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Pharm 1 Final Flashcards

1
Q

What are the 3 properties of an ideal drug?

A

1) Effectiveness: Most important. Does is to what its supposed to.
2) Safety: Doesn’t produce harmful effects, even in high doses.
3) Selectivity: Only does what its supposed to do.

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2
Q

Pharmacokinetics

A

How the body acts on the drugs.

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3
Q

What is the 4 pharmacokinetic process?

A

1) Absorption
2) Distribution
3) metabolism
4) excretion

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4
Q

Pharmacodynamics

A

The impact of the drugs on the body.

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5
Q

What is the Nursing process in drug therapy?

A

ADPIE
A - Assessment. Collect data. Provides foundation
D - Diagnosis. (nurse diagnosis).
P - Plan.
I - Implement. Carry out and record outcomes.
E - Evaluation. Determines degree of tx success.

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6
Q

Controlled Substance Act…

A

-The lower the number the, the higher the abuse, the tighter the control.
-The higher the number, the lower the abuse, the looser the control.
I - Has no medical use in US. (heroin)
II - Used in US, potential for abuse.

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7
Q

How many names does each drug have, and what are they?

A

1) Chemical: chemistry nomenclature.
2) Generic: Each drug has ONE generic name.
3) Trade Name: (brand name). Created by drug company and easier to remember. Must be FDA approved.

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8
Q

What are the problems with the generic drug name?

A

Generic: Too many syllables. Difficult to pronounce, remember, not used much.

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9
Q

What are the problems with the Trade name?

A

One drug with multiple names.

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10
Q

What’s the problem with OTC drugs?

A

Active ingredients can change without changing the trade name.

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11
Q

What is absorption?

A

Movement of drug from the site of administration into the blood.

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12
Q

What is distribution?

A

Movement of drug from blood into the interstitial space of tissues and then into the cells.

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13
Q

What is Metabolism?

A

Enzymatically mediated alteration of the drug structure.

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14
Q

What is Excretion?

A

Movement of drugs and metabolites out of the body.

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15
Q

What are the 3 ways cells cross membranes?

A

1) Channels/Pores: These are small and very few things pass through. Most drugs have a molecular weight of 300-500 and these only allow about 200 MW.
2) Transport systems: Carriers that move drugs from one side of the cell membrane to the othwer. Some use energy, some don’t. These are selective. (ex. P-glycoprotein)
3) *Direct membrane penetration: Most Common! Resort to this because drugs are too large to pass through channels. To do this, drugs must be Lipophilic.

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16
Q

What factors effect absorption?

A
  • Rate of dissolution.
  • Surface area.
  • Blood flow.
  • Lipid solubility.
  • pH partitioning. (if one side of membrane is more acidic, basic drugs will be drawn to it).
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17
Q

What are the barriers, patterns, advantages, and disadvantages to the IM route?

A
  • Barriers: Capillary wall –> insignificant.
  • Patterns: Depends on water solubility and blood flow.
  • Advantages: Depot preparations = absorbed over long period so it lowers # of injections.
  • Disadvantages: Discomfort. Inconvenient. Local tissue injury, nerve damage, bleeding risk.
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18
Q

What are the barriers, patterns, advantages, and disadvantages to the PO route?

A
  • Barriers: Layer of epithelial cells, the capillary wall. P-glycoproteins transporting drugs back out of the cell.
  • Patterns: Depends on pH of stomach, solubility, food in gut etc…
  • Advantages: Easy, convenient, inexpensive, safer.
  • Disadvantages: Variability, inactivation from stomach, patient has to remember to do it, local irritation.
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19
Q

What are the barriers, advantages, and disadvantages to the IV route?

A
  • Barriers: None
  • Advantages: Rapid onset. Know exactly how much in system. Permits use of fluid and irritant drugs.
  • Disadvantages: Difficult. Need provider/equipment. Irreversible, fluid overload, embolism.
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20
Q

What are the barriers, patterns, advantages, and disadvantages to the SQ route?

