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165 Cards in this Set
- Front
- Back
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established official standards and requirements for accurate labeling of drug products
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Pure Food and Drug Act (1906)
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restricted the importation, manufacture, sale, and use of opium, cocaine, marijuana, and other drugs that the act defined as narcotics
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Harrison Narcotic Act (1914)
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Required proof of safety from the manufacturer before a new drug could be marketed
Authorized factory inspections Established penalties for fraudulent claims and misleading labels |
Food, Drug, and Cosmetic Act (1938)
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Regulated distribution of narcotics and other drugs of abuse
Categorized these drugs according to therapeutic usefulness and potential for abuse |
Comprehensive Drug Abuse Prevention and Control Act; Title II, Controlled Substances Act (1970)
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Established guidelines for research studies and data to be submitted to the FDA by manufacturers
Shortened the time required to develop and market new drugs |
Drug Regulation Reform Act (1978)
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What event led to the creation of the FDA?
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the Thalidomide crisis
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drugs that are not approved for medical use and have high abuse potentials
(heroin, LSD, marijuana, peyote, GHB) |
Schedule I
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drugs that are used medically and have high abuse potentials
(morphine, cocaine, methamphetamine) |
Schedule II
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Drugs with less potential for abuse...but abuse may lead to psychological or physical dependence
(androgens, anabolic steroids, codeine) |
Schedule III
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drugs with some potential for abuse
(benzodiazepines, sedative-hypnotics, appetite suppressants) |
Schedule IV
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Products containing moderate amounts of controlled substances
They may be dispensed by the pharmacist without a physician's prescription but with some restrictions regarding amount, record keeping, and other safeguards. (antidiarrheal drugs..Lomotil) |
Schedule V
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Why is cocaine used in the OR?
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for nasal surgery as a vasoconstricter
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What determines drug tolerance?
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your liver!
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recipients often report both therapeutic and adverse effects from "dummy medications" given to them in clinical drug trials
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placebo response
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occurs when the body becomes accustomed to a particular drug over time so that larger doses must be given to produce the same effects
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tolerance
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tolerance to pharmacologically-related drugs
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cross-tolerance
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any undesired responses to drug administration
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adverse effects
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desired responses to drug administration
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therapeutic effects
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adverse effects that occur with usual therapeutic doses of drugs
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side effects
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a fever associated with administration of a medication (through an allergic reaction, damaging body tissues, increasing body heat, or acting on the temperature-regulating center in the brain)
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drug fever
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an unexpected reaction to a drug that occurs the first time it is given
usually attributed to genetic characteristics that alter the person's drug-metabolizing enzymes |
idiosyncrasy
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may occur with mind-altering drugs (opioid analgesics, sedative-hypnotic agents, antianxiety agents, and CNS stimulants)
may be physiologic or psychologic |
drug dependence
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the ability of a substance to cause cancer
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carcinogenicity
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the ability of a substance to cause abnormal fetal development when taken by pregnant women
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teratogenicity
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drug that produces effects similar to those produced by naturally occurring hormones, neurotransmitters, and other substances
may accelerate or slow normal cellular processes, depending on the type of receptor activated |
agonist
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drug that inhibits cell function by occupying receptor sites; it prevents natural body substances or other drugs from occupying the receptor sites and activating cell functions
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antagonist
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occur when two drugs with similar pharmacologic actions are taken
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additive effects
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occurs when two drugs with different sites or mechanisms of action produce greater effects when taken together
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synergism or potentiation
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occurs when one drug messes with the metabolism or excretion of a second drug, resulting in intensified effects of the second drug
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interference
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occurs when one drug kicks out a second drug from its plasma protein-binding sites, increasing the effects of the second drug
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displacement
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type of drug that can be given to antagonize the toxic effects of another drug
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antidote
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Drugs act differently on different people. This is called:
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the Goldilocks effect
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the study of the interaction of chemicals with living organisms to produce biological effects
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pharmacology
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the strength of drug binding
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affinity
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the ability of a compound to stimulate the receptor to some action
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efficacy
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what the body does to the drug
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pharmacokinetics
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What are the 4 phases of pharmacokinetics?
