Pharmacology Unit 2: Study Guide w/ Vocabs

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Pharmacology Unit 2: Study Guide w/ Vocabs
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Pharmacology Unit 2: Study Guide w/ Vocabs
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  1. 1) Ø Know the difference between the official name, chemical name, generic name and trade name of a drug
    • a) Official name
    •   i) – name used in the official drug reference, USP (Pharmacopoeia of the United States)
    •    (1) Between 1906 & 1974 the NF (National Formulary) was also “official”
    •      (a) Now combined w/ the USP
    •   ii) (Ex: tetracycline hydrochloride)
    • b) Chemical name
    •   i) –name describes the exact chemical composition of a drug
    •   ii) (Ex: 4-dimethylamino-4.12 aoctahydro-3,6,10,12,12a-pentahydroxyl1-6-methyl,1,11-dioxi-2-napthacenecarboxamide hydrochloride)
    • c) Generic name
    •   i) –For older drugs, this is the name handed down through antiquity
    •   ii) –For newer drugs, it is usually the “code” name given during testing phase that is based upon the chemical name
    •    (1) The naming decision is made by the United States Adopted Name (USAN) committee
    •   iii) The generic name will become official name if drug is included in USP
    •    (1) (Ex: tetracycline hydrochloride)
    •   iv) Contrast w/: Therapeutic Equivalent
    •    (1) Different drug completely
    •      (a) (NOT a Generic Equivalent, which has exact same active ingredients)
    •      (b) Only in managed care setting
    •      (c) May be on a particular hospital’s “substitution” list as having equivalent therapeutic usefulness
    • d) Trade name
    •   i) –copyrighted name whose use is restricted to a single company:
    •    (1) May be renewed
    •      (a) Name remains w/ one company
    •    (2) This is in contrast to the 17 year patent on the drug itself
    •      (a) After 17 years may see generic products
    •        (i) (Drug doesn’t stay w/ the company after patent expires: other people/company then can make it)
    •     (b) Ex:
    •        (i) Tetracyn (Pfiphermeces)
    •        (ii) Achromycin (Lederle Labs)
    •        (iii) Symcin (Squibb)
  2. 2) Ø Review the drug reference books we discussed and the key characteristics of each.
    • a) The Pharmacopeia of the United States of America (USP)
    •   i) 1st published in 1820
    •   ii) Published every 5 years w/ supplements as needed
    •    (1) Single drugs
    •    (2) Full time director, voluntary team of pharmacologists, physicians, pharmacists, nurses, consumer activist
    •    (3) Older drugs deleted in favor of newer, more effective agents
    •     (a) (Authoritative: Gives average dose, toxicity, methods of administration
    •       (i) Also: How to prepare drugs, standards for tablet disintegration, etc.)
    • b) “National Formulary” (NF)
    •   i) 1888-1975, but now combined w/ USP
    •   ii) Single drugs and formulas for drug mixtures
    •   iii) Often included drugs deleted from USP
    •    (1) NF and USP in combination are the ONLY official drug references
    • c) AMA Drug Evaluation
    •   i) –prepared by appointed experts
    •   ii) Drug grouped according to use
    •   iii) General discussion provide of each group
    •    (1) *Favorable and unfavorable judgments expressed
    • d) “Physician’s Desk Reference” (PDR)
    •   i) Also PDR for non-prescription medications
    •   ii) -manufacturers buy space (like bunch of ads)
    •   iii) Information similar to drug inserts
    •   iv) Cross-reference to generic and chemical names
    •    (1) Especially useful section on drug identification and dosage forms
    •      (a) Manufacturers can’t promote :”unlabeled” or “off-label” uses listed (meaning not FDA approved); unless filing a supplemental application
    •        (i) Note: 1997 “FDA Modernization Act” does permit drug company to disseminate peer reviewed articles for unlabeled uses the company has committed to file a supplemental application on
    • e) “Drug Facts and Comparisons” (DF&C)
    •   i) Drugs grouped according to use
    •   ii) *Comparison of various drug forms including cost comparison
    •    (1) Includes over-the-counter medications
    •   iii) Now includes color photo section
    • f) “American Hospital Formulary Service” (AHFS)
    •   i) Similar to DF&C
    •   ii) Pharmacist use
    • g) Other sources:
    •   i) Journals
    •    (1) Nursing and Medical Journals
    •      (a) “The Medical Letter
    •         (i) (publish every 2 weeks, current – good record for recognizing significant changes)
    •   ii) Package insert
    •    (1) Must be approved by FDA
    •    (2) Legally may only include “labeled” uses
    •    (3) Other reference sources may include “unlabeled” uses
    •   iii) Textbooks
    •    (1) “Goodman and Gilman’s The Pharmacological Basis of Therapeutics
  3. 3) Ø What is the difference between local and systemic drug activity. Be able to identify an example
    • a) Local drug activity
    •   i) –drug action occurring only at the site of application
    •    (1) Usually on skin or mucous membranes
    •    (2) May be in a joint, in the stomach or anywhere
    •      (a) Action is where the drug is placed!
