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hi everyone > pharmacology > Flashcards

pharmacology Flashcards

1
Q

what is pharmacology?

A

the study of the affects of drugs on the function of living systems environment
(Ritter, J. et al. 2020)

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1
Q

what is pharmacodynamics?

A

what the drug does to the body
(Ritter, J. et al. 2020)

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2
Q

what is pharmacokinetics?

A

what the body does to the drug, how the drug enters, moves through and leaves the body
(Ritter, J. et al. 2020)

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3
Q

what are the 6 functions of pharmacology?

A

targets, specificity, drug, antagonists, molecular action of drugs, cellular actions of drugs
(Ritter, J. et al. 2020)

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4
Q

what are targets?

A

drugs designed to work through specific targets and are specific to only those targets
(Ritter, J. et al. 2020)

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5
Q

what is specificity?

A

many drugs act through specific receptors and will only bind to certain targets
(Ritter, J. et al. 2020)

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6
Q

what are antagonists?

A

drugs that block receptor action
(Ritter, J. et al. 2020)

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7
Q

what are molecular actions of drugs?

A

where drugs work at a molecular level which alter an aspect of cell or tissue
(Ritter, J. et al. 2020)

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8
Q

what are cellular actions of drugs?

A

drugs that works at cellular levels, altering the way the cell functions, achieved by interacting with genetic mechanisms
(Ritter, J. et al. 2020)

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9
Q

what is first step of the analgesia ladder?

A

relieve mild pain, give non-opioid drugs, paracetamol or NSAIDs
(Ritter, J. et al. 2020)

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10
Q

what is the third step of the analgesia ladder?

A

if pain is increasingly bad, give strong opioid such as morphine, diamorphine, methadone
(Ritter, J. et al. 2020)

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11
Q

what are the side effects that come with giving strong opioids?

A

nausea, vomiting, constipation, long term use can lead to addiction
(Ritter, J. et al. 2020)

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12
Q

how do targets work?

A

are mostly proteins such as receptors and enzymes with their activity being altered by the drug
(Ritter, J. et al. 2020)

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13
Q

where do analgesics work?

A

different sites of nervous system - peripheral and CNS
(Ritter, J. et al. 2020)

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14
Q

what part of the nervous system do NSAIDs work?

A

peripheral by inhibiting release of chemical mediators
(Ritter, J. et al. 2020)

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15
Q

where do opioids act in the nervous system?

A

CNS by inhibiting transmission of the pain stimulus or stimulating descending inhibitory pathways that reduce the excitability of neurones in the ascending pathway
(Ritter, J. et al. 2020)

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16
Q

how does specificity work?

A

Drugs will have similar binding properties with their targets and specificity is due to the shape at the molecular level of both the drug and its target. They will fit together and by getting together will alter the overall shape of the target
(Ritter, J. et al. 2020)

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17
Q

what is the problem with specificity?

A

no drugs are exactly specific and could cause other actions which lead to side effects, nurses should recognise and consider these
(Ritter, J. et al. 2020)

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18
Q

what are cyclo-oxygenase inhibitors?

A

enzymes involved in production of prostaglandins
(Ritter, J. et al. 2020)

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19
Q

what are prostaglandins?

A

stimulate the inflammatory response in the local tissue and also stimulate nociceptive nerve endings
(Ritter, J. et al. 2020)

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20
Q

what happens when prostaglandin is inhibited?

A

as they act on hypothalamus which controls temp, inhibiting them will reduce inflammation which will then reduce fever
(Ritter, J. et al. 2020)

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21
Q

what is the difference between agonist and antagonist?

A

agonists are when a drug occupies a receptor and a process is activated
antagonists are when it occupies a receptor but does not activate a process
(Ritter, J. et al. 2020)

22
Q

what is affinity?

A

how easily and strongly a drug binds to the receptor
(Ritter, J. et al. 2020)

23
Q

what is the difference between a drug with high and low affinity?

A

high affinity = bind easily and stay bound for longer
low affinity = briefly bind and then be released
both can activate the receptor but high affinity will activate it for longer
(Ritter, J. et al. 2020)

24
Q

what is the efficacy of a drug?

A

the tendency for the drug once bound to activate the receptor and so produce its effect
(Ritter, J. et al. 2020)

25
Q

what is the concentration of a drug?

A

the higher the concentration, the greater chance the drug will bump into the receptor and produce its effect
(Ritter, J. et al. 2020)

26
Q

how do lipid soluble drugs pass the membrane?

A

easily because they are non-polar making the phospholipid highly permeable to them

27
Q

why can’t most water soluble drugs pass the membrane?

