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Pharm Chapter 5-15 Quiz
Unit One Quiz
121
Pharmacology
Undergraduate 1
09/16/2012

Additional Pharmacology Flashcards

 


 

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Term
Pro-Drugs
Definition
(Subcategory of Metabolic Process) initially inactive and exert no pharmacological effects until they are metabolized. Conversion from fat-soluble to water soluble and exert. No pharmacological effect.

 

 

 

Term
Metabolism
Definition
The method by which drugs are inactivated or bio-transformed by the body. Active drugs is changed into inactive metabolites then excreted.
Term
Additive effects
Definition
(Drug-Drug Interaction)
Occurs when 2 drugs with similar pharmacological actions are taken.
Ex: drinking & sedatives
Term
Synergism
Definition
(Drug Drug Interactions)
Occurs when 2 Drugs with different sites or mechanisms of action produce greater effects when taken together.
Ex: acetaminophen, codeine, Tylenol 3
increases analgesic effect.
Term
Interference
Definition
(Drug-Drug Interactions)
One drug interfers with the metabolism of a second drug. May lead to intensified effects of the second drug.
Term
Displacement
Definition
(Drug-Drug Interaction)
A drug with a strong attraction to protein binding sites may displace a less tightly bond drug. May increase the effects of the displaced drug.
Ex: aspirin displaces warfarin=increases te drug w/anticoagulant effects.
Term
What are the factors that affect drug metabolism?
Definition
Enzyme induction and Enzyme inhibition
Term
Where are Drug-metabolizing enzymes located?
Definition
Kidneys, liver, red blood cells, plasma, lungs, gastrointestinal mucosa.
Term
What is the most important guide for pediatric drug therapy?
Definition
Child's age, weight, and level of growth and development.
Term
"Five Rights"
Definition
drug, dose, patient, route, time
Term
Agonist
Definition
drugs that produce a response. Accelerate or slow down normal cellular processes. Similar effects as naturally produced hormones.
Term
What are the characteristics of a receptor?
Definition
Activates a drug. Protiens and drugs bind to affect a target affect. All body cells do not respond to all drugs. Drug molecules must occupy a minimal number of receptors to produce pharmacological effect.
Term
Antagonists
Definition
Drugs that block response, inhibit cell function.
Term
Bio-availability
Definition
(Subcategory of Absorption)
portion of a drug that reaches systemic circulation & available to ct on body cells
Term
First-Pass effect
Definition
the process in which a drug passes to the liver first.
Term
Scheduler I
Definition
MOST easily(high)abused.
NOT approved for medical use, NOT therapeutic. EXP: Rohypnol, Lysergic Acid Diethylamide (LSD), and Heroin,Ecstacy
Term
Pharmacokinetic
Definition
The process of drug movement to achieve drug action: Absorption, Distribution, Metabolism, and Excretion.
Term
Prototypes
Definition
Individual drugs that represent groups of drugs. Often the first drug of a particular group to be developed. EXP: Morphine is the prototype of Opioid analgesics. Penicillin is the prototype of antibacterial drugs.
Term
Local
Definition
Act mainly on the site of application
Term
Systemic
Definition
Taken into the body circulated via the blood stream to sites of action, and eventually eliminated from the body.
Term
Trade Name
Definition
or Brand Name name designated and patented by the manufacturer. Capitalized.
Term
Absorption
Definition
The process that occures from the time a drug enters the body to the time it enters the bloodstream to be circulated.

