Week 6- Pharmacology Flashcards
1
Q
What is pharmacolgy?
A
- Is the study of drugs, their actions, dosage, therapeutic uses and adverse effects
2
Q
What is the leading cause of pt safety errors in healthcare?
A
- Medication errors
3
Q
What are drugs?
A
- It’s a substance that alters biological activity in a person
4
Q
What are some reasons drugs are prescribed?
A
- Promote healing (anti inflammatory)
- Cure disease (antibacterial)
- Prevent disease
- Control of slow the process (chemo)
- Decrease risk of complications (anticoagulants)
- Increase comfort (analgesic)
- Replacement therapy (insulin)
- Reduce excessive activity (sedative)
5
Q
What 4 disciplines is it separated into?
A
- pharmacodynamics
- pharmacokinetics
- pharmacotherapeutics
- toxicology
6
Q
What is pharmacodynamics?
A
- The study of biochemical and physiological effects of drugs and their mechanisms of action
7
Q
What is pharmacokinetics?
A
- How the body interacts with administered substances for the entire duration of exposure
8
Q
What is pharmacotherapeutics?
A
- The use of drugs for the prevention, treatment, diagnosis, and modification of normal functions. Ex. pregnancy prevention
9
Q
What is toxicology?
A
- Study of the adverse effects of chemicals or physical agents on living organisms
10
Q
What are the drug effects?
A
- Therapeutic= beneficial tx
- Side effects= unwanted rxns
- Toxic effects= dangerous side effects
- Hypersensitivity= allergic rxns
- Idiosyncratic= unusual rxn by an individual to a normally harmless substance
- Iatrogenic= negative effect caused by error or OD
- Teratogenic= harmful effects on fetus
11
Q
What are the 4 interactions?
A
- Synergism
- Antagonism
- Potentiation
- Additive
12
Q
What does synergism mean?
A
- When combined effect is greater than that predicted by their individual potencies, the combination is said to be synergistic
- Med A + Med B= ABCDE- too many side effects
13
Q
What does antagonism means?
A
- Opposing action (half ass works)
14
Q
What does potentiation mean?
A
- To increase the strength or effect
15
Q
What does additive mean?
A
- Combining 2= the sum of each
- Tylenol & advil
16
Q
What does absorption mean when it comes to meds?
A
- From its site of administration into the body to specific target organs and tissues
- Ultimate goal is reaching a therapeutic concentration in the bloodstream
17
Q
What are the mechanisms of medication absorption?
A
- Active transport (moving against the gradient)
- Passive diffusion (doesn’t use energy)
18
Q
Blood flow and medication absorption
A
- A properly functioning circulatory system greatly enhances the rate of meds absorbed
19
Q
What does distribution mean?
A
- Process by which a med moves throughout the body
- Blood is the primary distribution vehicle
- Factors that change the way blood flows will change the way meds are transported
20
Q
What does biotransformation mean?
A
- Manner in which the body metabolizes meds- first pass effect
- Chemical alteration by various bodily systems to create compounds that are more easily excreted from the body
21
Q
What does excretion mean?
A
- Body eliminates the remnants of the drug
- Could be toxic or inactive metabolites
- Occurs primarily through the kidneys via 3 mechanisms (glomerular filtration, tubular secretion, partial reabsorption)
22
Q
What is chronotropic effect?
A
- Changes HR
23
Q
What is Inotropic effect?
A
- Changes the contractility of the heart
24
Q
What does dromotropic effect?
A
- Affects the conduction speed in the AV node, and subsequently the rate of electrical impulses in the heart
25
What do Beta Blockers- Class 2 do?
- Reduce O2 demand of the heart muscle
- Affect the beta cells- B1 (cardiac) & B2 (bronchial)
26
How does Beta Blockers- Class 2 work?
- Blocks the effect of epi & norepi, therby reducing HR
- Dilates blood vessels, thereby reducing BP
- Can affect both B1 & B2 receptors or be selective and affect 1 only
27
What are some common beta blockers?
Ending in LOL
- Atenolol
- Metoprolol- lopressor
- Labetalol
- Propanolol- inderal
- Carvedilol- coreg
- Bisoprolol- monocor
28
What is the main action of Calcium Channel Blockers?
- Main action is to relax smooth muscle, decreasing peripheral resistance
- Used to tx HTN
- 1 Localizes the smooth muscles
- 2 Decreases cardiac workload, HR & cardiac contractions
29
Common calcium channel blockers?
Ending in ine
- Amlodipine
- Nicardipine
- Nifedipine
- Nimodipine
- Felodipine
30
How do diuretics work?
- Decrease BP by decreasing blood volume and sodium retention
- Increase the elimination of water, sodium, and electrolytes
- This then reduces BP by reducing peripheral resistance (by decreasing blood volume) and cardiac output
31
What are diuretics?
"Water Pills"
- Medication that acts on kidneys to increase diuresis
32
What are diuretics used to treat?