    • b) Systemic drug activity
    •   i) –Action of a drug that is absorbed then distributed throughout the body
    •    (1) Action may be on
    •      (a) Whole body
    •      (b) Or a specific target organ
    •      (c) (key: it’s at some place other than place you place it)
    •    (2) Toxic effects may occur when drug applied for local effects = become systemically absorbed
  4. 4) Ø Review the routes of drug administration and the major advantage/disadvantage of each.
    • a) Skin and Mucous Membranes (Chiefly “topical” routes)
    •   i) Skin
    •    (1) Local action usually intended
    •      (a) Uses- antiseptic, cleansing, emollient
    •      (b) Caution – skin broken
    •    (2) (Systemic examples?
    •      (a) Transdermal patches, nicotine patches, estrogen patches, etc)
    •   ii) Nasal mucosa
    •    (1) Local: sprays, nose drops, decongestants, hemostatic
    •      (a) Caution:
    •        (i) If too much applied may become systemically absorbed
    •        (ii) Even if correctly used, patient may have contraindications such as high BP or glaucoma
    •    (2) Systemic: vasopressin, cocaine, heroin
    •   iii) Inhalation
    •    (1) Local:
    •      (a) Antibiotics
    •      (b) Detergents and enzymes for breaking up secretions
    •    (2) Systemic:
    •      (a) Anesthetics, CO2, O2 & NO
    •   iv) Genitourinary
    •    (1) Local action intended
    •      (a) Caution: Traumatized tissue: dangerous systemic effect
    • b) Gastrointestinal Tract (Enteral Routes)
    •   i) Oral
    •    (1) –usually for systemic effect (exception: antacids, etc)
    •    (2) Reasons used:
    •      (a) Convenience: simplest route to bloodstream
    •      (b) Safety: takes 1.1.5 hours to see full effect
    •      (c) Cost: less expensive than injections
    •    (3) Timing around meals
    •      (a) Before: quicker absorption, but more easily destroyed
    •      (b) With: drug irritations
    •      (c) After: slower absorption desired
    •    (4) Contraindications of oral route
    •      (a) (-Why you would not want some1 to use it)
    •      (b) Patient vomiting or unconscious
    •      (c) Drug too irritating
    •      (d) Drug doesn’t reach blood in high enough concentration
    •         (i) (-if low bioavailability )
    •         (ii) Not absorbed through GI tract
    •        (iii) Destroyed by digestive enzymes
    •        (iv) Destroyed by liver (metabolism)
    •           1. Portal system
    •           2. Sublingual, buccal, or rectal route will bypass the portal circulation
    •   ii) Sublingual and Buccal
    •    (1) Systemic
    •      (a) For drugs destroyed by liver or digestive enzymes
    •      (b) Do not chew, swallow, or take w/ water
    •    (2) Local
    •      (a) Anesthetic or antiseptic (dentist)
    •   iii) Rectal
    •    (1) Local
    •      (a) Stimulate defecation reflex
    •    (2) Systemic
    •      (a) Retention enemas or suppositories
    •    (3) Why Use?
