Week 1 - terminologies Flashcards
First recorded reference to pharmacology was written by
Samuel Dale in 1693
Father of American pharmacology
John Jacob Abel
Factors affecting drug response
age: infant/elderly (give less drugs)
weight: peds based on kilograms
gender: female (high in fat) male (high in muscle ) [hormones]
health status: liver/kidney problem; immune suppress; vascular inefficiency ( decrease blood flow); pregnancy (teratogenic)
tetratogenic: category (A, B, C, D, X) [D or X do not give]
genetics: missing enzymes affect drug metabolism (absorption); lacking of clotting factors; caffeine clearance rate
body mass: in general inceased BM = increased drugs
Drug-to-drug interaction
tolerance: pain meds
compliance: (TB meds 3mo/6mo/9mo)
Diet (food interaction): grapefruit juice; drugs taken before/with/after food
Routes of medication administration
oral: enteric coated; g-tube IM: 90 degrees; z-track SubQ: 45-90 degrees transdermal: through skin/patch IV: bolus, push, drip eye drops ear drops
Pharmacology
the study of medicine; the discipline pertaining to how drugs improve or maintain health
subject ranging from understanding how drugs are administered, to where they travel in the body, to the actual responses produced
biologics
naturally produced substances use for prevention/ treatment process
substances that produce biologic responses withing the body; they are syntehsized by cells of the human body, animal cells, or microogranism
agents naturally produced in animal cells, by microorganisms, or by the body itself
therapeutic action
desired affect
*depends on use of drug - the therapeutic and S/E changes
how a drug produces its physiological effect on the body
the beneficial effect that medical treatment causes to the body
i.e. a diuretic treats HTN by lowering plasma vol
adverse reaction
undesireable effect (S/E)
negative reactions to a drug
undesirable, inadvertent, unexpected and potentially dangerous responses to a medication
allergic reaction
slow progress
acquired hyper response of the body defenses to a foreign substance (allergen)
occurs when an individual develops an immune response to a medication
pruitus, edema, runny nose, skin rash, or reddened eyes with tears
anaphylaxis
a severe type of allergic reaction that involves the massive, systemic release of histamine and other chemical mediators of inflammation that can lead to life-threatening shock
a life-threatening, immediate allergic reaction that causes respiratory distress, severe bronchospasm, laryngeal edema, a quick drop in B/P, as well as cardiovascular collapse
allergies to bee stings, tree nuts, plants/animals, acute dyspnea, hypotension, tachycardia
REQUIRES IMMEDIATE ATTENTION
contraindication
reason to not give drug
conditions that make it unsafe or potentially harmful to administer specific medications
specific situation in which a drug, procedure, surgery should not be used, because it may be harmful to the person
tetracyclines can stain developing teeth
side effects
expected drug reaction
expected and predictable effects that result at therapeutic dosages
morphine of pain relief usually results in constipation
therapeutic classification
classify according to use (how it works –> mechanism of action)
method for organizing drugs on the basic of their clinical usefulness in treating particular disease
drugs are classified into different groups according to their chemical characteristics, structure and how they are used to treat specific disease
influence blood clotting - anticoagulant, lowering blood cholesterol - antihyperlipidemic
pharmacologic classification
method for organizing drugs on the basis of their mechanism of action
drugs are organized by the way they work
mechanism of action: decrease plasma volume - diuretic, blockes heart calcium channels - calcium channel blocker, dilates peripheral blood vessels - vasodilator
chemical name
base or chemical composition
strict chemical nomenclature used for naming drugs established by the international union of pure and applied chemistry (IUPAC)
generic name
US adopted name council
there is only one generic name for each drug which is assigned by the U.S. Adopted Name Council
generic names does not change between states
- most does not change in different countries
Trade name
brand name - manufacturer
assigned by the company marketing the drug
proprietary or product or brand name
bioavailability
amount of a drug to cause therapeutic effect
ability of a drug to reach the bloodstream and its target tissues
the physiological ability of the drug to reach its target cells and produce its effects
1st pass effect, mostly for oral
- some drugs get deactivated
(whatever available drug to reach the site is the bioavailability
Formulary list of drugs
hopsitals, pharmacists, carries
covered by insurance, can be prescribed and dispensed
list of drugs and drug recipes commonly used by pharmacists
the first standard commonly used by pharmacists, list of drugs and drug recipes (US Pharmacopoeia [USP]) established in 1820
a list of prescribed drugs, both generic and brand name, used by practitioners to id drugs that offer the greatest overall value
negative formulary list
can not be presrived or dispensed
not covered by insurance
reasons to be on the list: black box warnings; S/E; costs
a list of tradename drugs that pharmacists may not dispense as generic drugs
drugs specifically determiend by Board of Pharmay and Board of Medicine to demonstrate clinically significant biological/therapeutic inequivalence, could produce adverse clinical effects, or pure threat to health and patient safety
addiction
psychological craving for substance
the continue use of a substance despite its negative health and social consequences
overwhelming feeling that drives someone to use a drug repeatedly
dependance
physiological and psychological
-do not get substance –> exhibit withdrawal
strong physiological or psychological need for a substance
controlled substances
potential abuse for scheduled classifications
a drug whose use is restricted by the COntrolled Substance Act of 1970
have a potential for abuse and dependence and have a “schedule” classification
Schedule 1: highest potential for abuse (heroin, LSD, marijuana, ectasy)
Schedule 5: lowest
Teratogenic drug classification
a substance that has the potential to cause a defect in an unborn child during pregnancy
places drugs into categories A, B, C, D, X
category A: the safest group
category X: the most danger to the fetus
Pharmacokinetics and its four compnents
how drug travel in the body
- absorption: depends on route
- distribution: blood, lymphatic channels
- metabolism: liver, parts of kidneys
- excretion: kidneys, lungs, skin
study of how drugs are handled by the body
biotransformation
