Prelim Flashcards
(77 cards)
1
Q
5 rights of medication admin
A
- drug
- dose
- time
- patient
- route
2
Q
major uses of drugs
A
- symptomatic
- preventive
- diagnostic
- curative
- contraceptive
3
Q
classification of drugs
A
- therapeutic
- pharmacologic
4
Q
Sources of drugs
A
- Natural
- Synthetic
- Semisynthetic
5
Q
- chemical name
- generic
- trade (proprietary)
A
- describes the drug’s chemical composition and molecular structure
- name given by the US Adopted Name Council
- the drug has a registered trademark, use of name restricted by the drug’s patent owner(the manufacturer)
6
Q
Properties of Ideal Drug
A
- effectiveness
- safety
- selectivity
7
Q
Additional Properties of Ideal Drug
A
- reversible action-anesthetic
- predictability-know how patient will respond
- ease of admin
- freedom from drug interactions
- low cost
- chemical stability-no loss of effectiveness with storage
- possession of a simple generic name
8
Q
pharmacotherapeutics/clinical pharmacology
A
the use of drugs and the clinical indications for drugs to prevent and treat diseases
9
Q
neuropharmacology
A
effects of medication on central and peripheral nervous system functioning
10
Q
psychopharmacology
A
studies the effects of medication on the psyche; observing changed behaviors of the body and mind, and how molecular events are manifest in a measurable behavioral form
11
Q
dealing w/ the composition, use, and development of medicinal substances of biological origin and especially medicinal substances obtained from plants
A
pharmacognosy
12
Q
the part of medicine concerned w/ dosage, depends on factors like age, climate, weight, sex
A
posology
13
Q
the science of dosage form design. deals w/ the process of turning a new chemical entity into a medication to be used safely and effectively by patient
A
pharmaceutics
14
Q
studies genetic variation that gives rise to differing response to drugs
A
pharmacogenetics
15
Q
deals w/ the application of genomic technologies to new drug discovery and further characterization of older drugs
A
pharmacogenomics
16
Q
study of pharma on a molecular basis
A
molecular pharma
17
Q
the scientific study of ethnic groups and their use of drugs
A
ethnopharmacology
18
Q
study of poisions and unwanted responses to therapeutic agents
A
toxicology
19
Q
Phase where all drugs must be in solution to cross biologic membranes. a solid drug(tablet) has to disintegrate before it can be absorbed.
A
pharmaceutical phase
20
Q
the study of what the body does to the drug
A
pharmacokinetic phase
21
Q
study of what the drug does to the body. the mechanism of drug actions in living tissues.
A
pharmacodynamic
22
Q
the fraction of the drug that reaches the systemic circulation following administration by any route
A
bioavailability
23
Q
metabolism of a drug during its first passage throughgut wall and liver
A
first pass metabolism
24
Q
comparison of bioavailability of different formulations of the same drug
A
bioequivalence
25
drug absorbed into the systemic circulation through the oral or gastric mucosa, the small intestine, or rectum
enteral route:
-buccal
- sublingual
- oral
- rectal
26
eye drops, nasal spray, lotions, ear drops
topical route
27
intravenous, intramuscular, subcutaneous, intradermal, intrathecal, intraarticular, intraperitoneal
parenteral route
*retain 100% bioavailability, therefore smaller doses are appropriate
28
the transport of a drug in the body by the bloodstream to its site of action
-factors affecting:
distribution
1. blood flow
2. capillary permeability
3. binding of drugs to proteins
- class I: dose is less than avail binding sites
- class II: dose is greater than avail binding sites
- admin of class I & class II
4. tissue binding/affinity
29
the degree of distribution of a drug into various body compartments and tissues
volume of distribution
| Vd = D/C
30
Biologic transformation of a drug into:
- an inactive metabolite
- a more soluble compound
- a more potent metabolite
*delayed drug metabolism results in:
metabolism/biotransformation
*accumulation of drugs
prolonged action of drugs
31
- the rate of drug metabolism is directly proportional to the concentration of free drug
- the enzyme is saturated by a high free drug concentration
-first order kinetics
low doses
-zero order kinetics
high doses
32
converts lipophile molecules into more polar molecule by introducing or unmasking a polar functional group such as -OH or -NH
-may increase, decrease, or leave unaltered the drugs pharmacologic activity
Phase I reactions
33
conjugation reactions
- glucoronidation-most impt
- neonates-lack conjugation, chloramphenicol
phase II rxns
34
the elimination of drugs from the body
execretion
35
the time it takes for one-half of the original amt of a drug in the body to be removed
half-life
36
drugs are generally administered to maintain a steady-state concentration within the therapeurtic window
maintenance of dose
37
a delay in achieving the desired plasma levels of drug may be clin unacceptable. So this drug can be injected as a single dose to achieve the desired plasma level rapidly, followed by an infusion to maintain the steady state.
