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Pharmacology > Drug Rules and Dosing > Flashcards

Drug Rules and Dosing Flashcards

1
Q

Pharmacology

A

The study of how drugs work in the body

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2
Q

Clinical pharmacology (therapeutics)

A

The study of how drugs are specifically applied to clinical conditions (the applications of pharmacology)

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3
Q

Mechanism of action

A

How a drug alters normal physiology (negative and positive side effects)

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4
Q

Physiological changes

A

Alter patient’s clinical parameters

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5
Q

Adverse effects

A

Alter behaviors of the patient (i.e. vomiting)

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6
Q

Rule #1 for safe drug usage

A

All drugs are poisons (it’s often how much you give and how it is administered that has the potential to save a life or take a life)

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7
Q

Rule #2 for safe drug usage

A

All doses are guesses (a dose is an estimation of what amount of drug should produce the beneficial effect on average for a population of animals; have to take into account the variations in the individual patient’s physiology; most dosages are based on anecdotal evidence)

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8
Q

Rule #3 for safe drug usage

A

No drug is a silver bullet (no drug completely eradicates a disease; all drugs produce positive or negative side effects, must weigh the benefits and risks)

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9
Q

Rule #4 for safe drug usage

A

Complacency kills (once you get comfortable with a drug, risk of forgetting rules 1-3; need to be vigilant and check for early signs of adverse effects)

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10
Q

Chemical name

A
  • Name given to drug when first discovered
  • Assigned by the Chemical Analysis Society
  • ID the atomic or molecular structure
  • Found on package insert
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11
Q

Non-proprietary name

A
  • “Generic” name or active ingredient
  • Assigned by United States Adopted Names council (not owned by one company)
  • Usually written in lower case
  • Name includes prefix (IDs the individual drug within a group) and stem (IDs the drug group)
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12
Q

Proprietary name

A
  • Brand (or trademark) name
  • Name developed by the company that is requesting approval for the drug from the FDA (IDs property of that company)
  • Drugs are marked under the brand name while under patent protection. Once the patent expires, the company can market its product either as the generic name or the brand name
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13
Q

Generic equivalent drugs

A
  • Must be approved by FDA
  • “Identical” requirement is a legal term, not necessarily realistic (to be identical, the drug has to be 80-125% bioequivalent to the original drug)
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14
Q

Bioequivalent

A

An equivalent amount of generic drug must be absorbed and delivered to the target site in the body compared to the original brand or parent drug; must include the identical amount of the active ingredient

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15
Q

Generic equivalents in food animals

A
  • The amount of the drug residue left after the withdrawal time can be no more than the original patent drug
  • May have other chemicals added to enhance absorption - but must still have the same bioequivalence of 80-125% with no greater residue left
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16
Q

Residue

A

Amount of drug left in the meat, eggs, or milk

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17
Q

Withdrawal time

A

The amount of time from the last dose of the drug until the animal can be harvested for human food or its products (eggs, milk) used for human food

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18
Q

Extract

A
  • Drugs that are prepared from plant or animal parts
  • Regulated by the FDA (under dietary supplements and food)
  • Generally less expensive
  • May be variability from batch to batch on the active ingredient (but still needs to be within the bioequivalent range)
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19
Q

Nutraceutical

A
  • Natural, bioactive chemical compound; includes vitamins, minerals, and herbal supplements
  • Regulated by the FDA (under dietary supplements and food)
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20
Q

Legend Drugs

A
  • Medications that require prescriptions or must be ordered in-house by the clinician
  • Identifiable by Rx symbol or a legend (caution describing federal law restriction)
  • Cannot be dispensed without a valid Veterinarian-Client-Patient-Relationship (VCPR) (vet has examined the patient or has adequate knowledge of the patient, and has agreed to assume responsibility for veterinary care)
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21
Q

The Green Book

A

Lists all FDA approved drugs and generics both OTC and legend drugs

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22
Q

Over the counter (OTC)

