Pharmacology

Front 1

Definition of Pharmacology

Back 1

The study of drugs and their interactions with living systems

Front 2

The 5 Rights of Drug Administration

Back 2

*Right route
*Right dose
*Right patient
*Right time
*Right drug

Front 3

6 things on the Medication Order

Back 3

*Patient's name
*Date order was written
*Name of medication
*Dosage (including size, frequency, and # of doses)
*Route of delivery
*Signature of prescriber

Front 4

How long does Dr have to sign medication order?

Back 4

24 hours

Front 5

Nursing diagnosis is...

Back 5

the conclusion about patient's problems

Front 6

Planning..

Back 6

Sets out specific interventions directed at solving or preventing the problem(s) identified in the analysis

Front 7

Implementation...

Back 7

Consists of the initiation and completion of specific actions by the nurse. It is completed by observing and recording the outcomes of treatment.

Front 8

The 3 times a medication label should be read...

Back 8

*When the med is taken from the storage area.
*Just before removing it from the container.
*Upon returning the medication container to storage or prior to discarding the empty container.

Front 9

Amount of time allowed to give medication...

Back 9

1/2 hour before or after scheduled time.

Front 10

Routes available...

Back 10

*Oral
*Rectal
*Vaginal
*Parenteral (intradermal, sub q, intramuscular, intravenous)
*Enteral - absorbed through stomach or small intestine
*Topical

Front 11

Angle degree for intradermal injection...

Back 11

10-15

Front 12

Angle degree for subcutaneous injection...

Back 12

45

Front 13

Angle degree for intramuscular injection...

Back 13

90

Front 14

Routes available for medication administration...

Back 14

*Inhalation
*Transdermal (patch)
*Otic - ear
*Intrathecal - injection into subarachnoid space
*Epidural - injection into the epidural space
*Intraarticular - injection into the joint

Front 15

Sublingual is...

Back 15

under the tongue

Front 16

Buccal is...

Back 16

in the cheek

Front 17

Insulin absorbs fastest in the ____, then the _____, then the _____.

Back 17

abdomen, arm, leg

Front 18

When documenting medication in a patient's chart, make sure to include..

Back 18

*Patient's name
*Date and time of administration
*Name of the med, amount, and route
*Any adverse reactions experienced by the patient
*Any complications in administering the drug
*If the medication was not given, state why, and dispose of the drug
*Patient data such as VS
*Your name and title

Front 19

Evaluation is....

Back 19

performed to determine if the nursing interventions worked.

Front 20

Drug

Back 20

any chemical that affects the physiological processes of a living organism

Front 21

Medication

Back 21

any natural or synthetic substance intended to prevent, diagnose, treat, or cure a disease or other medical condition.

Front 22

All medications are drugs,

Back 22

but not all drugs are medications.

Front 23

Therapeutic use...

Back 23

to relieve symptoms

Front 24

Diagnostic use...

Back 24

to diagnose

Front 25

Curative use....

Back 25

kill or remove the causative agent of a disease. (Antibiotics)

Front 26

Replacement use...
(Supplemental)

Back 26

replace substances normally found in the body. (Synthroid)

Front 27

Preventive or prophylactic use...

Back 27

to ward off or lessen the severity of the disease. (HIV prophylactic)

Front 28

Palliative therapy

Back 28

make the patient as comfortable as possible.

Front 29

Supportive therapy

Back 29

maintains the integrity of body functions while the patient is recovering from illness or trauma.

Front 30

Chemical name

Back 30

describes the drug's chemical composition and molecular structure

Front 31

Generic name

Back 31

is the official name given a drug.
(nonproprietary name)

Front 32

Trade name

Back 32

brand name under which a company manufactures a generic drug.
(Proprietary name)

Front 33

The patent life of a drug is usually ____ years long.

