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56 Cards in this Set

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Drug
Any chemical that can affect living processes
Pharm
Study of drugs and their interactions with living systems
Clinical Pharm
Study of drugs in HUMANS
Theraputics
Use of drugs, to diagose, prevent or treat disease or PREVENT pregnancy
Properies of Ideal Drug
1. effective-elict response for why it is given

2. Safety-not many drugs are safe.

3. Selectivity-drugs that only give response to which is given. (no side effect) no such thing.
Other factors that our properties
1. reversible
2. chemical stability
3. Ease of Adminstration
4. Low Cost
5. Predictabilty
6. Freedom from drug reactions.
7. Possession of simple generic name.
What is a theraputic objective
drug to provide max benefit w/ minimal harm
Factors that determine drug response
1. Primary-adminstration-drug errors

2. Pharmakenetics-absorption, distribution, metabolism, excretion
3. Pharmadynamics-impact of drugs on the body-drug receptor interaction, placebo, pt functional state
What is assesssment?
Pt interview, physical exam, halth histories, lab tests, observations
What is analysis?
Analysis of actual or potential health problems. Do nursing diagnoses.
Nursing Diagnose
statement of patients health problem related to probable cause or risk factors
Planning
Specific interventions directed at solving problems identified. Nursing interventions and HP inteventions put together.
Implementation
Begins with carring out interventions planned
Evaluation
Determine degree to which succeeded.
Federal Pure Food and Drug Act of 1906
all drugs be free of adulterants.
Food drug and Cosmetic Act
1938. People died using antibodic. This made an issue that all drugs needed to go through FDA.
Harris-Kefauver Amendment
1962 Passed 3 things:

1. All drugs had to show effectiveness.

2. Drugs approved from 1932 go through testing

3. Need to have rigous testing on all medicatoins.
Controlled Substances Act
Standards for drugs that cause abuse (1970)
1992
1. Accelerated approval on cancer drugs and aids
2. Could be marketed prior to phase 3 trials provided phase 4 trials were done.
1997
1. More drugs faster approved
2. More children research
3. Drug companies can give off label articles about their drugs provided they do research.

4. Drug companies have to give 6 months notice about drugs going off market.
Absorption
site of admin to into blood
Distribution
from blood to interspecial tissues of body
Metabolism
alteration of drug usually in liver.
Excretion
drugs out of the body
To cross a memrane
1. Lipid soluble
2. transport system
3. through channel or pore. not many pores are small enough.
Polar molecules
Uneven distribution of electrical charge. No net charge. Hard time passing through the cell.
Ions
have a charge...very small and only the smallest go through the membrane.
Aborption
1. better blood flow the better.

2. the larger the surface area. In the intestine instead of the stomach.

3. Lipid soluble very much better
entertic coated pills
1. protect stomach from acid and pepsin in the stomach

2. to protect the stomach from any drugs that cause discomfort.
Distribution
movement from the blood to interstial speace of tissue
Distribution
1. blood flow to tissues tumors abscess.

2. blood exiting the vascular system..through capillary beds

3. Can it enter the cells. The ability for the cell to enter the cell.
Blood-Brain barrier
lipid soluble can move through

transport can work if already set up.
Metabolism
1. Pass through the liver.
2. Helps those who are lipid soluble get ready for execretion from the kidneys
3. Can lead to toxicity if not broken down.
First pass effect
Certain drugs can be inactivated by the liver ex. nitroglycerin.
Excretion
Most important organ: kidney
2. out of hte body into breat milk
theraputic range
b/t minimum effect and toxicity.
Half-life
time required to reduce the amount of drug by fifty percent
Loading dose
1st inital dose
Plateau phase
how drug bulidisin the body when multiple doses are given
pharmacodynamic
what drugs do to the body and the mechanism which is done.
Dose patient relationship
Determine Min
Determine Max
Determine the amouthn of drug increases that produces a disered effect.
Maximal Efficacy
LARGEST EFFECT A DRUG CAN PRODUCE. THIS IS VERY IMPORTANT IN A DRUG. This is also dependent on individuals.
Relative Potency
NOT AN IMPORTANT QUALITY. Amount of drug to have effect.
Drug Receptors
need to bind to a cellular binding site to produce an effect. We can reverse by taking drug away.
Simple Occupancy Theory
As receptor site increase the amount of response increases. When all are filled up you should be at max efficency.
Affinity is directly related to potoncy
the more drug-the stronger the attraction b/t a drug and its receptors.
Agonists
Drug molecules that activate receptors. These have HIGH affinity and HIGH intrinic activity.
Antagonists
Drug molecules that prevent activation at receptor sites. No intriic activity. YES...then have HIGH affinity.
Partial Agonist
Has only moderate intrinic activity-acts as antagonist or Agonists....can be bothF
4 primary families on cell membrane
1. cell membrane embedded enzyme lie on surface of cells

2. Ligand-gated ion channel; millisecond; lie on surface of cells.

3. G protenin couples receptor system. Shake receptor sites; for this to be cmoplete we must have an entire family of G protein effects.

4. Transcription Factors-DNA replication. w/i nucleus rather then on surface. Responses are delayed...takes longer for reception to occur. Responsible for DNA and protein Sythesis. Anatogist are hypersentified. Agonist get tired.

Some drugs don't need receptors like anticipetics and antacids.
Idiosyncratic effect
genetic predispostion to certian drugs
Iatrogenic
produced from drug you are taking like glucose intoleranc from HTN drugs.
Drug Tolerance
decrease responsive to a srug as a result of repeated dose.
Pharmacoldynamic drug toleratance
long term, mrophine, paxil is thought to reslut from process that occur in response to chronic receptor occupation.
Metabolic Tolerance
accelerated metabolism. Need more meds.
Tachyphylaxis
reduction in drug response brought on by repeated dosing over time.