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absorption
distribution metabolism excretion |
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What type of drug can cross the blood-brain barrier?
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lipiphilic
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the proportion of the administered drug that is actually available to produce systemic effects
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bioavailability
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used to estimate the body surface area of a child based on his height and weight
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nomogram
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How does the increased thinness and permeability of a child's skin affect pharmacokinetics?
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this causes an increased absorption of topical drugs
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How does the immature blood-brain barrier in neonates and infants affect pharmacokinetics?
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this causes an increased distribution of drugs into the CNS
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How does the increased percentage of body water in neonates and infants affect pharmacokinetics?
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this causes an increased volume of distribution
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How does altered protein binding in neonates and infants affect pharmacokinetics?
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this may lead to a greater proportion of unbound/active drug and greater risks of adverse drug effects (dosage requirements may be decreased or modified)
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How does decreased glomerular filtration rate in neonates and infants affect pharmacokinetics?
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This leads to slowed excretion of drugs eliminated by the kidneys
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How does decreased activity of liver drug-metabolizing enzyme systems in neonates and infants affect pharmacokinetics?
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this leads to slowed metabolism and elimination, with increased risks of drug accumulation and adverse effects
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How does increased activity of liver drug-metabolizing enzyme systems in children affect pharmacokinetics?
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this leads to a rapid rate of metabolism and elimination of some drugs
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What pregnancy drug category is: No risk demonstrated to fetus?
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category A
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What pregnancy drug category is: No adverse effects in animals and no human studies available?
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category B
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What pregnancy drug category is: Only given when absolutely needed. Animal stuies have shown adverse reactions. No human studies available?
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category C
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What pregnancy drug category is: Definite fetal risks. May still be given in life threatening conditions.
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category D
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What pregnancy drug category is: Absolute teratogen. Never used?
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category X
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How should you take oral medications, as a general rule?
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with 6-8 oz of water, in a sitting or standing position
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neurotransmitter system that uses acetylcholine as its neurotransmitter
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cholinergic system
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What is the main function of acetylcholine?
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memory
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What disease is dopamine associated with?
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schizophrenia
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What is the main function of GABA neurotransmitters?
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they are inhibitory
without these, you are VERY honest (little kids and old people) |
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Which neurotransmitter system uses norepinephrine as its neurotransmitter?
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noradrenergic system
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What is the main function of serotonin?
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it is the source of all joy
also associated with sleep |
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What is the brand name of morphine?
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MS Contin
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What is the pharmacological classification of morphine?
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opioid agonist
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What is the therapeutic classification of morphine?
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opioid analgesic
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What is the boxed warning associated with morphine?
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Make sure no one pushes the PCA button besides the patient.
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What schedule are opiates?
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schedule 2
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What do opiates inhibit the release of?
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substance P
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What is the #1 side effect of morphine?
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constipation
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What is the life-threatening effect associated with morphine?
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respiratory depression
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opiate that is 100 times more potent than morphine and is usually only given by advanced practice nurses
is sometimes put in lollipops to give to children in the hospital |
Fentanyl (Sublimaze)
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What is the brand name of Methadone?
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Methadose
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What is the pharmacological classification of Methadone?
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opioid agonist
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What is the therapeutic classification of Methadone?
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opioid analgesic
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a substitute drug to use when you're trying to withdraw from morphine
it is less potent and doesn't give the same euphoria |
Methadone/Methadose
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What is the brand name of Naloxone?
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Narcan
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What is the pharmacological classification of Naloxone/Narcan?
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opioid antagonist
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What is the therapeutic classification of Naloxone/Narcan?
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antidote (reversal agent)
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drug given to reverse a morphine overdose
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Naloxone/Narcan
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What is the problem associated with Naloxone/Narcan?
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its half-life is shorter than that of morphine so it is excreted faster
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What is the brand name of Meperidine?
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Demerol
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What is the pharmacological classification of Meperidine/Demerol?
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opioid agonist
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drug used in people who are allergic to morphine
it is also given to people when they are shivering |
Meperidine/Demerol
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What is the adverse effect associated with Meperidine/Demerol?
