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145 Cards in this Set

  • Front
  • Back
Any chemical that can affect living processes
Drug
The study of drugs and their interactions with living systems
Pharmacology
The study of drugs in humans
Clinical pharmacology
the use of drugs to diagnose, prevent or treat disease or to prevent pregnancy or the medical use of drugs
Therapeutics
Properties of an ideal drug
Effectiveness, safety and selectivity
Process that determines how much of an administered dose gets to its sites of action
Pharmacokinetics
Processes that determine the nature and intensity of the response
Pharmacodynamics
Is there any such thing as a safe drug?
no
What is the objective of drug therapy?
to provide maximum benefit with minimum harm
What was the first american law to regulate drugs
Federal Pure Food and Drug Act of 1906
What did the first law regulate?
testing for toxicity
The Harris-Kefauver were the first admendments to do what?
Proof that a drug was effective; that drugs actually be of some benefit
The development and testing of new drugs takes about how long?
6 to 12 years only 1 in 5 actually gains approval
What is the most reliable way to objectively assess drug therapies?
Randomized controlled trials (RCT)'s
What are the two principal steps in new drug development?
preclinical testing and clinical testing
During which stage are drugs evaluated for toxicities, pharmacokinetic properties and potentially useful biologic effects?
Preclinical
Clinical trials occur in how many phases?
4
Are drugs every released to the general public during clinical trials?
Yes during stage 4 postmarketing surveillance
Why is there very limited information on drug effects on woman and children?
until recently very little drug testing was done in women
and children
Why does testing not detect all adverse effects of a new drug?
1)a relatively small number of patients are given the drug
2)patients are carefully selected they do not represent the full specturm of individuals who will eventually take the drug and 3)patients in trials take the drug for a relatively short time.
Drugs have three types of names
a chemical name, a generic or nonproprietary name and a trade or proprietary name
Which drug name constitutes a description of a drug using the nomenclature of chemistry?
Chemical Name
What names are assigned by the United States Adopted Names Council?
Generic Names or nonproprietary
Names under which drugs are marketed?
Trade names or proprietary or brand names
Are all FDA-approved generic products therapeutically equivalent to their brand name counterparts
Yes
The controlled substances Act, passed in 1970 set rules for the manufactures and distribution of what drugs
Drugs considered to have potential for abuse
Each drug has only one generic name but can have how many trade names?
Many
What are the three systems used by health professionals
Metric, apothecary and the household systems
All prescriptions should be written with which system?
Metric
What are the three essential parameters of measurement that are associated with the prescription and administration of drugs within each system of measurement?
Weight, Volume, and Length
This is the most utilized parameter of measurement
Weight
This usually refers to liquids
Volume
What are the prefered measures for weight, they are the most accurate
Gram and Milligram
What are the primary units of measurement in the metric system?
Gram for weight, liter for volume, and meter for length.
This is one millionth of the base unit
Micro
this is one thousandth of the base unit
milli
this is one hundredth of the base unit
centi
this is one tenth of the base unit
deci
this is one thousand base units
Kilo
g
gram
mg
milligram
mcg
microgram
kg
kilogram
L
liter
mL
milliliter
m
meter
cm
centimeter
mm
millimeter
When do we use a leading zero?
to emphasize the decimal pint for fractional amounts less than 1
This was the first system of medication measurement used by pharmacists and physicians
apothecary
This system utilizes roman numerals
apothecary
The unit for dosage calculation in the apothecary system is
gr grain
These are special measured quantities expressed in Arabic numbers
internationl unit, unit and milliunit
When effects of a drug occur at the site of applicatoin this is called?
