LESSON 1: Principles and Concepts of Pharmacology Flashcards
(139 cards)
1
Q
Why study pharmacology?
A
Healthcare workers need to have knowledge about the actions and effects of medications
2
Q
What is pharmacology?
A
The study of drugs
3
Q
What is a substance that brings about a change in biological function through its chemical actions
A
Drug
4
Q
WHO defines a drug as _____
A
Something that gives benefit to the recipient
5
Q
Drugs produce _____
A
A biologic effect
6
Q
Sources of drugs
A
- Made from snthetic chemicals
- Extracted from plants or animals
- Products of genetic engineering
7
Q
What is the preferred term by WHO for drugs with therapeutic use?
A
Medicine
8
Q
What are the effects of drugs that are non-therapeutic and used as a recreation?
A
- Addictive
- Narcotic
- Mind-altering
9
Q
Describes the drug’s chemical composition and molecular structure
A
Chemical name
Example: 2-(p-isobutylphenyl) propionic acid
10
Q
Name given by the Unites States Adopted Name Council
A
Generic name (nonproprietary name)
Example: Ibuprofen
11
Q
The drug has a registered trademark; use of the name restricted by the drug’s patent owener (usually the manufacturer)
A
Trade name (proprietary name)
Example:
Motrin (other countries),
Advil (Philippines)
12
Q
How is drug classified?
A
Catergorize medications with similar characteristics by their class
Medication classification indicates:
* Effect on the body system
* Symptom it relieves
* Desired effect
13
Q
Examples of classification based on body system
A
- Cardiac drug
- GI drug
- CNS drug
14
Q
Examples of classification based on symptom the medication relieves
A
- Pain-reliever
15
Q
Examples of classification based on the medicine’s desired effects
A
- Oral hypoglycemics
- Antihypertensive medications
16
Q
True or False: A medication may also be part of more than one class
A
True
Example: Aspirin
* Analgesic: relieves pain
* Antipyretic: relieves fever
* Anti-inflammatory: relieves inflammation
* Anti-platelet: prevents stroke recurrence
17
Q
True or False: Medications are available in a variety of forms and preparations
A
True
18
Q
True or False: The form of the medication will determine its route of administration
A
True
19
Q
The composition of medication is designed to _____
A
Enhance its absorption and metabolism
One can alter the characteristics of absorption and design a formulation that is easier to absorb
20
Q
Enumerate the medication forms
A
- Tablet
- Capsule
- Elixir
- Enteric-coated
- Suppository
- Suspension
- Transdermal patch
21
Q
Which of the medication forms: drug with alcohol as a base; usually sweet
A
Elixir
22
Q
Which of the medication forms: prevents the dissolution of drugs in the stomach and absorbed later in the intestine
A
Enteric-coated
23
Q
Which of the medication forms: placed in the anus
A
Suppository
24
Q
Which of the medication forms: drugs that you mix with liquid
A
Suspension
25
Which of the medication forms: drug is absorbed through the skin
Transdermal patch
| Example: Some anti-hypertensive medication, medication for dizziness
26
Concepts as to how drugs can reach the market
New Drug Development
27
Conducted in a regulatory facility after it has completed animal testing
Investigational new drug (IND) application
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Must be obtained for all human test subjects
Informed consent
29
Can be completed only after approval
Investigational drug studies
30
A shortened process used for life-saving drugs
| Medications must show early promise in Phases I and II
Expedited drug approval
31
Which clinical phase of investigational drug studies: A small number of healthy subjects are used
Phase I
| Determing **possible adverse effect**
32
Which clinical phase of investigational drug studies: Small number of volunteer subjects who have illness
Phase II
| Determine the **possible dosing** in a small number of patients
33
Which clinical phase of investigational drug studies: Large number of subjects are used
Phase III
34
Which clinical phase of investigational drug studies: Post-marketing
Phase IV
| Determine **drug reactions** that are very rare
35
Concerned with the use of chemicals in the prevention, diagnosis, and treatment of disease
Medical Pharmacology
36
Concerned with the **use of chemicals** in the **prevention, diagnosis, and treatment of disease**
Medical Pharmacology
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Concerned with **undesirable effects** of chemicals on living systems and deals with the **adverse effects** of drugs and poisonous effects of various chemicals
Toxicology
38
Scientific discipline that **involves all aspects of the relationship between drugs and humans**; involves both t**herapeutic and non-therapeutic use of drugs**
Clinical Pharmacology
39
# Scope of Pharmacology:
Deals with **genetically mediated variations** in drug responses; Involves the study of a **population**
Pharmacogenetics
40
# Scope of Pharmacology:
The use of **genetic information** to **guide the choice of drug therapy** on an **individual basis**; Involves the study of the effect of a particular drug for** one particular person** given that we have knowledge about the genetic make-up of that particular person
Pharmacogenomics
41
# Scope of Pharmacology:
Deals with the development of new drug delivery systems and new dosage forms
Biopharmaceutics
42
# Scope of Pharmacology:
Study of **drug effects** at the **population level**; Helps in regulation of drugs
Pharmacoepidemiology
43
# Scope of Pharmacology:
Deals with the use of chemotherapeutic agents to** inhibit or destroy invading microbes, parasites or cancer cells** with **minimal effect on healthy living tissues**
Chemotherapy
44
# Scope of Pharmacology:
Branch of pharmacology that deals with **identification, selection, preservation, combining, analyzing, standardization, preparing, compounding and dispensing** of medicines for **administration to the patient**.