loading dose
= (Vd)(desired steady-state plasma conc)/F
38
a measure of the amount of drug necessary to produce an effect of a give magnitude
potency
| EC50
39
ability of a drug to elicit a response when it interacts with a receptor
efficacy
*a drug with greater efficacy is more therapeutically beneficial than one that is more potent
40
the dose of a drug (mg/kg) that kills 50% of the pop
Lethal dose LD50
41
the dose of the drug required to produce a specific intensity of effect in 50% of the pop
effective dose ED50
42
gives measure as to the amt by which a therapeutic dose may be exceeded before eliciting toxic effects
-tells safety of drug
therapeutic index=LD50/ED50
43
a decreasing response to repetitive drug doses
tolerance
44
a physiologic or psychological need for a drug
dependence
45
effect = to the summation of 2 drugs
additive effect
46
2 or more drugs work together against one target, producing an effect that is greater than the individual effect of the 2 generic name
synergistic
47
one druge reduces or blocks the effect of another
antagonistic effect
48
that drug A boosts the effects of drug B, often by increasing the levels of drug B in the blood
potentiation
49
an adverse outcome of drug therapy in which a patient is harmed in some way
adverse drug rxn
- side effects
- toxicity
- allergy
50
unintentional adverse effects that are treatment induced
iatrogenic responses
51
time it takes for the drug to elicit a therapeutic response
onset
52
time it takes for a drug to reach its max therapeutic response
peak
53
time a drug conc is sufficient to elicit a therapeutic response
duration
54
once drug is at site of action, it can modify the rate (increase or decrease) at which the cells or tissues function
ways drugs produce therapeutic effects
55
Sympathetic adrenergic
- postganglionic neurons release norepinephrine
| - adrenal medulla releases epinephrine and norepinephrine
56
parasympathetic cholinergic
- preganglionic neurons release acetycholine
| - postganglionic neurons release acetylcholine
57
cholinergic receptor types
- nicotinic
- postganglionic dendrites and cell bodies in both symp and parasymp
- muscarinic
58
adrenergic receptor types
- alpha 1
- alpha 2
- beta 1
- beta 2
59
drugs that stimulate the parasymphathetic nervous system (PSNS)
-act on receptors that are activated by acetylcholine
cholinergic agonists
60
- located postsynaptically
- smooth muscle
- cardiac muscle
- glands of parasymp fibers
- effector organs of cholinergic symp fibers
muscarinic receptors
61
bind to cholinergic receptors, activating them
- choline esters: Ach, carbachol, bethanicol
- naturally occurring alkaloids: pilocarpine
direct-acting cholinergic agonist
-2 groups
62
- muscarinic/nicotinic activity
- v HR and cardiac output
- v BP
- ^ salivary secretion/motility
- enhances bronchiolar secretions
- expulsion of urine
- miosis
acetylcholine
63
- ^tone & motility of bladder and GI tract
- relaxes sphincters in bladder and GI tract to empty
- helpful for postsurgical atony of bladder and GI
- oral dose or SC injection
Bethanechol
64
- both muscarinic and nicotinic actions
| - used to treat glaucoma by causing pupillary contraction and decrease in intraocular pressure
carbachol
65
- muscarinic activity
- used in opththalmology, contraction of ciliary muscle and miosis
- emergency lowering of intraocular pressure in glaucoma
- promotes salivation in patients w/ xerostomia due to radiotherapy, sjogren's syndrome
pilocarpine
66
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acetylcholinersterase inhibitors (reversible)
-inhibit the enzyme cholinesterase, which breaks down Ach, making it more avail at the receptors
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indirect-acting cholinergic agonists
67
short acting AchE inhibitor
| -used in diagnosis of Myasthenia Gravis
edrophonium
68
- intermediate-acting(2-4hrs)
- increases intestinal and bladder motility
- topical-treat glaucoma
- treatment for overdosage of atropine, phenothiazine, TCA
physostigmine
69
- absorbs poorly from GI tract
- doesn't enter CNS
- intermediate acting(30min-2hrs)
- stimulate contractility before it paralyzes
- therapeutic use: stimulate bladder and GI, antidote for tubocurarine, treat MG
Neostigmine
70
-used in chronic management of MG
pyridostigmine and ambenonium
71
used in alzheimer
tacrine, donezepil, rivastigmine, galantamine
72
- acetylcholinersterase inhibitors (irreversible)
- bind to cholinesterase and form a permanent covalent bond
- the body must make new cholinsterase
indirect-acting cholinergic agonist
73
- organophosphate
- covalently binds via phosphate group
- generalized cholinergic stimulation, paralysis of motor function, convulsion
- produce intense miosis
echothiophate
74
cholinergic toxidrome
| -SLUDGEM
- Salivation
- Lacrimation
- Urinary incontinence
- Diarrhea
- Gastrointestinalcramps
- Emesis
- Miosis
75
drug effects of PSNS
- ^gastric secretions
- ^GI motility
- ^urinary frequency
- constrict pupil
- reduced intraocular pressure
- ^salivation & sweating
- v HR
- vasodilation
- bronchial constriction, narrowed airways
76
drugs that block or inhibit the actions of acetylcholine in the PSNS
- block at the muscarinic receptors
- they inhibit nerve transmission at these receptors
cholinergic-blocking agents
77
anticholinergic toxidrome
- Hot as a hare
- dry as a bone
- red as a beet
- mad as a hatter
- blind as a bat
- fever
- v salivation, dry mouth
- flushing
- hallucinations
- mydriasis