Factors that affect the rate and extend the drug absorption are: Dosage form, route and administration, administration site,blood flow, and GI function.
Term
Distribution
Definition
The transport of drug molecules within the body. Drugs are carried by blood and tissue fluids to: Action sites, metabolism sites, excretion sites. Depends on adequacy of blood circulation. Distributes rapidly to organs w/large blood supply like-Protein binding, blood brain barrier, pregnancy, lactation.
Term
What are controlled drugs and guidelines for scheduling?
Definition
Narcotics, stimulants, depressants, hallucinogens, and anabolic steroids. Store in locked containers.
Term
Generic Name
Definition
(lowercase)
Related to the chemical or Official name(amoxicillin)from the company that did the research and development and received initial approval from the FDA. Ending suggest classification "cillin"
NOT capitalized.
Term
What are the best ways to study for pharmacology?
Definition
(best)TEXTBOOK
drug reference book- use in clinical practice
journal articles
select internet sites.
Term
Schedule V
Definition
LEAST potential for abuse.
contains moderate amounts of controlled substances.
Regulated by lay. Records kept.
May dispense without a prescription some restrictions on amts purchased.
EXP: Lomotil and decongestants Codeine cough syrups.
Term
Schedule IV
Definition
Some potential for abuse.
Used therapeutically.
EXP: Valium, ativan, phenobarbital
benzodiazepines, sleep aids
Term
Schedule II
Definition
HIGH potential for abuse, cannot be refilled, used therapeutically, dependance. EXP: codeine, morphine, oxycodone, methamphetamine, ritalin, and pentobarbital
Term
Schedule III
Definition
LESS ABUSE potential.
Used therapeutically.
May lead to psychological or physical dependency.
EXP: anabolic steroids, ketamine, mixtures with small amounts of opiates.
Term
What does the Comprehensive Drug Abuse Prevention & Control Act passed in 1970 regulate?
Definition
manufacturing & distribution of narcotics & controlled substances.
Term
Drugs are classified according to which features?
Definition
therapeutic usefulness
Term
What categories of controlled substances are most easily abused?
Definition
Schedule I
Term
The main goal of current drug laws & standards is to ensure?
Definition
Drugs marketed for thrapeutic purposes are safe & effective.
Term
FDA since 1962 require to test drugs, companies initially do testing on?
Definition
Animals 1st, FDA reviews test results, next clinical trial in humans.
Term
The DEA requires registered individuals & companies legally empowered to handle controlled substances they must do?
Definition
1. Keep accurate records of all transactions.
2. Be registered w/DEA.
3. Provide for secure storage of controlld substances.
Term
A/an _____ is an inactive substance simular in appearance to the actual drug?
Definition
placebo
Term
Having drugs available OTC has potential advantages & disadvantages. What is one of the advantages?
Definition
faster, more convenient to treatment and accessibility.
Term
Having drugs available OTC has potential advantages & disadvantages. What is one of the disadvantages?
Definition
inaccurate self diagnoses, potential risk choosing wrong drug, delay treatment, drug reactions & interactions. Over/Misuse
Term
How many phases and what are they when the FDA(1962) approves testing on Humans?
Definition
4 phases.
Phase I-healthy volunteers
Phase II-a few doses given to a certain # of subjects
Phase III-drugs given to larger group of subjects in blind study
Phase IV-FDA evaluated data from Phase I,II, III for drug safety & effectiveness allows to go to market and continues monitoring drug effect.
Term
How will you study to be successful in Pharmacology?
Definition
textbook
Term
Factors that affect the rate and extend the drug absorption are?
Definition
Dosage form, route and administration, administration site,blood flow, and GI function.
Term
Protein-binding
Definition
Drug distribution an important factor process affected by;inactive due to large size & inability to leave bloodstream. Albumin acts as a carrier
protein binding.
blood brain barrier-only drugs that are lipid soluble or a transport system can cross.
pregnancy-drugs cross can affect fetus
and lactation-drugs enter breast milk, can affect infant.
Term
Lady perscribed meds to control hypercholesterolemia. 2 yrs later dr. gives her a higher dose of meds due to a process called ____?
Definition
Enzyme induction
Accelerates metabolism, may need larger dose to maintain therapeutic effect, can become toxic
Term
Man perscribed combo of drugs to treat disease process. He's showing signs of toxicity to new drugs. A possble cause in absorption of meds is called ___?
Definition
enzyme inhibition
2 or more drugs compete for smae metaboizing enzymes. Smaller dose needed.
Term
Some drugs or metabolilites are excreated in bile then eliminated in feces, others are excreated in bile, reabsorbed from the small intestine, returned to the liver. This process is called ____ ____?
Definition
enterohepatic recirculation
Term
Measurements of serum drug levels(SDL) is useful in the following situations?
Definition
1. when drugs w/a narrow margin of safety are given, because their therapeutic dose are close to their toxic dose.

