Week 1 - terminologies

Question 1

First recorded reference to pharmacology was written by

Answer 1

Samuel Dale in 1693

Question 2

Father of American pharmacology

Answer 2

John Jacob Abel

Question 3

Factors affecting drug response

Answer 3

age: infant/elderly (give less drugs)
weight: peds based on kilograms
gender: female (high in fat) male (high in muscle ) [hormones]

health status: liver/kidney problem; immune suppress; vascular inefficiency ( decrease blood flow); pregnancy (teratogenic)

tetratogenic: category (A, B, C, D, X) [D or X do not give]
genetics: missing enzymes affect drug metabolism (absorption); lacking of clotting factors; caffeine clearance rate

body mass: in general inceased BM = increased drugs

Drug-to-drug interaction

tolerance: pain meds
compliance: (TB meds 3mo/6mo/9mo)

Diet (food interaction): grapefruit juice; drugs taken before/with/after food

Question 4

Routes of medication administration

Answer 4

oral: enteric coated; g-tube
IM: 90 degrees; z-track
SubQ: 45-90 degrees
transdermal: through skin/patch
IV: bolus, push, drip
eye drops
ear drops

Question 5

Pharmacology

Answer 5

the study of medicine; the discipline pertaining to how drugs improve or maintain health

subject ranging from understanding how drugs are administered, to where they travel in the body, to the actual responses produced

Question 6

biologics

Answer 6

naturally produced substances use for prevention/ treatment process

substances that produce biologic responses withing the body; they are syntehsized by cells of the human body, animal cells, or microogranism

agents naturally produced in animal cells, by microorganisms, or by the body itself

Question 7

therapeutic action

Answer 7

desired affect

*depends on use of drug - the therapeutic and S/E changes

how a drug produces its physiological effect on the body

the beneficial effect that medical treatment causes to the body

i.e. a diuretic treats HTN by lowering plasma vol

Question 8

adverse reaction

Answer 8

undesireable effect (S/E)

negative reactions to a drug

undesirable, inadvertent, unexpected and potentially dangerous responses to a medication

Question 9

allergic reaction

Answer 9

slow progress

acquired hyper response of the body defenses to a foreign substance (allergen)

occurs when an individual develops an immune response to a medication

pruitus, edema, runny nose, skin rash, or reddened eyes with tears

Question 10

anaphylaxis

Answer 10

a severe type of allergic reaction that involves the massive, systemic release of histamine and other chemical mediators of inflammation that can lead to life-threatening shock

a life-threatening, immediate allergic reaction that causes respiratory distress, severe bronchospasm, laryngeal edema, a quick drop in B/P, as well as cardiovascular collapse

allergies to bee stings, tree nuts, plants/animals, acute dyspnea, hypotension, tachycardia

REQUIRES IMMEDIATE ATTENTION

Question 11

contraindication

Answer 11

reason to not give drug

conditions that make it unsafe or potentially harmful to administer specific medications

specific situation in which a drug, procedure, surgery should not be used, because it may be harmful to the person

tetracyclines can stain developing teeth

Question 12

side effects

Answer 12

expected drug reaction

expected and predictable effects that result at therapeutic dosages

morphine of pain relief usually results in constipation

Question 13

therapeutic classification

Answer 13

classify according to use (how it works –> mechanism of action)

method for organizing drugs on the basic of their clinical usefulness in treating particular disease

drugs are classified into different groups according to their chemical characteristics, structure and how they are used to treat specific disease

influence blood clotting - anticoagulant, lowering blood cholesterol - antihyperlipidemic

Question 14

pharmacologic classification

Answer 14

method for organizing drugs on the basis of their mechanism of action

drugs are organized by the way they work

mechanism of action: decrease plasma volume - diuretic, blockes heart calcium channels - calcium channel blocker, dilates peripheral blood vessels - vasodilator

Question 15

chemical name

Answer 15

base or chemical composition

strict chemical nomenclature used for naming drugs established by the international union of pure and applied chemistry (IUPAC)

Question 16

generic name

Answer 16

US adopted name council

there is only one generic name for each drug which is assigned by the U.S. Adopted Name Council

generic names does not change between states
- most does not change in different countries

