Intro to Pharm Flashcards Preview

Fundies First Module--First Exam > Intro to Pharm > Flashcards

Flashcards in Intro to Pharm Deck (108):
1

drug def

something put in body for intended effect

2

drugs that are almost exclusively harmful

poison

3

FDA def drug

substance intended for:
1. dx
2. cure
3. mitigation
4. treatment
5. prevention (prophylaxis) of disease

4

natural sources of drugs

1. botanical (plant)
2. mineral/ earth (metalic vs. non-metallic)
3. animal
4. microbiological (bacteria/fungi) (penicilin, gentimyocin, streptomyocin)

5

when nucleas of drug from natural source and chemical structure is altered

synthetic drug--most drugs nowadays

6

when nucleus of drug from natural source is retained but chem structure altered

semi-synthetic drug

7

desired gene spliced into rapidly repicating DNA (viral)--allowing vast production

recombinant DNA technology

8

mineral drugs

iron, mercury salts, zinc, iodine, selenium

9

advantages to recombinant DNA technology

1. huge amount can be produced
2. drugs can be obtained in pure form
3. it is less antigenic

10

Jenner--smallpox vaccine

contact with cowpox (milder disease in humans) --> immunity

11

vaccine

agent that resembles a pathogenic microorganism but does no cause the disease--immunity to wild-type microbe

12

study of all aspects of drugs--history-->therapeutics

pharmacology

13

clinical def of pharm

study of those specific aspect of drugs which have relevance in their use in treatment, prevention, or dx of human disease.

14

branch of pharmacology dealing with harmful effects of chemicals

toxicology

15

Paracelsus

the dose makes the poinson

16

clinical toxicology def

study of the adverse effects of drugs on humans when these drugs are used in disease dx, prevention, treatment, or in cases of accidental poinsoning

17

ability of chemical to kill microb w/out harming host

selective toxicity

18

side-effects aka

adverse drug reaction

19

what drug does to the body

pharmacodynamics

20

pharmacodynamics

what drug does to the body

21

what body does to the drug

pharmacokinetics

22

pharmacokinetics

what body does to the drug

23

pharmacokinetics- what body does to drug

1. absorption
2. distribution
3. metabolism
4. elimination

24

liver's goal in metabolizing drugs

make water soluble

25

best drugs

lipid soluble

26

2 important considerations in pharmacodynamics

1. mechanism of therapeutic and toxic rxns (mechanism of action)
2. Dose-response relationships--therapeutic window or index

27

dosage range where there is benefit while minimizing toxicity risk

therapeutic window or index

28

How the drug moves through the body

pharmacokinetics--most active forms of drugs have been chemically changed

29

passage of drug from aministration site to general circulation

drug absorption

30

movement of drug from general circulation to target tissue

drug distribution

31

biotransformation--often necessary for proper activity or excretion

drug metabolism--may make multiple passes

32

removal of drug or metabolite from body

elimination--may be changed or unchanged

33

elimination pathways

urine, feces, perspiration, respiration, milk, tears, asaliva

34

main organ for elimination

kidneys--

35

time required to eliminate 50% of absorbed dose of drug

half-life

36

most common use for drugs

therapeutic--treatment of disease

37

guard against disease--preventive

phrophylactic use--i.e. asparin for MI

38

drugs to identify or establish cause for disease

diagnostic use of drug

39

drugs that carry the "federal law prohibits dispensing w/out a prescription" label

legend drugs

40

SAFETY + EFFICACY of drug, but not specifically made for problem

appropriate off-label use

41

does the FDA regulate the practice of medicine?

No

42

must show safety and efficacy of treatment if using drugs_____-_____

off-label

43

drug interactions may ______ or _______ effect of drug; interactions can be ________ or ________

increased or decreased
positive (wanted by doc) or negative (not wanted by doc)

44

positive drug interactions may be ______ or ________

additive or synergistic

45

Predispositions for drug interactions

1. old age (organ and tissue decrease in function)
2. polypharmacy (lots of drugs)
3. genetics
4. hepatic or renal disease (higher levels of drugs in body)
5. use of drugs with narrow therapeutic index

46

Types of Drug interactions-- may be wanted or unwanted

1. drug-drug
2. drug-food
3. drug-disease
4. drug-receptor (mechanism of action for drug)

47

notorious drug-food interaciton

grapefruit

48

name for drug used during research

chemical name

49

the common or nonproprietary name of active drug--forever attached to drug compound or chemical

generic name

50

prescribing should be done using the

generic name i.e. acetaminophen

51

generic drug contrasted from

generic name

52

generic drugs must be ________ to a brand name drug

bioequivalent or identical

53

nutritional supplements and herbs covered under

DSHEA

54

average time before drug hits marked from Investigational New Drug IND application

