Chapter 7

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Chapter 7
2010-11-03 19:28:09

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  1. What is pharmacology?
    study of medications and their effect or action on the body
  2. Six Rights of Med Administration
    patient, medication, dose, route, time, documentation/reporting
  3. What is a chemical name
    • describes drug chemical makeup, the composition and molecular structure
    • Ex. 2-butyl-3-benzofuranyl 4-[2-(diethylamino)-ethoxy]-3,5-diiodophenyl ketone hydrochloride
  4. What is a generic name?
    • aka nonproprietary; a general name, not manufacturer specific, usually derived from chemical name but easier
    • Ex. amiodarone
  5. What is a trade name
    • aka brand name; unique name that the manufacturer registers the drug with the FDA, always capitalized
    • Ex. Cordarone, Pacerone
  6. What is an official name
    • name given after a generic name has been approved by US adopted names counsel, approved by FDA and listed in the USP
    • Ex. amiodarone USP
  7. Four sorces of drugs
    plants, animals, minerals, synthetic
  8. What is the Pure Food and Drug Act
    aimed to protect the public from mislabled, poisonous or harmful medications
  9. What is the Food, Drug and Cosmetic Act
    • - addition to the Pure Food Act that required information on label about habit forming substances, side effects.
    • - Authorized creation of FDA.
    • - Mandated that drugs could only be dispensed with a prescription from MD, dentist, or veterinarian
  10. What are schedule I drugs
    • - highest abuse potential
    • - severe dependence possible
    • - no accepted medical use
    • - ex. heroin, LSD, marijuana, MDMA
  11. What are schedule II drugs
    • - very high abuse potential
    • - may lead to severe addiction
    • - ex. amphetamine, opiates, cocaine, demerol, barbiturates
  12. What are schedule III drugs
    • - lower abuse potential than I and II
    • - low to moderate physical dependence
    • - high psychological dependence
    • - combination narcotics (those containing APAP)
  13. What are Schedule IV drugs
    • - low abuse potential
    • - limited dependence
    • - ex. phenobarbital, diazepam, lorazepam
  14. What are schedule V drugs
    • - lowest abuse potential
    • - limited dependence
    • - ex. cough syrups with codiene
  15. What does the FDA do
    determines safety and efficacy before a drug goes to market
  16. What does the DEA do
    rugulates physicians permitted to dispense controlled substances
  17. What does the Federal Trade Commision monitor
    - drug advertising
  18. What is the purpose of Phase I trials
    test drug in healthy individuals to determine safe dose
  19. What is the purpose of Phase II trials
    determine drug safety and efficiacy and establish most effective dose
  20. What is the purpose of Phase III trials
    evaluate efficacy and side effects
  21. What is the purpose of PHase IV trials
    postmarket to determine long term efficacy and cost effectiveness
  22. List some special populations in drug therapy
    • - pregnant patients
    • - breastfeeding patients
    • - pediatrics
    • - geriatrics
  23. Describe the CNS
    • - brain and spinal cord
    • - sends impulses to the body thru efferent nerves
    • - recieves impulses from the body thru afferent nerves
  24. Describe the peripheral nervous system
    • - somatic
    • - autonomic
  25. What is the autonomic nervous system
    • - sends sensory impulses from internal structures thru afferent nerves to the brain
    • - divided into sympathetic and parasympathetic
  26. What is a ganglia
    • - grouping of nerves in the periphery
    • - act as relay station to relay impulses
  27. Describe the sympathetic nervous system
    • - fight or flight
    • - active during stress and activity
    • - regulates hypoglycemia, hypothermia, trauma
    • - adrenergic nerves - release norepinephrine and epinephrine
    • - sympathomimetic - effect resembling symphatetic nervous system - after admin epi
    • - sympatholytic - inhibit sympathetic nervous system
  28. Describe the parasympathetic nervous system
    • - dominates during rest and relaxation
    • - aka rest and digest
  29. What is neurochemical transmission
    • process of chemical signaling between cells
    • - helps cells talk to each other
    • - helps nerves keep a signal going
  30. what is affinity of a drug
    - attraction of a drug to a receptor
  31. What is an agonist
    drug that binds to a receptor and causes a response
  32. What is a solution
    • liquid containing disolved chemical substances
    • ex. NS
  33. What is a suspension
    • - drug to be incorporated into solution
    • - need to be shaken
    • - will separate on standing
  34. What is a fluid extract
    concentrated form of drug
  35. What is a tincture
    - dilute alcoholic extract of a drug
  36. What are spirits
    volatile substance dissolved in alcohol
  37. What is a syrup
    drug suspended in sugar and water
  38. What is an elixer
    syrup with alcohol and flavoring added
  39. What is a milk
    • aqueous suspension of insoluble drug
    • ex. milk of magnesia
  40. What is an emulsion
    • liquid in liquid formulation
    • ex. oil in water
  41. What is a liniment or lotion
    for external use
  42. What is an extract in solid form
    concentrated preparation of drug made by putting drug into solution and evaporating the excess solvent out
  43. What is a powder
    drug that has been pulverized
  44. what is pill
    drug shaped into a form to be swallowed, usually coated to hide taste
