5 pharmacological priniciples
A
pharmaceutics
pharmacokinetics
pharmacodynamics
pharmacotherapeutics
pharmacognosy
5
Q
what are the 3 phases of drug activity
A
pharmaceutical phase
pharmacokinetic phase
pharmacodynamic phase
6
Q
what occurs during the pharmaceutical phase
A
disintegration of dosage form
7
Q
what occurs during the pharmacokinetic phase
A
absorption, distribution, metabolism, excretion
8
Q
what occurs during the pharmacodynamic phase
A
drug-receptor interaction
9
Q
why is drug absorption generally slower in young and the elderly
A
less gastric juices
10
Q
what can increase and decrease absorption depending on the situation
A
food
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
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
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
14
Q
pharmacokinetic phase: absorption. this is the process of
A
the drug leaving the site of administration and becoming available
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
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
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
18
Q
official definition of first pass effect
A
the metabolism of a drug and its passage from the liver into the circulation
19
Q
ways to bypass the liver-pharmacokinetic phase
A
sublingual
buccal
rectal
intravenous
intranasal
transdermal
vaginal
intramuscular
subcutaneous
inhalation
20
Q
when bypassing the liver what route undergoes a higher degree of first-pass effects
A
rectal
21
Q
when do you use the various methods of bypassing the liver: rectal
A
helpful when pl can’t swallow
22
Q
when do you use the various methods of bypassing the liver: intranasal
A
mostly recreational
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
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
25
when do you use the various methods of bypassing the liver: intramuscular and subcutaneous
gives diff flow of meds
26
when do you use the various methods of bypassing the liver: inhalation
delivers drugs you want to the place the injury is, gets less side effects because you don't need as many meds
27
when do you use the various methods of bypassing the liver: subcutaneous
subcutaneous port: for pain pump, pain relief long term if the patient can't handle oral
28
when do you use the various methods of bypassing the liver: intravenous
terrible for chronic pain because its fast acting
29
pharmacokinetics: distribution, what is it, what is it influenced by and why is it important
-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
30
pharmacokinetics: metabolism, where, whats it called and what enzyme
liver, biotransformation
cytochrome P-450 enzymes
31
what does the p-450 do
makes it easy for the body to find it and get rid of it
makes it water soluble
32
what are hepatics biotransformations
variations of p-450
33
when do people use renal dosing
for ppl in renal failure bc it will stay in their body, bc they can't eliminate
34
pharmacokinetics: excretion, what does it mean, what organ, other routes
-elimination of drugs from body
- kidney-main organ
-liver, bile feces, lungs, saliva, sweat and breast milk
35
pharmacokinetics: half life of a drug...what effects it, what is it useful for, how it is determined
-metabolism and elimination affects it
- useful for determining 'steady state'
- determined on how fast your liver works/how effective your kidney is
36
after 5 half-lifes what does that mean for the drugs
that there is effectively 0 drugs
37
what is a steady state, why is it important, used for what
-for chronic meds
- same amount of drug floating around at the same time (drug eliminated=drug absorbed)
-achieve a therapeutic effect
38
pharmacodynamics...what is it
what the drug does to people
39
pharmacodynamics: mechanisms of actions
-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
40
pharmacotherapeutics: nursing responsibility-assessment
current meds, pregnancy, illnesses, allergies, sensitivities, contraindications
41
pharmacotherapeutics: nursing responsibility- implementation
intent of the therapy, psycho-motor skill of administering
42
pharmacotherapeutics: nursing responsibility-monitoring
client's condition (therapeutic effect), side effects, adverse effects/rxns, toxic effects: all drugs capable, interactions
43
most important things while monitoring
charting
monitoring drug-drug interactions bc once you get past 3 drugs interacting you have no clue what will happen next
44
monitoring drug-drug interactions...types of effect
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
3 other drug related effects
teratogenic: all done in animals then observed in humans
mutagenic: causes a change as you go along
carcinogenic
46
what is a controlled substance
anything that has street value for recreational/not approved use
47
3 categories of over-the-counter drugs and example
1. restricted access drug-ask pharmacist ex. insulin
2. pharmacy only, antihistamines
3. general retail- acetaminophen
48
criteria for OTC status
- consumer can diagnose conditions, easy use, easy monitor
- limited drug interaction profile, low misuse potential, favourable adverse affect profile
49
for prescription drugs regarding refills
can't do refills on controlled substances/narcotics only discretionary changes in how you treat it
50
cellular adaptation...cells can adapt by
increasing/decreasing in size, number, structure
51
cell adaptation: atrophy
what is it, why does it occur
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
for cellular adaptation pathologic what is it
results from decreases in workload, use, pressure, blood supply, nutrition, hormonal stimulation, and nervous stimulation
53
cell adaptation: hypertrophy, what is it, why is it, casued by?