A

usually polarised with negative or positive charge (ionised) and will enter from aqueous pores but most drugs are usually too big to pass through them

28
Q

how are water soluble drugs transported?

A

solute transport carriers that facilitate movement passively down a concentration gradient; two important ones are OCTs and OATs

29
Q

what is pinocytosis?

A

another way drugs cross membrane, small section of membrane traps the drug and is then released into the cell cytoplasm
important for insulin which cross blood-brain barrier by this process

30
Q

what two factors can affect the movement of drugs across the membrane?

A

pH of its environment, many drugs are transported by blood plasma and so small amount will be unbound and active in plasma

31
Q

how does oral administration work?

A

Most absorption takes place in the small intestine. Peptide and protein drugs are subject to digestion within the gut as well as having to cross challenging epithelial barriers so this is not a good route for these drugs

32
Q

how much of a drug will be absorbed within 1-3 hours of taking it?

A

75%

33
Q

how does gut content affect the absorption of oral drugs?

A

feeding stimulates gastrointestinal motility and blood flow, some drugs cause gastric stasis which causes absorption to slowdown, rapid gut movement will also reduce absorption as drug will move too quickly through gut

34
Q

how does particle size affect absorption?

A

size can be adjusted to achieve quicker absorption rates, a capsule may contain both fast and slow absorbing components to extend the duration of effect of the drug

35
Q

what happens after the drug has been in the gut?

A

absorbed into blood system and is transported to liver via hepatic portal vein

36
Q

what is first pass metabolism?

A

degradation by hepatic enzymes in the liver, happens before drugs

37
Q

what is bioavailability?

A

the fraction of drug getting into the bloodstream (systemic circulation) given the administration route
IV route will give you 100% as it goes straight to blood stream

38
Q

why doesn’t oral route give you 100% drug absorption?

A

drug must get to the intestinal mucosa where it is absorbed, survive the enzymes in the gut and mucosa that would break it down, pass into the hepatic portal vein, survive first pass metabolism in the liver and eventually enter the systemic circulation

38
Q

what is bioequivalence?

A

used to compare different formulations of a drug. If they are bioequivalent they should have the same therapeutic effect if one is substituted for the other

39
Q

what is the blood-brain barrier?

A

the continuous endothelial barrier in the blood capillaries supplying the brain which makes the brain inaccessible to drugs with low lipid solubility.

40
Q

what are the two main compartments of the body?

A
  1. the central compartment comprising of organs and tissues with a high volume blood supply, heart, kidney, liver and brain.
  2. peripheral compartment is made up of fat, muscle and the peritoneal cavity
    - can effect different people in different ways depending on the distribution of tissues between these compartments, in particular fat
41
Q

how are drugs eliminated from the body?

A

metabolism and excretion

42
Q

how is drug metabolism achieved?

A
  1. catabolic reactions that break down drugs by oxidation - usually happen in liver
  2. anabolic reactions which join products from the first stage and result in an inactive product
43
Q

how does excretion work?

A

Most drugs leave the body through the urine either as the unchanged drug oras a polar (water soluble) metabolite

44
Q

what ways, apart from excretion, can happen to drugs?

A
  1. secreted into the bile via the liver, but most of these are then reabsorbed in the gut.
  2. Volatile drugs are excreted via the lungs in the exhaled gas
45
Q

what are the routes of administration that a drug can take?

A
  1. oral
  2. sublingual
  3. rectal
  4. inhalation
  5. injection - IV, subcut, IM
46
Q

What are nurse’s roles and repsonsibilites in regards to medication?

(Peate et al, 2014).

A

knowledge and theraputic uses of medicines
check identity and patient’s consent
assist with medication administratiom
only administer prescribed medication
check allergies

47
Q

What are the 5 safe medication administration rights?

(RCN, 2020)

A

right pateint
right time
right medication
right dose
right route

48
Q

What are controlled drugs?

A

prescription medication subject to legal controls to prevent it being misuded, being obtained illegally, or causing harm
has to be verified by two nurses independently that correct medication and dose are given

49
Q

What is polypharmacy?

(Kaufman, 2016)

A

The prescribing of many medicines for one individual, it is common as a result in the rise of multi-morbidity.

They are associated with adverse drug events like drug-drug interactions and adverse drug reactions.

Taking multiple medicines can adversely affect adherence, resulting in lost opportunities for health gain and wasted medicines

50
Q

What type of people are particularly vulnerable to polypharmacy?

(Kaufman, 2016)

A

Older and frail people.

51
Q

What is nurses role in the management of polypharmacy?

(Kaufman, 2016)

A

regular medication reviews
medicine management systems
research and education to improve safe practice

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