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162 Cards in this Set

  • Front
  • Back

The movement of a substance through a cell membrane against the osmotic gradient; that is, from an area of lesser concentraion to an area of greater concetnration, opoosite to the normal direction of diffusion; requires the use of energy to move a substance.

Active Transport

Agent that enhances the effects of other medications

Adjunct medication

Pertaining to the neurotransmitter Norepinephrine

Adrenergic

Force of attraction between a medication and a receptor.

Affinity

Medication that binds to a receptor and causes it to initiate the expected response.

Agonist

Medication that binds to a receptor and stimulated some of it's effects but blocks others.

Agonist-Antagonist OR partial agonist

The absene of the sensation of pain.

Analgesia

Mediaction that relieves the sensation of pain.

Analgesic

The absence of all sensation.

Anesthesia

Medication that induces a loss of sensation to touch or pain.

Anesthetic

Alkalotic compound used to uncrease the gastric environment's pH.

Antacid

Medication that binds to a receptor but does not cause it to initiate the expected response.

Antagonist

Medication used to treat and prevent abnormal cardiac rhythms.

Antiarrhythmic

Agent that kills or decreases the growth of bacteria.

Antibiotic

Medication that inhibits blood clotting.

Anticoagulant

Medication used to prevent vomiting.

Antiemetic

Medication that arrests the effects of histamine by blocking its receptors.

Antihistamine
Medication used to treat high blood cholestertol.
Antihyperlipidemic
Medication used to treat high blood pressure
Antihypertensive
Medications used to treat cancer
Antineoplastic Agents
Medication that decreases the formation of platelet plugs
Antiplatelet
Medication that suppresses the stiumulus to cough within the central nervous system.
Antitussive
Test that determines the amount and purity of a given chemical in a preparation in a laboratory.
Assay
Group of autonomic nervous cells located outside the central nervous system.
Autonomic Ganglia
The part of the nervous system that controls involuntary actions.
Autonomic Nervous System
Test to ascertain a medication's availability in the biologic model.
Bioassay
Amount of medication that is still active after it reaches a target tissue.
Bioavailability
Relative therapeutic effectiveness of chemically equivalent medications.
Bioequivalence
Time the body takes to clear one-half of a medication.
Biologic half-life
Special name given to the metabolism of medications.
Biotransformation
Tight junctions of tje capollaru endothelial cells in the central-nervous system vasculature through which only non-protein bound, highly lipid-soluble medications can pass.
Blood Brain Barrier
Process in ehich carrier proteins trasnport large molecules acros the cell membrane.
Carrier-mediated Diffusion
Pertaining to the neurotransmitter acetylcholine.
Cholinergic
One medication binds to a receptor site and causes the expected effect, but it simultaneously blocks another medication from tiggering its own response on the same receptor.

