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Pharmacology ch 1-4 and 29
Chapters 1-4 and 29
95
Pharmacology
Undergraduate 3
02/23/2011

Additional Pharmacology Flashcards

 


 

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Term
Pharmacotherapeutics
Definition
a branch of pharmacology that uses drugs to treat, prevent, and diagnose disese
Term
What does Pharmacotherapeutics focuses on?
Definition
the drugs effect on the body and the body's response to the drug
Term
What is Genetic Engineering?
Definition
The process of altering DNA
Term
Describe each step of a drug evaluation:
Definition
  • Preclinical Trials: tested on animals in lab
  • Phase I:  uses human volunteers to test the drugs
  • Phase II:  allows clinical investigators to try out the drug in patients who have the disease that the drug is designed to treat
  • Phase III: Involves use of drug in a vast clinical market, prescribers are informed of all the known reactions to the drug and precautions required for safe use
  • Phase IV: after drug is approved for marketing it enters a phas of continual evaluation
Term
Describe the FDA pregnancy categories:
Definition
  • Category A: no evidence of risk to fetus
  • Category B: adequate studies have shown no risk in 1st trimester, no evidence of risk in later trimesters
  • Category C: no adequate studies in pregnant women, animal studies have shown no adverse effects on fetus, or there are no adequate animal reproduction studies and no adequate human studies
  • Category D: evidence of fetal risk in humans, but potential benefits may outweigh the risks
  • Category X: evidence of fetal abnormalities or adverse effects in humans and animals - risk is not worth the benefit
Term
Chemical name:
Definition
name that is the description of the chemical structure of the drug listed in the hopital formulary along with the chemical formula diagram
Term
Generic name:
Definition
Name that is established when a drug is first manufactured which is protected for use only by the original manufacturer for a period of 17 years after which it becomes public property and may be used by any manufacturer
Term
Trade or Brand name:
Definition
name under which a drug is sold by the manufacturer who owns the name. No other company may use the name. Each brand name carries a registered trademark symbol
Term
Controlled substances act:
Definition
in 1970 established categories for ranking the physical and psycholocgical abuse of various drugs, which is determined by the FDA and enforced by the DEA
Term

Drug Schedules:

Definition
  • Schedule I (C-I): high abuse potential and no accepted medical use
  • Schedule II (C-II):  High abuse potential with sever dependence liability
  • Schedule III (C-III):  less abuse potential than schedule II drugs and moderate dependence liability
  • Schedule IV (C-IV):  less abuse potential than schedule III and limited dependence liability
  • Schedule V (C-V):  limited abuse potential.
Term
Schedule I (C-I):
Definition
high abuse potential and no accepted medical us (heroin, LSD)
Term
Schedule II (C-II)
Definition
high abuse potential with severe dependence liability (narcotics, amphetamines, and barbiturates)
Term
Schedule III (C-III)
Definition
less abuse potential than schedule II drugs and moderate dependence liability (nonbarbiturates, sedatives, nonamphetamine stimulants, limited amounts of certain narcotics)
Term
Schedule IV (C-IV)
Definition
less abuse potential. primarily small amounts of narcotics (codeine) used for antitussices or antidiarheals.  Some may be purchased w/out a prescription directly from pharmacist (purchaser must be at least 18, show ID, and phamacist must record info)