Back 33

17

Front 34

Plant sources:

Back 34

Opium poppy plant
Ex. Morphine and Codeine

Front 35

Animals:

Back 35

Beef and Pork Pancreas:
Insulin
Urine of Pregnant Mares:
Premarin
Cow and Pigs:
Bovine or Porcine Heparin

Front 36

Pharmacognosy

Back 36

The study of the natural drug sources (animals and plants)

Front 37

Physician's Desk Reference (PDR)

Back 37

Reference book published by the pharmaceutical industry. Has a pictorial section for product identification. The PDR is updated annually.

Front 38

1906 Pure Food and Drug Act

Back 38

Established official standards and requirements for accurate labeling of drug products. First American law to regulate drugs.

Front 39

1912 Sherley Amendment

Back 39

Prohibited fraudulent claims of drug effectiveness.

Front 40

1914 Harrison Narcotic Act

Back 40

Established the legal term narcotic and regulated the manufacture and sale of habit-forming drugs.

Front 41

1938 Federal Food, Drug, and Cosmetic Act

Back 41

Regulates the manufacture, distribution, advertising, and labeling of drugs in an attempt to ensure safety and effectiveness.
*The first legislation to regulate drug safety.*

Front 42

1962 Harris-Kefauver Amendments

Back 42

Created in response to the thalidomide tragedy that occurred in Europe in the early 1960s.
Amendments to the Food, Drug, and Cosmetic Act

Front 43

197 Comprehensive Drug Abuse Prevention and Control Act; Title II, Controlled Substance Act

Back 43

Controls the manufacture, importation, compounding, selling, dealing in, and giving away drugs that have the potential for addiction and abuse.

Front 44

Schedule I Drugs

Back 44

Drugs that are NOT APPROVED for medical use and have high abuse potentials.
Can only be disspensed with approved protocol (research only).

Front 45

Examples of Schedule I drugs

Back 45

Heroin, LSD, Peyote, Marijuana

Front 46

Schedule II Drugs

Back 46

Drugs that are used medically and have high abuse potentials.
Must have written prescription only. No telephone orders. No refills and container must have warning label.

Front 47

Examples of Schedule II Drugs

Back 47

Codeine, cocaine, Meperidine, Morphine, Amphetamine, Oxycodone

Front 48

Schedule III Drugs

Back 48

Drugs that have a lower potential for abuse than schedule I and Schedule II drugs.
Prescriptions may be refilled up to 5 times. Refills must be made within 6 months of the original order.

Front 49

Examples of Schedule III Drugs

Back 49

Codeine with selected other meds (acetaminophen), Hydrocodone, anabolic steroids

Front 50

Schedule IV Drugs

Back 50

Drugs with some potential for abuse.
Prescriptions may be refilled up to 5 times. Refills must be made within 6 months of original order.

Front 51

Examples of Schedule IV Drugs

Back 51

Benzodiazepines, phenobarbital, propoxyphene

Front 52

Schedule V Drugs

Back 52

These products contain moderate amounts of controlled substances.
May be dispensed without a prescription provided certain conditions are met.

Front 53

Examples of Schedule V Drugs

Back 53

Lomotil, Cough syrup with codeine

Front 54

Conditions that must be met for dispensing of Schedule V Drugs

Back 54

*The drug is dispensed by pharmacist.
*The amount dispensed is very limited (Not to exceed 200 ml).
*The recipient is at least 18 yoa and can prove it.

Front 55

Dependent intervention

Back 55

Doctor ordered

Front 56

Interdependent intervention

Back 56

collaborative between different medical teams

Front 57

Independent intervention

Back 57

no doctor order needed

Front 58

What type of insulin is only one molecule away from being identical to human insulin?

Back 58

Porcine

Front 59

Clinical Testing Phase I

Back 59

Subjects: Normal volunteers
Tests: Metabolism and biological effects

Front 60

Clinical Testing Phase II

Back 60

Subjects: Patients w/problem
Tests: Therapeutic utility and dosage range

Front 61

Clinical Testing Phase III

Back 61

Subjects: Large number of patients
Tests: Safety and effectiveness

Front 62

Blinded Investigational Drug Study

Back 62

study subject does not know if drug or placebo give but researcher does.