Competitive antagonism
The process of balancing the number and type of solutes across a semi-permeable membrane.
Diffusion
An agent that increases urine secretion and elimination of body wate; medication used to reduce the amount do circulating blood volume by increasing urination.
Diruretic
Medication packages that contain a single dose for a single patient.
Dose Packaging
binding of a medication or hormone to a target cell receptor that causes the number of receptors to decrease.
Down-regulation
Foreign substances taken into the human body.
Drugs
Correlation fo different amounts of a medication to a clinical response.
Drug-response relationship
Length of time the amount of medication remains above its minimum effective concentration.
Duration of action
A medication's ability to cause the expected response.
Efficacy
Delivery of a medication through the GI tract.
Enteral Route
Medication inteded to increase the productivity of a cough.
Expectorant
Common side effects of anti-psychotic medications, includes muscle tremors and parkinsonism-like effects.
Extrapyramidal symptoms
Process in which carrier proteins transport large molecules across the cell membrane
Facilitated Diffusion
Medication which acts directly on a thrombi to break them down, also known as thromboltics.
Fibrinolytics
Movement of water water out of the plasma, across the capillary membrane into the interstitial space.
Filtration
The liver's partial or complete inactivation of a medication before ite reaches the systemic circulation.
First-pass effect
Proportion of a medication available in the body to cause either desired or undersired effects.
free drug availability
Substance that increases blood glucolse levels
Glucagon
The stoppage of bleeding.
Hemostasis
A substance released during the degranulation of mast cells (also released by basophils) that through constriction on and dilation of blood vessels, increases blood flow to the injury site and also increases the permeability of vessel walls.
Histamine
The breakage of a chemical bond by adding water, or by incorporoatina a hydrol (OH-) group into one fragment and a hydrogen ion (H+) into the other.
Hydrolize
Instigation of sleep.
Hypnosis
A long-term condition of protection from infection or disease; the body's anility to respond to the presence of a pathogen.
Immunity
A substance in the body (naturally or acquired via medication) that reduces blood sugar levels.
Insulin
To become eletrically charged or polar.
Ionize
A competetive antagonist that premanently binds with a receptor site.
Irreversible antagonism
Medication used to decrease the firmness of stool.
laxative
AKA SRS-A's... A substance released by mast cells during inflammatory response that causes vasodilation, vascular permeability, and chemotaxis.
leukotriene
Agents used in the diagnosis, treatment, or prevetion of disease.
medication
The total changes that take place during physiologic processes; the body's breaking down of chemicals into different chemicals,
metabolism
Minimum level of a medication needed to cause the desired or given effect,
minimum effective concentration
Medication intended to make mucous thinner.
mucolytic
Specialized synapse between a nerve and the organ or tissue it innervates.
neuroeffector junction
Anesthesia that combines decreased sensation of pain with anmanesia while the patient remains conscious.
neuroleptanesthesia
Anti-psychotic (literally affecting the nerves)
neuroleptic
Nerve cell; cell that transmits electrical impulses.
neuron
Chemial messenger that conducts a nervous impulse across a synapse.
neurotransmitter
The binding of an antagonist causes a deformity of the binding site that prevents an agonist from fitting and binding.
noncompetitive antagonism
The time from administration until a medication reaches its maximum effective concentration.
onset of action
Movement of a solvent in a solution from an area of lower concentration to an area of higher solute concentration.
osmosis
To combine with oxygen
oxidize
Medication or other substance that blocks or inhibits the action of the parasympathetic nervous system; also called anthicholinergic.
parasympatholytic
Medication or other substance that causes effects of those like the actions of the parasympathetic nervous system; also called cholinergic.
parasympatheomimetic
Delivery of medication outside of the GI tract, typically using a needle to inject into the vascular system or other tissues.
parenteral route
Movement of a substance iwhtout the use of energy
passive transport
A microorganism capable of producing infection or disease.
pathogen
How a medication interacts with the body to cause its effects.
pharmacodynamics
How a medication is absorbed. distributed, metabolized, and excreted; hoe medications are trasnported into and out of the body.
pharmacokinetics
The study of medications and their interactions with the human body.
pharmacology
biochemical barrier at the maternal/fetal interface that restricts certain molecules.
placental barrier
describes the lengths of onset, duration, and termination of action, as well as the medication's minimum effective concentration and toxic levels.
plasma-level profile
Nerve fibers that extend from the autonomic ganglia to the target tissues.

postganglionic nerves
Nerve fibers that extend from the central nervous system to the autonomic ganglia.
preganglionic nerves
Medication that is not active when administered, but whose biotransformation converts it into active metabolites.
prodrug OR parent drug
medication that best demonstrates the calss's common properties and illustrates its particular characteristsics.
prototype
Medication used to treat mental or psychological disfucntion.
psychotherapeutic medication
Specialized protein that combines with a medication resulting in a biochemical effect.
receptor
Chemical that participates in complex cascading reactions that eventually cause a medication's desired effect.
second messenger
State of decreased anxiety and inhibitions.
sedation
Solution containing whole antibodies for a specific pathogen.
serum
Unintended response to a medication.
side effect
Substance that decreases surface tension.
surfactant
Medication or substance that blocks the action of the sympathetic nervous system; also called antiadrenergic.
sympatholytic
Medication or substance that casues effects like those of the smpathetic nervous system; also called adrenergic.
sympathomimetic
Space between nerve cells.
synapse
Medication that may deform or kill a fetus.
teratogenic drug
Time from when the medication's level drops below its minimum effective concentraion until it is eliminated form the body.
termination of action
Ratio of a medication's lethal dose for 50% of the population to it's minimum effective dose for 0% of the population.
therapeutic index
When a medication causes the formation of more receptors than normal.
up-regulation
Solution containing a modified pathogen that does notactually cause disease but stil stimulates the development of antibiodies specific to it.
vaccine
Drug names

1) Chemical name


2) Generic name


3) Official name


4) Brand name (aka trade or proprietary name)
Sources of Drug information

1) United States Pharmacopeia (USP)


2) Physician's Desk Reference


3) Dug inserts


4) AMA Drug Eveluation
Drug laws and regulators

1) Federal Law


2) State Laws


3) Individual ageny regulations
Schedule I drugs

High abuse potential; may lead to severe dependence; no accepted medical indications; used for research, analysis, or instruction only.


examples: herion, LSD, mescaline
Schedule II drugs

High abuse potential; may lead to severe dependece; accepted medical use.