A
  • No Rx, legend, or restrictive language on the packaging
  • Either has a very safe ingredient or a much lower amount of a prescription ingredient
  • Manufacturer will not release the drug if it is not idiot proof (for liability reasons)
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23
Q

United States Pharmacopiea (USP)

A
  • Non-governmental organization that sets the standards for purity and quality of drug manufacturing for drugs to be marketed in the US
  • Raw drug materials produced outside the US must be manufactured to USP standards or else drug companies in the US cannot use them in their drugs
  • Inability of foreign raw drug manufacturers to meet USP standards can result in US drug manufacturer being unable to produce the drug - get temporary shortages
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24
Q

Package insert

A
  • Contains brand name (and generic name)
  • Strength of the medication
  • IDs as legend drug
  • Physical description of drug form
  • Chemical name
  • Indications (will not describe off label use)
  • FDA approved dosage and administration
  • Dosage regimen
  • Adverse drug reactions
  • Side effects
  • Info for owners
  • Warnings and precautions
  • Black boxed warning
  • Clinical pharmacology
  • Safety and effectiveness
  • Storage conditions
  • How the medication is supplied
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25
Q

Dosage

A

How to determine the amount of drug that has been approved to be given to any animal

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26
Q

Dose

A
  • The mass of drug given to a single patient (calculated)

- Should not be listed as a volume amount or as a number of dose forms

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27
Q

Dosage regimen (package insert)

A
  • Dosage (can be a range)
  • Dosing interval (frequency to be given)
  • Route of administration
  • Based on half-life of the drug
28
Q

Parenteral administration

A

Any non-GI tract means of administration

29
Q

Contraindications (package insert)

A

Conditions under which a drug should not be given

30
Q

Relative contraindication

A
  • Caution should be used when deciding to use the medication

- Need to weigh the benefits v. risks of using the medication

31
Q

Absolute contraindications

A
  • Using the medication could cause life-threatening situations
  • The medication should never be used
32
Q

Warnings and precautions (package insert)

A
  • Sometimes lumped together by FDA
  • Warnings: reactions to drugs that may require medical intervention (significant safety issues)
  • Precautions: milder reactions or safety issues (typically do not warrant medication intervention)
33
Q

Adverse Drug Reaction (ADR)

A
  • An unwanted or harmful reaction experienced following the administration of a drug or combination of drugs under normal conditions of use and is suspected to be related to the drug
  • Ex: drug to drug interaction
  • Should be reported to FDA (form 1932a “Veterinary Adverse Experience, Lack of Effectiveness, or Product Defect Report”)
34
Q

Side effect

A

Any effect caused by a drug other than the intended therapeutic effect, whether beneficial, neutral, or harmful

35
Q

Black boxed warning

A
  • A warning designed to call attention to a serious or life-threatening risk
  • Strictest warning on the label
  • Patient needs to be monitored closely when using the drug
36
Q

Clinical pharmacology

A

Includes absorption, distribution, metabolism, and elimination

37
Q

Dosage forms

A
  • The physical appearance or description of a medication
  • Different routes require different dosages
  • Allows for ease of administration
  • Allows for marketing identification
  • Protects the medication in the route it needs to be given
38
Q

Tablets

A
  • Powders that are compressed into a round form

- Consists of active ingredient and excipients

39
Q

Active ingredient

A

Drug

40
Q

Excipients

A

All other ingredients in a tablet

  • Binders (hold the tablet together)
  • Disintegrants (allow the tablet to dissolve properly)
  • Colors, diluents, and flavoring agents
41
Q

Caplets

A

Elongated, oblong shaped tablets (makes easier to slide down the throat)

42
Q

Coatings

A
  • Tablets and caplets have coatings that may or may not be scored
  • Purpose: easier to swallow, protects from breakage, covers taste, protects from moisture or light, color for marketing
43
Q

Enteric coating

A

Made to remain intact while passing through the acidic environment of the stomach (pH 2-3), then they dissolve when they reach the more alkaline intestines of a human (pH 6)

