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126 Cards in this Set

  • Front
  • Back
DRUG
A chemical substance that affects the processes of living systems. Any substance with a pharmacological action used to treat or prevent a disease or condition.
DRUG USES
Treatment modalities, recreation, religious.
Can be legal, illegal, prescription, OTC, herbal, homeopathic, alcohol, tobacco, caffeine
DRUG CATEGORIES
By clinical indication (anticoagulant) or by body system (bronchodilator)
ANTICOAGULANT
Primarily prophylactic. Prevent fibrin deposits, extension of a thrombus and thromboembolic complications. 2 main groups - Parenteral (e.g. Herapin) and oral (Warfarin)
PROPHYLACTIC
Something that prevents or protects.
FIBRIN
The insoluble protein formed from fibrinogen by the enzymatic action of thrombin during the process of blood clot formation.
PARENTERAL
Entering the body not by the alimentary tract but rather by another means (such as the subcutaneous, the intramuscular, or often the intravenous route).
ANTI-INFECTIVE AGENTS
Antibiotics or anti-virals
ANTIHYPERTENSIVES
Reducing or controlling high blood pressure.
ANTIDYSRHYTHMICS
An agent that prevents or alleviates cardiac arrhythmia.
ARRHYTHMIA
An abnormal heart rhythm. In an arrhythmia the heartbeats may be too slow, too rapid, too irregular.
BETA BLOCKERS
A class of drugs that block beta-adrenergic substances such as adrenaline (epinephrine) in the "sympathetic" portion of the autonomic (involuntary) nervous system.
CYTOTOXICS
Drugs that are toxic to cells and act by inhibiting the synthesis of macromolecules.
DMARDS
Disease Modifying Anti Rheumatic Drugs
DIURETICS
Anything that promotes the formation of urine by the kidney.
HYPOLIPIDAEMIC
Pomoting the reduction of lipid concentrations in the serum.
IMMUNOSUPPRESSANTS
Agents that lower or reduce immune response; useful in organ transplant surgery to prevent organ rejection.
SOURCES OF DRUGS
Plants (foxglove, belladonna)
Animals/Humans (adrenaline, insulin)
Synthetic - made in a labaratory
Biotechnology - genetic manipulation
PHARMACEUTICAL
Comes from the greek 'to poison'. What matters is the DOSE. There is always the potential to cause harm.
DRUG THERAPY
Acute therapy - for critically ill patients.
Maintenance - prevents progression of the disease.
Supplemenatl - assists to maintain normal function.
Palliative - iam to make confortable in final stages.
Supportive - maintain integrity of body when recovering (i.e. surgery).
Pophylactic -AB's, contraception
GOAL OF THERAPY
To achieve therapeutic outcomes without injury to the patient.
NURSE'S DRUG RESPONSIBILITY
Safe, therapeutic and effective drug treatment: administer medications safely, efficently and observe patient for both desirable and undesirable effects.
PHARMACOLOGY
The study of the preparation, properties, uses and actions of drugs at their receptor sites.
PHARMACODYNAMICS
Is the study of the action of a drug in the body over a period of time, including the processes of absorption, distribution, localization in the tissues, biotransformation, and excretion.
PHARMACOKINETICS
What the body does to the drug.
PHARMACOTHERAPEUTICS
Of or relating to pharmacotherapeutics or pharmacotherapy' (the treatment of disease through the administration of drugs)
PHARMACOGNOSY
The branch of pharmacology that deals with drugs in their crude or natural state and with medicinal herbs or other plants.
TOXICOLOGY
The study of the nature, effects and detection of poisons and the treatment of poisoning.
DRUG INFORMATION SOURCES
- Pharmacist
- MIMS
- Nursing drug references
- Pharmacopoeia
- Product guide from maker
- journals, textbooks
DRUG LEGISLATION
Controls:
manufacture
sale
distribution
labelling and storage
administration

