Module 1-1

Question 1

what are the 6 rights of medication administration?

Answer 1

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

Question 2

define drug

Answer 2

Any chemical that affects the physiologic

processes of a living organism

Question 3

define pharmacology

Answer 3

study or science of drugs

Question 4

Chemical name

Answer 4

Describes the drug’s chemical composition and

molecular structure

Question 5

Generic name (nonproprietary name)

Answer 5

Name given by the United States Adopted Name
3
Council

Question 6

Trade name (proprietary name)

Answer 6

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

Question 7

naming example:

Answer 7

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

Question 8

Pharmaceutics

Answer 8

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

Question 9

Pharmacokinetics

Answer 9

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

Question 10

Pharmacodynamics

Answer 10

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

Question 11

Pharmacotherapeutics

Answer 11

The use of drugs and the clinical indications

for drugs to prevent and treat diseases

Question 12

Pharmacognosy

Answer 12

The study of natural (plant and animal) drug

sources ie. opium plant

Question 13

drug abosorption-fastest to slowest

Answer 13

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

Question 14

Pharmacokinetics: Absorption

Answer 14

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

Question 15

bioavailability

Answer 15

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

Question 16

bioequivalency

Answer 16

when two different formulations may have comparable bioavailability

Question 17

Factors That Affect Absorption

Answer 17

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

Question 18

Routes

Answer 18

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

Question 19

Enteral route

Answer 19

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

Question 20

First-Pass Effect

Answer 20

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

Question 21

Parenteral Route

Answer 21

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

Question 22

Topical Route

Answer 22

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

Question 23

Distribution

Answer 23

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

Question 24

Metabolism/Biotransformation

Answer 24

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

Question 25

Metabolism/Biotransformation

Answer 25

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

Question 26

Factors that decrease metabolism

Answer 26

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

Question 27

Factors that increase metabolism

Answer 27

Fast acetylator- genetically determined Barbiturate therapy - phenylbarbitol Rifampin therapy

Question 28

Delaying drug metabolism causes:

Answer 28

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

Question 29

Excretion

Answer 29

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

Question 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 ```

Answer 30

``` 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 ```

Question 31

Onset, Peak, and Duration

Answer 31

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

Question 32

Therapeutic Drug Monitoring

Answer 32

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

Question 33

Pharmacodynamics: | Mechanisms of Action

Answer 33

Receptor interactions  Enzyme interactions  Nonselective interactions

Question 34

Pharmacotherapeutics: | Types of Therapies

Answer 34

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

Question 35

Contraindications

Answer 35

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!

Question 36

Monitoring

Answer 36

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

Question 37

Monitoring (cont’d)

Answer 37

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

Question 38

Monitoring (cont’d)

Answer 38

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

Question 39

Drug Sources

Answer 39

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