examples: opium, cocaine, morphine, codeine, oxycodone, methadone, secobarbital
Schedule III drugs

Moderate abuse potential; may lead to moderate to low physical dependence or high psychological dependence; accepted medical indications.


examples: limited opiod amount susbtances that are combined with non-controlled substances: Vicodin, Tylenol with codeine.
Schedule IV drugs

Low abuse potential; limited psychological and/or physical dependece; accepted medical indications.


examples: diazepam, lorazepam, phenobarbital

Schedule V drugs

Low to no abuse potential; may lead to limited physical or psychological dependence; acepted medical indications.


examples: limited amounts of minor opiods; often seen in OTC cough or diarrhea treatments.
Six rights of Medication Administration

1) Patient


2) Medication


3) Dose


4) Time


5) Route


6) Documentation
Special considerations when administering drugs

1) Pregnant or potentially pregnant (also breastfeeding)


2) Pediatric patients


3) Geriatric patients
FDA Pregnancy risk drugs: Category A
Adequate studies in pregnant women have not demonstrated a risk to the fetus in the first or later trimesters.
FDA Pregnancy risk drugs: Category B

Animal studies have not demonstrated a risk to the fetus, but there are no adequate studies in prengant women


OR


Adequate studies in pregnant women have not demonstrated a risk to the fetus, but animal studies have demonstrated adverse effects.
FDA Pregnancy risk drugs: Category C

No adeuate studies have been done in humans or animals


OR


Animal studies have demonstrated adverse effects, but there are no adequate studies in human females; risks to fetus are potentially outwieghed by expected benefit.
FDA Pregnancy risk drugs: Category D
Fetal risks have been demonstrated. Incertain cercumstances, benefits could outweigh the risks.
FDA Pregnancy risk drugs: Category X
Fetal risks have been demonstrated. The risk so greatly outweighs any possible use; use should be avoided for pregnant or potentially pregnant patients.
Pharmacokinetic processes

1) Absorption - entrance into blood stream


2) Distribution - passage from bloodstream back into interstitial spaces and target cells.


3) Biotransformation - body's use or metabolism of the drug


4) Elmination - removal of drug wastes/leftovers from body systems, usually via urine, some via feces or exhalation.
Drug routes: Enteral

1) Oral (PO) - swallowed, drug must be able to tolerate the acidic gastric conditions.


2) Orogsatric/Nasogastric Tube - inserted into stomach via tube, drug must be able to tolerate the acidic gastric conditions. Usually only used when the patient has the tube in place for other reasons.


3) Sublingual (SL) - sprayed or placed under tongue for dissolution and absorption via the capillary bed. decreases problems with gastric acidity.


4) Buccal - placed between cheek and gum, similar to SL.


5) Rectal (PR) - Usually reserved for uncoscious or vomiting patient, or patient who cannot cooperate with oral or IV administration.

Drug Routes: Parenteral (pt 1 of 2)

1) Intravenous (IV) - Rapid onset, preferred route in most emergencies.


2) Endotracheal (ET) - This is an alternative route for SELECTED medications in an emergency.


3) Intraosseous (IO) - the intraosseous route delivers drugs to the medullary spaces of bones. Most often used as an alternative to IV administration in pediatric emergencies, it is also used in adults.


4) Umbilical - Both the umbilical vein and artery can provide an alternative to IV administration in newborns.


5) Intramuscular (IM) - This route allows slower absorption than IV, as the drug passes into the capillaries.


6) Subcutaneous - This route is slower than the IM route, because the subcutaneous tissue is less vascular than the muscle tissue.

Drug Routes: Parenteral (pt 2 of 2)

7) Inhalation / Nebulized - This route, which offers very rapd, adsorption, is especially useful for delivering drugs whose target tissues are the lungs.


8) Topical - Delivers drug directly to the skin (usually creams or balms.)


9) Transdermal - For drugs that can be absorbed through the skin, this route allows slow, continuous release (usually on a patch or paper with cream application.)


10) Nasal - Useful for delivering drugs directly to the nasal mucosa the nasal route has an expanding role in delivering systemically acting drugs.


11) Instillation - This route places the drug directly into a wound, the eye, or the ear.


12) Intradermal - This route is primarily used for allergen testing; delivers a drug or biological agent between the dermal layers.

Drug Forms: Solids

1) Powders


2) Tablets - powders compressed into a disklike form.


3) Suppositories - Drugs mixed into a wax-like base that melts at body temperature, allowing absorption by rectal or vaginal tissue.


4) Capsules - gelatin containers filled with powders or tiny pills, the gelatin dissolves releasing the drug into the GI tract.

