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165 terms

Pharmacology Chapter 1

Roach's Introductory Clinical Pharmacology
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Pharmacology
_________ is the study of drugs and their action on living organisms.
chemical, generic, official, trade, brand
What are the several types of drug names?
chemical
__________ name is the scientific term that describes the molecular structure of a drug; it typically is the chemical components of the drug.
generic
__________ name is the general name given to a drug that can be made or marketed by any company; it is non-proprietary.
trade
__________ name is capitalized and is selected by a specific company for marketing purposes.
generic name
To avoid confusion, what name should you use for the drug?
anti-infectives
Drugs that retard or destroy pathogens are classified as?
prescription, nonprescription, controlled substance
Once a drug is approved for use, the FDA assigns it to one of the following categories?
Prescription drugs
_________ _________ are designated by the federal government as potentially harmful unless their use is supervised by a licensed health care provider, such as a nurse practitioner, physician, or dentist.
adverse reactions
The nurse administers the drug and monitors the patient for therapeutic effect and _________ ___________.
legend drugs
Prescription drugs, also called ________ ________, are the largest category of drugs.
licensed HCP
Prescription drugs are prescribed by a ?
nonprescription drugs
_____________ ________ are designated by the FDA as safe and can be obtained without a prescription.
over the counter
Drugs that are purchased in a variety of settings, such as a pharmacy, drugstore, or the local supermarket are called ?
nonprescription drugs
Over the counter drugs are known as?
controlled substances
___________ ___________ are the most carefully monitored of all drugs. These drugs have a high potential for abuse and may cause physical or psychological dependency.
physical dependency
___________ ____________ is the habitual use of a drug, in which negative physical withdrawal symptoms result from abrupt discontinuation; it is the body's dependence on repeated administration of a drug.
Controlled Substances
____________ ____________ act of 1970 established a schedule, or classification system, for drugs with abuse potential.
Controlled Substances Act
This act regulates the manufacture, distribution, and dispensing of these drugs.
five schedules
The controlled substances act divides drugs into _____ ___________, based on their potential for abuse and physical and psychological dependence.
Schedule 1
High abuse potential, lack of accepted safety, not approved for medical use in the United States is what schedule?
Schedule 2
Potential for high abuse with severe physical or psychological dependence, approved for medical use in the United States
Schedule 2
The schedule approved for opioids such as meperidine, methadone, morphine, oxycodone, amphetamines; and cocaine.
Schedule 3
Less abuse potential than schedule 2 drugs, potential for moderate physical or psychological dependence
Schedule 3
Examples of this schedule are anabolic steroids, ketamine, hydrocodone/codeine compounded with an nonsteroidal anti-inflammatory drug
Schedule 4
Less abuse potential than schedule 3 drugs, limited dependence potential
Schedule 4
Examples of this schedule are some sedatives and anxiety agents, non-opioid analgesics, "diet drugs"
Schedule 5
Limited abuse potential
Schedule 5
Examples of this schedule are small amounts of opiod (codeine) used as antitussives or antidiarrheals, pregabalin (Lyrica)
A
(What PREGNANCY category?)
Adequate, well-controlled studies in pregnant women have not shown an increased risk of fetal abnormalities to the fetus in any trimester of pregnancy.
B
(What PREGNANCY category?)
Animal studies have revealed no evidence of harm to the fetus; however, there are no adequate and well-controlled studies in pregnant women
B
(What PREGNANCY category?)
Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
C
(What PREGNANCY category?)
Animal studies have shown an adverse effect and there are no adequate and well-controlled studies in pregnant women.
C
(What PREGNANCY category?)
Animal studies have been conducted and there are no adequate and well-controlled studies in pregnant women.
D
Adequate well-controlled or observational studies in pregnant women have demonstrated a risk to the fetus.

However, potential benefits may outweigh the risk to the fetus. If needed in a life-threatening situation or a serious disease, the drug may be acceptable if safer drugs cannot be used or are ineffective
X
Adequate well-controlled or observational studies in animals or pregnant women have demonstrated positive evidence of fetal abnormalities or risks.