- HTN
- Edema (heart failure & pulmonary edema)
- Renal diseases
- Hepatic diseases
33
What are the 5 types of diuretics?
1. Thiazide diuretics- hydrochlorothiazide
2. Loop diuretics- lasix
3. Potassium- sparing diuretics- spironolactone
4. Osmotic diuretics- mannitol
5. Carbonic anhydrase inhibtors- acetacolamide
34
What are loop diuretics?
- Inhibit Na+/ K+/ 2Cl (chlorine) transport proteins in the loop of henle
- This causes a reduction in the reabsorption of sodium which significantly increases diuresis
- Furosemide is the most common
35
What are potassium sparing diuretic?
- Increase diuresis but without causing potassium to leave the body
- Spironolactone- leaves some potassium behind
- Stops the entry of aldosterone into the nephron, which prevents sodium and water retention
36
What are thiazide diuretics?
- Act by inhibiting NaCl reabsorption into the distal convoluted tubule of the kidney
- Happens through the suppression of the sodium chloride contransporter
37
What are thiazide diuretics mainly used to treat?
- HTN
- Heart failure
- Kidney failure
- Diabetes
38
What are antihyperlipidemic agents?
- Cholesterol meds
- Used to lower the amount of LDL in the system
- Aids in assisting the excess levels of LDL back to the liver for removal, thereby lowering the levels in the system
39
What are some common cholesterol medication?
"STATIN"
- Pravastatin
- Simvastatin
- Ezetimibe
- Atorvastatin
- Rousvastatin
40
What are Antiplatelet medications?
- Interfere with the steps of clot formation
- Normally platelets enter the site of injury, activated by thrombin and collagen to increase clotting
- Bleeding is a common side effect of these medications
41
What are some common antiplatelet medications?
- ASA
- Dipyridamole
- Clopidogrel
- Trigrelor
42
What are anti coagulants?
Blood Thinners
- Used to make the blood less viscous
- Obtained by increasing the levels of antithrombin, which then inhibits clotting factors
43
What are the most common anti coagulants?
- Heparin and warfarin
- Heparin= works with antithrombin
- Warfarin= works to inhibit the vitamin K effects on clotting
44
What type of patients are on anti coagulants?
- Afib
- MI
- CVA
45
What are ACE inhibitors?
- Used to primarily treat HTN
- Lowers SBP and DBP by blocking the action of ACE
- Angiotension II levels rise= vasoconstriction, release of epi or norepi, Increased HR, Increased CO
- By inhibiting this release of angiotensin II and aldosterone, they decrease reabsorption of sodium in the kidneys, forcing it out of the system
46
What are some common ACE inhibitors?
"PRIL"
- Lisinopril
- Accupril
- Enalapril
- Ramipril
47
What are anti anginals?
- Used to increase blood and O2 supply to the heart while reducing workload of the heart
48
How do Anti Anginals work
- Can be accomplished by vasodilation or reducing vasospasm
- When the workload of the heart is decreased, the need for O2 decreases
- Reduction in cardiac workload is achieved by reducing HR
49
How does nitrates work?
- Dilate blood vessels and increase O2 supply to the heart
- Relax and dilate medium-large coronary arteries and veins- this increases O2 to the heart
- Reduces fluid backup in the ventricles, thereby reducing cardiac workload
50
What are Long Acting Beta Agonist and Corticosteroids?
- Taken daily to prevent asthma symptoms (controllers)- work by relaxing the muscle lining the airways
- LABA & Corticosteroids need to be used together
- Reserved for those pts whose symptoms can't be controlled by short acting bronchodilators
51
What are steroids?
- Anti-inflammatory drugs
52
How do steroids work in relation to respiratory?
- Reduce the infiltration of mediators of the inflammatory response in the airway cells
- Reduce the creation of proinflammatory substances- prostaglandins, leukotriene, macrophages
53
What are common long acting beta agonist?
- Fluticasone= flovent
- Budesonide= pulmicort
- Advair= combo drug
- Symbicort= combo drug
54
What are Short Acting Beta Agonist?
- AKA relievers, rescue medications
- Provide short-term, rapid relief of asthma symptoms
55
How do Short Acting Beta Agonist works?
- Reverse bronchospasm and open airways
- Act on the B2 cells of the smooth muscle in the airways (relaxes the bronchial smooth muscle)
56
What are common Short Acting Beta Agonist?
- Ventolin
- Levalbuterol
- Ipratropium
- Sprivia
57
What are Proton Pump Inhibitors?
- Effective in treating GERD
- Decrease gastric acid levels
58
How do proton pump inhibitors work?
- Act by interfering with the final step in gastric acid production
59
What are common Proton Pump Inhibitors?
"ZOLE"
- Omeprazole
- Esomperazole
- Pantaprazole
- Lansoprazole
60
What are Histamine 2 Inhibitors?