Question 17

Trade name

Answer 17

brand name - manufacturer

assigned by the company marketing the drug
proprietary or product or brand name

Question 18

bioavailability

Answer 18

amount of a drug to cause therapeutic effect

ability of a drug to reach the bloodstream and its target tissues

the physiological ability of the drug to reach its target cells and produce its effects

1st pass effect, mostly for oral
- some drugs get deactivated
(whatever available drug to reach the site is the bioavailability

Question 19

Formulary list of drugs

Answer 19

hopsitals, pharmacists, carries
covered by insurance, can be prescribed and dispensed

list of drugs and drug recipes commonly used by pharmacists

the first standard commonly used by pharmacists, list of drugs and drug recipes (US Pharmacopoeia [USP]) established in 1820

a list of prescribed drugs, both generic and brand name, used by practitioners to id drugs that offer the greatest overall value

Question 20

negative formulary list

Answer 20

can not be presrived or dispensed
not covered by insurance

reasons to be on the list: black box warnings; S/E; costs

a list of tradename drugs that pharmacists may not dispense as generic drugs

drugs specifically determiend by Board of Pharmay and Board of Medicine to demonstrate clinically significant biological/therapeutic inequivalence, could produce adverse clinical effects, or pure threat to health and patient safety

Question 21

addiction

Answer 21

psychological craving for substance

the continue use of a substance despite its negative health and social consequences

overwhelming feeling that drives someone to use a drug repeatedly

Question 22

dependance

Answer 22

physiological and psychological
-do not get substance –> exhibit withdrawal

strong physiological or psychological need for a substance

Question 23

controlled substances

Answer 23

potential abuse for scheduled classifications

a drug whose use is restricted by the COntrolled Substance Act of 1970

have a potential for abuse and dependence and have a “schedule” classification

Schedule 1: highest potential for abuse (heroin, LSD, marijuana, ectasy)
Schedule 5: lowest

Question 24

Teratogenic drug classification

Answer 24

a substance that has the potential to cause a defect in an unborn child during pregnancy

places drugs into categories A, B, C, D, X
category A: the safest group
category X: the most danger to the fetus

Question 25

Pharmacokinetics and its four compnents

Answer 25

how drug travel in the body - absorption: depends on route - distribution: blood, lymphatic channels - metabolism: liver, parts of kidneys - excretion: kidneys, lungs, skin study of how drugs are handled by the body

Question 26

biotransformation

Answer 26

chemical change a chemical undergo in body affinity of drug metabolism (biotransformation) process of chemically converting a drug to a form that is usually more easily removed from the body total of all biochemical reactions in the body

Question 27

affinity

Answer 27

ability of drug to attach to receptors chemical attraction that impels certain molecules to unite with others to form complexes attraction, for certain medications agents that are attracted to adipose tissue are thiopental (Pentoltholss), diazepam (Valium), and lipid-soluble vitamins

Question 28

drug protein complex

Answer 28

drug combine to protein; protein becomes unavailable of action increase protein complex --> decrease action of drug drug that has bound reversible to a plasma protein, particularly albumin, that makes the drug unavailable for distribution to body tissues many drugs bind reversibly to plasma proteins...are too large to cross capillary membranes; thus, the drug is not available for distribution to body tissues

Question 29

conjugates

Answer 29

combination of drugs that makes it more water soluble and helps excrete from the system side chains that, during metabolism, make drugs more water soluble and more easily excreted by the kidney

Question 30

therapeutic level

Answer 30

dosage range low: not medicated enough high: patient is more toxic refers to either the dosage range or blood plasma or serum concentration usually expected to achieve desired therapeutic effects

Question 31

plasma concentration

Answer 31

amount of plasma in the blood a measure of how much of a compound is present in a sample of plasma

Question 32

plasma half life of a drug

Answer 32

length of time for drug to become 50% when to give the next dose (rate depends on plasma half life) adenonsine half life is 8-sec the length of time required for the plasma concentration of a drug to decrease by half after administration

Question 33

loading dose

Answer 33

give highest dose first - so to reach therapeutic level first comparatively large dose given at the beginning of treatment to rapidly obtain the therapeutic effect of a drug a higher amount of drug, often given only once or twice to "prime" the bloodstream with a sufficient level of drug

