lecture 1

Question 1

General Principles

Answer 1

“To administer a drug safely, one must know its usual dose frequency, route of administration, indications, contraindications (condition… not taking medication due to harm it would cause), significant adverse reactions, and major drug interactions.”

Question 2

Pharmacology

Answer 2

the study of drugs and their actions and effects in body systems

Question 3

Pharmacodynamics

Answer 3

the study of biochemical and physiologic drug effects, and the mechanisms of drug action (how it works)

Question 4

Pharmacokinetics

Answer 4

the study of drug absorption, distribution, metabolism, and excretion (ADME)

Question 5

Pharmacognosy

Answer 5

the study of drugs derived from herbal or natural sources (not regulated like pharmaceuticals are, and difficult to know which dose is appropriate)

Question 6

Pharmacotherapeutics

Answer 6

the study of how drugs are best used and which drug is appropriate for a specific disease

Question 7

Toxicology

Answer 7

the study of poisons and poisonings (drugs are all toxins, ex. if you take too much)

Question 8

Toxicity

Answer 8

refers to drug’s ability to poison the body.

Question 9

Overdose

Answer 9

dose of a drug that causes harm (ex. also if the body doesn’t metabolize fast enough)

Question 10

Adverse drug reaction (ADR):

Answer 10

any response to drug that is noxious (toxic), unintended, and occurs at doses normally used for prophylaxis (prevention), diagnosis, or therapy.

Question 11

Side effect

Answer 11

an unintended drug effect; this can be beneficial

Question 12

The risks -vs- benefits when taking pharmaceuticals

Answer 12

-Taking prescription pharmaceuticals is not “risk-free”
-Many pharmaceuticals can have adverse effects
-Some treat one condition but increase the risk of developing a different condition (ex. increasing or decreasing blood pressure)
-The more serious the condition being treated, the more serious adverse effects are tolerated (cancer –vs- bone density or obesity)

Question 13

Risks –vs- benefits
(When treating a patient there are several factors to take into consideration)…

Answer 13

The disease and its severity
The age and health of the patient
The risks they are willing to take
What the patients wants
What is possible (cure, control symptoms, live longer if terminal)

Question 14

Chemical name

Answer 14

chemical makeup of a drug; often very complicated
N-acetyl-para-aminophenol (APAP)

Question 15

Generic name

Answer 15

also official, approved, or nonproprietary name; not protected by copyright
acetaminophen

Question 16

Proprietary name

Answer 16

also brand or trade name; assigned by manufacturers and protected by copyright
tylenol

Question 17

Drug Reactions: Idiosyncratic reaction

Answer 17

a unique, strange, or unpredicted reaction to a drug (can’t predict)

Question 18

Drug Reactions: Allergic reaction

Answer 18

hypersensitivity to a drug that occurs after a previous exposure to a similar or same drug, and develops rapidly after re-exposure

Question 19

Drug Reactions: Anaphylactic shock

Answer 19

idiosyncratic, sudden, and life-threatening allergic reaction

Question 20

Anaphylaxis

Answer 20

Anaphylaxis is a severe allergic reaction that occurs rapidly and causes a life- threatening response involving the whole body.
This reaction can lead to difficulty breathing and shock ultimately leading to death.

EpiPen is a registered trademark for the most commonly used autoinjector of epinephrine (a.k.a. adrenaline), used in medicine to treat anaphylactic shock.
Closes off blood vessels so fluids stop leaking

Question 21

Signs & Symptoms of an anaphylactic reaction

Answer 21

An allergic reaction usually happens within minutes after being exposed to an allergen, but sometimes it can take place several hours after exposure. A reaction can involve any of these symptoms, and a person could have one or more of these symptoms regardless of the allergen:

Skin system: hives, swelling, itching, warmth, redness, rash

Respiratory system (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion or hay fever-like symptoms (runny itchy nose and watery eyes, sneezing), trouble swallowing

Gastrointestinal system (stomach): nausea, pain/cramps, vomiting, diarrhea

Cardiovascular system (heart): pale/blue colour, weak pulse, passing out, dizzy/lightheaded, shock

Other: anxiety, feeling of “impending doom”, headache, metallic taste

Question 22

Tolerance

Answer 22

development of resistance to drug’s effects, such that dose must be continually raised to elicit desired response.