A

Nearly identical to IM

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21
Q

What happens if a drug binds to Albumin which is always in the blood stream?

A

The drug will have no effect. Albumin is 69,000 MW and because its so big it cant leave the blood stream.

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22
Q

What is a drug half life?

A

The amount of time it takes a drug in the body to decrease by 50%. When the amount of drug being administered reaches the amount of drug being eliminated, plateau will have been reached.

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23
Q

How many half life’s does it take for a drug to reach its plateau?

A

4

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24
Q

Maximal Efficacy?

A

The point to where, even if you give more drug, it wont have an effect.

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25
Q

Potency?

A

The amount of drug that must be given to elicit an effect.

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26
Q

If a drug is more selective, it has less…?

A

Side effects.

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27
Q

If a drug only interacts with a few receptors…?

A

It has a limited drug response.

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28
Q

If a drug interacts with many receptors…?

A

A wide variety of responses may occur.

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29
Q

What are 3 receptor-less drugs?

A

1) Antacids: Interacts with stomach molecules.
2) Antiseptic Alcohol: Breaks down bacterial proteins.
3) Magnesium enemas: Causes osmotic reactions to hold fluid in the bowel.

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30
Q

What does the therapeutic index measure?

A

It measure a drugs safety. The higher the index, the safer the drug. Drugs with a low index will be as harmful as they are effective.

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31
Q

What are the two androgens?

A

Testosterone and 17-alpha-alkylated.

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32
Q

What are the uses of the Androgens?

A
  • male hypogonadism: don’t produce enough testosterone.
  • Delayed puberty
  • Replacement therapy
  • Wasting in patients with AIDS.
  • Anemias
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33
Q

What are the effects of the Androgens?

A
  • Male: Increases genitals, body hair appears, bone/skeletal muscle increase. Sperm production/maturation.
  • Female: Maintenance of libido and promotion of clitoral growth.
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34
Q

What anabolic effect do androgens have?

A

Promotes growth of skeletal muscle

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35
Q

What erythropoietic effect does Androgen have?

A

Increases RBC production.

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36
Q

What are the adverse effects of Androgen?

A

-Virilization in women/girl/boys (acne, deepened voice, hair, libido, clitoral enlargement, menstrual irregularities.
-Hepatotoxicity
-Premature epiphyseal closure.
-Increased LDL’s, decreased HDL’s.
-TERATOGENIC
-Promotes growth of prostate cancer (not cause)
-Edema
Gynocomastia

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37
Q

What is the Androgen Prototype?

A

Testosterone

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38
Q

What oral agents are used to treat ED?

A

PDE5 Inhibitors

39
Q

What are PDE5 Inhibitors

A

Viagra, Levitra, and Cialis.

40
Q

Patients who use Viagra, should avoid which class of drugs? What is Viagra also used to treat?

A
  • Alpha Blockers.

- Pulmonary artery Hypertension

41
Q

What are the Adverse effects of the PDE5 Inhibitors?

A

Hypotension, Priapism, optic neuropathy, sudden hearing loss, MI, Sexual activity due to increased libido can cause heart events (not the drug itself).

42
Q

What are the PDE5 Inhibitor drug interactions?

A
  • Nitrates (hypotension)
  • Alpha blockers (hypotension)
  • CYP 3A4 Inhibitors.
43
Q

What are the contraindications of the PDE5 Inhibitors?

A
  • Men with cardiac problems in the last 6 months.
  • Men with hypotension
  • Men with hypertension
  • Heart failure
44
Q

What are the non-oral meds for ED?

A
  • Papaverine + Phentolamine

- Alprostadil

45
Q

What are the adverse effects of Papaverine + Phentolamine?

A
  • Priapism
  • O. Hypotension
  • Painless nodules
46
Q

What meds are used to treat PBH?