The use of the product is contraindicated in women who are or may become pregnant.
ABCDX
What are the FDA pregnancy risk categories?
DEA
Prescription practices of the primary health care provider for controlled substances are monitored by the ?
8-12 hours
In hospitals or other agencies that dispense controlled substances, the scheduled drugs are counted every __ to __ hours to account for each injectable, tablet, or other form of the drug.
7-12 years
Drug development is a long and arduous process that can take from __ to __ years, and sometimes longer.
FDA
The ____ has the responsibility for approving new drugs and monitoring drugs currently in use for adverse or toxic reactions.
pre-FDA phase, FDA phase
The development of a new drug is divided into what two phases?
pre-FDA
During what phase, does a manufacturer discover a drug that looks promising?
postmarketing surveillance
______________ ____________ occurs after the manufacturer places the drug on the market.
FDA by Medwatch
Health care professionals are encouraged to help with this surveillance by reporting adverse effects by reporting to the?
Orphan Drug Act of 1983
What special program was passed to encourage the development and marketing of products used to treat rare diseases?
200,000
How many individuals is it considered to be a "rare disease"?
rare disease
Multiple myeloma, cystic fibrosis, and phenylketonuria are types of what kind of diseases?
Oral drugs
What drugs go through these three phases: pharmaceutic phase, pharmacokinetic phase, and pharmacodynamic phase?
pharmaceutic phase
the drug dissolves
soluble
Drugs must be ________ to be absorbed.
parental drugs
What type of drugs are already dissolved and are absorbed more quickly?
enteric coating
Tablets that have an ________ ________ or time-releasing capsules do not disintegrate until they reach the alkaline environment of the small intestine.
pharmacokinetics
____________ refers to activities within the body after a drug is administered.
absorption, distribution, metabolism, excretion
What 4 activites do pharmacokinetics go through?
half-life
Another pharmacokinetic component is the ______ ______ of the drug.
half-life
is a measure of the rate at which drugs are removed from the body.
absorption
__________ follows administration and is the process by which a drug is made available for use in the body.
absorption
Which process do the drug particles in the GI tract move into the body fluids?
active transport, passive transport, pinocytosis
What three ways does absorption act in?
active transport
cellular energy is used to move the drug from an area of low concentration to one of high concentration
passive transport
no cellular energy is used as the drug moves from an area of high concentration to an area of low concentration
pinocytosis
cells engulf the drug particle (the cell forms a vesicle to transport the drug into the inner cell)
intravenous route
What route are drugs most rapidly absorbed?
slowly
(fast or slow) When drugs are absorbed orally, intramuscularly, or sub Q?
first pass effect
the metabolism of orally administered drugs by gastrointestinal and hepatic enzymes, resulting in a significant reduction of the amount of unmetabolized drug reaching the systemic circulation.
protein binding, blood flow, solubilty
Distribution of an absorbed drug in the body depends on __________ _________, _____ _____, and _________.
inactive
Drugs bound to protein are pharmacologically _________.
free drugs
Only ____ _____ can produce a therapeutic effect.
large blood supply
A drug is distributed quickly to areas with a _______ _________ ________, such as the heart, liver, and kidneys.
skin and muscle
Distribution of drugs in these areas occur more slowly.
biotransformation
Metabolism is also called?
metabolism
the process by which the body changes a drug to a more or less active form that can be excreted
metabolite
What's the resulting form of metabolism?
metabolite
an inactive form of the original drug
excretion
The elimination of drugs from the body is called _________.
kidney disease
Patients with what type of disease may require a dosage reduction and careful monitoring of kidney function?
half-life
_____ ______ refers to the time required for the body to eliminate 50% of the drug.
2-4
Drugs with a short half life hours?