Drug Forms: Liquids

1) Solutions - The most common liquid preparations. Generally water or oil based.


2) Tinctures - Prepared using an alcohol extraction process; some alcohol usually remains in the final drug preparation.


3) Suspensions - preparations in which the solid does not dissolve ; if left alone the solid will precipitate out.


4) Emulsions - Suspensions with an oily substance in the solvent; even when well mixed, globules of oil will separate out of the solution.


5) Spirits - Solution of a volatile drug in alcohol.


6) Elixirs - Alcohol and water solvent, often with flavorings added to improve the taste.


7) Syrups - Sugar, water, and drug solutions.

Types of Drug Actions

1) Binding to a receptor site - can be done in three ways:


a) naturally occurring neurotransmitter binds to a receptor site and creates a physiological response.


b) Administered drug (agonist) binds to the receptor site and create a response.


c) Administered drug (antagonist) binds to the receptor site but causes no response. Purpose is to block receptor site and prevent agonists from binding to the receptor site.


2) Changing the physical properties of cells - usually by changing the osmotic balance of the cell membrane.


3) Drugs that act by chemically combining with other chemical - examples are antacids (chemically neutralize the acid in the stomach.)


4) Altering a normal metabolic pathway - typically seen in chemotherapy, they alter the substrates created by the cell while forming and prevent or disrupt cell multiplication.

Drug Responses: Allergic Reaction

Also known as hypsersensitivity; this effect occurs as the drug is antigenic and activates the immune system, causing effects that are normally more profound than seen in the general population.

Drug Responses: Idiosynracy

A drug effect that is unique to the individual. Different than seen or expected in the population in general.

Drug Responses: Tolerance

Decreased response to the same amount of drug after repeated administrations.

Drug Responses: Cross Tolerance

Tolerance for a drug that develops after administration of a different drug. Example: Morphine and other opioid agents may have a cross tolerance.

Drug Responses: Tachyphylaxis

Rapdily ocurring tolerance to a drug; may occur after a single dose. This is typically seen in sympathetic agonists, specifically decongestant and bronchodilator agents.

Drug Responses: Cumulative Effect

Increased effectiveness when a drug is given in several doses.

Drug Responses: Drug Dependece

The patient becomes accustomed to the drugs presence in their body and will suffer from withdrawal symptoms upon its absence. The dependence may be physical or Psychological.

Drug Responses: Drug Interaction

The effects of one drug alter the response of another.

Drug Responses: Drug Antagonism

The effects of one drug block the response to another.

Drug Responses: Sumation

The additive effect. Two drugs that have the same effect are given, each drug works to its full potential. 1+1=2

Drug Responses: Synergism

Two drugs that have the same effect are given together and produce a greater response than the sum of their individual responses. 1+1=3

Drug Responses: Potentiation

One drug enhances the effect of another, a good example is phenergan enhancing the effects of morphine.

Drug responses: Interference

The direct biochemical interaction between two drugs. One affects the pharmacology of the other.

Factors altering drug response

1) Age - infants liver and kidney function is not fully developed; elderly function is decreasing, this can cause an altered response.


2) Body mass - underweight can cause on overdosage, overweight can cause drug-fluid dilution.


3) Sex


4) Environmental Milieu - various environmental stimuli can effect the response to a given drug.


5) Time of administration - before meals or after, will change the rate of absorption.


6) Pathological state - Diseases such as renal or hepatic dysfunctions can lead to excessive accumulation in the body tissues or decrease elimination.


7) Genetic factors - lack of specific enzymes or lower basal metabolism can alter the drug absorption or biotransformation, altering


patient's response.


8) Psychological factors - Usually called placebo effect. "NormAzaline"

Levels of Sedation:


Minimal Sedation (anxiolysis)

Responsiveness: Normal response to verbal stimulation


Airway: Unaffected


Spontaneous Ventilation: Unaffected


Cardiovascular function: Unaffected

Levels of Sedation:


Moderate Sedation / Analgesia (Conscious Sedation)

Responsiveness: Purposeful response to verbal or tactile stimuli


Airway: No intervention required


Spontaneous Ventilation: Adequate


Cardiovascular function: Usually Maintained

Levels of Sedation:


Deep Sedation / Analgesia

Responsiveness; Purposeful response after repeated or painful stimulation


Airway: Intervention may be required


Spontaneous ventilation: May be inadequate


Cardiovascular function: Usually maintained

Levels of Sedation:


General Anesthesia

Responsiveness: Unarousable, even with painful stimulation


Airway: Intervention often required


Spontaneous ventilation: Frequently inadequate


Cardiovascular function: May be impaired

Ramsey sedation score chart

1 - patient is anxious and agiated or restless, or both


2 - Patient is cooperative, oriented, and tranquil


3 - Patient responds to commands only


4 - Patient exhibits brisk response to light glabellar tap or loud auditory stimuli.


