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EMRG 1305 > Week 6- Pharmacology > Flashcards

Week 6- Pharmacology Flashcards

1
Q

What is pharmacolgy?

A
  • Is the study of drugs, their actions, dosage, therapeutic uses and adverse effects
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2
Q

What is the leading cause of pt safety errors in healthcare?

A
  • Medication errors
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3
Q

What are drugs?

A
  • It’s a substance that alters biological activity in a person
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4
Q

What are some reasons drugs are prescribed?

A
  1. Promote healing (anti inflammatory)
  2. Cure disease (antibacterial)
  3. Prevent disease
  4. Control of slow the process (chemo)
  5. Decrease risk of complications (anticoagulants)
  6. Increase comfort (analgesic)
  7. Replacement therapy (insulin)
  8. Reduce excessive activity (sedative)
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5
Q

What 4 disciplines is it separated into?

A
  1. pharmacodynamics
  2. pharmacokinetics
  3. pharmacotherapeutics
  4. toxicology
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6
Q

What is pharmacodynamics?

A
  • The study of biochemical and physiological effects of drugs and their mechanisms of action
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7
Q

What is pharmacokinetics?

A
  • How the body interacts with administered substances for the entire duration of exposure
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8
Q

What is pharmacotherapeutics?

A
  • The use of drugs for the prevention, treatment, diagnosis, and modification of normal functions. Ex. pregnancy prevention
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9
Q

What is toxicology?

A
  • Study of the adverse effects of chemicals or physical agents on living organisms
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10
Q

What are the drug effects?

A
  1. Therapeutic= beneficial tx
  2. Side effects= unwanted rxns
  3. Toxic effects= dangerous side effects
  4. Hypersensitivity= allergic rxns
  5. Idiosyncratic= unusual rxn by an individual to a normally harmless substance
  6. Iatrogenic= negative effect caused by error or OD
  7. Teratogenic= harmful effects on fetus
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11
Q

What are the 4 interactions?

A
  1. Synergism
  2. Antagonism
  3. Potentiation
  4. Additive
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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
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13
Q

What does antagonism means?

A
  • Opposing action (half ass works)
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14
Q

What does potentiation mean?

A
  • To increase the strength or effect
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15
Q

What does additive mean?

A
  • Combining 2= the sum of each
  • Tylenol & advil
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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
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17
Q

What are the mechanisms of medication absorption?

A
  • Active transport (moving against the gradient)
  • Passive diffusion (doesn’t use energy)
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18
Q

Blood flow and medication absorption

A
  • A properly functioning circulatory system greatly enhances the rate of meds absorbed
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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
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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
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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)
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22
Q

What is chronotropic effect?

A
  • Changes HR
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23
Q

What is Inotropic effect?

A
  • Changes the contractility of the heart
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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
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25
Q

What do Beta Blockers- Class 2 do?

A
  • Reduce O2 demand of the heart muscle
  • Affect the beta cells- B1 (cardiac) & B2 (bronchial)
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26
Q

How does Beta Blockers- Class 2 work?

A
  • 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
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27
Q

What are some common beta blockers?

A

Ending in LOL
- Atenolol
- Metoprolol- lopressor
- Labetalol
- Propanolol- inderal
- Carvedilol- coreg
- Bisoprolol- monocor

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28
Q

What is the main action of Calcium Channel Blockers?

A
  • 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
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29
Q

Common calcium channel blockers?

A

Ending in ine
- Amlodipine
- Nicardipine
- Nifedipine
- Nimodipine
- Felodipine

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30
Q

How do diuretics work?

A
  • 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
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31
Q

What are diuretics?

A

“Water Pills”
- Medication that acts on kidneys to increase diuresis

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32
Q

What are diuretics used to treat?

A
  • HTN
  • Edema (heart failure & pulmonary edema)
  • Renal diseases
  • Hepatic diseases
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33
Q

What are the 5 types of diuretics?

A
  1. Thiazide diuretics- hydrochlorothiazide
  2. Loop diuretics- lasix
  3. Potassium- sparing diuretics- spironolactone
  4. Osmotic diuretics- mannitol
  5. Carbonic anhydrase inhibtors- acetacolamide
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34
Q

What are loop diuretics?

A
  • 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
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35
Q

What are potassium sparing diuretic?

A
  • 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
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36
Q

What are thiazide diuretics?

A
  • Act by inhibiting NaCl reabsorption into the distal convoluted tubule of the kidney
  • Happens through the suppression of the sodium chloride contransporter
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37
Q

What are thiazide diuretics mainly used to treat?

A
  • HTN
  • Heart failure
  • Kidney failure
  • Diabetes
38
Q

What are antihyperlipidemic agents?

A
  • 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
Q

What are some common cholesterol medication?

A

“STATIN”
- Pravastatin
- Simvastatin
- Ezetimibe
- Atorvastatin
- Rousvastatin

40
Q

What are Antiplatelet medications?

A
  • 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
Q

What are some common antiplatelet medications?

A
  • ASA
  • Dipyridamole
  • Clopidogrel
  • Trigrelor
42
Q

What are anti coagulants?

A

Blood Thinners
- Used to make the blood less viscous
- Obtained by increasing the levels of antithrombin, which then inhibits clotting factors

43
Q

What are the most common anti coagulants?

A
  • Heparin and warfarin
  • Heparin= works with antithrombin
  • Warfarin= works to inhibit the vitamin K effects on clotting
44
Q

What type of patients are on anti coagulants?

A
  • Afib
  • MI
  • CVA
45
Q

What are ACE inhibitors?

A
  • 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
Q

What are some common ACE inhibitors?

A

“PRIL”
- Lisinopril
- Accupril
- Enalapril
- Ramipril

47
Q

What are anti anginals?