    •      (a) Bypass liver and digestive enzymes
    •      (b) Irritating to stomach
    •      (c) Uncooperative or unconscious patient
    •      (d) Antiemetic
    • c) Parental routes – Refers to injections (literally: other than GI tract)
    •   i) More hazardous route
    •    (1) Rapidly absorbed
    •      (a) Difficult to prevent total absorption and adverse effects
    •    (2) Local tissue damage
    •    (3) Entrance of microorganisms
    •   ii) Type of injection depend upon placement of needle
    •    (1) Intradermal – w/in dermin
    •    (2) Subcutaneous (hypodermic)
    •      (a) Usually use for drugs that are not irritating to the tissue
    •      (b) Ex: insulin, epinephrine
    •      (c) Slower than intravenously, faster than oral
    •    (3) Intramuscular
    •    (4) Intravenous
    •    (5) Intraarterial
    •    (6) Intraspinal – often used in “general” way
    •      (a) Epidural
    •      (b) Subdural
    •      (c) Subarachnoid
    •    (7) Intraarticular
    •      (a) To joints (very local)
    •   iii) The most commonly given injections are:
    •    (1) Subcutaneous
    •      (a) –must be highly soluble and potent in small volume
    •      (b) May use ice or a tourniquet in case of reaction
    •    (2) Intramuscular
    •      (a) Spreads over larger surface area
    •         (i) Absorption watery fluids may be more rapid
    •         (ii) Suspensions absorbed very slowly
    •      (b) Fewer sensory nerve endings
    •      (c) Irritation less likely to lead to necrosis
    •         (i) Caution- blood vessels and nerves in area
    •    (3) Intravenous
    •      (a) –most rapid and dangerous rout (even ice or tourniquet won’t help)
    •        (i) (No absorption required)
    •        (ii) Injection – irritating substances or emergency administration
    •        (iii) Infusion- often just fluids and electrolytes
    •            1. *if drug added, must be labeled (watch for incompatibilities w/ solution)
    •      (b) Ex: “iv”
  5. Under what circumstances would you NOT want to administer a drug orally?
    • -Patient vomiting or unconscious
    • -Drug too irritating
    • -Drug doesn’t reach blood in high enough concentration
    •         (i) (- if low bioavailability )
    •         (ii) Not absorbed through GI tract
    •        (iii) Destroyed by digestive enzymes
    •        (iv) Destroyed by liver (metabolism)
    •           1. Portal system
    •           2. Sublingual, buccal, or rectal route will bypass the portal circulation

  6. What are the different types of parenteral routes of administration, what are the main advantages/disadvantages we discussed in class?
    • i) Type of injection depend upon placement of needle
    •    (1) Intradermal – w/in dermin
    •    (2) Subcutaneous (hypodermic)
    •      (a) Usually use for drugs that are not irritating to the tissue
    •      (b) Ex: insulin, epinephrine
    •      (c) Slower than intravenously, faster than oral
    •    (3) Intramuscular
    •    (4) Intravenous
    •    (5) Intraarterial
    •    (6) Intraspinal – often used in “general” way
    •      (a) Epidural
    •      (b) Subdural
    •      (c) Subarachnoid
    •    (7) Intraarticular
    •      (a) To joints (very local)
    • ii) The most commonly given injections are:
    •    (1) Subcutaneous
    •      (a) –must be highly soluble and potent in small volume
    •      (b) May use ice or a tourniquet in case of reaction
    •    (2) Intramuscular
    •      (a) Spreads over larger surface area
    •         (i) Absorption watery fluids may be more rapid
    •         (ii) Suspensions absorbed very slowly
    •      (b) Fewer sensory nerve endings
    •      (c) Irritation less likely to lead to necrosis
    •         (i) Caution- blood vessels and nerves in area
    •    (3) Intravenous
    •      (a) –most rapid and dangerous rout (even ice or tourniquet won’t help)
    •        (i) (No absorption required)
    •        (ii) Injection – irritating substances or emergency administration
    •        (iii) Infusion- often just fluids and electrolytes
    •            1. *if drug added, must be labeled (watch for incompatibilities w/ solution)
    •      (b) Ex: “iv”
  7. Define: Official name
    • – name used in the official drug reference, USP (Pharmacopoeia of the United States)
    •    (1) Between 1906 & 1974 the NF (National Formulary) was also “official”
    •      (a) Now combined w/ the USP
    •   ii) (Ex: tetracycline hydrochloride)
  8. Define: Chemical name
    • –name describes the exact chemical composition of a drug
    •   ii) (Ex: 4-dimethylamino-4.12 aoctahydro-3,6,10,12,12a-pentahydroxyl1-6-methyl,1,11-dioxi-2-napthacenecarboxamide hydrochloride)
  9. Define: Generic name