chemical change a chemical undergo in body
affinity of drug
metabolism (biotransformation) process of chemically converting a drug to a form that is usually more easily removed from the body
total of all biochemical reactions in the body
affinity
ability of drug to attach to receptors
chemical attraction that impels certain molecules to unite with others to form complexes
attraction, for certain medications
agents that are attracted to adipose tissue are thiopental (Pentoltholss), diazepam (Valium), and lipid-soluble vitamins
drug protein complex
drug combine to protein; protein becomes unavailable of action
increase protein complex –> decrease action of drug
drug that has bound reversible to a plasma protein, particularly albumin, that makes the drug unavailable for distribution to body tissues
many drugs bind reversibly to plasma proteins…are too large to cross capillary membranes; thus, the drug is not available for distribution to body tissues
conjugates
combination of drugs that makes it more water soluble and helps excrete from the system
side chains that, during metabolism, make drugs more water soluble and more easily excreted by the kidney
therapeutic level
dosage range
low: not medicated enough
high: patient is more toxic
refers to either the dosage range or blood plasma or serum concentration usually expected to achieve desired therapeutic effects
plasma concentration
amount of plasma in the blood
a measure of how much of a compound is present in a sample of plasma
plasma half life of a drug
length of time for drug to become 50%
when to give the next dose (rate depends on plasma half life)
adenonsine half life is 8-sec
the length of time required for the plasma concentration of a drug to decrease by half after administration
loading dose
give highest dose first
- so to reach therapeutic level first
comparatively large dose given at the beginning of treatment to rapidly obtain the therapeutic effect of a drug
a higher amount of drug, often given only once or twice to “prime” the bloodstream with a sufficient level of drug
maintenance dose
once therapeutic level is reached, give pills and meds to continue/maintain it
dose that keeps the plasma drug concentration continuously in the therapeutic range
are given to keep the plasma drug concentration in the therapeutic range
lethal dose
amount of drug that can cause at least 50% death of patients
the dose of a chemical or biological preparation that is likely to cause death
toxicity
an adverse medication effect that is considered severe and can be life-threatening
refers to how poisonous or harmful a substance can be. drug toxicity occurs when a person has accumulated too much of a drug in his bloodstream, leadnig to adverse effects withing the body
therapeutic index
a window; ratio between 2 doses
- lethal dose and effective dose (LD_50 - ED_50)
a measure of a drug’s safety margin; the higher the value, the safer the drug. The therapeutic index offers the nurse practical information on the safety of the drug and a means to compare one drug with another
potency
the strength of a drug at a specified concentration or dose
a drug that is more potent will produce a therapeutic effect at a lower dose, compared with another drug in the same class
efficacy
the ability of a drug to produce a desired response
the magnitude of maximal response that can be produced form a particular drug
agonist
are helpers
agonists bind to receptors to make receptors to do their functions
drug that is capable of binding with receptors to induce a cellular response
medications that bind to or mimic the receptor activity that endogenous compounds regulate
antagonist
blockers
antagonist blocks receptors
drugs that blocks the response of another drug
medications that can block the usual receptor activity that endogenous compounds regulate or the receptor activity of other medications
antidote
medication to counteract specific poison
suppress the adverse effect of a specific drug
counter the effects of poisons or toxins in a number of cases
general areas of toxicity where antidotes may be effective include heavy metals, radioactive exposure, and overdosing of pharmacologic agents
receptor
places where drugs go and combine to cause changes in the body
the structural component of a cell to which a drug binds in a dose-related manner to produce a response
a cellular macromolecule to which a medication binds in order to initiate its effects
pharmacogenetics
area of pharmacology that examines the role of genetics in drug response
the study of genetic variations that give rise to differences in drug response
medication reconciliation
for patient admit, transfer, discharge
- meds taken at home, prescribed drugs, OTC drugs, herbal supplements can cause othe rproblems
the process of keeping track of patients’ medications as their care proceeds form one health care provider to another
a process of comparing and reconciling a list of patient’s current medications with new medication prescriptions to resolve any discrepancies
polypharmacy
taking too much medications at once/ multiple medications for one drug
- reason - multiple providers
- go to multiple pharmacies
- lost of memory (dementia)
the taking of multiple drugs concurrently
patient receiving multiple prescriptions, sometimes for the same condition, that have conflicting pharmacologic actions
receptors in human body and its functions
beta and alpha: types of subreceptor found in the sympathetic nervous system
kappa and mu: type of opioid receptor
beta receptors
- beta 1: heart
- beat 2: bronchial/vascular smooth muscle
alpha receptors
- vessels
kappa receptors
- opioid receptor for pain
- (KOR) contribute to analgesia in the spine and may exhibit dysphoria and sedation, but do not generally lead to dependence
mu receptors
- opioid receptor
- are thought to give most of their analgesic effects in the CNS as well as many S/E including sedation, respiratory depression, euphoria, and dependence
anticholinergic effect
opposite of muscarinic effect
everything dries up
parasympathetic nervous system
dry mouth; constipation; urinary retention; tachycardia; pupilary dilation; blurring of vision; hyperpyrexia (fever)
drug that blocks the actions of the parasympathetic nervous system
effects that are a result of muscarinic receptor blockade
i.e. dry mouth can be relieved by sipping on liquids; photophobia can be managed by use of sunglasses; and urinary retention can be reduced by urinating before taking the medication
muscarinic effect
opposite of anticholinergic
lots of fluid
diarrhea; urinary incontinence; bradycardia; increase in GI motility
type of cholinergic receptor found in smooth muscle, cardiac muscle, and glands
all these are parasympathetic effects form acetylcholine stimulating the muscarinic receptor