  45. What is a capsule
    gelatin container enclosing a medication
  46. what is a pulvule
    like a capsule but not made of gelatin, does not separate
  47. What is a suppository
    drug mixed in a firm base that melts at body temp
  48. What is an ointment
    semisolid prepartion for external aplication
  49. what is a patch
    medication impregnated into membrane or adhesive that is applied to the skin
  50. What is a vapor
    gaseous medication administration
  51. Describe local and systemic effects
    • - local - the reaction from direct application to the tissue
    • - systemic - the reaction after the drug is absorbed, involves more than one organ
  52. What is percutaneous route of administration
    med absorbed through skin or mucous membrane
  53. What is transdermal route of administration
    • deliver of drug through the patients skin
    • - absorption can be affected by thickness of skin, hair, circulation
  54. What is sublingual med administration
    • under the tongue
    • rapidly absorbed
  55. What is the buccal route of adminsitration
    • between the cheek and gum
    • - ex. glucose gel
  56. What is the pulmonary route
    inhalation or injection into the pulmonary system
  57. What is NAVEL
    • Drugs that can be delivered by pulmonary route
    • Naloxone, Atropine, Vasopressin, Epinephrine, Lidocaine
  58. What is enteral route
    • drug is absorbed somewhere along GI tract
    • - all po drugs are enterally administered
  59. What is a parenteral route
    • medications are administered by any route other than the alimentary canal (digestive tract), skin or mucous membrane
    • - administered with needle and syringe
    • - IV - most rapid absorption
    • - IO - can use for any med that can be given IV
    • - IM - take longer to act because must be absorbed from muscle to blood
    • - SQ - small amout of drug injected into fat, slow absorption
  60. What is pharmacokinetics
    • study of metabolism and action of a medication within the body
    • - time it takes for absorption, duration of action, distribution and excretion
  61. What is absorption
    • - med transfer from site of administration to target organ
    • - depends on blood flow, surface area, concentration, pH
  62. What is distribution
    • process by which a medication moves throughout the body
    • - drug disributes to the blood
    • - only free drug in the blood (not bound to proteins like albumin) can have an effect on tissues
  63. What is biotransformation
    • the manner in which the body metabolizes medications
    • - can involve either transforming hte medication into a metabolite or making it more water soluble
  64. What is excretion
    - elimination of the drug either as toxic or inactive metabolites
  65. What is glomerular filtration
    passive process where blood flows through the kidney, glomeruli are bundles of capillaries
  66. What is tubular secretion
    active transport process in which meds are bound to transporters to aid in elimination
  67. What is partial reabsorption
    occurs when some of the drug is reabsorbed after being filtered
  68. What is pharmacodynamics
    • way a medication produces a response
    • aka mechanism of action
  69. Four ways medications can cause an action
    • - change in cell properties
    • - bind to receptor
    • - bind with other chemicals in the body
    • - alter normal metabolic pathways
  70. what is an anatagonist
    blocks receptor site from being stimulated by other chemicals in the body
  71. what is biological half life
    time it takes for body to eliminate half of the drug
  72. What are the factors affecting drug response
    • - age
    • - weight
    • - sex
    • - environment
    • - time of administration
    • - condition of the patient
    • - genetic factors
    • - psychologic factors
  73. What are side effects
    reactions that can manifest as signs or symptoms that are not what wewanted to happen but are expected due to how the medicaion works
  74. what is an iatrogenic response
    • an adverse condition inadverently induced in a patient due to a medication
    • ex. developing a UTI due to folley catheter or developing a GI infection due to antibiotic
  75. What is idiosyncrasy
    a unique response to a drug that is not seen in other patients
  76. What is tolerance
    • - can result from taking a medication for an extended period of time
    • - must take higher dose to get the same response
  77. what is cross tolerance
    - patient develops tolerance to a class of drugs
  78. what is tachyphylaxis
    patient becomes rapidly tolerant to a medication
  79. What is a cumulative effect
    increased effect when a drug is given in several successive doses
  80. What is a stimulation effect
    • - addictive effect
    • - two drugs given have the same effect therefore causing an enhanced response in the patient
  81. What is synergism
    a patient gets two drugs that result in a greater effect than the sum of either drug alone
  82. what is potentiation
    the effect one drug has on another, in particular, one drug increases the effect of another
  83. What is interference
    the direct biochemical interaction that takes place between two drugs
  84. What are the components of a drug profile
    • - drug name - generic and trade name
    • - classification - based on effect
    • - mechanism of action - describes how medicine works
    • - indications - reasons for using the drug
    • - kinetics - ADME
    • - side effects and ADRs
    • - routes of administration
    • - forms - tablets, capsules, liquid, injection