Front 63

Double-Blind Investigational Drug Study

Back 63

Both researcher and study subject are "blinded" to actual identity of substance administered.

Front 64

Clinical Testing Phase IV

Back 64

Postmarketing Studies
Conducted by pharmaceutical companies to obtain further proof of the therapeutic effects of the new drug.

Front 65

Drug companies gather information on a new drug for ___ years after it is realeased to consumers.

Back 65

2

Front 66

Pharmacokinetics

Back 66

A particular drug's onset of action, peak effect, and duration of action are all characteristics defined by pharmacokinetics.
Also, the study of drug movement throughout the body. Includes the drug metabolism and drug excretion.

Front 67

Absorption

Back 67

the movement of a drug from its site of administration into the bloodstream for distribution to the tissues.

Front 68

Onset of action

Back 68

time required for the drug to elicit a therapeutic response.

Front 69

Duration of action

Back 69

length of time that drug concentration is sufficient to elicit a therapeutic response

Front 70

Peak effect

Back 70

time required for a drug to reach it's maximum therapeutic response

Front 71

Bioavailability

Back 71

a measure of the extent of drug absorption for given drug and route. (From o% - 100%)

Front 72

First pass effect

Back 72

the initial metabolism in the liver of a drug absorbed from the GI tract before the drug reaches system circulation through the blood stream

Front 73

Distribution

Back 73

refers to the transport of drug molecules within the body.
Depends on availability of blood supply,
1st to heart, liver, kidney, brain
Last to skin, muscle, fat

Front 74

If less protein in vascular system

Back 74

lower dose of drug given

Front 75

P-450 Enzymes

Back 75

in liver to help metabolize meds

Front 76

Metabolism (Biotransformation)

Back 76

the process by which the body inactivates drugs

The enzyme systems of the LIVER are the primary site for metabolism of drugs.

Front 77

Excretion

Back 77

the removal of drugs from the body.

The most important organ for drug excretion is the KIDNEY.

Front 78

Most drugs are lipid soluble:

Back 78

they can go across the cell membrane but are harder to excrete

Front 79

Serum half-life

Back 79

the amount of time required for 50% of the drug to be eliminated from the body

Takes 5 half-lifes to be efficiently removed from the body.

Determines rate of absorption, distribution, matabolism, and excretion.

Front 80

Blood-Brain barrier

Back 80

specialized cells in the brain capillaries allow only certain substances from the blood to enter the brain.

Drugs need to be lipid-soluble to get across or a transport system.

Front 81

Dosage

Back 81

the amount of drug that is to be given at one time

Front 82

Initial Dose

Back 82

the first dose

Front 83

Average dose

Back 83

the amount of drug proven most effective with minimum toxic effects

Front 84

Factors for dosage

Back 84

age, weight, disease processes, another disease, infection, past history, allergies, safest route to administer, least amount that can be given

Front 85

Maintenance dose

Back 85

the amount that will keep concentrations of the drug at a certain level in the patient's bloodstream

Front 86

Maximum dose

Back 86

the largest amount of medication that can be given safely to a patient

Front 87

therapeutic dose

Back 87

the amount needed to produce the desired effect

Front 88

Unit dose

Back 88

a premeasured amount of the medication, individually packaged on a per dose basis.

Front 89

Lethal dose

Back 89

amount of medication that could kill a patient

Front 90

Drug-Drug Interactions
Additive Effects

Back 90

occur when two drugs with similar pharmacological actions are taken.
Ex. aspirin + Oxycodone=increased analgesia

Front 91

Drug-Drug Interactions
Synergistic Effects

Back 91

occur when two drugs administered together interact in such a way that their combined effects are greater than the sum of the effects for each drug alone.

Front 92

Drug-Drug Interactions
Interference

Back 92

by one drug with metabolism or elimination of a second drug may result in intensified effects of the second drug.