    • –For older drugs, this is the name handed down through antiquity
    •   ii) –For newer drugs, it is usually the “code” name given during testing phase that is based upon the chemical name
    •    (1) The naming decision is made by the United States Adopted Name (USAN) committee
    •   iii) The generic name will become official name if drug is included in USP
    •    (1) (Ex: tetracycline hydrochloride)
    •   iv) Contrast w/: Therapeutic Equivalent
    •    (1) Different drug completely
    •      (a) (NOT a Generic Equivalent, which has exact same active ingredients)
    •      (b) Only in managed care setting
    •      (c) May be on a particular hospital’s “substitution” list as having equivalent therapeutic usefulness
  10. Define: Trade name
    • copyrighted name whose use is restricted to a single company:
    •    (1) May be renewed
    •      (a) Name remains w/ one company
    •    (2) This is in contrast to the 17 year patent on the drug itself
    •      (a) After 17 years may see generic products
    •        (i) (Drug doesn’t stay w/ the company after patent expires: other people/company then can make it)
    •     (b) Ex:
    •        (i) Tetracyn (Pfiphermeces)
    •        (ii) Achromycin (Lederle Labs)
    •        (iii) Symcin (Squibb)
  11. What is: (USP)-The Pharmacopeia of the United States of America
    • i) 1st published in 1820
    •   ii) Published every 5 years w/ supplements as needed
    •    (1) Single drugs
    •    (2) Full time director, voluntary team of pharmacologists, physicians, pharmacists, nurses, consumer activist
    •    (3) Older drugs deleted in favor of newer, more effective agents
    •     (a) (Authoritative: Gives average dose, toxicity, methods of administration
    •       (i) Also: How to prepare drugs, standards for tablet disintegration, etc.)
  12. What is:(NF) National Forumlary
    • i) 1888-1975, but now combined w/ USP
    •   ii) Single drugs and formulas for drug mixtures
    •   iii) Often included drugs deleted from USP
    •    (1) NF and USP in combination are the ONLY official drug references
  13. What is: AMA Drug Evaluations?
    •   i) –prepared by appointed experts
    •   ii) Drug grouped according to use
    •   iii) General discussion provide of each group
    •    (1) *Favorable and unfavorable judgments expressed
  14. What is:(PDR) Physician's Desk Reference?
    •   i) Also PDR for non-prescription medications
    •   ii) -manufacturers buy space (like bunch of ads)
    •   iii) Information similar to drug inserts
    •   iv) Cross-reference to generic and chemical names
    •    (1) Especially useful section on drug identification and dosage forms
    •      (a) Manufacturers can’t promote :”unlabeled” or “off-label” uses listed (meaning not FDA approved); unless filing a supplemental application
    •        (i) Note: 1997 “FDA Modernization Act” does permit drug company to disseminate peer reviewed articles for unlabeled uses the company has committed to file a supplemental application on
  15. What is:(DF&C) Drug Facts and Comparisons?
    •   i) Drugs grouped according to use
    •   ii) *Comparison of various drug forms including cost comparison
    •    (1) Includes over-the-counter medications
    •   iii) Now includes color photo section
  16. What is:(AHFS) American Hospital Formulary Service?
    •   i) Similar to DF&C
    •   ii) Pharmacist use
  17. What are the other drug reference books?
    •   i) Journals
    •    (1) Nursing and Medical Journals
    •      (a) “The Medical Letter
    •         (i) (publish every 2 weeks, current – good record for recognizing significant changes)
    •   ii) Package insert
    •    (1) Must be approved by FDA
    •    (2) Legally may only include “labeled” uses
    •    (3) Other reference sources may include “unlabeled” uses
    •   iii) Textbooks
    •    (1) “Goodman and Gilman’s The Pharmacological Basis of Therapeutics
  18. Define: Local drug activity?
    •   i) –drug action occurring only at the site of application
    •    (1) Usually on skin or mucous membranes
    •    (2) May be in a joint, in the stomach or anywhere
    •      (a) Action is where the drug is placed!
  19. Define: Systemic drug activity
    • i) –Action of a drug that is absorbed then distributed throughout the body
    •    (1) Action may be on
    •      (a) Whole body
    •      (b) Or a specific target organ
    •      (c) (key: it’s at some place other than place you place it)
    •    (2) Toxic effects may occur when drug applied for local effects = become systemically absorbed
  20. What are the: "Topical" routes (via Skin & Mucous Membranes)
    • i) Skin
    •    (1) Local action usually intended
    •      (a) Uses- antiseptic, cleansing, emollient
    •      (b) Caution – skin broken
    •    (2) (Systemic examples?