A
  • **5 alpha reductase inhibitors (finasteride and dutasteride)
  • Alpha 1 adrenergic antagonists
47
Q

What are the adverse effects of the 5 alpha reductase inhibitors?

A
  • Gynomastia
  • Decreased ejaculation fluid
  • TERATOGENIC
48
Q

What are the adverse effects of the alpha 1 adrenergic antagonists?

A

-Vasodilation
-Hypotension
-Somnolence (drowsy)
-Nasal congestion
complications for men undergoing cataract surgery.

49
Q

What are the Non selective alpha 1 drugs and what are their adverse effects?

A
  • Alfuzosin, Terazosin and Doxazosin.
  • vasodilation
  • drowsy
  • Nasal congestion
50
Q

What are the selective alpha 1 drugs and what are their adverse effects?

A
  • Silodosin and Tamsulosin
  • Abnormal Ejaculation
  • cataract surgery complications
51
Q

What are cycloplegics?

A

Drugs that paralyze the muscle.

52
Q

What are mydriatics?

A

Drugs that dilate the pupil

53
Q

What effect do anticholinergic drugs have on the eye?

A

Cycloplegia and mydriasis.

54
Q

What anticholinergics are used for the eye?

A

Atropine, cyclopentaolate, homatropine, scopolamine, tropicamide.

55
Q

What are the adverse effects of the anticholinergic drugs on the eye?

A

Blurry vision, photophobia (intolerance to light), angle closure, systemic effects.

56
Q

What is phenylephrines effect on the eyes? What are its Adverse effects on the eye?

A
  • Its an alpha agonist. It causes Mydriasis.

- A/E: Angle closure and floaters.

57
Q

What drugs are used to treat Allergic conjunctivitis?

A
  • Mast Cell Stabilizers: Cromolyn and lodoxamide.
  • Histamine 1 receptor agonists: Azelastine and olopadine.
  • NSAIDs
  • Glucocorticoids
  • Ocular decongestants
58
Q

What are the adverse effects of using glucocorticoids for allergic conjunctivitis?

A

Cataracts, Eye infection, increased Intra-ocular pressure.

59
Q

What are the adverse effects of using Ocular decongestants for allergic conjunctivitis?

A

Vasoconstriction, rebound congestion.

60
Q

What is used to treat age related dry macular degeneration?

A

High dose of antioxidants and zinc.

61
Q

What class of drugs are used to treat age related wet macular degeneration?

A

Angiogenesis Inhibitors.

62
Q

What are the Adverse effects of angiogenesis inhibitors?

A

Endophthalmitis, increased intraocular pressure, ocular discomfort, blurred vision, floaters, punctate keratitis.

63
Q

What are the classes of drugs used to treat glaucoma? ABCCMP

A
  • Beta blockers
  • prostaglandin analogs
  • alpha 2 agonists
  • muscarinic agonists
  • cholinesterase inhibitors
  • carbonic anhydrase inhibitors.
64
Q

What are the side effects of Beta blockers used for Glaucoma?

A

Decreased HR, Decreased pulse, bronchospasm, AV block.

65
Q

What are the side effects of prostaglandins used for Glaucoma?

A

Increased brown pigment, more effective in African americans

66
Q

What are the side effects of muscarinic agonists used for Glaucoma?

A

Retinal detachment and local irritation.

67
Q

What are the side effects of cholinesterase inhibitors used for Glaucoma?

A

cataracts

68
Q

What are the side effects of carbonic anhydrase inhibitors used for Glaucoma?

A

Allergies and bitter taste.

69
Q

What is the preferred approach to treating Acute Otitis Media?

A

A high dose of amoxicillin/clavulanate.

70
Q

What is What are the 4 stratagies of treating Recurrent Otitis Media?

A

1) Short term antibacterial therapy
2) Prophylactic antibacterial therapy
3) prevention and tx of the influenza
4) tympanostomy tubes

71
Q

What are the preferred drugs for treating Acute Otitis Externa?