6 years

55

considerations in choosing route of admin

1. speed--closest to target
2. characteristics of drug--absorbable?
3. patient state-- i.e. conscious/ child
4. Risk--some routes ^toxicity
5. positive correlation btwn risk of injection and by-pass of barriers to absorption--i.e. risk of infection for I.V.
6. Cost

56

Topical administration

1. Oral --sublingual (bipasses liver) / buccal (not for high dose drugs)
2. Skin--i.e. cream--local or systemic
3. eye--i.e. antibiotic drops

57

Respiratory administration

1. intranasal meds--topical
2. inhaled medications--drugs delivered to alveoli and bronchioles

58

enteral administration

drug somewhere along GI tract
1. oral
2. rectal

59

parenteral administration

1. bypass GI tract
2. ex. IV, IM, SC, ID, IO, epidural

60

topical administration

1. oral
2. classical topical route
3. transdermal

61

transdermal patches benefits

1. self administered
2. avoid first pass metabolism ("downstream from liver)
3. systemic
4. can be chewed
Many drugs moving this dirrection

62

Enteral admin

PO (by mouth)

63

enteral admin disadvantages

1. variable absorption
2. upset stomach
3. compliance
4. first pass metabolism

64

"absorption rate limiting" steps

pill coating

65

dissolving of drug happens in stomach--absorption happens in_______

small intestine (large surface area due to microvilli--pH effects degree of ionization of drugs therefor drug absorption--will dictate direction of movement through membranes

66

pH in stomach lower when

food present

67

pH of small intestine optimal for

enzymatic activity--digestion of protein, carbs, and lipids--enzymes secreted into duodenum

68

small intestine pH rises

as food moves toward terminal end

69

colon

1. lacks microvilli
2. semi solid contents
3. lower pH than small intestine
4. lubcricated with mucin
5. poor absorption but some drugs designed to be absorbed here (sustained release products)

70

rectal

1. pH 7
2. little fluid
3. variable absorption
4. MIGHT escape first-pass metabolism
5. good for peds

71

parenteral administration

w/ needle i.e.
1. IV
2. IM
3. SubQ
4. ID

72

advantages to parenteral admin

1. rapid delivery
2. rapid onset
3. good control

73

disadvantages to parenteral admin

1. skilled personel
2. expensive
3. hard to reverse adverse rxn
4. infection (infiltration or extravasation)

74

intraarterial

for injection of dx substances

75

IM admin

along with subQ--most common parenteral route

76

IM admin depends on

1. blood flow
2. lateral dispersion of drug
3. can be controlled by adding vaso constrictor/dilator

77

subcutaneous SC

same factors for absorption as IM

78

locations for SC

abdomen, upper back, hips, lat prox arms (thicker subQ)

79

Intradermal admin

same factors as IM--lower blood flow than muscles
TB test

80

Intraosseous admin

large volumes of fluid able to be infused

81

Intraarticular (injection into joint capsule)

usu. steroids, antimicrobials, anesthetics

82

Intralesional admin

usu. before removal of lesion

83

Epidural admin

injection ABOVE dura mater typically at L3-L4 level
usually for anesthetic

84

Intrathecal admin

injection through dura mater into spinal canal into CNS
w/out going through BBB--rare

85

pumps can deliver meds

epidural, transdermal, subcutanious

86

in addition to drug approval, the FDA

reviews evidence for safety and efficacy of drug through postmarketing surveillance--

87

New drug application filed

for ordinary clincal use, after completion of phase III clincal trials

88

phase I drug trials

establish safety/ pharmacokinetics on healthies

89

Phase II drug trials

establish efficacy and dose on diseased ppl

90

Phase III drug trials

verify efficacy on large population of diseased ppl

91

Phase IV drug trials

postmarketing surveillance

92

generic drugs available

20 years after IND applicaiton

93

highest cause of liver failure

tylenol -- toxic metabolite builds up in liver

94

Pregnancy categoriy A drug

controlled studies show no risk

95

Pregnancy category B drugs

no evidence of risk in humnas; the chance of fetal harm is remote

96

Preg Cat C drugs

Risk not exclueded. Adequate studies lacking. chance of fetal harm but benefits outweigh risks.

97

Preg Cat D drugs

positive evidence or risk. studies in humans show fetal risk. potential benefit in pregnant women may outweigh risk.

98

Preg Cat X drugs

Contraindicated--shouldn't be used

99

controlled substance schedules from abuse potential -->low potential

C-I --> C-V

100

high abuse no clinical application

C-I

101

high abuse w/ clinical application

C-II

102

less potential for abuse w/ clinical application

C-III

103

low abuse potential as related to C-III

C-IV

104

lowest abuse potential w/ clinical appliaction

C-V -- some OTC, but not all

105

will be a test Q on conversion in metric

1 kg = 2.2 lbs -- for pt weight
1 tsp = 5 mL

106

kg --> g --> mg --> mcg

*

107

3 part solution =

3% of X in solution

108

1 mg =

1000 mcg