Pharmacy
| Pharmacist prepares compounds and dispenses medicines upon written order
45
# Scope of Pharmacology:
Branch of pharmacology that deals with the **source of drugs derived from plants and animals**; Study of **physical and chemical properties** of such substances
Pharmacognosy
46
# Pharmacologic Principles
How various drug forms influence pharmacokinetic and pharmacodynamic activities
Examines the difference between injectable medications, oral formulations such as capsules and tablets, and control-release medications
Pharmaceutics
47
# Pharmacologic Principles
The study of what the body does to the drug
* Absorption
* Distribution
* Metabolism
* Excretion
* Relationship of dose and concentration
Involves the study of the drug dose and drug levels
Involves the study of the drug and what happens to the drugs before it gets to its are of action
Pharmacokinetics
48
# Pharmacologic Principles
The study of what the drug does to the body
* Actions of the drug on the body
* Mechanism of drug actions in living tissues
* Relationship between drug concentration and pharmacological response
Involves the study of the drug concentration and pharmacological response
Involves the study of what would happen if a drug binds to a receptor
Pharmacodynamics
49
# Pharmacologic Principles
The use of drugs and the clinical indications for drugs to prevent and treat diseases
Pharmacotherapeutics
50
# Pharmacologic Principles
The study of natural (plant and animal) drug sources
Pharmacognosy
51
# Pharmacokinetics
Movement of drug from the site of administration to the systemic circulation (intravascular)
Absorption
52
Measures the extent to which drug is absorbed
Bioavailability
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It means that the drug has the same bioavailability in the same concentration of the agent when given to a person.
Bioequivalent
54
Factors that affect absorption
* Administration route of the drug
* Ability of medication to dissolve
* Food or fluids administered with the drug
* Body surface area
* Status of the absorptive surface
* Rate of blood flow to the small intestine
* Lipid solubility of medication
* Status of GI motility
55
True or False: A drug’s route of administration affects the rate and extent of absorption of that drug
True
56
# Route of Administration:
Drug is absorbed into the systemic circulation through the oral or gastric mucosa, the small intestine, or rectum
Enteral Route (GI Tract)
57
A drug given orally may be extensively metabolized by the liver before reaching the systemic circulation
First Pass Effect
58
First-Pass Routes
* Hepatic artery
* Oral
* Portal Vein
* Rectal
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Non First-Pass Routes
* Aural
* Buccal
* Inhalation
* Rectal
* Intraarteria
* Intramuscula
* Intranasal
* Intraocular
* Intravaginal
* Intravenous
* Subcutaneous
* Sublingual
* Transdermal
60
# Route of Administration:
Provides peak concentration because it immediately reaches the bloodstream
Parenteral
61
Fastest delivery into the blood circulation
Intravenous
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# Route of Administration:
Used only if you want the effect to be local and not diffuse
If the drug needs to be continuously released in the body without
taking them per orem
Topical
63
The transport of a drug in the body by the bloodstream to its site of action
Distribution
64
Factors that affect distribution
* Protein binding
* Water soluble vs. fat soluble
* Blood-brain barrier
* Areas of rapid distribution: heart,liver, kidneys, brain
* Areas of slow distribution: muscle, skin, fat
65
The biologic transformation of a drug into an inactive metabolite, a more soluble compound, or a more potent metabolite
