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Flashcards in Module 1-1 Deck (39):
1

what are the 6 rights of medication administration?

right drug, right dose, right time, right route, right patient, right documentation

2

define drug

Any chemical that affects the physiologic
processes of a living organism

3

define pharmacology

study or science of drugs

4

Chemical name

Describes the drug’s chemical composition and
molecular structure

5

Generic name (nonproprietary name)

Name given by the United States Adopted Name
3
Council

6

Trade name (proprietary name)

Brand name, The drug name has a registered trademark; use
of the name is restricted by the drug’s patent owner
(usually the manufacturer)

7

naming example:

chemical: 2-isbuphenyl blah blah
generic name: ibuprofen
trade name: Motrin

8

Pharmaceutics

The study of how various drug forms
influence pharmacokinetic and
pharmacodynamic activities

9

Pharmacokinetics

The study of what the body does to the drug
 Absorption
 Distribution
 Metabolism
 Excretion

10

Pharmacodynamics

The study of what the drug does to the body The mechanism of drug actions in living tissues

11

Pharmacotherapeutics

The use of drugs and the clinical indications
for drugs to prevent and treat diseases

12

Pharmacognosy

The study of natural (plant and animal) drug
sources ie. opium plant

13

drug abosorption-fastest to slowest

liquids elixirs and syrups, then suspension solutions, powders, capsules, tablets, coated tablets, enteric-coated tablets

14

Pharmacokinetics: Absorption

The rate at which a drug leaves its site of
administration, and the extent to which
absorption occurs. Includes bioavailability and bioequivalency

15

bioavailability

the percent of administered dose of unchanged drug that reaches systemic circulation. Impeded by complete absorption and first pass effect

16

bioequivalency

when two different formulations may have comparable bioavailability

17

Factors That Affect Absorption

Absorption characteristics vary according to
the dosage form and route:
Food or fluids administered with the drug
Dosage formulation 
Status of the absorptive surface
Rate of blood flow to the small intestine
Acidity of the stomach
Status of GI motility

18

Routes

A drug’s route of administration affects the
rate and extent of absorption of that drug Enteral (GI tract) - easy cheap
Parenteral - fastest
Topical - slower, longer duration, more localized

19

Enteral route

The drug is absorbed into the systemic
circulation through the oral or gastric mucosa
or the small intestine
 Oral
 Sublingual
 Buccal
 Rectal

20

First-Pass Effect

The metabolism of a drug and its passage
from the liver into the circulation
 A drug given via the oral route may be extensively metabolized by the liver before reaching the systemic circulation (high first-pass effect)
 The same drug—given IV—bypasses the liver, preventing the first-pass effect from taking place, and more drug reaches the circulation

21

Parenteral Route

Intravenous (fastest delivery into the blood
circulation)
 Intramuscular
 Subcutaneous
 Intradermal
 Intraarterial
 Intrathecal - into spinal column
 Intraarticular - into a joint

22

Topical Route

 Skin (including transdermal patches)
 Eyes
 Ears
Nose
 Lungs (inhalation)
 Rectum - half has first pass effect has does not
 Vagina

23

Distribution

The transport of a drug in the body by the
bloodstream to its site of action
 Protein-binding
 Water soluble vs. fat soluble - if lipid soluble it will penetrate cell membranes easier
 Blood-brain barrier - small lipid soluble get through easier
 Areas of rapid distribution: heart, liver,
kidneys, brain
 Areas of slow distribution: muscle, skin, fat

24

Metabolism/Biotransformation

The biochemical transformation of a drug into
an inactive metabolite, a more soluble
compound, or a more potent metabolite
 Liver (main organ)
 Skeletal muscle
 Kidneys
 Lungs
 Plasma
 Intestinal mucosa

25

Metabolism/Biotransformation

Biologic transformation of a drug into:
An inactive metabolite
 A more soluble compound
 A more potent metabolite

26

Factors that decrease metabolism

Cardiovascular dysfunction
Renal insufficiency
 Starvation
 Obstructive jaundice - blockage in bile duct
 Slow acetylator
 Erythromycin or ketoconazole drug therapy- inhibit enzymes

27

Factors that increase metabolism

Fast acetylator- genetically determined
Barbiturate therapy - phenylbarbitol
Rifampin therapy

28

Delaying drug metabolism causes:

Accumulation of drugs
Prolonged action of the drugs ->drug toxicity, higher blood levels for longer periods of time
Stimulating drug metabolism causes:
Diminished pharmacologic effects

29

Excretion

The elimination of drugs from the body
Metabolize drugs to make them more polar to be able to get rid of them
 Kidneys (main organ)
 Liver
 Bowel
 Biliary excretion
 Enterohepatic recirculation - break it down and it gets reabsorbed

30

Half-life effectively removed after about 5 half-lives
1 half-life - 50% removed
2 half-lives - 75% removed
3 half-lives - 87.5% removed
4 half-lives - 93.75% removed
5 half-lives - 97% removed

The time it takes for one half of the original
amount of a drug to be removed from the
body
A measure of the rate at which a drug is
removed from the body
Most drugs considered to be effectively
removed after about five half-lives
Steady state - amount of drug removed via elimination = to amount absorbed. That is when the drug is at steady state, after about 4 to 5 half-lives

31

Onset, Peak, and Duration

Onset
The time it takes for the drug to elicit a
therapeutic response
Peak
The time it takes for a drug to reach its
maximum therapeutic response
Duration
The time a drug concentration is sufficient to
elicit a therapeutic response

32

Therapeutic Drug Monitoring

Peak level
Highest blood level- too high causes toxicity
Trough level (nadir)
Lowest blood level - too low inefficient

33

Pharmacodynamics:
Mechanisms of Action

Receptor interactions
 Enzyme interactions
 Nonselective interactions

34

Pharmacotherapeutics:
Types of Therapies

Acute therapy-short term, antibacterial cure
 Maintenance therapy- hypertension or schitzo
 Supplemental/replacement therapy- insulin
 Palliative therapy- make someone comfortable in terminal in terminal state opiods
 Supportive therapy-fluids and electrolytes ex. flu
 Prophylactic therapy-to prevent something ex. antibiotics prior to surgery or traveling
 Empiric therapy- clinical probability therapy antibiotic based on signs and symptoms

35

Contraindications

Any characteristic of the patient, especially a disease state, that makes the use of a given medication dangerous for the patient. Liver damage, kidney disease
It is important to assess for contraindications!

36

Monitoring

Therapeutic index
 Ratio of a drug’s toxic level to the level that
provides therapeutic benefits
Tolerance
 Decreasing response to repeated drug doses-
Dependence
 Physiologic or psychological need for a drug

37

Monitoring (cont’d)

Interactions may occur with other drugs or food
 A drug interaction is the alteration of a drug’s action by:
 Other prescribed drugs
 Over-the-counter medications
 Herbal therapies

38

Monitoring (cont’d)

Drug interactions
 Additive- 1+1=2
 Synergistic-1+1=3 diaretic and aceinhibitor
 Potentiation-one of the drugs does not have an effect
 Antagonistic- tetracycline and antacid
 Incompatibility- drugs cannot be mixed in an iv

39

Drug Sources

Four main sources for drugs
 Plants- caffeine from coffee, nicotine from tobacco
 Animals- insulin, heparin, hormones
 Minerals- sodium chloride,
 Laboratory synthesis- most drugs,