local effect
when the drug must be absorbed into the bloodstream before it can be distributed to a distant location
systemic effect
When a drug is swallowed and absorbed from the stomach or small intestine
oral route
When drugs are given directly into the stomach or intestine, (e.g. through a nasogastric or gastrostomy tube)
enteral
When drug is held under the tongue and absorbed
Sublingual
When medication is held against mucous membranes of cheek until it dissolves
buccal
Drug acts locally or is absorbed directly through skin
Topical (skin)
the drug is placed into a body cavity
Topical (instillations)
a device breaks the drug into finely dispersed particles, which are breathed into the respiratory passages
Topical (inhalation)
Injections
Parenteral
Types of Parenteral
Intravenous, Intramuscular, Subcutaneous, Intradermal, Intraspinal, Intrathecal (into subarachnoid space)and Epidural
To convert to a smaller unit you must
Multiply
to convert to a larger unit you must
divide
When you multiply you are moving the decimal point which direction
right
When you divide you are moving the decimal point which direction
left
The standard 3mL syringe is calibrated in ?
Tenths of a mL
The 1mL syringe is calibrated in ?
hundredths of a mL
How many times do you check the drug label before giving medication to the patient?
3 times
What is a lot number used for?
the FDA requires a lot number so if there is a recall
the National Drug code or NDC is like a persons
social security number for drugs
By law what name must be indentified on all drug labels?
generic name
By what metric parameters is dosage strength referred
milligrams
Name two forms by which injectable medications may be supplied
solution or dry powdered
What does supply dosage refer to?
both dosage strength and form
X measured units per some quantity
What is the study of drug movement throughout the body?
Pharmacokinetics
What are the four processes of pharmacokinetics?
absorption, distribution, metabolism, and excretion
What is the definition of elemination?
combination of metabolism and excretion
The movement of a drug from its site of administration into the blood
absorption
movement of a drug from the blood to the interstitial space of tissues and from there into cells
distribution
enzymatically mediated alteration of the drugs structure
metabolism
movement of drugs and their metabolites out of the body
excretion
What does the rate of absorption determine?
how soon effects will begin
What does the amount of absorption help determine
how intense effects will be
What five factors affect drug absorption?
Rate of dissolution, surface area, blood flow, lipid solubility and pH partitioning
Explain how the rate of the dissolution can affect drug absorption?
before it can be absorbed it must first dissolve
Explain how the surface area available can affect drug absorption?
the larger the surface area the faster absorption will be
Explain how blood flow can affect drug absorption
more rapid from sites where blood flow is high, blood containing newly absorbed drugs will be replaced rapidly by drug free blood, maintaining a large gardient, causing rapid absorption
Explain why highly lipid-soluble drugs are absorbed more rapidly than drugs whose lipid solubility is low
lipid soluble drugs can readily cross the membrances that separate them from the blood
Explain how pH partitioning can influence drug absorption
Absorption will be enhanced when the difference between the pH of plasma and the pH at the site of administration is such that drug molecules will have a greater tendency to be ionized in the plasma
Define enteral
via the gastrointestinal [GI] tract
What is the literal and common definition of parenteral
literal-outside the GI tract
Common-by injection
Name the three principal parenteral routes of administration
intravenous, subcutaneous, and intramuscular
What are the four advantages of intravenous administration?
Rapid onset, control, use of large fluid volumes, and use of irritant drugs
What are the five disadvantages of intravenous administration?
High cost, difficulty and inconvenience, irreversibility, fluid overload, infections and embolism
What two factors can affect the rate of absorption when giving a drug by the IM route?
Water solubility of the drug and blood flow to the site of injection
What are two advantages to using the intramuscular route instead of the intravenous route
poorly soluble drugs and deposit preparations (preparations from which the drug is absorbed slowly over an extended time.
what are 2 disadvantages to using the intramuscular route instead of the IV route to the oral route
discomfort and inconvenience
How does the subcutaneous route compare to the intramuscular route?
nearly identical
What is the major barrier to absorption when drugs are given orally
epithelial cells that line the GI tract
Name 6 factors that can affect the rate and extent of absorption of drugs administered orally
solubility and stablility of the drug, gastric and intestinal pH, gastric emptying time, food in the gut, coadministration of other drugs, special coatings on the drug preparation
When a drug is swallowed and absorbed in the GI tract, what organ must it pass through in order to enter the general circulation?