To protect people from harm due to inappropriate access to, or use, of drugs.
THERAPEUTIC GOODS ACT 1989
prducts used in the prevention, diagnosis, cure or alleviation of disease, defect or injury in people or animals.
MUST approve the product before release on to the market.
IS BLOOD A THERAPEUTIC GOOD?
Yes!
NARCOTIC DRUGS ACT 1967 (COMMONWEALTH)
Aims to control illegal manufacture, supply and use of narcotic drugs.
Licenced manufacturer.
Allows for criminal prosecution.
NARCOTIC
An agent that causes insensibility or stupor; usually refers to opioids given to relieve pain.
An addictive drug, such as opium, that reduces pain, alters mood and behavior, and usually induces sleep or stupor.
DRUGS, POISONS & CONTROLLED SUBSTANCES ACT 1981 (VICTORIA)
- Designates drugs into categories
- regulates the issue of licences
- dictates restruictions and conditions (including documentation on registers)
- reglates authority to prescribe
- covers labelling, advertising, manufacture, packing, storage, supply admin
SCHEDULES
Depending on:
potency
toxicity
therapeutic use
modes of action
safety
potential for addiction or abusr
other ingredients present
need for drug to be readily available
SCHEDULE 2
S2 Poison - medicinal poisons

i.e. Panadol
SCHEDULE 3
S3 Poison - potent substances

i.e. Anti-histamines
SCHEDULE 4
S4 Poison - restricted substances

i.e. anti biotics
SCHEDULE 8
S8 Poison - drugs of addiction

i.e. narcotics
SCHEDULE 11
S11 S4 Poison - potential for abuse

i.e. morphine
PRESCRIPTION DRUGS
S4 and S8 labelled drugs
Medication must be ordered by an authorised health care practioner, vet, dentist
PRESCRIPTION
Must be:
written in ink on a printed form
signed by the prescriber in their own handwriting
legible
ORPAHN DRUGS (S100)
Highly specialised
Used to treat, prevent, diagnose rare diseases
Less than 2000 can be affected by disease
costs involved arte usually prohibitive
Define TRADE name.
When a drug company markets a particular drug product, it selects and copyrights a PROPRITARY or TRADE name. It only applies to the individual drug company and their formulation of the drug.
Define GENERIC name.
The approved name is usually assigned by the manufacturer with the approval of the drug regulating authority. It becomes the official name. It is usually a shorter name derived from the chemical name.
Define CHEMICAL name.
A precise description of the drug's chemical composition and molecular structure. It is particularly meaningful to medicinal chemists.
List drug information sources for CONSUMERS.
Drug and poisons information centre, medical practioners, pharmacists, drug leaflets and the internet.
List drug information sources for HEALTH PROFESSIONALS.
Pharmacopoeias, formularies, text books, reference books (i.e. MIMS), drug and poison information centre, drug leaflets.
PHARMACOPOEIA
Official source of drug information published by governments or government bodies. Contains all legally available drugs, descriptions, formulae, strengths, standards of purity and dosage forms.
FORMULARY
Similar to a Pharmacopoeia but they also contain drug actions, adverse effects, general medical guidelines for pharmacists dispensing medicines and the 'recipes' for production such as tablets, injections, oitments and eye drops.
What is the role of FEDERAL legislation regarding drugs?
Quality, safety and efficacy (effectiveness) but not directions for prescription and administration.
Takes precedence over state law if a conflict exists.

e.g. Therapeutic Goods Act (Commonwealth 1989)
e.g. Narcotic drugs ACT 1967
What is the role of STATE legislation regarding drugs?
Provides more specific details for regulation such as diections for prescription and administration.
e.g. Drugs, poisons and controlled substances regulations (Vic) 1995
Can the schedule of a drug change?
Yes depending on the dose.