Term
What are some concerns about OTC drugs?
Definition
  • may mask signs and symptoms of underlying disease
  • taking with prescription meds my result in drug interactions
  • taking incorrectly may result in serious overdose
Term
Pharmacodynamics
Definition
science of dealing with interactions between living organisms and foreign chemicals
Term
What are the basic drug actions?
Definition
  • to replace or act as substitues for missing chemicals
  • to increase or stimulate certain cellular activies (agonist drugs)
  • to depress or slow certain cellular activities (beta-blockers)
  • to interfer with the functioning of foreign cells (antibiotics)
Term
What occurs on cell receptor sites?
Definition
  • they react to certain chemicals
  • the better fit between receptor site and chemical, the more pronounced the reaction
  • Enzymes within the body are need to breakdown the chemicals to open up the receptor site
Term
Agonists
Definition
interact directly with receptor sites to cause the same activity that natural chemicals would cause (ex. insulin)
Term
Competitive antagonist:
Definition
react with receptor sites to block normal stimulation producing no effect (ex. curare prevents muschle stimulation causing paralysis)
Term
Noncompetitive antagonist:
Definition
react with specific receptor sites on a cell and by reacting they prevent the reaction of another chemical with a different receptor site on that cell
Term
Pharmacokinetics:
Definition
involves the study of absorption, distribution, metabolism, and excretion of drugs
Term
Critical concentration (therapuetic levels):
Definition
the amount of a drug that is needed to cause a therapeutic effect
Term
Loading Dose:
Definition
A higher dose than that usually used for treatment (ex. give lasix 40 mg IV now then 20 mg IV q 8 hours)
Term
Dynamic equilibrium:
Definition
the actual concentration that a drug reaches in the body
Term
What is dynmaic equilibrium affected by?
Definition
  • absorption
  • distribution
  • biotransformation
  • excretion
Term
What are the routes to give drugs and the factors that affect absorption?
Definition
  • IV - no affect on absorption
  • IM - perfusion or blood flow to muscle, fat content, temp
  • SubQ - perfusion of blood flow to tissue, fat content, temp
  • Oral (PO) - acidity in stomach, time in stomach, blood flow to GI, presence of interacting foods or drugs
  • Rectal (PR) - perfusion or blood flow to the retum, lesions in the rectum, length of time retained for absorptions
  • Musous membrane (sublingual, buccal) - perfusion or blood flwo to the area, integrity of the mucous membranes, presence of food or smoking, length of time retained in area
  • Topical (skin)- perfusion or blood flow to the area, integrity of the skin
  • Inhalation - perfusion or blood flow to the area, intergrity of lung lining, ability to administer the drug properly
Term
First-pass effect:
Definition
medications are extensively metabolized by the liver, as a result a large percentage of the oral dose is destroyed and never reaches the tissue
Term
Biotransformation:
Definition
process which drugs are changed intonew, less active chemicals
Term
What is the most important organ in biotransformation?
Definition
the liver
Term
Excretion:
Definition
removal of drugs from the body
Term
What organ is most important to excretion of medications?
Definition
the kidneys
Term
Half-life
Definition
the time it takes for the amount of drug in the body to decrease to one-half the peak level
Term
What is half-life affected by?
Definition
  • absorption
  • distribution
  • metabolism
  • excretion
Term
What 11 factors influence drug effects?
Definition