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it can cause seizures, especially in people with renal failure
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What is the brand name of Nalbuphine?
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Nubain
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What is the pharmacological classification of Nalbuphine/Nubain?
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opioid agonist/antagonist
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opioid drug used with OB b/c it doesn't cause as much respiratory depression in the neonate
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Nalbuphine/Nubain
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What is the brand name of Capsaicin?
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Zostrix
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herbal product derived from cayenne peppers
it works topically through the skin and blocks the release of substance P |
Capsaicin/Zostrix
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What is Capsaicin/Zostrix typically used for?
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local arthritis (hands)
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What is one of the best drugs to relieve pain in cancer patients?
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Fentanyl given through a skin patch
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Never take more than _____ mg of aspirin a day.
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4000 mg
(more than this will damage the kidneys) |
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The normal dosage of aspirin for mild pain, fever, or inflammation is:
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650 mg every 4 hours
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With arthritis, you can take up to _____g of aspirin a day. However, you must check the patient's __________ first.
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6 grams
creatinine level |
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Low doses of aspirin are used to prevent synthesis of ____________, a prostaglandin in the platelets.
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thromboxane A
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The lifespan of a platelet is:
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7-10 days
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What are the side effects of aspirin?
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nausea
GI bleeding anticoagulation bleeding increased uric acid allergic reaction |
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Who should NOT be given aspirin?
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People with:
GI disorders aspirin-sensitive asthma renal disease kidney stones children |
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Virus + childhood + aspirin =
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Reye's syndrome
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The only children who are given aspirin those with:
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rheumatoid arthritis
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What pregnancy category is aspirin?
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category D (do NOT take during pregnancy!)
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What is the #1 symptom of early toxicity or intolerance to aspirin?
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tinnitus
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What is the brand name of aspirin?
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ASA
Bufferin |
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What is the pharmacological classification of aspirin?
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salicylate
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What is the therapeutic classification of aspirin?
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antipyretic
non-opioid analgesic NSAID |
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What is the brand name of Acetaminophen?
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Tylenol
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What is the therapeutic classification of Acetaminophen?
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antipyretic
non-opioid analgesic NSAID |
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What is the difference between aspirin and tylenol?
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Tylenol has no anti-inflammatory or antiplatelet activity and does not cause GI upset
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What is the drug of choice for fever in children?
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acetaminophen
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An overdose of Tylenol can cause:
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liver damage
(Never give Tylenol to someone with liver failure) |
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Never take more than _______ mg of Tylenol a day.
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4000 mg
(8 extra strength tablets) |
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Tylenol must be dosed by:
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a nomogram
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What is the antidote for Tylenol?
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Acetylcysteine (Mucomyst)
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What is the brand name of Sumatriptan?
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Imitrex
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What is the therapeutic classification of Sumatriptan/Imitrex?
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vascular
headache suppressants |
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drug that is given to treat migraines (by causing vasoconstriction)
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Sumatriptan/Imitrex
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What is the high risk/high alert that is associated with Sumatriptan/Imitrex?
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When given with an antidepressant (SSRI), Imitrex can cause serotonin syndrome, when your blood pressure and cardiovascular numbers go up so high that you get very tremulous.
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What should you check before giving Sumatriptan/Imitrex?
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blood pressure
history of MI or chest pain make sure not on BCP or too much caffeine |
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What is the herbal medicine used to treat migraines?
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Feverfew
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Do not take Feverfew at the same time you are taking:
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Sumatriptan/Imitrex b/c it will cause too much vasoconstriction
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Having gout is a risk factor for developing ___________.
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heart disease
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The two drugs that treat gout are:
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Allopurinal/Zyloprim
Colchicine |
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What is the brand name of Allopurinal?
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Zyloprim
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What is the therapeutic classification of Allopurinal/Zyloprim?
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anti-gout
anti-hyperuricemia |
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What is the therapeutic classification of Colchicine?
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anti-gout
anti-hyperuricemia |
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drug used to treat acute gout and to prevent renal failure in chemo patients
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Colchicine
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drug used to treat chronic gout and to prevent renal failure in chemo patients
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Allopurinal/Zyloprim
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What is the high risk/high alert associated with Colchicine?