    •      (a) Transdermal patches, nicotine patches, estrogen patches, etc)
    •   ii) Nasal mucosa
    •    (1) Local: sprays, nose drops, decongestants, hemostatic
    •      (a) Caution:
    •        (i) If too much applied may become systemically absorbed
    •        (ii) Even if correctly used, patient may have contraindications such as high BP or glaucoma
    •    (2) Systemic: vasopressin, cocaine, heroin
    •   iii) Inhalation
    •    (1) Local:
    •      (a) Antibiotics
    •      (b) Detergents and enzymes for breaking up secretions
    •    (2) Systemic:
    •      (a) Anesthetics, CO2, O2 & NO
    •   iv) Genitourinary
    •    (1) Local action intended
    •      (a) Caution: Traumatized tissue: dangerous systemic effect
  21. What are the: Enteral routes (via Gastrointestinal [GI] tract)
    • i) Oral
    •    (1) –usually for systemic effect (exception: antacids, etc)
    •    (2) Reasons used:
    •      (a) Convenience: simplest route to bloodstream
    •      (b) Safety: takes 1.1.5 hours to see full effect
    •      (c) Cost: less expensive than injections
    •    (3) Timing around meals
    •      (a) Before: quicker absorption, but more easily destroyed
    •      (b) With: drug irritations
    •      (c) After: slower absorption desired
    •    (4) Contraindications of oral route
    •      (a) (-Why you would not want some1 to use it)
    •      (b) Patient vomiting or unconscious
    •      (c) Drug too irritating
    •      (d) Drug doesn’t reach blood in high enough concentration
    •         (i) (-if low bioavailability )
    •         (ii) Not absorbed through GI tract
    •        (iii) Destroyed by digestive enzymes
    •        (iv) Destroyed by liver (metabolism)
    •           1. Portal system
    •           2. Sublingual, buccal, or rectal route will bypass the portal circulation
    •   ii) Sublingual and Buccal
    •    (1) Systemic
    •      (a) For drugs destroyed by liver or digestive enzymes
    •      (b) Do not chew, swallow, or take w/ water
    •    (2) Local
    •      (a) Anesthetic or antiseptic (dentist)
    •   iii) Rectal
    •    (1) Local
    •      (a) Stimulate defecation reflex
    •    (2) Systemic
    •      (a) Retention enemas or suppositories
    •    (3) Why Use?
    •      (a) Bypass liver and digestive enzymes
    •      (b) Irritating to stomach
    •      (c) Uncooperative or unconscious patient
    •      (d) Antiemetic
  22. What are the: Parental routes
    • Refers to injections (literally: other than GI tract)
    •   i) More hazardous route
    •    (1) Rapidly absorbed
    •      (a) Difficult to prevent total absorption and adverse effects
    •    (2) Local tissue damage
    •    (3) Entrance of microorganisms
    •   ii) Type of injection depend upon placement of needle
    •    (1) Intradermal – w/in dermin
    •    (2) Subcutaneous (hypodermic)
    •      (a) Usually use for drugs that are not irritating to the tissue
    •      (b) Ex: insulin, epinephrine
    •      (c) Slower than intravenously, faster than oral
    •    (3) Intramuscular
    •    (4) Intravenous
    •    (5) Intraarterial
    •    (6) Intraspinal – often used in “general” way
    •      (a) Epidural
    •      (b) Subdural
    •      (c) Subarachnoid
    •    (7) Intraarticular
    •      (a) To joints (very local)
    •   iii) The most commonly given injections are:
    •    (1) Subcutaneous
    •      (a) –must be highly soluble and potent in small volume
    •      (b) May use ice or a tourniquet in case of reaction
    •    (2) Intramuscular
    •      (a) Spreads over larger surface area
    •         (i) Absorption watery fluids may be more rapid
    •         (ii) Suspensions absorbed very slowly
    •      (b) Fewer sensory nerve endings
    •      (c) Irritation less likely to lead to necrosis
    •         (i) Caution- blood vessels and nerves in area
    •    (3) Intravenous
    •      (a) –most rapid and dangerous rout (even ice or tourniquet won’t help)
    •        (i) (No absorption required)
    •        (ii) Injection – irritating substances or emergency administration
    •        (iii) Infusion- often just fluids and electrolytes
    •            1. *if drug added, must be labeled (watch for incompatibilities w/ solution)
    •      (b) Ex: “iv”
  23. Define: Injection
    -irritating substances or emergency administration
  24. Define: Infusion
    • - often just fluids and electrolytes
    •            1. *if drug added, must be labeled (watch for incompatibilities w/ solution)

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