1. weight

2. age

3. gender

4. physiologic factors

5. pathologic factors

6. genetic factors

7. immunologic factors

8. psychological factors

9. environmental factors

10. drug toleracne

11. cumulative effect

Term
Where can drug-to-drug interactions occur?
Definition
  • site of absorption
  • during distribution
  • during biotransformation
  • during excreation
  • at the site of action
Term
What effects can occur in a drug-to-drug interaction?
Definition
  • Antagonistic: two drugs cancel eachother out 1+1=0 (ex. morphine & naloxone)
  • Additive: two drugs with similar mechanisms "sum" their effects: 1+1=2 (alcohol & sedatives)
  • Synergistic: two drugs with different mechanisms produce greater effect: 1+1=3 (codeine & ASA)
Term
Where do Drug-Food interactions occur?
Definition
usually when the drug and food are in direct contact in the stomach
Term
What are some examples of foods that interact with drugs?
Definition
  • Vitamin K antagonize the actions of oral anticoagulant (coumadin)
  • Dairy (calcium rich) products & tertracycline form an insoluble compound
  • Grapefruit juice affects the liver enzyme system up to 48 hours and results in increased or decreased serum levels of drugs
Term
Drug-laboratory test interactions:
Definition

drugs may alter results of lab testing

example

*antibiotics such as carbencicillin can increase serum Na,

*use of fragmin can increase AST- liver funtion test

Term
Adverse Drug Reactions
Definition
undesired effects that may be unpleasant or even dangerous
Term
Reasons adverse drug reactions occur:
Definition
  • Drug may have other effects on the body besides therapeutic effect
  • patient is sensitive to the drug given
  • drug's action on the body causes other responses
  • patient is taking too much or too little of the drug
Term
What are the types of drug allergies?
Definition
  • Anaphylactic
  • Cytotoxic
  • Serum sickness
  • Delayed allergic reaction
  • Dermatologic
Term
What occurs when a patient is having an anaphylactic reaction?
Definition
An antibody reacts with specific sites that cause a release of chemicals including histamine that produce immediate reactions (mucus membrane swelling and constricting bronchi) which can lead to respiratory distress and repiratory arrest.
Term
What would be assessed for to determine a person was having an anaphylactic reactioin?
Definition
  • Hives, rash
  • difficulty breathing
  • increased BP
  • dilated pupils
  • diaphoreses, "panic" feeling
  • increased heart rate
  • respiratory arrest
Term
What occurs in the body during a cytotoxic reaction?
Definition
antibodies that circulate in the blood attack antigens (the drug) on cell sites and cause death to the cell; reaction not immediate but may be seen over a few days
Term
What would you assess for to determine if a person was having a cytotoxic reaction?
Definition
  • CBC showing damage to blood-forming cells (decreased hematocrit, WBC count, and platelets),
  • liver function test indicating elevated enzymes
  • renal function test indicating decreased renal function
Term
What occurs in the body when a patient is having a serum sickness reaction?
Definition
allergy involves antibodies that circulate in the blood which cause damage to various tissues by depositing in blood vessels; reaction may occur up to 1 week or more after exposure to drug
Term
What would you assess for to determine if someone was having a serum sickness reaction?
Definition
  • Itchy rash
  • high fever
  • swollen lymph nodes
  • swollen and painful joints
  • edema of face and limbs
Term
What occurs in the body when a person is having a delayed allergic reaction?
Definition
The reaction occurs several hours after exposure and involves antibodies that are bound to specific WBC
Term
What would you assess for to determine if a patient was having a delayed reaction?
Definition
  • rash
  • hives
  • swollen joints (similar reaction to poison ivy)
Term
What is a dermatologic reaction?
Definition
  • abnormalities of the skin occur, red areas, blisters (rash/hives)-ex. antibiotics
  • inflammation of the mucous membrane may occur (Stomatitis)- ex. antineoplastics
Term
What is a superinfection and what do you assess for?
Definition
  • destruction of the body's normal flora
  • Assess for fever, diarrhea, and/or vaginal discharge
Term
What is blood dyscrasia and what do you assess for?
Definition
  • bone marrow suppression (antineoplastics & antibiotics)
  • Assess for fever, chills and weakness
Term
What do you assess for to determine there is toxicity to the liver?
Definition
  • fever
  • nausea
  • jaundice
  • change in color or urine or stool
  • elevated liver enzymes
Term
What
Definition
Term
What do you assess for to determine there is toxicity to the kidney?
Definition
  • change in urinary pattern or
  • elevated BUM and creatinine
Term
What is drug poisoning and what does it do to the body?
Definition
it occurs when an overdose of a drug damages multiple body systems; damage to multiple systems can leaad to a fatal reaction
Term
hypoglycemia
Definition
low serum blood glucose levels
Term
hyperglycemia
Definition
high serum blood glucose levels
Term
hypokalemia
Definition
decreased serum potassium level
Term
hyperkalemia
Definition
increase in serum potassium level
Term
What type of effects can drugs have on our sensory?
Definition
  • Ocular toxicity (Chloroquin) - vision changes
  • Auditory damage (ASA) - damage to 8th cranial nerve
Term
What neurologic effects can drugs have a people?
Definition
  • General CNS -altered level of consciousness
  • Atropine-like (anticholinergic) effects - dry mouth, urinary retention, blurred vision
  • Parkinson-like syndrome - muscle tremors and changes in gait
  • Neuroleptic Malignant syndrome - extrapyramidal symptoms
Term
Teratogenicity
Definition
drugs that may harm developing fetus
Term
What are the Nursing responsibilities when administering drugs?
Definition
  • Assessment
  • Administration of medications and therapy
  • Assessment of reation/outcome to medications
  • teaching
  • evaluation of teaching effectiveness
Term
What all does the nurse assess for in a patient?
Definition
  • Medical history - centain conditions prevent pts use of some meds
  • Surgical history - may require new med as a result of surgery
  • social history - level of education, support, financial means
  • Medications - drug to drug interactions
  • Allergies - pts may have cross-sensitivity to meds
Term
What are the 8 patient rights?
Definition

Right:

1. patient

2. drug

3. dosage

4. route

5. frequency & timing

6. recording

7. storage

8. preparation

Term
What are the elements of patient teaching?
Definition
  • Name, dose, and action of drug
  • Timing of administration
  • Special storage and preparation instructions
  • Specific OTC drugs or alternative therapies to avoid
  • Special comfort or safety measures
  • specific points about drug toxicity
  • specific warnings about drug discontinuation
Term
What needs to show on the hospitals medication order?
Definition
  • date and time of order
  • pt name, and ids (medical record #, date of birth)
  • drug
  • dosage
  • route
  • frequency
  • special administration instructions
Term
What needs to show on the community medication order?
Definition
  • pt name
  • pt date of birth
  • drug
  • drug dosage
  • drug route
  • drug frequency
  • any special instructions
  • amount of meds to dispense
  • number of refills
Term
Where are the main nerve centers for the ANS?
Definition
  • Hypothalamus
  • Medulla
  • Spinal Cord
Term
What is the ANS (Autonomic Nervous System)?
Definition
  • the involuntary or visceral nervous system. 
  • works closely with the endocrine system
  • generally occurs with little conscious awareness of its activity.
  • regulates and integrates the body's internal functions
  • integrates parts of the CNS & PNS to reast to changes in the internal and external environment
Term
What bodily functions are regulated by the ANS?
Definition
  • Blood Pressure
  • Heart Rate
  • Respirations
  • Body temp
  • water balance
  • urinary excretion
  • digestive functions
Term
What are the divisions of the ANS?
Definition
Sympathetic & parasympathetic
Term
Describe the Sympathetic Nervous System (SNS):
Definition

fight or flight - responsible for preparing the body to respond to stress.

 

 

Term
What is another name for the SNS and why?
Definition
the thoracolumbar system because the CNS cells that originate impulses are located in the thoracic and lumbar sections of the spinal cord
Term
Describe the SNS preganglionic neurons?
Definition
Short axons and transmits acetylcholine
Term
Describe the SNS postganglionic neurons:
Definition

Long axon and

transmits norepinephrine and epinephrine

Term
In the SNS, what are the neurotrasmitter terminators?
Definition

MAO (Monoamine oxidase)

COMT (caterchol-O-methyltransferase)

Term
What is affected with the SNS is activated?
Definition
  • BP and HR increase
  • Respiratory efficiency also increases
  • bronchi are dilated and repiratory rate increases
  • pupils dilate
  • piloerection
  • blood is diverted from the GI tract
  • Blood is diverted from internal organs
Term
What occurs the Alpha 1-receptors are stimulated?
Definition
  • Vasoconstriction - increased peripheral resistance, increased BP
  • Mydriasis
  • Increased closure of external sphincter of the bladder
Term
What occurs when Alpha 2 receptors are stimulated?
Definition
  • Nerve membranes act as modulators of norepinephrine release
  • Beta cells in pancreas help to moderate teh insulin release stimulated by SNS activation
Term
What occurs when Beta 1-receptors are stimulated?
Definition
  • Heart has increased chrontropy and inotropy
  • heart has increased AV node conduction and velocity
  • Renal juxtaglomarular cells increase renin release

-responsible for increased lipolysis or breakdown of fat for energy in peripheral tissues

Term
What occurs when Beta 2-receptors are stimulated?
Definition
  • vasodilation of the smooth muscle in blood vessels
  • Dilation of bronchi
  • incresed muscle and liver breakdown of glycogen and increased release of glucagon
  • relaxed uterine smooth muscles
Term
What occurs when the parasympathetic nervous system is stimulated?
Definition

"rest and digest"

  • increased motility & secretions in the GI tract
  • decreased HR and contractility
  • constriction of the bronchi with increased secretion
  • relaxation of the GI and urinary bladder sphincters
  • pupillary constriction
Term
Describe the PNS preganglionic neuron:
Definition
Long axon and transmits acetylcholine
Term
Describe the PNS postganglionic neuron:
Definition
Short axon and transmits acetlycholine
Term
What are the four basic kinds of cholinergic nerves?
Definition
  • All preganglionic nerves in the ANS, both PNS & SNS
  • Postganglionic nerves in PNS and a few in SNS
  • Motor nerves on skeletal muscles
  • Cholinergic nerves within the CNS
Term
Where muscarinic receptors found?
Definition
  • receptors stimulated by muscarine
  • found in visceral effector organs
  • found in sweat glands
  • found in some vascular smooth muscle
Term
What occurs when muscarinic receptors are stimulated?
Definition
  • pupil constriction
  • increased GI motility
  • increased salivation
  • increased urinary bladder consriction
  • decreased HR
Term
Where are Nicotinic receptors found?
Definition
Located in the CNS, adrenal medulla, autonomic ganglia, and neuromuscular junction
Term
What occurs when Nicotinic receptors are stimulated?
Definition
  • Muscle contraction
  • Autonomic response
  • release of Norepinephrine and epinephrine from adrenal medulla
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