WK 1: Infection/Immunity/Cellular Adaptation/Into to PathoPharm Flashcards
(122 cards)
1
Q
Pharmacology
A
study of the biologic effects of drugs that are introduced into the body to cause some sort of change
2
Q
Pharmacokinetic
A
what happens to drugs within the body
3
Q
pharmacodynamics
A
-MOA
-what do drugs do in the body/how they work
4
Q
Generic name of a drug
A
-the official name
-can only have ONE generic name
-usually more complicated name
-lowercase
for the tests, must know generic names
EX: generic name: acetaminophen
5
Q
Chemical name of a drug
A
-long and complex
-used within research
EX: N-acetyl-para-aminophenol is the chemical name for Tylenol
6
Q
Trade name of a drug
A
-brand name
-easier to remember
-uppercase
EX: Tylenol
7
Q
What is a prototype of a drug
A
-typically the first drug that represents a group/class of medication
EX: Tylenol was the prototype for acetaminophen
8
Q
Therapeutic effects of drugs
A
-intended effects of drug
-what we want to happen
9
Q
Side Effects of drugs
A
-unintended effects
-unavoidable
EX: getting an upset stomach when taking Tylenol
10
Q
Toxicities of drugs
A
harmful effects
11
Q
Adverse Effects of drugs
A
-unexpected reaction
-dangerous reaction
12
Q
Allergic reaction of a drug
A
-unexpected
-potential to be dangerous
-involves immune system response
13
Q
What do you need to know with each medication?
A
- generic name
-drug classification
-MOA
-indications
-common/serious adverse effects
-nursing indications
14
Q
What is a nursing indication?
A
-thinking about what the nurse needs to consider/ worry about with a certain medication.
-what needs to be assessed prior to giving med?
-any SERIOUS interactions?
-CYP drug?
-any condraindications?
15
Q
What cooperation approves the use of new drugs?
A
FDA (food and drug administration)
16
Q
phases of drug approval through the FDA
A
- Preclinical trials (animal testing)
- Phase I (human volunteers)
- Phase II (patients w/ intended Dz)
- Phase III (Vast clinical market)
- Phase IV (continued evaluation by FDA)
17
Q
Schedule 1 controlled substance
A
NOT approve for medical use
EX: heroin, LSD
18
Q
Schedule 2 controlled substance
A
used medically but HIGH POTENTIAL for abuse
-no Rx refills allowed
EX: narcotics, amphetamines
19
Q
Schedule 3 controlled substance
A
have less potential for abuse
EX: non barbiturate sedatives, non-amphetamines, stimulants; i.e. lortab, vicodin
20
Q
Schedule 4 controlled substance
A
Some potential for abuse
EX: primarily sedatives, anti-anxiety medications; i.e Xanax, valium, Ambien
21
Q
Schedule 5 controlled substance
A
Low potential for abuse
medications with small amounts of certain narcotics or stimulants
Ex: cough suppressants with some codeine, ephedrine containing medications
22
Q
Over the Counter Medications (OTC)
A
-consumers must be able to diagnose own condition and monitor effectiveness easily
-low risk side effects
-low abuse potential
23
Q
Dietary and herbal Supplements can only claim affect on what?
A
body structure or function
NOT medical conditions
24
Q
Why is it important to get a full health history in regards to medications and daily herbal intake?
A
Some herbals can increase the toxicity of prescription medications OR cause decreased therapeutic effects
25
What is a teratogen?
a substance that causes congenital malformations in developing fetuses
Ex: alcohol, weed, nicotine
26
Categories of Teratogens
A: safe for fetus
B: lack of studies to show benefit/ risk
C: No studies, talk to OB
D: possible risk to fetus, talk to OB
X: known risk that cannot be outweighed
27
What are some examples of category X tetragens?