44
Q

Sustained release (SR) or Extended release (ER)

A

Releases drug over time as it passes through the GI tract (should never be split, crushed or chewed)

45
Q

Molded tablets

A
  • Chewable tablets

- Contain: active ingredient, binders, lactose, sucrose, or dextrose, and flavoring agent

46
Q

Gel caps or capsules

A
  • Powdered drug surrounded by a capsule made of gelatin, modified starch, or cellulose
  • Can be modified to make it harder, softer, more readily dissolvable, or lubricated for easier swallowing
  • Microencapsulation can make capsules sustained release
  • Not commonly used in vet med because they can get stuck, chewed, or opened
47
Q

Lozenge or troche

A

Hard candy-like tablet that is meant to dissolve in the mouth

48
Q

Implant

A

Solid polymer material that dissolves and releases medication over a period of months

49
Q

Suppositories

A

Administered per rectum to dissolve and be quickly absorbed

50
Q

Powder

A

Formulation in which a drug powder is mixed with other powdered excipients to produce a final product (dissolve faster than tablets or capsules because disintegration is not an issue)

51
Q

Granules

A

Consisting of powder particles that have been aggregated to form a larger mass (must disaggregate before dissolution and absorption)

52
Q

Ointments and creams

A

Liquefy at body temperatures (helps medication flow into cracks and crevices)

53
Q

Pastes

A
  • Designed to retain solid form at boy temperature
  • Administered with large syringe
  • Often used to orally administer medications
  • Ex: deworming and pain medications
54
Q

Transdermal gel

A

-Most commonly pluronic lecithin organogel
-Delivers drug via transdermal route to the boodstream
Applied to inner surface of pinnae

55
Q

Transdermal patch

A
  • Consists of drug incorporated into a reservoir, a protective backing layer, a rate-limiting release membrane, and an adhesive layer
  • Cannot cut all patches, must read insert first
56
Q

Aerosol

A

Designed to be inhaled into the lungs (metered dose inhalers (MDI) and aerosol chambers

57
Q

Solutions

A
  • Drug dissolved in a medium (usually liquid solvent)
  • Can be given IV
  • Aqueous solution (water), syrup (sugar solution), or elixir/tincture (alcohol solution)
58
Q

Suspensions

A
  • Drug not dissolved in the liquid
  • Drug settles out over time
  • Can be given PO, IM, SQ, but never IV
  • Must be shaken before administration
59
Q

Syrup caution

A

Often human drugs are made with artificial sweeteners

-Xylitol is toxic (causes hypoglycemia (lyperinsulinemia) and liver necrosis in dogs

60
Q

Emulsions

A
  • System consisting of two immiscible liquid phases (one of which is dispersed throughout the other in the form of fine droplets
  • Drug is dissolved in liquid solution then mixed with an oil-based medium (does not dissolve)
  • Must be shaken before administration
  • Ex: propofol
61
Q

Lotions

A

Emulsion of oil and water + additional ingredients that keep the two liquid layers together
-Ex: topically applied hand creams, antiseptic lotions, antibiotic, or antifungal lotions

62
Q

Liniments

A

Liquid dose form applied topically but then must be rubbed into the skin to administer the drug
-Sometimes referred to as balms

63
Q

Injectable dosage forms

A

Delivered using a needle/catheter and syringe or IV line

64
Q

Ampules

A
  • Glass bottle with narrow neck (snap to open)
  • Contents must be filtered before administration
  • Only good for 24 hours, meant for only one use
  • Does not contain preservative
65
Q

Multi dose vials

A
  • Can be used multiple times
  • Has rubber stopper to prevent introduction of bacteria
  • Usually contains preservative
  • Should be discarded after 28 days (unless states otherwise)
66
Q

Single dose vials

A
  • Should only be punctured once
  • Do not contain preservatives
  • Often in powdered form that will need reconstituted

Pharmacology (6 decks)

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