Question 23

Drugs that commonly produce tolerance are:

Answer 23

Opiates
Barbiturates
Tobacco
Nitrates (for cardiovascular disease, angina)
Alcohol

Question 24

Other Drug Effects: Cumulative Effect

Answer 24

occurs when body cannot completely metabolize and excrete one drug dose before next dose is given.

Question 25

Other Drug Effects: Synergism

Answer 25

occurs when the combined action of two or more agents produces a greater effect than expected from agents acting separately. If two drugs are taken together that are similar in action, such as barbiturates and alcohol, which are both depressants

Question 26

Other Drug Effects: Potentiation

Answer 26

a greater effect than expected caused from additive properties of two or more drugs. Potentiation occurs when two drugs are taken together and one of them intensifies the action of the other. (not usually 2 meds working on the same system like above?, they are usually working on different systems)

Question 27

Safe Medication Administration

Answer 27

Medications have the potential to cause serious harm to the patient. All medication orders must come from the physician or other authorized health-care professional Vigilance is needed to prevent errors and ensure quality patient care.

Question 28

Principles of Drug Administration

Answer 28

Assess patient health and obtain medication history and use of vitamins, herbs, or food supplements prior to giving medications. Determine if route of administration is suitable. Assess socioeconomic factors and ability to self-administer (if applicable) - mental health like dementia, etc

Question 29

Seven Rights of Drug Administration

Answer 29

1.Right patient 2.Right drug 3.Right dose 4.Right route 5.Right time 6.Right technique 7.Right documentation

Question 30

Over-the-counter (OTC) drugs

Answer 30

available for self-medication; do not require prescription

Question 31

Legend or prescription drugs:

Answer 31

require prescription from licensed practitioner (physicians, dentists, veterinarians, etc.)

Question 32

Medication Errors

Answer 32

Inappropriate or incorrect administration of a drug Medication errors should be preventable through effective system controls involving all levels of health-care workers as well as the patient. Some errors are caused by manufacturing mistakes.

Question 33

Errors Occur in Three Stages

Answer 33

Prescribing or ordering medication Dispensing medication Administering medication and monitoring for side effects

Question 34

Why Medication Errors Occur

Answer 34

Miscommunication Missing information Lack of appropriate labeling by manufacturer or pharmacist Environmental factors (ex. If you’re trying to give medication to one person and another person in the room is screaming… this can affect your concentration) Poor management

Question 35

Causes of Medication Errors

Answer 35

Wrong patient Incorrect route Incorrect drug Incorrect dose Incorrect time Incorrect technique Incorrect information on patient chart

Question 36

Manufacturing Errors

Answer 36

The sulfanilamide disaster of 1937 is an example of formulation or manufacturing errors. Elixir Sulfanilamide. During September and October 1937 this drug was responsible for the deaths of more than 100 people in 15 states; company reformulated drug by dissolving sulfanilamide in diethylene glycol- the chemical commonly used in antifreeze (ethylene glycol, which is sweet to eat but poisonous) Mislabeling, contamination, wrong drug, wrong concentration, wrong doses of drugs, counterfeit drugs, and undiscovered toxicity are other causes.

Question 37

Reducing Medication Errors

Answer 37

Provide adequate, trained staff Use standardized metric measurement systems Develop consistent error-tracking systems Establish clear system for review of drug orders, ordering, dispensing, and administration Maintain medication profiles with regularly updated allergy and reaction histories Provide suitable, safe work environments

Question 38

Ethics

Answer 38

standards of behavior that encompass the concepts of right and wrong beyond a given situation’s legal considerations.

Question 39

Confidentiality

Answer 39

health professionals must maintain strict confidentiality Health-care workers must know laws of state/province in which they work, including rules that apply to phoning prescriptions to pharmacists.

Question 40

Pharmaceutical company representatives provide drug samples to physician offices.

Answer 40

These samples may not be sold

Question 41

Lifestyle changes –vs- pharmaceuticals

Answer 41

Pharmaceuticals are necessary and the best treatment option for many diseases/conditions or to control symptoms. However many pharmaceuticals are prescribed for diseases or conditions which have the potential to be cured or controlled by lifestyle changes. Some examples are obesity, hypertension, cardiovascular disease, type II diabetes, insomnia, anxiety and osteoporosis.