-thalidomide
-chemotherapy agents
-Isotretinoin / Retin A (acne treatment)
28
Pharmacogenomics
study of how genes affect a persons response to drugs
29
Pathophysiology
study of disease and injury
30
Disease
disruption in homeostasis
-Physical: injury, HF
-Mental: depression, anxiety
-Social: Autism
31
Causes of Disease: intrinsic condition
genes
immunity
age
gener
32
Causes of Disease: extrinsic condition
bacteria
viruses
injury
behaviors
stressors
fungi
33
Process of Disease
1. Identification: Signs (objective) and symptoms (subjective)
2. Occurrence: How often, when?
3. Diagnosis: identification
4. Etiology: cause
5. Prognosis: Likelihood of recovery
34
Stages of Disease
1. Exposure: where did they get sick?
2. Onset: sudden/insidious/latent/prodromal/manifestations
3. Remission
4. Convalescence
35
Types of disease causes:
1. Idiopathic
2. Latrogenic
3. Exacerbation
1. unknown cause. Think "idiot"
2. caused by some treatment they received/medical reason. think "lateral"
3. worsening of a disease, acute decline of chronic disease
36
Hypo-
below, less than normal
Ex: hypokalemia = low potassium
37
Hyper-
above normal, excess
Ex: hyperkalemia = high potassium
38
-penia
decrease, deficiency
Ex: neutropenia: low white blood cells
39
-cytosis
referring to cells
Ex: phagocytosis= ingesting of old cells
40
-osis
-a condition, status, or process
-production or increase
-invasion or infection
41
-itis
disease or inflammation
42
-pathy
disease or suffering
43
Three Phases of Drug Action
1. pharmaceutic phase
2. pharmacokinetic phase
3. Pharmacodynamic phase
44
Phase 1 of drug action: pharmaceutic phase
Dissolution phase, all oral drugs must go through dissolution in order to be absorbed
45
Phase 2 of drug action: pharmacokinetic phase
-what the body does to the drug
-has four processes:
1) absorption: through small intestines into blood
2) distribution: drug leaving blood, passing through cell membrane to site of action
3) metabolism/biotransformation: liver metabolizes drug
4) excretion: kidney excretion
46
Drugs crossing the cell membrane
-drugs must be lipid soluble to pass the phospholipid bilayer
-water soluble drugs require passage through channels or pores
47
First Pass Effect and Bioavailability
-percentage of drug broken down in liver
-bioavailability is the amount of drug left after first pass
-bioavailability of PO meds vary, bioavailability of IV meds are 100%
48
What are the three routes of absorption?
1. Enteral: GI tract (EC/PO/SL/buccal/rectal)
2.Parenteral:
(SQ, IM, IV, Intrathecal, epidural)
3. Topical/ Transdermal (eyes/ears/skin/nose/lungs)
49
why cant you give a patient a PO drug rectally?
they have a different bioavailability
50
Where do enteric coated medications break down?
the small intestine
51
Where do PO medications break down?
the stomach
52
what are some disruptions in medication distribution?
-decreased blood flow
-PVD
-abscesses
-tumors
53
What is the blood brain barrier (BBB)?
cells in capillary wall of brain with very tight junctions that prevent drug passage through
54
what kind of drugs can cross the blood brain barrier?
What else can cross the BBB?
-drugs that have a transport system
-drugs that are lipid-soluble
-alcohol
-glucose
*think of how they affect mental state*
55
what is the major organ/site for drug metabolism?
the liver
56
what is the major site for excretion?
kidney
57
kidney disease or dysfunction can cause decreased drug excretion, what does this lead to?
the drug can build up and cause toxicity
58
serum half-life (T 1/2)
time required for the serum concentration of a drug to decrease by 50%
-this dictates how often a drug is given and how far apart the dosing is
59
what is a "steady state"
when intake of a drug is equal to the amount of drug metabolized and excreted
-goal of elimination is having a steady state
60
onset of a medication
time it takes for drug to elicit therapeutic response
61
peak of a medication
time it takes for drug to reach its maximum therapeutic effect
62
duration of medication
time drug concentration is sufficient to elicit a therapeutic response
63
receptors
proteins that are located on cell surfaces
64
Agonist vs. Antagonist
Agonist: stimulates / activates
Antagonist: inhibits / blocks
(produces action by preventing other natural substances from binding)
65
Therapeutic Index
the measure of relative safety of drugs
66
Black Box Warning
required by the FDA for dangerous drugs
-strongest safety warning a drug can have while still being on the market
67
What are some high alert drugs?
