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Controlled Substance Classes
- Schedule I High abuse potential no medical purpose
- Schedule II Legit medical purpose
- Schedule III Lower abuse than Sched II
- Schedule IV Lower abuse than III
- Schedule V Lower abuse than IV
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Types of Schedule I Controlled Substances
Heroin, Marijuana, LSD
High abuse potential no medical purpose
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Types of Schedule II Controlled Substances
Fentanyl, Methylphenidate (Ritalin), Cocaine
Legit Medical Purpose
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Types of Schedule III Controlled Substances
Hydrocodone (Vicodin), Acetaminophen with codeine, Ketamine
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Types of Schedule IV Controlled Substances
Diazepam (Valium), Lorazepam (Ativan)
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Types of Schedule V Controlled Substances
Narcotic cough medicines
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What are the three Medication names any medication is given?
The Chemical name, The Generic Name, and the Brand name which is chosen by the manufacturer and approved by the FDA
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12 components of Medication Profiles
- Medication Names
- Category or class of medication
- Uses/Indication
- Mechanism of action (pharmacodynamics)
- Pregnacy Risk factors
- Contraindications
- Available forms
- Dosage
- Administration and monitoring considerations
- Potential incompatibility
- Adverse effects
- Pharmacokinetics
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Phrmacodynamics is?
the alteration a function or process within the body an administered medication gives
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Pharmacokinetics is?
The action of the body on a medication
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When a medication binds with a receptor site, one of four possible actions will occur?
- 1. Channels permitting the passage of ions in cell walls may be opened or closed.
- 2. A biochemical messenger becomes activated, initiating other chemical reactions within the cell.
- 3. a normal cell function is prevented.
- 4. a normal or abnormal function of the cell begins.
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Agonist Medications
Initiate or alter a cellular activity by attaching to receptor sites, prompting a cell response.
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Antagonist Medications
prevent endogenous or exogenous agonist chemicals from reaching cell receptor sites and initiating or altering a particular cellular activity.
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Affinity
is the ability of a medication to bind with a particular receptor site.
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Competitive Antagonist
Temporarily bind with cellular receptor sites, displacing agonist chemicals.
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Noncompetitive Antagonist
Premanently bind with receptor sites and prevent activation by agonist chemicals.
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Partial Agonist
- Chemical attach to cellular receport sites.
- Binds to receptor but doesn't initiate as much cellular activity or change like other agonists.
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Factors Affecting a response to medications
Age, Weight, Environment, Genetic Factors, Pregnancy, and Psychosocial Factors
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What is therapeutic Index
The relationship between the median effective does and the median lethal dose or median toxic dose.
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What is cross-tolerance?
When repeated exposures to a medication within a particular class has the potential to cause a tolerance to other medications in that same class.
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What is Tachyphylaxis?
When repeated doses of medications within a short time rapidly cause tolerance, making the medication virtually ineffective.
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What is a Stimulant and what are some examples of stimulants?
- Stimulants cause a transient increase in physical, mental, or emotional performance.
- Caffeine, cocaine, and amphetamines
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What is a depressant and what are some examples of depressants?
- Medications and chemicals, in contrast to stimulants, reduce CNS and sympathetic nervous system funtioning, causing sedation, anxiolysis, respiratory depression, bradycardia, hypotension.
- Benzodiazepines, alcohol, and opiods
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The onset and peak of a medication is generally related to what?
Absorption and distribution
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The duration of effect is generally related to what?
Medication metabolism and elimination
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The duration of the medication is determined by what?
The bodies ability to regenerate cells
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What is bioavalability?
The percentage of the unchanged medication that reaches systemic circulation.
*Medications delivered by IV route by definition have 100% bioavalibility.
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What areas have capillary cells for a continious barrier? and what does this prevent?
- The blood-brain barrier, blood-placenta barrier, and the blood-testes barrier.
- prevents the passage of medicaiton molecules through openings in capillary walls.
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Biotransformation is a process that has four possible effects on a medication absorbed into the body
- 1. an inactive substance can become active, capable of producing desired or unwanted clinical effects.
- 2. An active medication can be changed into another active medication.
- 3. An active medication can be completely or partially inactivated.
- 4. a medication can be transformed into a substance that is easier for the body to eliminate.
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Where does most biotransformation occur?
In the liver!
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What system is responsible for the metabolism of different medication groups?
P-450
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What body tissues have some ability to cause biotransformation?
Kidneys, skin, lungs, GI tract, and many others.
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Medications and chemicals in the body follow two distinct patterns of metabolism and elimination...?
Zero-order elimination and first-order eliminiation
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What is Zero-order elimination?
a fixed amount of a substance is removed during a certain period, regardless of the total amount in the body.
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What is First-order elimination?
- The rate of elimination is directly influenced by the plasma levels of the substance.
- *Majority of medications and chemicals undergo this type of elimination.
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What institute has developed a list of error-prone medication abbreviations?
The Institute for Safe Medication Practices.
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The six Rights or "R's" of Medication Administration?
- Right Patient
- Medication
- Dose
- Route
- Time
- Documentation and reporting
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Important Recepor Sites Within the Body?
- Alpha-1
- Alpha-2
- Beta-1
- Beta-2
- Dopaminergic
- Nicotinic
- Muscarinic-2
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Alpha-1 Receptors
Vasoconstrict of arteries and veins
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Alpha-2
- Insulin restriction
- Glucagon secretion
- Inhibition of norepinephrine release
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Beta-1
- Affects the Heart
- Increase HR
- Increase contractility
- Increase Conduction
- Renin secretion for urinary retention
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Beta-2
- Lungs
- Bronchus and bronchiole relaxation
- Insulin secretion
- Uterine relaxation
- Arterial dilation in key organs
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Dopaminergic
Vasodilation of renal and mesenteric arteries
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Nicotinic
Present at neuormuscular juntion, allowing acetylcholine to stimulate muscle contration
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Muscarinic-2
Present in the heart; activated by ACh to offset sympathetic stimulation, decreasing HR, contractility, and electrical conduction velocity.
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