Karch Scf Ch 1, 2 Level 1 Pharmacology Unit 1

Front 1

Chapter 1

Back 1

Introduction to Drugs

Front 2

Nurses' Responsibilities

Back 2

Administering drug
Assessing for adverse effects
Interveining to make the drug regimen more tolerable
Providing patient teaching aboput drugs and regimen
Monitoring and prevention of medical errors

Front 3

Pharmacology Def

Back 3

The study of the biological effects of chemicals on living organisms

Front 4

Pharmacotheraopeutics

Back 4

Pharm branch that uses drugs to Treat, Prevent, and Diagnose disease

Front 5

Pharmacotherapeutics focuses on

Back 5

The drug's effect on the body
The body's response to the drug

Front 6

Two types of drug effects

Back 6

Therapeutic
Adverse

Front 7

Sources of drugs

Back 7

Plants
Animal products
Inorganic compounds
Synthetic sources-most common

Front 8

In pharm, animal products have been used to replace

Back 8

Human made chemicals
ex. pig insuline, BGH

Front 9

Animal product preparations have been replaced by:

Back 9

Genetically engineered
Synthetic preparations by bacteria
Due to purity and safety

Front 10

Iron, aluminum, fluoride, gold and iron are examples of

Back 10

Inorganinc compounds

Front 11

Drug Evaluations or
Clinical Trials have these 5 steps:

Back 11

Preclinical trials
Phase I studies - Phase IV studies

Front 12

Preclinical trials

Back 12

Chemicals are tested on laboratory animals
-tests for presumed effect on living tissue
-to evaluate any adverse effects

Front 13

Phase I studies

Back 13

Chemicals are tested on human volunteers (Mostly healthy males)

Front 14

Phase II studies

Back 14

Drugs are tried on informed patients with a specific disease.
Looking for effectiveness of the drug

Front 15

Phase III studies

Back 15

Drugs are tried on a vast clinical market
Looking for drug-drug interactions
Followed by FDA Approval

Front 16

Phase IV studies

Back 16

Continued Evaluation
Drugs are studied while available on the general market
Looking for effectiveness in the general population

Front 17

FDA Pregnancy Categories

Back 17

Indicate the potential for a systemically absorbed drug to cause birth defects.
Based on risk/benefit

Front 18

Pregnancy category A

Back 18

Adequate studies in pregnant women have not demonstrated a risk to the fetus in the first trimester of pregnancy, and there is no evidence of risk in later trimesters

Front 19

Pregnancy category B

Back 19

Animal studies have not demonstrated a risk to the fetus but there are not adequate studies in pregnant women.
Also no evidence of risk in later trimesters.

Front 20

Pregnancy category C

Back 20

Animal studies have shown an adverse effect on the fetus but there are no adequate studies in humans.
Benefits of using drug in pregnant women may be acceptable

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Pregnancy category D

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There is evidence of human fetal risk.
The potential benefits from use in pregnant women may be acceptable despite potential risks

Front 22

Pregnancy category X

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Fetal abnormalities or adverse reactions have been demonstrated
Risk clearly outweighs benefit

Front 23

1970 Controlled Substance Act

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Defined drug abuse and classified drugs as to their potential for abuse.
Controlled distribution, storage and use of controlled drugs

Front 24

1983 Orphan Drug Act

Back 24

Provided incentives for the development or orphan drugs for the treatment of rare disease

Front 25

DEA Schedule I

Back 25

High abuse potential and no accepted medical use (heroin, marijuana, LSD)
Never Rx'ed

Front 26

DEA Schedule II

Back 26

High abuse potential eith severe dependence liability (narcotics, amphetamines, barbiturates)
Written Rx only c no refills

Front 27

DEA Schedule III

Back 27

Less abuse potential than Sch II drugs and moderate dependence liability (nonbarbiturate sedatives, nonamphetamine stimulants, certain narcotics in limited amounts.
Written or oral Rx

Front 28

DEA Schedule IV

Back 28

Less abuse potential than Sch III drugs and limited dependence liability (some sedatives, anxiety agents, and non-narcotic analgesics
Written or oral Rx

Front 29

DEA Schedule V

Back 29

Limited abuse potential. Primarilly skmall amounts of narcotics (codine) used as antitussives or antidiarrheals.
Limited amounts may be purchased without an Rx at +18 years

Front 30

Drug names follow this ordered convention

Back 30

Chemical name
Generic name
Trade name

Front 31

Although generic drugs have the same chemical makeup as trade name drugs, other qualities may make them differ in:

Back 31

Pharmacokenetics and
Bioavailability

Front 32

Drugs are chemicals that are introduced into the body to

Back 32

Bring about some sort of change

Front 33

Drugs can come from many sources incluing

Back 33

Plants, animals, inorganic elements, synthetic preparations

Front 34

The FDA regulates the development and marketing of drugs to ensure

Back 34

Safety and Efficacy

Front 35

Preclinical trials involve testing of potential drugs on laboratory animals to determine

Back 35

Therapeutic and adverse effects

Front 36

Phase I studies test potential drugs on

Back 36

Healthy human subjects

Front 37

Phase II studies test potential drugs on patients

Back 37

who have the disease the drug is designed to treat

Front 38

Phase III studies test drugs in the clinical setting to determine

Back 38

Any unanticipated effects or lack of effectiveness

Front 39

FDA pregnancy categories indicate

Back 39

The potential or actual teratogenic effects of a drug

Front 40

DEA controlled substance categories indicate

Back 40

The abuse potential and associated regulation of a drug

Front 41

Generic drugs are sold under their

Back 41

Chemical names, not brand names

Front 42

Orphan drugs

Back 42

Are chemicals that have been discovered to have some therapeuticeffect but are not financially advantageous to develop into drugs.

Front 43

OTC drugs

Back 43

Are available without Rx for the self-treatment of various complaints

Front 44

OTC drugs qualities

Back 44

Are considered very safe and useful when taken as prescribed
May previously have been Rx meds

Front 45

OTC concerns

Back 45

OTC can mask the signs and symptoms of an underlying disease
Mixing OTC and Rx can result in drug interaction
Mixing OTC and Rx can result in an overdose

Front 46

Chapter 2

Back 46

Drugs and the Body

Front 47

Pharmacodynamics

Back 47

The science dealing with interactions between the chemical components of living organisms and foreign chemicals

Front 48

Drug Actions
Drugs usually work in one of four ways

Back 48

Replace or act as substitutes for missing chemicals
Increase or stimulate certain cellular activities
Depress or slow cellular activities
Interfere with the functioning of foreigh cells (chemotherapeutic agents)

Front 49

Receptor site interactions

Back 49

Drugs act on certain areas of the cell to cause a specific effect within the cell.

Front 50

Receptor site interactions

Back 50

The better the fit between the receptor site and the chemical, the more pronounced the reaction

Front 51

Receptor site interactions

Back 51

Enzymes within the body break down the chemicals to open up the receptor site

Front 52

Drug-receptor interation types

Back 52

Agonist
Partial agonist
Antagonist
Competitive atagonist
Noncompetitive antagonist

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Antagonist

Back 53

Drug binds to the receptor and there is a response

Front 54

Partial agonist

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Drug binds to receptor, and there is a diminished response compared to that of the agonist

Front 55

Antagonist

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Drug binds to the receptor, but there is no response. Drug prevents binding of the agonists

Front 56

Competative agonist

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Drug competes with the agonist for binding to receptor. If it binds, there is no response

Front 57

Noncompetitive antagonist

Back 57

Drug combines with different parts of receptor and inactivates it, so the agonist has no effect

Front 58

Noncompetitive antaginist is harder to reverse because

Back 58

it binds to cell sites better

Front 59

Drug-enzyme interactions

Back 59

Durgs which cause their effects by interfering with the enzyme systems that act as catalysts for various chemical reactions.

Front 60

Selective toxicity

Back 60

The ability of a drug to attack only those systems found in foreigh cells

Front 61

Pharmacokinetics is

Back 61

The study of what the body does to the drug

Front 62

Pharmacokinetics includes

Back 62

Absorption
Distribution
Metabolism (biotransformation)
Excretion

Front 63

Bioavailability

Back 63

The amount, or fraction of d, that reaches circulation in an unmetabolized form

Front 64

Absorption

Back 64

Passage of a drug from the site of administration into the bloodstream

Front 65

Factors affecting absorption

Back 65

Administration route
Foods or fluids administered with drug
Dosage formulation
Status of the absorptive surface
Rate of blood flow to the administration surface (sm. intestine)
Acidity of the stomach
Status of GI motility

Front 66

Absorption routes

Back 66

Route affects rate and extent
Enteral (GI) safest and least $$
Parenteral (IV, IM, Sub Q)
Topical

Front 67

Enteral route of absorption

Back 67

Drug is absorbed into the systemic circulation through the oral or gastric mucosa, small intestine, or rectum
Oral, sublingua, buccal, rectal

Front 68

Parenteral Route of absorption

Back 68

Intravenous (IV) fastest delivery
Intramuscular (IM)
Subcutaneous (Sub Q)
Intradermal (ID)