Insulin
Heparin
Opioids
Injectable potassium chloride ( IV KCL)
Neuromuscular blocking agents
chemotherapy drugs
68
how can the nurse minimize drug interactions?
-minimize # of drugs patient receives
-thorough drug history
-vigilant monitoring of patients taking drugs with a narrow therapeutic index
69
Drug interactions that increase therapeutic effects
1. Additive effects: 2 drugs w/ similar MOA
2. synergism/potentiation: 2 drugs w/ different MOA but combined effect
3. activation: decreases metabolism rate of drug
4. displacement: displacement of one drug by second drug increases effect of displaced drug
70
Antidote
drug given to ANTAGONIZE the toxic effects of another drug
71
Older adults and pharmacokinetic consequences
-Hepatic Changes: drugs metabolize slower
-GI Changes: decreased absorption of oral drugs
-Cardiac/ Circulatory
-Renal Changes: drugs excreted less completely
72
Inflammation
-d/t cell injury
-protective mechanism
"-itis"
-Acute (<2wks) vs. chronic
73
Localized signs of inflammation
redness, swelling, heat, pain, loss of function
74
Two causes of inflammation
1. Exogenous: external -> surgery, burns
2. Endogenous: Internally -> tissue ischemia
75
chemotaxis
process by which neutrophils are attracted to inflamed tissue
76
types of inflammatory exudates
1. Serous: water, mild inflammation
2. Serosanguineous: pink tinged
3. Purulent: severe inflammation w/ bacterial infection
4. Hemorrhagic: lots of RBC, most severe
77
systemic manifestations of Cytokines IL-1, IL-6, and TNFa
*cytokines are responsible for systematic responses to inflammation
fever
increased neutrophils
lethargy
muscle catabolism
78
B-cells
-Humoral immunity
-two kinds: Memory cells and plasma cells
79
T-cells
-Cell-mediated (recognize antigens on surface of cells)
-part of adaptive defense mechanism
80
What are the five classes of antibodies?
1. IgG: most common. protect against bacterial/viral infections
2. IgM: for cytotoxic functions
3. IgA: Secretory functions (saliva, tears, etc..)
4. IgD: "B-cell helpers"
5. IgE: against allergic reactions/parasites
81
Passive Immunity
-think breastfeeding
-transfer of plasma containing antibodies from immunized person to non-immunized person
82
Active Immunity
-vaccines
83
Types of vaccinations
1. Traditional: inactive or killed organisms (flu shot)
2. Attenuated: weakened but still live vax. (flu vax nasally) CANNOT give to people with weakn immune systems/underlying conditions
3. Toxoids: inactive toxins (tetanus)
4. Conjugate: H. Influenzae type B
5. mRNA: newest
84
What is an infection?
colonization of a host by a microbial species
-can be localized or systemic
85
Virus caused infection
-cannot multiple without a host cell
-common
-DNA/RNA with protein shell
86
Bacteria caused infection
-single celled
-can reproduce inside or outside cells
-common
87
Fungal infection
-spore forming organism
-rare
Ex: yeast infection
88
Protozoa infection
-rare
-live in water
Ex: maleria
89
Helminths infection
-rare
-parasitic worms
90
Prions infection
-rarest
-only composed on proteins
91
Direct vs. Indirect transmission of infection
Direct: kissing, sex, direct contact from soil
Indirect: airborne, vehicle or vector borne
92
Vector vs. Vehicle borne transmission
Vector: something else is carrying the Dz. Ex: mosquitos ad ticks
Vehicle: carried by water, blood, food
Ex: Hepatits ??
93
Different portals of entry for organisms
1.Oropharynx and nasopharynx (airways, lungs, stomach, GI tract)
2. GU tract (UTI)
3. Skin (biggest vulnerability)
4. Translocation (movement of bacteria across intestinal lining)
5. Blood (needle-stick)
6.MAternal-Fetal Transmission
94
Stages of Infection
1. Incubation Period
(organism entering body/multiplying)
2. Prodromal Stage
(pre-symptoms/not feeling well)
3. Acute Stage
(Full blown symptoms)
4. Convalescent Stage
(Dz getting better, feeling better)
5.Resolution Phase
(pathogen eliminated. Some never reach this phase, like chickenpox, why?)