e.g. Nystatin oral, topical, vaginal. S2 or S3: 100,000 IU; oral, vaginal or cutaneous candidiasis or S4 combination ointment with other antibiotics
Explain drug ABSORPTION.
The prcoess by which unchanged drug proceeds from the site of administration into the blood. For absorption to occur it is necessary for the drug to cross a membrane and enter the blood vessels on the other side. The membrane is usually a lipid bylayer with dispersed protein molecules through it. The proteins can act as carriers, enzymes, receptors or antigenic sites.
Explain drug DISTRIBUTION.
After a drug reaches the sytemic circulation it can be distributedto various sites within the body. Distribution is defined a sthe process of reversible transfer of a drug between one location and another (one of which is usually blood). Most of the drug is distributed to organs with a high blood supply (heart, liver, kidneys) and then more slowly to organs such as skeletal muscle and fat.
Explain drug BIOTRANSFORMATION.
Also called drug metabolism. The process of chemical modification of a drug and is almosty always carried out by an enzymes. 70% of drugs undergo metabolism to some extent and in some cases the products of metabolism have less biological activity than the parent drug. Metabolism usually results in the formation of a more water-soluble compound or metabolite which can then be excreted. The liver is the primary site for metabolism.
Explain drug ELIMINATION.
A drug continues to exert a pharmacological effect (sometimes a toxicological effect) in the body until it is eliminated. Elimination is the irreversible loss of the drug from the body by the process of metabolism and excretion.
What factors effect drug metabolism?
- genetics
- age
- disease states
-environmental factors (diet, other drugs)
What factors effcet drug distribution in the body?
- permeability of xapillaries
- cardiovascular function
- lipid solubility or insolubility of the drug
What factors effcet drug distribution in the body?
- permeability of xapillaries
- cardiovascular function
- lipid solubility or insolubility of the drug
Tablet formula?
STOCK REQUIRED
--------------
STOCK STRENGTH

= NUMBER OF TABLETS
Injections or mixtures formula?
stock required volume
-------------- X -------
stock strength 1

= volume required
IV Drip Rate for standard giving set
volume (ml) drop factor
----------- X -----------
time (hrs) 60

= drops per minute
Intermittent standard IV rate ie. Burettes
volume (ml) drop factor
----------- X -----------
time (mins) 1

= drops per minute
IV pump rates?
volume (ml)
-----------
time (hrs)