A

fluoroquinolones. These are not ototoxic and don’t cause local reactions.

72
Q

What are the oral medications for AOE?

A

cephalexin and ciprofloxacin. Only for adults.

73
Q

What drugs treat Fungal Otitis Externa?

A

Clotrimazole, itraconazole and fluconazole.

74
Q

How is Fungal Necrotizing Otitis externa treated?

A

Anti-psuedomonal therapy. Primaxin or merrem IV.

75
Q

What ways can Acne be treated?

A

1) Nondrug tx
2) Topical antibiotic
3) Oral drugs.

76
Q

What are some of the meds used for acne?

A
  • Topical: Benzoyl Peroxide, clindamycin and erythromycin, dapsone (can turn skin yellow or orange), retinoids.
  • Oral: Isotretinoin (Accutane), sprironolactone.
77
Q

What are the Topical Drugs used for Psoriasis?

A
  • Glucocorticoids (thinning of the skin)
  • Vitamin D3 analogs (itchy) (calcipotriene, calcitriol)
  • Tazarotene (dry skin, itchy, burning)
  • anthralin
  • tars (stink, itchy, burning)
78
Q

What are the Systemic drugs used for Psoriasis?

A
  • Methotrexate: (GI problems, bone marrow suppression, liver, TERATOGENIC)
  • Acetretin: (hair loss, skin peeling and all kinds of face issues, TERATOGENIC)
  • Cyclosporin: (Kidney damage)
79
Q

Which drugs are used to treat Actinic Keratosis?

A
  • Flurouracil (topical)

- Imiquimod

80
Q

Whats used to treat Eczema?

A

Immunosuppresents: Pimecroliumus and tacrolumus.

81
Q

What drugs are used to treat warts?

A

Cryotherapy (freeze), podophyllin, bichloracetic and trichloracetic acid, imiquimod and podofilox.

82
Q

What drugs are used for the prevention of warts?

A

Gardisil and Cervarix.

83
Q

What drugs are used to treat Seborrheic dermatitis and dandruff?

A

Ketoconazole and Nizoral (head and shoulder)

84
Q

What drugs are used for Hair loss?

A

Topical minoxidil (HTN), Finesteride (used for BPH and baldness)

85
Q

What is a drug used for Pulmonary Arterial Hypertension?

A

Sildenafil

86
Q

What is neonatal respiratory distress syndrome a deficiency in?

A

Lung surfactant

87
Q

What are some drugs used to treat Neonatal respiratory distress syndrome?

A

-“actant”
Poractant alfa
calfactant
beractant
-Prenatal of postnatal glucocorticoids (“methasone”)
-The risks don’t outweigh the benefits postnatal.

88
Q

What 7 things are used to treat Cystic Fibrosis?

A

-Pancreatic enzymes
-fat soluble vitamins
-Chronic inhaled antibiotics (tobramycin, aztreonam)
-Oral and IV antibiotics
-Inhaled Dornase Alfa
-Oral ibuprofen
-Inhaled B2 agonists
-

89
Q

What drugs are used to treat Sickle Cell anemia?

A
  • Analgesics
  • glucocorticoids
  • Hydroxyurea (severe myelosuppression)
90
Q

What drugs are used to treat Hyperuricemia (gout) due to cancer chemotherapy?

A

Rasburicase

Allopurinol

91
Q

Drugs used for dialysis patients…

A
  • Calcium binders: Calcium carbonate and calium acetate.

- Non calcium binders: Sevelamer hydrochloride, sevelamer carbonate, lanthanum carbonate

92
Q

Drug classes used for Fibromyalgia:

A
  • Amitriptyline
  • SSRIs
  • SNRIs
  • Anticonvulsants
  • Analgesics
  • sleep aids
93
Q

Drugs used for Lupus…

A
  • NSAIDs
  • Glucocorticoids
  • Hydroxychloroquine
  • Immunosuppressants
  • Belimumab

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