95
The Infectious Process Steps
1. injury
2. increased permeability
3. immigration of leukocytes
4.phagocytosis
5. exudate
6. systemic symptoms
96
The Infectious Process: Injury
-initial insult to area occurs
-short period of vasoconstriction(why?)
-prolonged period of vasodilation (why?)
97
The Infectious Process: Increased permeability
-fluid pulled into vascular space
-fluid moves out of vessel to the place of injury
98
The Infectious Process: Immigration of Leukocytes
-neutrophils attracted to area of injury
99
The Infectious Process: phagocytosis
WBC's recognize, engulf, and destroy invading organisms
100
The Infectious Process: Exudate
purpose of exudates are to transport the leukocytes to injured area, dilute toxins and transport nutrients for healing process
101
The Infectious Process: systemic symptoms
-can occur if infectious process does not stay localized
-stimulates hypothalamic fever set point
102
Colonization vs. Infection
-if an infection sticks around longer than a systemic infection it can turn into a colonization
-colonization: in a specific body site, no S/Sx present. Ex: staph Infection
-Infection: clinical S/Sx of illness/inflammation present, colonization can develop into infection
103
Nosocomial
Infections that occur within a healthcare facility
104
Drug resistant infections
-MRSA: METHICILLIN resistant staph aureus
-CRE: CARBAPENEM (class of Abx) resistant enterobacteriaceae
-MDRO: MULTI-DRUG resistant organism
105
what is a superinfection?
an new infection that occurs during treatment for a different infection
-Abx killing normal/helpful flora, then drug resistant pathogens cause superinfection
Ex: C-Diff
106
Cellular adaption
changes in the cells to permit survival & maintenance of cellular function
-cells can change size/form
107
Abnormal cellular changes can occur due to...?
radiation, medication, lack of oxygen
108
Atrophy of cells
-shrinking of cell size
-all atrophic cells have decreased function
-Physiologic: d/t developmental issue
-Pathologic: d/t environmental conditions
109
Hypertrophy of cells
-increased size of cell
-can increase function
-can also occur with Dz processes/negative effect
110
Hyperplasia of cells
-increase in # of cells d/t increased cellular devision usually in response to injury
-hyperplasia usually turns into dysplasia
111
Normal hyperplasia examples versus abnormal
Normal: pregnancy related changes, wound healing
Abnormal: BPH, thyroid hyperplasia, endometrial hyperplasia
112
Dysplasia cells
abnormal changes in size/shape/organization of mature cells.can be reversible
-can be precursor to cancer, BUT does not indicate cancer.
113
Metaplasia cells
-most associated with cancer
-allows cells to survive better in hostile environment, IS reversible
114
Neoplasm
irregular growth b/c of gene mutation
115
Anaplasia
cancer cells
-neoplasia and anaplasia used interchangeably
116
Cancer
uncontrolled cellular growth with rapid uncontrolled proliferation and loss of ability of cells to differentiation
117
Neoplasms: Benign vs. Malignant
Benign: more mature, stay in one spot, usually do not cause issues, usually encapsulated
Malignant: not mature cells, often metastasize, no capsule
118
Necrosis
cellular injury that can lead to cellular death d/t Dz, injury, or failure of blood supply.
-irreversible, can lead to gangrene
119
Liquefactive necrosis
in tissues with lots of lipids.
release of proteolytic enzymes
120
Dry Gangrene
-blackened/dry/wrinkled
-spreads slow
-has demarkation line
121
Wet Gangrene
-foul smell, can be systemic, liquefaction
-extensive bacterial infection
-cold, pulseless, swollen
-NO line of demarkation
122
Gas Gangrene
-anaerobic, spore forming
-destroys connective tissue
-gaseous bubbles
-w/ severe trauma / compound fractures