= ml per hour
IV pump - Burettes
volume 60
------- X ---------
time (mins) 1

= ml per hour
Paediatric Doses?
mg/kg/day
What is HEPATIC FIRST PASS?
When a drug is carried to the liver via the Hepatic Portal system.
What is a HIGH HEPATIC FIRST PASS EFFECT?
When the drug is processed and metabolised before it reaches the the target site and therefore has little or no effect. eg. Glyceryl Nitrate (Anginine) when administered orally.
What is the PEAK OF ACTION of a drug?
The amount of medication in the blood that represents the highest level during administration cycle.
What a drug's THERAPEUTIC RANGE?
Range of blood concentration considered therapeutic for any drug - (between toxic and sub-therapeutic).
What is PLASMA HALF LEFE?
Time interval taken for a drug level in the body to become half that of the initial dose as a result of metabolism and excretion processes.
Give an example of a drug with a long half life.
FLUOXETINE - half life is 48 hours. Takes about 2 weeks for the drug to become therapeutic.
Give an example of a drug with a short half life.
Paracetamol - hlaf life of 1 to 3.5 hours.
Define ADVERSE DRUD REACTION.
A response to a drug which is noxious and unintended, and which occurs at doses normally used or tested in man for the prophylaxis, diagnosis, or therapy of diseasae, or for the modification of physiological function.
Outline 6 factors which may contribite to ADSVERSE DRUG REACTIONS.
Age (elderly or neonates)
Gender (women more han men)
Dose
Polypharmacy (increases risk)
History
genetic factors
Describe factors that influence medication in paediatrics.
Slowed peristalsis and gastric emptying can lead to a greater degree of drug absorbency. The activity and concentration of digestive secretions is lower and low levels of bile may lead to impaired absorption of fat-soluble drugs. Gastric acid secretion can be erratic and may result in reduced bioavailability. Poor peripheral tissue perfusion and reduced skeletal muscle mass can influence the rate of drug absorption from an injection site. Neonates have thin skin so topical drug absorption is enhanced.
Describe factors that influence medication in the elderly.
As for paediatrics but also as a body ages the amount of fat increases and can have an impact on the bahvaiour of drugs.
Describe factors that influence medication during pregnancy.
Peristalsis and gastric emptying may be slowed, increasing the amount of drug that may be absorbed. Gastric secretion can be erratic. Expanded plasma volume during pregnancy can change the way some drugs are distributed. Most drugs can cross the placental barrier and effect the fetus. generally drugs should be withheld during preganancy.
Describe factors that influence medication during lactation.
Most drugs can pass from the mother to the baby during lactation. As a general rule, small lipophilic molecules that are positively charged (cations) and have poor plasma protein binding are more likely to be deposited into and accumulate in breast milk.
How are drugs categorised for use in pregnancy?
In Australia and NZ drugs are categorised from no evidence of increased TERATOGENICITY to demonstrable TERATOGENICITY.
What is TERATOGENICITY?
Agents that cause morphological defects in the developing human in utero.
What ia a category 'A' drug in relation to pregnancy?
Drugs taken by a large number of women during pregnancy and by women of child bearing age which have no proven increase in occurences of fetal damage or no other hamful effects on the fetus.
What ia a category 'B' drug in relation to pregnancy?
Drugs taken by a limited number of pregant or of childbearing age women. No proven increase of fetal damage or other hramful effects on the fetus (includes 3 sub categories based on animal testing).
What ia a category 'C' drug in relation to pregnancy?
Drugs that have caused or are suspected of causing fetal harm without causing malformation. Harmful effects may be reversible.
What ia a category 'D' drug in relation to pregnancy?
Drugs that have caused or are suspected of causing higher occurences of fetal malformation or irreversible damage.
What ia a category 'X' drug in relation to pregnancy?
Drugs with a high risk of causing irreversible damage. They should not be used in pregnancy or when there is a possibility of pregnancy.
What is POLYPHARMACY?
- use of meds with no apparent indication
- use of duplicate meds
- concurrent use of interacting meds
- use of contraindicated meds
- use of inappropriate meds
- use of drug therapy to treat ADRs
- improvement following discontinuation of meds
What is the QUALITY USE OF MEDICINES?
Australia has a policy at the Commonwealth level - to ensure the availability of essential, affordable drugs of acceptable quality, safety and efficacy. It aims to meet the medication needs of patients so that optimal health outcomes and economic objectives are achieved.
What is the role of the PBS?
Provides reliable, timely and affordable access to a wide range of medicines for all Australians.
What is BIOAVAILABILITY?