Question 34

maintenance dose

Answer 34

once therapeutic level is reached, give pills and meds to continue/maintain it dose that keeps the plasma drug concentration continuously in the therapeutic range are given to keep the plasma drug concentration in the therapeutic range

Question 35

lethal dose

Answer 35

amount of drug that can cause at least 50% death of patients the dose of a chemical or biological preparation that is likely to cause death

Question 36

toxicity

Answer 36

an adverse medication effect that is considered severe and can be life-threatening refers to how poisonous or harmful a substance can be. drug toxicity occurs when a person has accumulated too much of a drug in his bloodstream, leadnig to adverse effects withing the body

Question 37

therapeutic index

Answer 37

a window; ratio between 2 doses - lethal dose and effective dose (LD_50 - ED_50) a measure of a drug's safety margin; the higher the value, the safer the drug. The therapeutic index offers the nurse practical information on the safety of the drug and a means to compare one drug with another

Question 38

potency

Answer 38

the strength of a drug at a specified concentration or dose a drug that is more potent will produce a therapeutic effect at a lower dose, compared with another drug in the same class

Question 39

efficacy

Answer 39

the ability of a drug to produce a desired response the magnitude of maximal response that can be produced form a particular drug

Question 40

agonist

Answer 40

are helpers agonists bind to receptors to make receptors to do their functions drug that is capable of binding with receptors to induce a cellular response medications that bind to or mimic the receptor activity that endogenous compounds regulate

Question 41

antagonist

Answer 41

blockers antagonist blocks receptors drugs that blocks the response of another drug medications that can block the usual receptor activity that endogenous compounds regulate or the receptor activity of other medications

Question 42

antidote

Answer 42

medication to counteract specific poison suppress the adverse effect of a specific drug counter the effects of poisons or toxins in a number of cases general areas of toxicity where antidotes may be effective include heavy metals, radioactive exposure, and overdosing of pharmacologic agents

Question 43

receptor

Answer 43

places where drugs go and combine to cause changes in the body the structural component of a cell to which a drug binds in a dose-related manner to produce a response a cellular macromolecule to which a medication binds in order to initiate its effects

Question 44

pharmacogenetics

Answer 44

area of pharmacology that examines the role of genetics in drug response the study of genetic variations that give rise to differences in drug response

Question 45

medication reconciliation

Answer 45

for patient admit, transfer, discharge - meds taken at home, prescribed drugs, OTC drugs, herbal supplements can cause othe rproblems the process of keeping track of patients' medications as their care proceeds form one health care provider to another a process of comparing and reconciling a list of patient's current medications with new medication prescriptions to resolve any discrepancies

Question 46

polypharmacy

Answer 46

taking too much medications at once/ multiple medications for one drug - reason - multiple providers - go to multiple pharmacies - lost of memory (dementia) the taking of multiple drugs concurrently patient receiving multiple prescriptions, sometimes for the same condition, that have conflicting pharmacologic actions

Question 47

receptors in human body and its functions

Answer 47

beta and alpha: types of subreceptor found in the sympathetic nervous system kappa and mu: type of opioid receptor beta receptors - beta 1: heart - beat 2: bronchial/vascular smooth muscle alpha receptors - vessels kappa receptors - opioid receptor for pain - (KOR) contribute to analgesia in the spine and may exhibit dysphoria and sedation, but do not generally lead to dependence mu receptors - opioid receptor - are thought to give most of their analgesic effects in the CNS as well as many S/E including sedation, respiratory depression, euphoria, and dependence

Question 48

anticholinergic effect

Answer 48

opposite of muscarinic effect everything dries up parasympathetic nervous system dry mouth; constipation; urinary retention; tachycardia; pupilary dilation; blurring of vision; hyperpyrexia (fever) drug that blocks the actions of the parasympathetic nervous system effects that are a result of muscarinic receptor blockade i.e. dry mouth can be relieved by sipping on liquids; photophobia can be managed by use of sunglasses; and urinary retention can be reduced by urinating before taking the medication

Question 49

muscarinic effect

Answer 49

opposite of anticholinergic lots of fluid diarrhea; urinary incontinence; bradycardia; increase in GI motility type of cholinergic receptor found in smooth muscle, cardiac muscle, and glands all these are parasympathetic effects form acetylcholine stimulating the muscarinic receptor