5 - Patient exhibits a sluggish response to light glabellar tap or loud auditory stimulus.


6 - Patient exhibits no response.

Major diseases treated with psychtherapeautic medications

1) Schizophrenia


2) Depressions


3) Bipolar disorder

Antiseizure medication

Type of Seizure Drug of choice




Partial Seizure Phenytoin; Carbamazepine




Grand Mal Carbamazepine, Phenytoin,


Phenobarbital




Absence Valproic acid, Ethosuximide

Major classes of antipsychotic medication

1) Phenothiazines


2) Butyrophenones


3) Atypicals

Major classes of antidepressant medication

1) TCAs


2) SSRIs


3) MAOIs

SLUDGE and effects of cholineric medications

1) Salivation


2) Lacrimation


3) Urination


4) Defication


5) Gastric Motility


6) Emesis


SLUDGE results in EXTREME fluid loss.

Effects of atropine overdose

1) Hot as Hell


2) Blind as a Bat


3) Dry as a Bone


4) Red as a Beet


5) Mad as a Hatter

Types of Sympathetic receptors

Adrenergic


alpha 1 - causes constriction to the arteriole and veins, can cause mydriasis of the eye, and ejaculation


alpha 2 - causes presynaptic terminal inhibition


beta 1 - causes dilation of the lung and arteriole, inhibits uterine contractions, causes skeletal muscle tremors.


beta 3 - lipolysis of adipose tissue




Dopaminergic - vasodilation especially to kidneys.

Common Catecholamines

Natural


- Epinephrine


- Norepinephrine


- Dopamine




Synthetic


- Isoproterenol


- Dobutamine

Adrenergic Receptor Specificity


Antiarrhythmics - routinely classified through the Vaughn-Williams and Singh classification system.

I: Na+ channel blockers - affect sodium influx


1A (slow conduction and decrease the repolarization rate widens QRS and prolongs the QT)


1B (increase the rate of repolarization, reduce automaticity in ventricular cells which can help treat rhythms resulting from ectopic ventricular foci)


1C (decrease the conduction velocity through the atria and ventricles as well as through the bundle of His and purkinje network, they also delay ventricular repolarization.)


II: Beta blockers - used in the treatment of arrhythmias resulting from excessive sympathetic stimulation.


III: K+ channel blockers - indicated in the treatment of vfib and refractory vtach.


IV: Miscellaneous Ca channel blockers - decrease SA and AV node automaticity, most use is to decrease the conductivity through the AV node. Also cause a slow in the ventricular response of Afib and Aflutter, can also terminate SVT originating from a re-entrant circuit.


V: Miscellaneous (antiarrhthmics)

Antiarrhytmic Catergories


Drugs used to treat thrombi

1) Antiplatelets


2) Anticoagulants


3) Fibrinolytics

Main Indications for GI drug therapies

1) Peptic ulcers


2) Constipation


3) Diarrhea and emesis


4) Digestion/absorption disorder

Categories of Laxatives

1) Bulk forming


2) Stimulant


3) Osmotic


4) Surfactant

Summary of Hormone Actions

Insulin Preparations and Durations

Fat Soluble Vitamin Deficiencies

A - lack causes night blindness, skin lesions


found in butter, yellow fruit, green veggies, milk




D - lack causes bone and muscle pain, weakness, softening of bones.


found in fish, fortified milk, sunlight




E - lack causes hyporeflexia, ataxia, anemia


found in nuts, wheat, green veggies




K - lack causes increased bleeding


found in liver, green veggies

Water Soluble Vitamin Deficiencies

B1 (thiamine) - lack causes peripheral neuritis, depression, anorexia, poor memory


found in whoel grain, meats, peas, beans, nuts




B2 (riboflavin) - lack causes sore thoar, stomatitis, painful or swollen tongue, anemia


found in milk, eggs, cheese, green veggies




B2 (niacin) - lack causes skin eruptions, diarrhea, enteritis, headache, dizziniess, insomnia


found in meat, eggs, milk




B6 (pyridoxine) - lack causes skin lesions, seizures, peripheral neuritis


found in liver, meats, eggs, vegetables




B9 (folic acid) lack causes megaloblastic anemia


found in liver, fresh greens, yeast




B12 (cyanocobalamin) - lack causes irreversible nervous system damage, pernicious anemia


found in fish, egg yolk, milk




C - lack causes scurvy


found in citrus fruit, tomato, strawberry