2. to document SDL associated w/drug dose, therapeutic effects or adverse effects.

3. to monitor unexpected response to a drug dose. Ex:decreased therapeutic or increased adverse effect.

4. Drug overdose is suspected.
Term
Serum Drug Level
Definition
A lab measurement of the amt. of a drug in the blood at a particulr tme. Reflects; dosag, absorption, bioavailibility, half-life, rate of metabolism & excretion.
Term
For most drugs serum levels indicate the onset, peak, duration of drug reaction. After a single dose of a drug is given, onset of action occurs when the drug level reaches ____?
Definition
MEC Minimum effectve concentration.

must be presentbefore a drug exerts its pharmacologic action on boy cells; determined by drug dose, and how well absorbed into blood stream.
Term
Serum half-life
Definition
aka Eliminatio half life.
time required for serum concentratin o drug to decrease by 50%.
Term
When a drug is given at a stable dose. How many 1/2 life periods to achieve steady state concentration & develope equilibrium between tissues & serum concentrate?
Definition
4-5
Term
Receptor Theory of Drug Action
Definition
When drug molecules bind w/ receptors molecules; initiates physiochemical reactions that stimulate or inhibit normal cellular function.

Drugs exert their effects by chemically binding w/ receptors cells.
Term
Non-receptor drug actions
Definition
Few drugs taht do not act on receptor sites include.

Antacids (neutralize HC acid)
increase Osmotic diuretics(mannital)
Anticancer drugs(purines)
Metal chelaing agents.
Term
Drug-diet interactions.
Definition
Food may slow the absorption of drug if t be taken on empty stomach.

Dr. orders selegiline for Parkinson's disease. Tyramine rich foods to avoid by pt taking MAO inhibitors incluse aged cheese, sauerkraut, soy sause, tap or draft beer.

Diagnosed w/ aterial fibrilation & perscribed Coumandin. Pt should avoid food w/ Vit K.

Tetracyclie (antibiotic) & dairy milk & cheese should be avoided.