A
  • Used to increase blood and O2 supply to the heart while reducing workload of the heart
48
Q

How do Anti Anginals work

A
  • 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
Q

How does nitrates work?

A
  • 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
Q

What are Long Acting Beta Agonist and Corticosteroids?

A
  • 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
Q

What are steroids?

A
  • Anti-inflammatory drugs
52
Q

How do steroids work in relation to respiratory?

A
  • Reduce the infiltration of mediators of the inflammatory response in the airway cells
  • Reduce the creation of proinflammatory substances- prostaglandins, leukotriene, macrophages
53
Q

What are common long acting beta agonist?

A
  • Fluticasone= flovent
  • Budesonide= pulmicort
  • Advair= combo drug
  • Symbicort= combo drug
54
Q

What are Short Acting Beta Agonist?

A
  • AKA relievers, rescue medications
  • Provide short-term, rapid relief of asthma symptoms
55
Q

How do Short Acting Beta Agonist works?

A
  • Reverse bronchospasm and open airways
  • Act on the B2 cells of the smooth muscle in the airways (relaxes the bronchial smooth muscle)
56
Q

What are common Short Acting Beta Agonist?

A
  • Ventolin
  • Levalbuterol
  • Ipratropium
  • Sprivia
57
Q

What are Proton Pump Inhibitors?

A
  • Effective in treating GERD
  • Decrease gastric acid levels
58
Q

How do proton pump inhibitors work?

A
  • Act by interfering with the final step in gastric acid production
59
Q

What are common Proton Pump Inhibitors?

A

“ZOLE”
- Omeprazole
- Esomperazole
- Pantaprazole
- Lansoprazole

60
Q

What are Histamine 2 Inhibitors?

A
  • Also used to treat GERD
61
Q

How do Histamine 2 Inhibitors work?

A
  • 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
Q

What are common H2 Inhibitors?

A
  • Pepcid
  • Ranitidine
63
Q

How does Anti Nausea medication work?

A
  • 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
Q

What is nausea often caused by?

A
  • 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
Q

What are common anti nausea medications?

A
  • Gravol- dimenhydrinate
  • Ondansetron- zofran
66
Q

How do laxatives work?

A
  • 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
Q

What are some common laxatives?

A
  • Senna= senokot
  • Bisacodyl= dulcolax
  • Docusate= colace
  • PEG 3350= miralax
68
Q

How does epilepsy medication work?

A
  • 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
Q

What are common meds for epilespsy?

A
  • Dilantin
  • Valproic acid
  • Lamotrigine
  • Carbamazepine
  • Levetiracetam
70
Q

What are opioids?

A
  • 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
Q

What can opioids be classified as?

A
  • Agonists= bind and stimulate the receptor, produce analgesia
  • Antagonist= bind to the receptor but don’t activate it (ex. narcan)
72
Q

What are common opioid meds?

A
  • Morphine
  • Hydromorphone
  • Oxycodone
  • Fentanyl
  • Hydrocodone
  • Codeine
  • Tramadol
  • Percocet
73
Q

What are NSAIDS?

A
  • Have anti-inflammatory, analgesic and antipyretic properties
74
Q

How do NSAIDS work?

A
  • 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
Q

What are benzodiazepines?

A
  • Often used to treat anxiety, slow brain activity
  • Given to treat sleeping disorders, seizure disorders and anxiety
76
Q

How do benzodiazepines work?

A
  • Depresses the limbic system
  • This reduces emotions, anxiety, fear, pain, etc
  • Works of GABA receptors in the brain, reduces the neuronal excitiability
77
Q

What are common psych meds?

A
  • Alprazolam= Xanax
  • Clonazepam
  • Lorazepam= Ativan
  • Diazepam
  • Midazolam
  • Oxazepam
78
Q

What are the 2 categories of antidepressants?

A
  • TCI= tricyclic antidepressant (affect norepi lvls)
  • SSRIs= Selective serotonin reuptake inhibitors (affect serotonin lvls)
79
Q

How do antidepressants work?

A
  • 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
Q

What are common antidepressant meds?

A
  • Amitriptyline
  • Nontriptyline
  • Trazadone
  • Mirtazapine
  • Bupropion
  • Paxil
  • Zoloft
  • Effexor
81
Q

How do antipsychotics work?

A
  • 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
Q

Antipsychotics are often accompained by….

A

Sedative side effects
- Confusion
- Decreased ability to regulate body temp
- Weight gain

83
Q

What are common antipsychotic meds?

A
  • Olanzapine
  • Quetiapine
  • Risperidone
  • Arpiprazole
84
Q

How does oral diabetic medication work?

A
  • Treats type 2 diabetes
  • Works by stimulating insulin release from pancreatic beta cells
  • Also decrease glycogenosis- process of converting glycogen to glucose
85
Q

What are common oral diabetic meds?

A
  • Metformin
  • Januvia
  • Glyburide
  • Sitagliptin/ metformin
86
Q

What is insulin?

A
  • Used for all type 1 diabetics
  • Since it’s a protein, it need to be administered IM
  • Can be rapid-acting, short-acting
87
Q

What are common insuline?

A
  • Novolog
  • Humalog
  • Humulin
  • Levemir
88
Q

How does hyperthyroid meds work?

A
  • Work by depleting excess thyroid hormones
  • Measured by TSH- Thyroid Stimulating Hormone
89
Q

What are common hyperthyroid meds?

A
  • Methimazole
  • Propylthiourcil
90
Q

How do hypothyroid meds work?

A
  • Work by stimulating the release of TSH
  • Mimic the natural actions of the thyroid hormones produced by the body
91
Q

What are common hypothyroid meds?

A
  • Levothyroxine

EMRG 1305 (12 decks)

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