Metabolism
| Liver (main organ), kidneys, lungs, plasma, intestinal mucosa
66
Delayed drug metabolism causes _____
* Accumulation of drugs
* Prolonged action of drugs
67
Stimulating drug metabolism causes _____
* Enhancement in metabolism
* Inhibition of metabolism
68
Mediated by cytochrome P450 enzymes (e.g. CYP1A2, CYP2D6, CYP3A4)
* Oxidation, deamination, desulfuration, reduction, hydrolysis
* These enzymes are largely targeted against lipid-soluble and non-polar (no charge) drugs which are difficult to eliminate
Majority of medications are lipid soluble and non polar
Phase I Reaction
69
Metabolizes 50% of drugs metabolized in the liver
CYP34A
70
Usually renders drug polar and excretable in kidneys
* Conjugation, glucuronidation, acetylation, sulfation
Phase II Reaction
71
The elimination of drugs from the body by making it water soluble
Excretion
| Kidneys (main organ), liver, bowel
72
Study of the mechanism of drug actions in living tissues
* Drug-induced alterations to normal physiologic function
* Goal of therapy: Therapeutic effect
Pharmacodynamics
73
Ways in which a drug can produce a therapeutic effect
Mechanism of action
74
True or false: The effect of a particular drug depends on the cell or organ targeted by the drug
True
Once the drug binds to its “site of action” it can modify the rate at which a cell or tissue functions
75
Drug binds to a receptor and induce an effect
Receptor interaction
76
Degree to which a drug binds with a receptor
Affinity
77
True or false: The drug with the best "fit" or affinity will elicit the best response
True
78
Drug binds to receptor → there is a response
Agonist
| Example: Adrenergic agents such as Epinephrine
79
Drug binds to receptor → there is no response; prevents binding of agonists
Antagonist
| Examples:
Alpha blockers (propanolol and atenolol)
Beta blockers
80
Drug can inhibit or facilitate the action of a particular enzyme
Enzyme interaction
81
Drugs will physically interfere with or chemically alter cell process → final product is altered causing cell defect or cell death
Non-specific Interaction
82
Disintegration of dosage form and dissolution of drugs depending on the form of drug and where it is given
Pharmaceutical phase
83
Drugs will be absorbed, distributed, metabolized, and excreted even before it reaches the drug receptor
Pharmacokinetic phase
84
Drug-receptor interaction
Pharmacodynamic phase
85
Sites of drug actions
1. Action potential in nerve presynaptic nerve fiber
2. Synthesis of transmitter
3. Storage
4. Metabolism
5. Release
6. Reuptake
7. Degradation
8. Receptor of transmitter
9. Receptor-induced increase or decrease in ionic conductance
86
Types of medication action
* Therapeutic Effect
* Side Effects
* Adverse Effects
* Toxic Effect
* Idiosyncratic Reactions
* Allergic Reaction
* Medication Interactions
* Iatrogenic Response
87
Unintended secondary effects a medication predictably will cause
Side Effects
88
The expected or predictable physiological response a medication causes
Therapeutic Effects
89
Undesirable response of a medication; Unexpected effects of drug not related to therapeutic effect; Must be reported to FDA; Can be a side effect or a harmful effect
Adverse effects
90
A category of adverse effects: which is the extension of therapeutic effect
Pharmacologic
91
A category of adverse effects: which is specific only to a particular patient
Idiosyncratic
92
A category of adverse effects: which is an allergic reaction
Hypersensitivity
93
It is a type of ADE. Defined as any response to a medication that is 'noxious or unintended and occurs at normal doses' in patients for whom the drug has been properly prescribed and administered.