Hypercholesterolemia & perscribed statin avoid gratefruit.
Term
Drug-diet interaction
Definition
Coumadin is anticoagulant. Offset & predispose pt to thromboembolic disorder. avoid Vit K, Spinach, green leafy veggies.
Term
Drug-drug interaction
Definition
mixing alcohol & narcotics
Term
A/an ____ medication drug can be given to _____ counteract the toxic effects of another drug?
Definition
Antidote, antagonize
Term
Because of the potntially fatal adverse effects and risks ofdrug abuse and dependence, all o the opioid analgesics have ____?
Definition
black box warnings
Term
A Schedule II drug that is similar to codeine in its ananlgesic and antitussive effects is called ____?
Definition
Hydrocodone
Term
An opium alkaloid and Schedule II drug that is used for analgesic and antitussive effect is called ____?
Definition
Coeine
Term
An opium alkaloid that is mainly used to relieve moderate to severe pain is called ____?
Definition
Morphine
Term
A potent opioid that is wiedely used for preanesthetic medication, postoperative analgesia and chronic pain that requires an opioid analgesic is called ____?
Definition
Fentanyl
Term
A synthetic drug that is similar to morphine but with a longer duration of action is called ____?
Definition
Fentanyl
Term
Mrs. Smith is 12 hours status post appendectomy. Her son asks the nurse to rduce the amt of pain medicaton that hi mother is taking. He states, "When I had my appendix out, I needed half the pain meds that she does." You state?
Definition
Pain isa subjective experience, we all feel pain differently.
Term
Mr. James is receiving an opiod analgesic for bon pain related to a fractured femur. On post-op day 3, he still requests pain meds every 2-3 hours. His incision is clean, dry, and intact, and there are no signs or symptoms of an infections process surrounding the incision. You respond to his request for pain medicaiton by assessing for?
Definition
drug tolerance
Body becomes accustomed to particular drug and larger dose is needed.
Term
Mrs. Wlson states that her pain is unbearable. You have an order for one or two tablets of an opioid analgesic for pain relief. Which of the following is one method that you may use to assess the intensity of the pain?
Definition
Use a numerical scale of 0-10 with 0 being the least amt of pain.
Term
Mr. Peters presents in the emergey dept. and states tat he is experiencing pain in his shoulder and chest muscles. The Physician orders a cardiac diagnostic assessment. The client ass you why the doctor feels tat he has cardiac problems if his shoulder hurts. What would you tell him?
Definition
You may have referred pain. Pain of ardiac origin may radiate to the neck, shoulders, chest muscles and down the arms, often the left side.
Term
You administer an oral opioid analgesic to a pt. at 6pm for pain documented as 6 on a scale of 0-10. At 6:30pm the client states tat the pain level is 3 on the scale. The pt. asks why you returned to reassess the pain, You state that for proper pain mangement the nurse must?
Definition
Assess every pt. in rlation to pain, initially to determine appropriate interventions and later to determine wheather the interventios were effective in preventing or relieving pain.
Term
Mrs. Zeta is recovering from shingles. She is experiencing sharp pain in the area of the healed pustules on her left rib cage. She does not like how the opioid ananlgesic that is rdered makes her feel, and she refused the medication. What physician orders would be best?
Definition
Lidoderm in the form of a transdermal gel patch.
Term
Mrs. Woods injured her knee in a moor vehicle accident. Her pain is not managed during physical therapy with pain meds alone. After assessing the pt. for further damage to the joint, the dr. orders corticosteroids. Mrs. Woods ask how corticosteroids will improve her mobility and manage her pain? You respond
Definition
Cortcosteroids can reduce inflammation, iritability and spontaneous discharge in injured nerves and other tissues.
Term
Mr. Smith complains of foot pain related to diabetic neuropathy. He asks why did dr. order tricyclic antidepressants (TCA) stating, "I am not depressed; I just have pain. You respond
Definition
TCA's inhibit the reuptake of norepinephrine and serotonin in nerve synapses, thereby making these neurotransmitters more available to inhibit pain signals.
Term
Mrs. Smith is experiencing uncontrolled pain related to hr peripheral neuropathy. Multiple analgesics have been used to manage her pain w/o success. The dr. orders gabapentin. As part of your teaching plan, you explain to the pt. that gabapentin works withthe nerve cells that carry pain and ____?
Definition
decrease their irritability so that they will be less likely to carry pain signals.
Term
Mr. Smith comes to emergency with a severe headache and pain that is unresolved for 24 hrs. You note; he has self administering 500 mg of acetaminophen, two pills every 4 hrs. The dr. orders a liver panel. He states "I only took acetaminophen, why are you concerned? As part of the teaching plan you instruct Mr. Smith that the max dose of acetaminophen is 24 hrs is?
Definition
4 grams
and what he took was 6 grams.
Term
The dr. orders NSAIDs for your pt. with a sprained ankle. As part of you education plan you explain what NSAIDs do. You tell pt?
Definition
NSAIDs reduce inflammatory chemicals that cuase, increase or maintain pain signals.
Term
____ pain is caused by lesions or physiologic changes that injure peripheral pain receptors, nerves or the CNS. It is characterized by excessive excitability in the damaged area or surrounding normal tissues, so that nerve cells discharge more easily. As a result, pain may arise spontaneously or from a normally nonpainful stimulus, such as a light touch.
Definition
neuropathic
Term
Your client describes the pain in his injured ankles as buring and cramping. The symptoms re examples of which type of pain?
Definition
Somatic acute pain
Term
____ types of pain demands attention less urgently; may not be characterized by visible signs; ad is ften accompanied by emotional stress, increased irritability, depression, social withdrawal, financial distress, loss of libido, disturbed sleep patterns, diminishd appetite, weight loss, an decreased ability to perform usual activities of daily living?
Definition
Chronic pain
Term
____types of pain may be caused by injury, trama, spasm, diease processes ad treatment or diagnostic procedures that damage body tissues; s often described as sharp or cutting; is usually proportional in intensity to the amt of tissue damge; nd seves as warning system by damanding the sufferer's attention and compelling behavior to withdraw from or avoid the pain proucing stimulus?
Definition
Acute pain
Term
A pt. is admitted to the emergency dept for an opioid overdose. What would you expect he dr. to order to reverse the actionof an opioid?
Definition
Naloxone (Narcan)
Term
Mr. Smith age 80 comes to ER dept. with a fractured ankle and multiple abrasions and contusions. He is admited to the hospital with an order for oxycodone for pain. Oxycodonemay be prescribedfor a geriatric pt. because the drug has____?
Definition
a short half life and is less likely to accumulate causing toxicity or overdose.
Term
A 4 yr old admitted to hospital for broken tibia and parents are worried he may not be able to describe his pain. You state to parents?
Definition
Your child may behave aggressively or complain verbally of discomfort.
Term
A 32 yrs old woman in active labor and delivery asks or opioid analgesics. You respond?
Definition
Opioids administered during labor & delivery may depress fetal and neonatal respiration.
Term
____ is an antihypertensivedrug that may be used to treat opioid withdrawal?
Definition
Clonidine (Catapres)
Term
Name the Antiseizure drugs?
Definition
Carbamazepine (Tegretol)
Gabapentin (Neurotin)
Lamotrigine (Lamictal)
Levetiracetam (Keppa)
Term
Name the Anti-gout drugs?
Definition
Allopurinol (Zyloprim)
Term
Name the Antipsychotic drugs?
Definition
Phenothiazine
Chlorpromazine (P) (Thorzaine)