- Also used to treat GERD
61
How do Histamine 2 Inhibitors work?
- Histamine stimulates acid secretion in the gastric cells- by production of pepsin
- Pepsin is a digestive enzyme found in the gut
- Secreted when food is present in the stomach
- These meds block this stimulation from happening
62
What are common H2 Inhibitors?
- Pepcid
- Ranitidine
63
How does Anti Nausea medication work?
- Primary goal is to either block the nausea sensation in the brain, or reduce the cause of the nausea
- Additionally, some meds work by blocking the transmission of nausea sensation from the GI system to the brain
64
What is nausea often caused by?
- Release of serotonin
- This is released during stress and if your gut senses something toxic
- Serotonin is produced to help expel whatever is in your system out- typically through vomiting
65
What are common anti nausea medications?
- Gravol- dimenhydrinate
- Ondansetron- zofran
66
How do laxatives work?
- Create an enzyme that swells in the presence of liquid
- Once it swells, the bowel gets the sensation that it's full, causing them to evacuate
67
What are some common laxatives?
- Senna= senokot
- Bisacodyl= dulcolax
- Docusate= colace
- PEG 3350= miralax
68
How does epilepsy medication work?
- Goal of the meds is to reduce the instances of seizures by suppressing seizure activity
- Done by controlling the voltage- dependent sodium channel
- Drugs are aimed at delaying the movement of these ions- maintaining homeostatic balance
69
What are common meds for epilespsy?
- Dilantin
- Valproic acid
- Lamotrigine
- Carbamazepine
- Levetiracetam
70
What are opioids?
- Naturally occuring, from the poppy plant
- Opioids bind to the opioid receptors found at the base of the spinal cord, brainstem, thalamus, hypothalamus, and limbic system
71
What can opioids be classified as?
- Agonists= bind and stimulate the receptor, produce analgesia
- Antagonist= bind to the receptor but don't activate it (ex. narcan)
72
What are common opioid meds?
- Morphine
- Hydromorphone
- Oxycodone
- Fentanyl
- Hydrocodone
- Codeine
- Tramadol
- Percocet
73
What are NSAIDS?
- Have anti-inflammatory, analgesic and antipyretic properties
74
How do NSAIDS work?
- Reduce the production of prostaglandins
- Chemicals that promote inflammation, pain and fever
- Cox-1 & Cox-2 are the main enzymes that create prostaglandins
- Cox-2 is responsible for clotting factors
75
What are benzodiazepines?
- Often used to treat anxiety, slow brain activity
- Given to treat sleeping disorders, seizure disorders and anxiety
76
How do benzodiazepines work?
- Depresses the limbic system
- This reduces emotions, anxiety, fear, pain, etc
- Works of GABA receptors in the brain, reduces the neuronal excitiability
77
What are common psych meds?
- Alprazolam= Xanax
- Clonazepam
- Lorazepam= Ativan
- Diazepam
- Midazolam
- Oxazepam
78
What are the 2 categories of antidepressants?
- TCI= tricyclic antidepressant (affect norepi lvls)
- SSRIs= Selective serotonin reuptake inhibitors (affect serotonin lvls)
79
How do antidepressants work?
- Alter the lvls of serotonin, dopamine, and noradrenaline- keeping them at normal, required lvls
- Most commonly used to treat general depressive disorders, OCD and anxiety
80
What are common antidepressant meds?
- Amitriptyline
- Nontriptyline
- Trazadone
- Mirtazapine
- Bupropion
- Paxil
- Zoloft
- Effexor
81
How do antipsychotics work?
- Aimed at blocking the lvls of dopamine being secreted and absorbed by the body
- At the medulla, brainstem and hypothalamus point
- Cross the blood brain barrier easily
82
Antipsychotics are often accompained by....
Sedative side effects
- Confusion
- Decreased ability to regulate body temp
- Weight gain
83
What are common antipsychotic meds?
- Olanzapine
- Quetiapine
- Risperidone
- Arpiprazole
84
How does oral diabetic medication work?
- Treats type 2 diabetes
- Works by stimulating insulin release from pancreatic beta cells
- Also decrease glycogenosis- process of converting glycogen to glucose
85
What are common oral diabetic meds?
- Metformin
- Januvia
- Glyburide
- Sitagliptin/ metformin
86
What is insulin?
- Used for all type 1 diabetics
- Since it's a protein, it need to be administered IM
- Can be rapid-acting, short-acting
87
What are common insuline?
- Novolog
- Humalog
- Humulin
- Levemir
88
How does hyperthyroid meds work?
- Work by depleting excess thyroid hormones
- Measured by TSH- Thyroid Stimulating Hormone
89
What are common hyperthyroid meds?
- Methimazole
- Propylthiourcil
90
How do hypothyroid meds work?
- Work by stimulating the release of TSH
- Mimic the natural actions of the thyroid hormones produced by the body
91
What are common hypothyroid meds?
- Levothyroxine