    • - doses - what should be given based on condition
    • - special considerations/special populations
  85. What is an analgesic
    - medication to relieve pain (induce analgesia)
  86. Name some common analgesics
    • - opioid agonist - bind to opiate receptors and block pain signal
    • - nonopiod anagesics - can reduce fever also
    • 1. salycilates - ASA
    • 2. NSAIDs - ibu
    • 3. para aminophenol derivatives - APAP
  87. What is an opiod antagonist
    - reverse effects of an opioid drug
  88. What is an opioid agonist-antagonist
    decrease pain but do not have the same side effects of opioid agonist
  89. What is an anesthetic
    • causes loss of sensation to touch or pain
    • - systemic - general anesthesia
    • - local - focuses only on a portion of the body
  90. What is a sedative
    drug that reduces anxiety by causing sedation
  91. What is a hypnotic
    drug that ensure sleep
  92. Name some classes of sedative hypnotics
    • - benzodiazepines - most commonly used for sedation, ex. ativan, valium, versed (end in pam)
    • - barbiturates - similar to benzos, work on GABA, phenobarbital
    • - nonbarbiturate hypnotics - less side effects with similar effect of barbiturates and benzos, ex. propofol, etomidate
  93. How does an anticonvulsant work
    inhibit influx of sodium into cells to reduce depolarization
  94. What is a CNS stimulant and how does it work
    • - increase release of dopamine and norepinephrine to increase wakefulness and awareness
    • - ritalin
  95. What is a stimulant
    • cause excitation of CNS
    • ex. cocain, caffeine, amphetamines
  96. What are cholinergic medications
    • - work on parasympathetic NS
    • - block ACh effects
    • Side effects
    • Salivation/sweating
    • Lacrimation
    • Urination
    • Defecation/drooling/diarrhea
    • GI upset
    • Emesis
  97. What are muscarinic cholinergic antagonist
    • block ACh at athe muscarinic receptors
    • ex. atropine
    • increase secretions, HR, dilates pupils and decreases GI
  98. What are neuromuscular blocking agents
    • affect somatic NS by inducing paralysis
    • depolarizing - continuous stimulation of muscle cells, ex. succinylcholine
    • nondepolarizing - long acting, do not stimulate, ex. vecuronium
  99. What are sympathomimetics
    • stimulate sympathetic NS
    • stimulation at the adrenal medulla to release norepi and epi
    • lead to stimulation of dopaminergic receptors producting dialtion - no meds here
    • lead to stimulation of adrenergic receptors
  100. Adrenergic receptors
    • alpha 1 - produce vasoconstriction and bronchoconstriction
    • alpha 2 - control release of norepi
    • beta 1 - increase HR, cardiac contraction increased and strengthened, increase cardiac conduction
    • beta 2 - stimulate vasodilation and bronchodilation
  101. What are chronotropic medications
    affect the HR
  102. What are inotropic drugs
    affect force of contraction
  103. What are dromotrophhic drugs
    effect conduction and velocity of the heart
  104. what are cardiac glycosides
    • block ionic pumps in the heart to increase Ca concentration
    • ex. digoxin
  105. What are antiarrhythmics
    • treat rhythm disorders
    • sodium channel blockers - slow conduction in heart
    • beta blockers
    • potassium channel blockers - increase contraction
    • calcium channel blockers - block inflow of Ca into cell decreasing force of contraction
  106. treatment goals of antihypertensives
    • keep BP w/in normal limits
    • improve blood flow
    • reduce stress placed on heart
  107. What are diuretics
    • help kidney remove excess salt and water leading to decreased volume and decreases stress on CV
    • Thiazides - control sodium and water excreted by kidney
    • loops - lower concentration of sodium and calcium ions
  108. What are vasodilators
    • act on smooth mucles of arterioles and veins
    • ex. nitro
  109. Sympathetic blocking agents
    • beta blockers
    • adrenergic inhibitors
  110. Agiotensin converting enzyme inhibitor (ACE)
    • target RAAS
    • decrease conversion of angiotensin I to angiotensin II
  111. Angiotensin II receptor antagonists
    block angiotensin II from binding to receptor
  112. Antiplatelets
    • interfere with aggregation or collection of platelents
    • do NOT break down aggregated platelets, only prevent further build up
  113. Anticoagulant
    prevent thrmobi from forming
  114. fibrinolytic agents
    dissolve thrombus after clot has formed and prevent it from breaking off and entering the bloodstream
  115. xanthines
    • second line treatment for respirtory emergency
    • releive constriction by relaxing smooth muscles of bronchioles and stimulating cardiac muscles to work harder to increase blood flow
    • stimulate CNS
    • ex. caffeine
  116. Antacids
    • neutralize stomach acid
    • relieve indigestion
    • mylanta, tums, MOM
  117. Antiflatulants
  118. Antiemetics
    • treat vomiting
    • promethazine, compazine, reglan, zofran
  119. emetics
    syrup of ipecac
  120. H2 receptor antagoinist
    reduce acid produced in stomach by blocking cells that secrete acids
  121. antineoplastic medications
  122. uricosuric medications
    lower uric acid levels in the body by increasing excretion of uric acid by the kidney
  123. toxoid
    modified bacterial toxin to stimulate antibody forming
  124. vaccine
    suspension of nonpathogenic organism given to induce immune response
  125. immunosuppressants
    inhibit body's ability to attack foreign objects/organs
  126. bioavailability
    amount of drug still active once reaching target