Nonphenothiazine
Haloperiodol (Haldol)
Clozapine (P) (Clozaril)
Term
Name the Antiparkinsons drugs?
Definition
Lovodopa (P)
Benztropine (Cogentin)
Term
Aspirin(ASA), NSAIDs(P), and acetaminophen(tylenol) can also be called?
Definition
antiprostaglandin drugs
Term
____ sensitize pain receptors an increase the pain associated with other chemical mediators of inflammation an immunity?
Definition
prostaglandin
Term
Body temperature (fever) is controlled by a regulating center in the ____?
Definition
hypothalmas
Term
____ is the normal body response to tissue damage from any source, and it may occur in any tissue or organ. It is an attempt by the body to remove the damaging agent and repair the damaged tissue.
Definition
inflammation
Term
Inflammation may be a component of vitually any illness. Inflammatry conditions affecting organs or systems are often named by adding the suffix-____ to the nvolved organ or system?
Definition
itis
Term
Injectable NAID often used for pain?
Definition
Ketorolac
Term
Inflammation of the bursa?
Definition
Bursitis
Term
Nonperscription drug commonly used as an aspirin substitute because it does not cause nausea, vomiting or GI bleeding
Definition
Acetaminophen (Tylenol)
Term
Chronic, painful, inflammatory disorders that affects they synovial tissue of hinge like joints, tissures round these joints, an eventually other body organs?
Definition
Rheumatoid arthritis
Term
Prototype of the analgesic-antipyretic-antiflammatory drugs and the most commonly used salicylate?
Definition
Aspirin
Term
Acetaminophen poisoning, max adult dose of 4mg daily from all sources. What are the symptoms of overdose?
Definition
1.Anorexia, N/V, diaphoresis may occur.

2.Symptoms may subside, but tests of liver function begin to show incresed levels.

3.Jandice, Vomiting, CNS stimulatio with excitemnt and delirium occur.