increase in size of cells
- natural adaptation
- increased work demand
- physiologic, pathologic-heart muscle hypertrophy bad
- reversible, not problematic short term, natural
54
cell adaptation: hyperplasia, what is it and leads to what
increase in number of cells (more cell division)
-physiologic (compensatory-organs regenerate, hormonal-replaces/supports new growth), pathologic
- leads to more serious conditions
55
dysplasia: what is it, what is formed, when it is used in the real world
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
cell adaptation: metaplasia, what is it, and examples
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
ways to hurt a cell
hypoxic: lack of oxygen
anoxia: total lack of oxygen
ischemia: reduced blood supply leading to cellular death
58
what happens if a cell dies
necrosis-process of cellular dissolution
59
what happens during necrosis and what is used to make you feel better
-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
what is the process of cells dying naturally and what does it do
apoptosis: programmed cell death characterized by active cellular self-destruction
61
what is a hematoma and what is the limitation, what happens once it's drained
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
contusion, what, where, major cause of bruising in the elderly
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
laceration, what is it, why should you close it
-tear in the skin
-close it to prevent infection
64
avulsion
flap of lacerated skin
65
amputation
severed limb/area of the body
66
abrasion, what is it, why is it difficult
removal of superficial layers of skin
-this is difficult to clean because they take a long time to heal
67
types of necrosis
dry gangrene
68
ways your skin protects itself
-skin and epithelial linings
- mucus, sweat, tears, earwax, saliva
- proteins on skin
- normal bacterial flora
- mechanical processes like cough, vomiting or sneezing
69
second line of defence
inflammatory response
70
what activates the inflammatory response
infection, mechanical damage, oxygen deprivation, chemical agents, temp, radiation
71
types of immune response
-non specific immune response
- specific immune response
- humoral response (b cells)
- cell-mediated response (t cells)
72
steps of the inflammatory response
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
inflammation sx-symptoms
-increased blood flow results in heat
- increased capillary leakage causes swelling
- increased histamine and other cytokines causes pain and itching
74
humoral mediated (b cell) is also known as
antibody mediated immunity
75
stages of humoral mediated immune response
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
humoral mediated(b cell)-ways different antibodies work
-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
what happens when B cells are confronted with an antigen: first and second
first: b cells produce memory cells, as well as plasma cells (primary response)
second: memory cells now stick to and destroy antigen
78
primary response: what is, and duration
- Be cells produce memory cells and plasma cells
- slow response: days/ weeks to recruit enough plasma cells to bring infection under control
79
secondary response: what is it and response time
- quicker response
- memory cells are used and they stick on and destroy antigens
80
cell meditated (t cell) also known as
cytotoxic (killer) t cells
81
what do cytotoxic(killer) t cells do
attacks body cells that have been infected by virus, bacteria or fungus
82
where does immune response occur
thymus gland, lympth nodes, breast, liver, spleen, lymph nodes
83
wound healing
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
what are the physiological signals that make you aware that you are responding to stress
Increased heart rate, shallow breathing, muscle tension, sweating, dilated pupils, digestive changes, and cognitive effects signal stress response.
-fight or flight
85
what makes you waterproof
carotene
86
what part of the autonomic nervous system is the stress response a part of
sympathetic branch
87
what other glands/ system is part of the stress response
pituitary and adrenal glands of the endocrine system and the immune system
88
how is the stress response triggered?
by actual stressor present in body or perceived by mind
89
what does an aroused SNS cause
catecholamines to be released by adrenal gland
90
hypothalamic corticotropin-releasing factor (CRF) stimulates what to release hormones
pituitary gland
91
what does adrenocorticotrophic hormones (ACTH) stimulate?
adrenal gland or adrenal cortex to release cortisol
92
two types of catecholamines and what does it do
epinephrine and norepinephrine
prepares body for fight or flight
93
qualities of epinephrine
enhances cardiac motility, heart rate and venous return, dilates skeletal blood vessels, causes transient hyperglycemia, mobilizes free fatty acids and cholesterol
94
qualities of norepinephrine
regulates/raises blood pressure by constricting peripheral vessels, inhibits GI activity, dilates eyes
95
importance of cortisol
-mobilizes substance needed for cellular metabolism
- increases blood glucose, increase in hormone actions
96
what could high cortisol result in
immunosuppression
97
what does cortisol directly influence
immune responses to antibodies suppresses inflammatory response
98
what is sodium balance mediated by
aldosterone- a mineralocorticoid
99
what synthesizes and secretes aldosterone
adrenal cortex
100
what does aldosterone do and where
increase the reabsorption of sodium and secretion of potassium by the distal tubule of the kidney
101
what could immune-related conditions be related to
- stress
- interactions between immune, nervous and endocrine systems
102
central stress response
-glucocorticoids (adrenal cortex) due to adrenocorticotrophic hormone (pituitary gland)
- parasympathetic system
- allostasis
- chronic or disregulated allostasis
103
function of parasympathetic system
balances the sympathetic nervous system
-influences adaptation/maladaptation to stress
104
allostasis function
adaptive physiologic response to stressful events
105
chronic or disregulated allostasis meaning
long-term or chronic exaggerated responses to stress
can lead to disease