Liver
What are the 2 major advantages of the oral route
convenient and inexpensive
4 disadvantages to using oral route
Variability of absorption, inactivation, complience of patient, local irritation of GI tract
If two drugs contain the same amount of identical chemical compounds they are said to be?
Chemical Equivalences
When chemical equivalence drugs absorb at the same rate and to the same extent they are?
Bioavailablity
How may two tablets that contain the same drug differ?
Made by different manufacturers can differ in their rates of disintegration and dissolution
What are the two general purposes for the use of enteric coated tablets
to protect drugs from acid and pepsin in the stomach and to protect the stomach from drugs that can cause gastric discomfort
Describe how sustained release capsules work to vary the release of the drug throughout the day
Capsules contain spheres that have coatings that dissolve at variable rates
Name two advantages for the use of sustained release capsules
Permit a reduction in the number of daily doses and produce relatively steady drug levls over an extended time
Name six additional routes of administration
topically, transdermal, inhaled, rectal suppositories, vaginal suppositories, and direct injection
Movement of drugs throughout the body is known as?
distribution
Three major factors affecting drug distribution
blood flow to tissues, ability of a drug to exit the vascular system, and ability of a drug to enter cells
Name two pathological conditions where treatment with drugs is difficult because of poor blood flow to the tissues
Abscesses and tumors
Describe how drugs usually leave a capaillary to enter the interstitial space in the tissue
pass between capillary cells rather than through them, movement into the interstitial space is not impeded
Name two organs in the body where drugs must cross a cell membrane
blood brain barrier, placenta
If a drug can bind easily to albumin in the blood, how can this affect the amount of drug available to the desired site of action?
because albumin is too large to leave the bloodstream, drug molecules that are bound can not leave either
If a large percentage of molecules of a certain drug is bound to albumin molecules in the blood stream and another drug knocks a lot of the molecules off and takes their place, what potentially could happen?
Toxicity
What is another term for metabolism
biotransformation
This is the enzymatic alteration of drug structure
metabolism
where does most drug metabolism take place
liver
What is the most important consequence of drug metabolism
accelerated renal drug excretion
What are six possible consequences of drug metabolism that have therapeutic significance
accelerated renal excretion of drugs, drug inactivation, increased therapeutic action, activation of "prodrugs" increased toxicity and decreased toxicity
A compound that is pharmacologically inactive as administered and then undergoes conversion to its active form within the body is a?
Prodrug
How might metabolism increase toxicity?
by converting relatively safe compounds into forms that are toxic
Why are infants especially sensitive to drugs?
because the liver does not develop its full capacity to metabolize drugs until one year
What might happen if two drugs that are metabolized in a similar way are given at the same time?
compete with each other for metabolism and thereby decrease the rate at which one or both agents are metabolized.
What is the rapid hepatic inactivation of certain oral drugs known as?
First pass effect
What are 6 ways drugs exit the body?
Urine, breast milk, bile, lungs, sweat and saliva
What are the 3 processes that result in urinary excretion of drugs?
Glomerular filtration, Passive tubular reabsorption and active tubular secretion
What can be the result of two drugs given at the same time that compete for active tubular transport? how might this be beneficial?
Can delay renal excretion thereby prolonging effects
The plasma drug level below which therapeutic effects will not occur
Minimum effective concentration
When plasma drug levels climb to high
toxic concentration
Range between Minimum effective concentration and toxic concentration
Therapeutic Range
A steady level of drug in the body
plateau
The time required for the amount of drug in the body to decline by 50%
half life
How does a drug's half life affect the dosing schedule?
affects the dosing interval
The highest level the drug reaches in the body
Peak concentration
The lowest level the drug reaches in the body
trough concentration
When would doing lab work to measure the peak or trough of a drug be mose valuable to determine safe drug levels?
when drug has a narrow therapeutic range
When a large initial dose is given this is called?
loading dose
Doses administrated after the loading dose
Maintenance doses
How many half-lives does it take for most 94% of the drug to leave the body?
4