4.Vascular collapse, coma, death occur.
Term
Mr. Smith goes to dr. w/inflammation & edema in his left great toe, lasting several days. The dr. orders a uric acid level & diagnoses the pt. w/gout. The dr. orders oral colchicine. Explain how to take med to Mr. Smith and how long it will take for pain & swelling to subside?
Definition
24-48 hours by PO
4-6 hr by IV
Term
A pt. w/ the diagnoses of gout ask how long he should take his colchiine when he experiences symptoms. You respond?
Definition
Take s directed when pan begins until relief is obtained or N/V and diarrhea occur.
Term
The pt w/ chronic gout asks how he can reduce the uric acid levels in his body whenhe begins to self administer colchicine. You respond?
Definition
Drink 2-3 quarts of fluid daily; this will decrease uric acid levelsand help prevent formation of uric acid kidney stones.
Term
Ms. Smith complins of mild headache. Dr. orders 325mg, 2 tablets by mouth every 4-6 hours. She staes she usually takes ibuprfen and asks why the dr. ordered acetaminophen (tylenol)? You respond?
Definition
Acetaminophen (tylenol) is often the inital drug of choice for relieving mild to moderate pain and doesn't cause N/V, or GI bleeding.
Term
Mr. Smith dr. orders aspirin 81mg PO each ay as tratmen related to his recent myocardial infarction. He asks can he take acetaminophen instead, you respond?
Definition
Acetaminophen isan effective aspirin substitute for pain or feverbutnot for prevention of heart attack or stroke.
Term
Celia age 16, ask if she can take 2 Tylenol every 2 hrs during exams, because it helps relieve her tension headaches. You respond?
Definition
Do not exceed recommended doses of acetaminophen due to risk of life threatening liver damage.
Term
Mr. Adams is taking aspir 81mg by mouth each day for prevention of recurren myordial infarction. He maks a dentst appt for tooth extraction and calls dr. office and asks if he is at risk for bleeding. You respond?
Definition
Yes, low doses of aspirin may increase your risk of bleeding; I will call you with your new dr. orders.
Term
Mr. Smith age 80 goes to dr. office w/ complaints of fatigue and change in color of his stool. He is taking ibuprofen 400mg each night for general discomfort. The dr. orders a stool test for guaiac, which is positive results. The dr. discontinues the ibuprofen. You explain the risk of chronic use of NSAIDs is?
Definition
GI bleed
Term
When an NSAID is given during late pregnancy to prevent premature labor, it may adversely affect the ____ of the fetus?
Definition
kidney
Term
Which of the followig is the most effective treatment for a febrile episode in a child aged 6-36 months?
Definition
Alternating acetaminophen & ibuprofen every 4 hours over a 3 day period.
Term
Mrs. Smith asks why she must consult w/ her dr. when she uses cold products for her children. You respond?
Definition
There is a risk of overdose, because acetaminophen is a very common ingredient in OTC cold, flu, fever and pain remedies.
Term
A student nurse asks you why acetaminophen and NSAIDs help to reduce cancer pain. You respond?
Definition
Cancer often produces chronic pain from tumor invasion of tissues or complication of treatment. These drugs prevent sensitization of peripheral pain receptors by inhibiting prostaglndin formation.
Term
Aspirin increase the risk of bleeding and should generally be avoided for many weeks before and after surgery?
Definition
1-2 weeks
Term
Excessive use of simple analgesics, analgesics containing sedaties or caffeine, trptas, opiois orergotamine are believed to play a role in triggering ____?
Definition
overuse headaches/rebound headaches
Term
Both categories of migraine abortive drugs (ergot alkaloids and serotonin agonits)exert powerful vasoconstrictive effects and have the potential to ____?
Definition
raise blood pressure
Term
Aspirin is not recommended for children under the age of 15 years due to the risk of _____?
Definition
Reye's syndrome
Term
Mr. Smith dr. orders an ergot preparation for her migraine headache. You explain how to take medication, you respond?
Definition
take it at the onset of a headache and lie down in a quiet darkened room.
Term
A pt. who self administers the meds butalbital may experience?
Definition
overuse headaches or withdrawal issues.
Term
Three meds that may be given to reduce serum uric acid levels and prevent joint inflammation and renal calculi are ____, ____ and ____.
Definition
allopurinol, prbenecid, sulfinpyrazon
Term
____ is a product that helps restore the "shock absorbing" ability of joint structures.
Definition
hyalurnic acid (Synvise)
Term
When using fumazenil (Romazicon) asan antidote for benzodiazepine overdose, the nurse should?
Definition
oserve for re-sedation after admin of the antidote.
Term
When admin benzodiazepines to pts with malnutrition or liver damage, the nurse should monitor carefully for?
Definition
toxicity
Term
When a pt. tells you "My sister often has a sleep problem similar to mine" you should respond?
Definition
by telling her medication should not be shared.
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