21-24
Drugs with a long half life hours?
onset of action
time between administration of the drug and onset of its therapeutic effect
peak of concentration
when absorption rate equals the elimination rate (not always the time of peak response)
duration of action
length of time the drug produces a therapeutic effect
Pharmacodynamic phase
_________ is the study of the drug mechanisms that produce biochemical or physiologic changes in the body.
pharmacodynamics
_____________ deals with the drug's action and effect in the body.
therapeutic effect
The primary effect of a drug is the desired or _________ ___________.
alteration in cellular function, alteration in cellular environment
A drug exerts its action by two main mechanisms:
receptor
The function of a cell is altered when a drug interacts with a ________.
receptor-mediated drug action
This occurs when a drug molecule selectively joins with a reactive site---the receptor--- on the surface of a cell.
pharmacologic
When a drug binds to and interacts with the receptor, a ___________ response occurs.
agonist
a drug that binds with a receptor and stimulates the receptor to produce a therapeutic response.
antagonist
a drug that joins with receptors but does not stimulate the receptors
competitive, noncompetitive
What are the two types of antagonists?
competitive antagonist
competes with the agonists for receptor sites.
competitive antagonist
bind reversibly with receptor sites, administering larger doses of an agonist can overcome the antagonist effects.
noncompetitive antagonist
binds with receptor sites and always blocks the effects of the agonists.
Human genome project
was a study to determine the different components of the human genetic code.
pharmacogenomics
is the study of how people's responses to medications are variable due to individual genetic variation.
pharmacogenetics
is the creation of individualized drug therapy that allows for the best choice and dose of drugs.
first trimester (3 months)
Drugs administered to pregnant women, particularly during what trimester, may have teratogenic effects?
teratogen
any substance that causes abnormal development of the fetus, often leading to severe deformation.
Adverse reactions
_________ ________ are undesirable drug effects.
side effects
to explain mild, common, and nontoxic reactions
adverse reactions
to describe more severe and life-threatening reactions
allergic reaction
is an immediate hypersensitivity reaction.
antigen
A drug allergy occurs because the individual's immune system responds to the drug as a foreign substance called _________.
antibodies
Lymphocytes respond by forming ________.
antibodies
protein substances that protect against antigens
antigen
Common allergic reactions reactions occur when the individual's immune system responds aggressively to the _________.
Chemical mediators
__________ _________ released during the allergic reaction produce symptoms ranging from mild to life-threatening.
primary health care provider
Any indication of an allergic reaction is reported to the ________ ______ ___ _____ before the next dose of the drug is given.
immediately
Allergic reactions that occur __________ often are the most serious.
anaphylactic shock
_______ ________ is an extremely serious allergic drug reaction that usually occurs shortly after the administration of a drug to which the individual is sensitive.
immediate medical attention
Anaphylactic shock requires ______ _________ __________.
Anaphylactic shock
Treatment of this is to raise the blood pressure, improve breathing, restore cardiac function, and treat other symptoms as they occur.
epinephrine
_________ (adrenalin) may be given subQ injection in the upper extremity or thigh and may be followed by a continuous intravenous infusion.
hypotension
_________ and shock may be treated with fluids and vasopressors.
Bronchodilators
__________ are given to relax the smooth muscles of the bronchial tubes.
Antihistamines
____________ and corticosteroids may also be given to treat urticaria and angioedema.
angioedema
____________ is another type of allergic drug reaction.
angioedema
manifested by the collection of fluid in the subQ tissues.
angioedema
What drug allergic rx commonly affects eyelids, lips, mouth, and throat?
aphyxia
Angioedema can be dangerous when the mouth is affected, because the swelling may block the airway and ________ may occur.
drug idiosyncrasy
____ __________ is a term to describe any unusual or abnormal reaction to a drug.
Pharmacogenetics
__________ is the study of ways that specific genes can enhance sensitivity or resistance to certain drugs.
pharmacogenetic disorder
____________ _______ is a genetically determined abnormal response to normal doses of a drug.
pharmacogenetic disorder
This abnormal response occurs because of inherited traits that cause abnormal metabolism of drugs.