It describes the amount of a drug that is svailable to the body to produce a therapeutic effect. It is detrermined by aborption and hepatic first pass. It is expressed as a percentage of the dose administered.
What is BIOEQUIVALENCE?
A drug is bioequivalent to another drug when they are absorbed and act in the same way following administration. It is important when considering different brand names of the same generic drug.
What does LIPOPHILIC mean?
Averse to interacting with lipids: water soluble.
What does HYDROPHOBIC mean?
Being averse to interacting with water; insoluble in water.
What is a DEPOT INJECTION?
An injection given, usuallt into a muscle, which releases the drug slowly into the circulation.
What is a SUSPENSION?
A preparation where a relatively insoluble drug is mixed with a liquid or gas; the solid drug particles are suspended in the liquid.
What is an EMULSION?
A preparation where a relatively insoluble drug in liquid form is mixed with a liquid or gas; the liquid drug particles are suspended in the liquid.
What is an ELIXER?
A pleasant tasting liquid medicine containing alcohol and/or glycerol and/or a sweet syrup to mask the taste of the active ingredient.
What are PESSARIES?
A pessary is a vaginal suppository.
What does ENTERIC mean?
A coating on a tablet that is insoluble in stomach acid. Tablets with such a coating should not be crushed. Tablets will be absorbed in the intestines rather than the stomach.
What is DIFFUSION?
The random movement of molecules from areas of high concentration to areas of low concentration. Most drugs are absorbed by diffusion.
What are ACIDIC DRUGS?
Acidic drugs will be best absorbed in the stocmach. e.g. Asprin. An acidic drug taken after a meal may have a therapeutic effect faster owing to gastric absorption. Acidic drugs are usually bound to albumin.
What are BASIC DRUGS?
Basic drugs are better absorbed in the small intestines. That absorption takes place mainly in the intestine can be a problem if the basic drug is taken for fast action and is given orally after a meal. It may take longer for the drug to reach an absoptive surface. Basic drugs are usually bound to globulin.
What is a PROTEIN BINDING DRUG?
Drugs that are transported in the blood attached to blood proteins. The binding is temporary. protein bound drugs will not leave the blood stream.
What si the BLOOD BRAIN BARRIER?
Part of the meningeal membranes and capillaries that prevent the entry of many poisons and drugs into the brain.
What is the TESTICULAR BARRIER?
protects spermatogenesis from some blood-borne chemicals.
What is OXIDATION?
Increasein the positive charge on an atom or molecule.
What is HYDROLYSIS?
The breakdown of a compaound by the addition od=f water.
What is CONJUGATION?
Literally joining together. A term used to describe the combination of a drug with an acid in drug metabolism.
What is a LOADING DOSE?
A priming dose that will produce therapeutic levels more quickly.
What is the nurse's role in drug therapy?
safe, therapeutic and effective drug treatment, administer medication safely, efficently and observe patient for both desirable and undesirable effects.
What is ACTIVE TRANSPORT?
The drug is pumped across the membrane, usually at a faster rate than by diffusion.
Where does drug metabolism occur?
Mainly in the liver and kidneys. Can be lungs, muscle tissue, GI tract lining and circulating blood.
What information is recorded on an ADR form?
patient and reporter info, drug, the reaction, treatment of the reaction, outcome of the reaction and treatment, all drugs involved inteh reaction, adtes of starting and stopping the drug, doses and reasons for the medication.
What are the 5 rights of medication administration?
right patient
right drug
right dose
right time
right route
What are some drugs which are known to have a reaction when taken with grapefruit.
warfrin, oestrogens, benzodiazepines
Which conditions require drug therapy even during pregnancy?
Hypertension, epilepsy, diabetes, infections
What is a SYMPATHOMIMETIC DRUG?
Drugs that mimic sympathetic stimulation.
What is a SYMPATHOLYTIC DRUG?
Drugs that block or imhibit sympathetic stimulation (an antagonist).
What is PARASPMPATHOLYTIC DRUG?
Relating to an agent that Annuls or antagonizes the effects of the parasympathetic nervous system; atropine
What is an OPIOID ANALGESIC?
An agent that mimics endogenous opioids by activating poioid receptors in the CNS and PNS to produce analgesia, respiratory depression, sedation and constipation.
What does NSAID stand for?
Non steroidal anti-inflammatory drug.
What are NSAIDS used for?
Inhibit the synthesis of prostaglandins. Theye are COX inhibitors. They act to relieve the symptoms of inflammation.
Identify some common NSAIDS.
Aspirin, indomethacin, naproxen, celecoxib...
PARACETAMOL
Is an analgesic agent, not a true NSAID. It has no significant anti-inflammatory or antiplatelet activity. It has an antipyretic effect. It is best taken on a empty stomach for fast action. It is the preferred analgesic for children.