Front 69

Topical route of absorption

Back 69

Skin (Includes transdermal patches)
Eyes
Ears
Nose
Lungs (Inhalation)
Vagina

Front 70

Protein binding affects drug release and duration

Back 70

due to the strengy by which the durg is bound to the proteins in the blood. Tightly bound drugs are released very slowly and have a long duration. Loosely bound drugs act and are excreted quickly. Some drugs compete for binding and can inhibit effectiveness or cause toxicity

Front 71

Drugs with high lipid solubility more easilly pass through the

Back 71

Blood-brain barrier

Front 72

Drug cautions for pregnant or lactating women

Back 72

Many drugs easilly cross the placenta or are excreted in breast milk

Front 73

Metabilism or Biotransformation is

Back 73

The biological transformation of a drug into:
Inactive metabolites
More soluble compounds
More potent metabolites

Front 74

Metabilism or Biotransformation occurs at

Back 74

Liver (mainly)
Kidneys
Lungs
Plasma
Intestinal Mucosa

Front 75

First-Pass Effect

Back 75

Orally administered drugs are absorbed from the small intestine directly into the portal venous system and a large % is metabolized by the liver. Effectiveness is decreased by enzymes of the cytochrome P450 system.

Front 76

First-Pass Effect:
Oral
vs
Parenteral administration

Back 76

The recommended dose for oral drugs can be considerably higher than the recommended dose for parenteral drugs due to first pass cleansing by liver

Front 77

Distribution

Back 77

The movement of a drug by the bloodstream to the body's tissues (after first-pass effect)

Front 78

Factors affecting distribution

Back 78

Lipid solubility (blood-brain barrier)
Protein-binding ability
Blood-brain barrier
Areas of rapid distribution
Areas of slow distribution
(Perfusion of the reactive tissue)

Front 79

Factors that decrease metabolism

Back 79

Cardiovascular dysfunction
Renal Insufficiency
Starvation/Low albumin levels

Front 80

Factors that increase metabolism

Back 80

Fast acetylator
Barbituates
Rifampin therapy

Front 81

Delayed drug metabolism results in

Back 81

Accumulation of drugs
Prolonged action of drugs

Front 82

Stimulating drug metabolism results in

Back 82

Diminished pharmacologic effects

Front 83

Excretion is

Back 83

The elemination of drugs from the body

Front 84

Excretion is carried out by these organs

Back 84

Kidneys (main organ)
Liver
Bowel

Front 85

Dynamic Equilibrium/Steady State

Back 85

The actual amount of a drug that reaches the body
Is a balance of
Absorption
Distribution
Biotransformation
Excretion

Front 86

Half-Life of Drugs

Back 86

The time it takes for 1/2 of the original amount of the drug to be removed from the body

Front 87

Critical Concentration of a drug

Back 87

The amount of a drug that is needed to cause a therapeutic effect

Front 88

Loading Dose of a drug

Back 88

A higher than usual initial dose designed to reach critical concentration more quickly

Front 89

In monitoring for the effectiveness of a drug therapy:

Back 89

Know the intended therapeutic action
Unintended, but potential side effects

Front 90

Factors affecting the body's response to a drug

Back 90

Weight
Age
Gender
Physiological factors-diurnal rhythm, electrolyte & acid-base balance
Pathological factors-disease, dysfunctions, disorders, BP
Genetics
Immunologics-alerties to drugs
Psychological
Environmental
Drug tolerance
Cumulation-drug buildup to toxicity

Front 91

Peak drug level

Back 91

Time the drug is at the highest active level
-usually 1/2 to 1 hour after giving

Front 92

Trough level

Back 92

Time the drug is at the lowest active level
-Usually 1/2 hour before next dose

Front 93

Reason for therapeutic drug monitoring

Back 93

To monitor for toxicity
To maintain therapeutic range

Front 94

Therapeutic index

Back 94

The ratio between a drug's therapeutic benefits and its toxic effects

Front 95

Tolerance

Back 95

A decreasing response to repetitive drug doses

Front 96

Dependence

Back 96

Physiological or psychological need for a drug
-Addiction

Front 97

Drug interactions

Back 97

The alteration of the action of a drug by:
-Other prescribed drugs
-Over-the-counter drugs
-Herbal therapies

Front 98

Geriatric considerations to drugs

Back 98

Cardiovascular
Gastrointestinal
Hepatic
Renal

Front 99

Cardiovascular

Back 99

- Cardiac output = - absorption and - distribution
- Blood flow = - absorption and distribution

Front 100

Gastrointestinal

Back 100

+ pH
- Peristalsis = delayed gastric emptying

Front 101

Hepatic

Back 101

- Enzyme production = - metabolism
- Blood flow = - metabolism

Front 102

Renal

Back 102

- Blood flow = - excretion
- Function = - excretion
- Glomerular filtration rate = - excretion