hemolysis
destruction of red blood cells
blood thinners
Patients with pharmacogenetic disorder use aspirin, chloramphenicol, and the sulfonamides because these drugs are ?
drug tolerance
______ _________ is a term used to describe a decreased response to a drug, requiring an increase in dosage to achieve the desired effect.
opioids, tranquilizers
Drug tolerance may develop when a patient takes certain drugs such as ______ and ________, for a long time.
physical drug dependance
The development of drug tolerance is a sign of _________ _____ _________.
cumulative drug effect
________ ____ ________ may be seen in those people with liver or kidney disease because these organs are the major sites for the breakdown and excretion of most drugs.
cumulative drug effect
This drug effect occurs when the body is unable to metabolize and excrete one dose of a drugbefore the next dose is given
cumulative drug effect
________ _____ _____ can be serious because too much of the drug can accumulate in the body and lead to toxicity.
drug-drug
A ______ ______ interaction occurs when one drug interacts with or interferes with the action of another drug.
additive, synergistic, antagonistic
Drug-drug interactions can produce effects that are ______, _______, _____.
additive drug reaction
________ _______ ________ occurs when the combined effect of two drugs is equal to the sum of each drug given alone.
drug synergism
_______ ___________ occurs when drugs interact with each other and produce an effect that is greater than the sum of their separate actions.
drug synergism
______ __________ is exemplified when a person takes both a hypnotic and alcohol.
antagonistic drug
___________ _____ reaction occurs when one drug interferes with the action of another, causing neutralization or a decrease in the effect of one drug.
absorption
When a drug is given orally, food may impair or enhance its ________.
empty stomach
When is drug absorbed into the bloodstream more quickly?(full or empty stomach?)
1 or 2 hours
Drugs that should be taken on an empty stomach are administered __________ after meals.
age, wt, sex, disease, route of administration
What are the factors that influence drug responses?
smaller
Infants and children usually require _____ doses of a drug than adults.
kids, adults
What age group usually require smaller doses?
polypharmacy
________ is the taking of numerous that can potentially react with one another.
elderly patients
Poly pharmacy is seen particularly in _______ patients who have multiple chronic diseases.
170 lbs
Dosages are based on a wt of approximately _____ lbs, which is calculated to be the average weight of men and women.
smaller
Women may require a __________ dose of some drugs than men.
disease
Sometimes disease is an indication for not prescribing a drug or for reducing the dose of a certain drugs.
liver disease
In ________ _________, the ability to metabolize or detoxify a specific type of drug may be impaired.
kidney disease
Patients with _______ _____ may exhibit drug toxicity and a longer duration of drug action.
intravenous
________ administration of a drug produces the most rapid drug action.
IV, IM, SubQ
List administration routes from most rapid to least.
herbal medicine
aka herbalism, and herbal therapy are names for complementary/alternative therapy that uses plants or herbs to treat various disorders.
WHO
According to _____, 80% of the world's population relies on herbs for a substantial part of their health care.
herbs
________, as well as vitamins and minerals, are classified as dietary or nutritional supplements.
dietary supplement health and education act
This act defines substances such as herbs, vitamins, minerals, amino acids, and other natural substances as "dietary supplements".
dietary herbs
_________ ______ are not approved by the FDA and are not intended to diagnose, treat, cure, or prevent any disease.
Are you having any difficulty breathing?
Mr. Carer has a rash and prupritus. You suspect an allergic reaction and immediately assess him for other more serious symptoms. What question would be most important to ask Mr. Carter?
impaired ability to metabolize or detoxify a drug
Mr. Jones, a newly admitted patient, has a history of liver disease. In planning Mr. Jones' care, the nurse must consider that liver disease may result in an?
allergic reaction
A patient asks the nurse to define a hypersensitivity reaction. The nurse begins by telling the patient that a hypersensitivity reaction is also called an __________ _______.
an effect greater than the sum of the separate actions of two or more drugs
In monitoring drug therapy, the nurse is aware that a synergistic drug effect may be defined as ?