Front 93

Drug-Drug Interactions
Displacement

Back 93

of one drug from plasma protein-binding sites by a second drug increases the effects of the displaced drug.
Ex. Aspirin + Warfarin=increased anticoagulant effect

Front 94

Drug-Drug Interactions
Antagonistic effects

Back 94

is a drug blocker. it is an interaction between drugs in which their effects are decreased

Front 95

Polypharmacy

Back 95

people who take multiple drugs a day

Front 96

Pregnancy Safety Categories
Category A

*A-OK TO USE*

Back 96

studies indicate no risk to human fetus

Front 97

Pregnancy Safety Categories
Category B

Back 97

studies indicate no risk to animal fetus, info for humans not available.

Front 98

Pregnancy Safety Categories
Category C

*CAUTION*

Back 98

adverse effects reported in animal fetus, info for humans not available.

Front 99

Pregnancy Safety Categories
Category D

*DANGER*

Back 99

possible fetal risks in humans reported; consideration of potential benefit vs. risk may warrant use of drug.

Front 100

Pregnancy Safety Categories
Category X

*CROSS OFF - DON'T EVER USE!*

Back 100

fetal abnormalities reported an positive evidence of fetal risk in humans.

Front 101

Neonatal and Pediatric Considerations

Back 101

Immaturity of organs = absorption: gastric emptying is slowed; intramuscular absorption is affected; distribution:protein binding is decreased.

Front 102

Neonatal and Pediatric Considerations

Back 102

Metabolizing enzymes are decreased. Glomerular filtration and tubular secretion are decreased.

Front 103

Gastric acidity isn't same as adult's until child is ___ yoa.

Back 103

2

Front 104

Kidney function is not the same as an adult's until child is ___ yoa.

Back 104

1

Front 105

Adverse effects of drugs
GI Effects

Back 105

anorexia, nausea, vomiting, diarrhea, constipation

Front 106

Adverse effects of drugs
Hematologic effects

Back 106

bleeding disorders, bone marrow depression, anemia

Front 107

Adverse effects of drugs
Hepatotoxicity

Back 107

hepatitis, hepatic necrosis

Front 108

Adverse effects of drugs
Nephrotoxicity

Back 108

renal insufficiency or failure

Front 109

Adverse effects of drugs
Hypersensitivity or Allergic reaction

Back 109

symptoms vary, may occur with any drug, unpredictable and unrelated to dose

Front 110

Adverse effects of drugs
Anaphylactic shock

Back 110

a life-threatening allergic reaction characterized by respiratory distress and cardiovascular collapse

Front 111

Adverse effects of drugs
Idiosyncrasy

Back 111

an unexpected reaction to a drug that occurs the first time it is given

Front 112

Adverse effects of drugs
Drug dependence

Back 112

may occur with any mind-altering drugs (narcotics, sedatives)

Front 113

Adverse effects of drugs
Carcinogenicity

Back 113

the ability of a substance to cause cancer

Front 114

Adverse effects of drugs
Teratogenicity

Back 114

the ability of a substance to cause abnormal fetal development when given to pregnant women.

Front 115

Sources of Drugs
Plants

Back 115

Ex. purple foxglove plant
Trade name: Digitalis

Ex. Poppy plant (opium)
Trade name: Morphine

Front 116

Sources of Drugs
Minerals

Back 116

Ex. Magnesium
Trade name: Milk of magnesia

Front 117

Sources of Drugs
Animals

Back 117

Ex. Pancreas of cow or hog
Trade name: insulin

Front 118

Sources of Drugs
Syntehtic

Back 118

Ex. Meperidine
Trade name: Demerol

Front 119

Adverse Effects of Drugs
Tolerance

Back 119

decreasing response to meds

Front 120

Adverse Effects of Drugs
Cross-tolerance

Back 120

phenomenon
Tolerant to one type of drug and being tolerant to another because it's the same class.