Adverse Drug Reactions (ADE) ADR
94
May develop after prolonged intake or when a medication accumulates in the blood because of impaired metabolism or excretion, or excessive amount taken
Toxic Effects
95
Toxic levels of opioids can cause ______
respiratory depression
96
Antidotes available to reverse effects such as____
Naloxone
97
Unpredictable effects-overreacts or under reacts to a medication or has a reaction different from normal
IDIOSYNCRATIC REACTIONS
98
Idiosyncratic drug reactions are usually caused by abnormal levels of drug-metabolizing enzymes. ______ leads to toxicity, _____leads to not getting its therapeutic effect
Overabundance; Deficiency
99
Unpredictable response to a medication. Makes up greater than 10% of all medication reactions
Allergic reaction
100
Severe allergic reactions
Anaphylactic reaction
101
Mild allergic reactions
hives, rash, pruritus
102
Other types of drug reactions: Structural effect in unborn fetus (thalidomide)Fetus doesn’t develop limbs properly
Teratogenic
103
Other types of drug reactions: Causes cancer
Carcinogenic
104
Other types of drug reactions: Changes genetic composition (radiation, Chemicals)
Mutagenic
105
Occurs when one medication modifies the action of another; Common in people taking several medications at once
Drug interactions
106
Unintentional adverse effects that occur during therapy
Iatrogenic responses
107
Drug interaction that is beneficial (sometimes can be bad). Effect of 2 meds combined is greater than the meds given separately.
Synergistic effects
108
Alcohol & Antihistamines, antidepressants, barbiturates, narcotics; All can depress _____, should not be given to sleeping patient
Sensorium
109
_____ are required to achieve a constant therapeutic concentration of a medication because a portion of medication is always being excreted
Repeated doses
110
Time it takes for excretion processes to lower the serum medication concentration by 1⁄2
Serum Half-life
111
Usually done for drugs with a very narrow therapeutic range
Therapeutic drug monitoring
112
The time it takes for one half of the original amount of a drug in the body to be removed
Half life
113
Number of half lives that is considered as steady state
4-5 Half lives
114
The time it takes for the drug to elicit a therapeutic response
Onset
115
The time it takes for a drug to reach its maximum therapeutic response
Peak
116
The time a drug concentration is sufficient to elicit a therapeutic response
Duration
117
Type of therapy: Give the drug once to relieve pain
Acute therapy
118
Type of therapy: Taken regularly to control the blood pressure, or blood levels
Maintenance therapy
119
Type of therapy: Replace something that the patient does not have (ex. Insulin)
Supplemental therapy
120
Type of therapy: Maintain comfort for the patient, not treating the condition anymore
Palliative therapy
121
Type of therapy:Supports and maintains body functions, but not necessarily treat the condition
Supportive therapy
122
Type of therapy: Drugs given so that certain conditions would not recur
Prophylactic therapy
123
Type of therapy: Drugs used based on actions, rather than scientific evidence.
Empiric therapy
124
The ratio between a drug’s therapeutic benefits and its toxic effects
Therapeutic index
125
The ratio between a drug’s therapeutic benefits and its toxic effects
Therapeutic index
126
A decreasing response to repetitive drug doses
Tolerance
127
A physiologic or psychological need for a drug
Dependence
128
Drug interactions: the alteration of action of a drug by:
- Other prescribed drugs
- Over-the-counter medications
- Herbal Therapies
129
Drug interactions:
Additive effect
Synergistic effect
Antagonistic effect
Incompatibility
130
What are the Five Rights of Medication Administration?
○ Right drug
○ Right dose
○ Right time
○ Right route
○ Right patient
131
Always_____ the entire “system” of medication administration. This involves ordering, dispensing, preparing, administering, documenting
double check
132
Other "rights" : (familiarize)
● Proper drug storage
● Proper documentation
● Accurate dosage calculation
● Accurate dosage preparation
● Careful checking of transcription of orders
● Patient safety
● Close consideration of special situations
● Prevention and reporting of medication errors
● Patient teaching
● Monitoring for therapeutic effects, side effects, toxic effects
● Refusal of medication
133
What is the relevance of medication shapes?
It’s just that it can help differentiate your drug from other manufacturers' drugs. (For tablets taken orally)
134
What are the drugs that are commonly enteric coated?
Aspirin
135
How long does a medication need to be taken before it acquires a toxic effect?
It becomes toxic, for example, if it exceeds the patient’s ability to metabolize the drug
136
What if the dose you take is much more than what can be handled by the liver?
you saturate the enzymes that act to break it down, then you’re going to have toxicity.
137
What happens if we crush the tablet and mix it with water or milk? Will it still remain effective or still have the same effects?
There are certain drugs that you cannot mix with certain foods. Most likely, marami pwede pero ‘di lahat.
138
What is the reason why enteric-coated drugs are given?
to prevent gastric irritation
139
Is there an effect whether the drug is synthetically produced or naturally based?
if they have the same chemical structure, there will be no difference in the degree of effectivity.