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It can be fatal, and the cumulative dose should not exceed 4 mg.
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What is the brand name of Chrondronitin?
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Joint Health
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What is the therapeutic classification of Chrondronitin/Joint Health?
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NSAID
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an herbal supplement that is used to help joint pain. It has been shown to diminish the loss of cartilage in people with osteoarthritis.
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Chrondronitin/Joint Health
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What is the brand name of Ketorolac?
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Toradol
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What is the therapeutic classification of Ketorolac/Toradol?
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non-opioid analgesics
NSAID |
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the only injectible NSAID. It is used a lot in orthopedics because it is a good reliever of bone pain.
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Ketorolac/Toradol
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What should you check before giving Ketorolac/Toradol?
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creatinine (b/c it is excreted renally)
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drug used when you can't use a triptan for a migraine (used for refractory migraines); highly potent
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DHE 45
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When are anti-anxiety drugs appropriate?
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overwhelming situations that you can't control
when we need to induce amnesia (surgery) to promote sleep |
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What is the brand name of diazepam?
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Valium
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What is the pharmacological classification of Diazepam/Valium?
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benzodiazepine
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What is the therapeutic classification of Diazepam/Valium?
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anti-anxiety
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The only FDA approved uses for benzodiazepines are:
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overwhelming phobias
seizures |
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What is the brand name of Flumazenil?
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Romazicon
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What is the pharmacological classification of Flumazenil/Romazicon?
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benzodiazepine antagonist
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drug given to reverse a benzo overdose
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Flumazenil/Romazicon
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What is the problem with Flumazenil/Romazicon?
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it has a short half-life so it may be excreted faster than the benzo
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anti-anxiety drug used a lot in people with post-traumatic stress disorder
it is a favorite of psychiatrists CAN be used long term |
Buspirone/BuSpar
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What is the brand name of Buspirone?
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BuSpar
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What is the side effect associated with Buspirone/BuSpar?
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increased libido
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herbal drug that some people think helps anxiety
causes horrible nightmares during anesthesia |
Kava
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hypnotic drug given for sleep
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Zolpidem/Ambien
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What is a side effect of Zolpidem/Ambien?
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unconcious eating (unexplained weight gain)
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NEVER mix Ambien with ___________.
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alcohol
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What is the brand name of Chloropromazine?
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Thorazine
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What is the pharmacological classification of Chloropromazine/Thorazine?
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phenothiazine
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What is the therapeutic classification of Chloropromazine/Thorazine?
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anti-psychotic
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What drug is associated with extrapyramidal symptoms (involuntary muscle movement and sensitivity to the sun)?
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Chlorpromazine (Thorazine)
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What is the prototype for the second generation “atypical” antipsychotic drugs?
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Clozapine (Clozaril)
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anti-psychotic drug that is used for acute episodes of schizophrenia
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Ziprasidone (Geodon)
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Who should NOT take Ziprasidone/Geodon?
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patient with a prolonged QT interval (drug will cause ventricular tachycardia)
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Depression meds work by raising your ___________ or ___________.
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norepinephrine
serotonin |
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Before putting someone on an antidepressant med, check their ____________.
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thyroid (to rule out a thyroid disorder)
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TCA antidepressant that raises norepinephrine levels
used for chronic pain (raises your threshold to it) |
Imipramine (Tofranil)
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SSRI anti-depressant that decreases how much serotonin you break down
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Fluoxetine (Prozac)
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What is the black box warning associated with Fluoxetine (Prozac)?
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Administration to adolescents has been associated with a greater incidence of completed suicide.
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What are the 4 signs of depression?
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Change in mood, early morning awakening, change in appetite, and loss of interest in sex
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mood-stabilizing (antimanic) drug used to treat people with bipolar disorder
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Lithium carbonate (Lithobid)
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What 2 herbal drugs are used to treat depression?
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St. John's wort
selenium |
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antidepressant that is only used when the risk of the patient dying from suicide is so great that you are willing for monitor for all of the side effects of it
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Phenelzine (Nardil)
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