Pharmacology General Principles

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Bioavailability

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the ability of a drug to reach the bloodstream and its target tissues

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Chemical Name

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the scientific or technical name of a substance

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Controlled substance

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A drug whose use is restricted by the Comprehensive Drug Abuse Prevention and Control Act.

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Generic Name

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nonproprietary name of a drug assigned by the government

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pharmacologic classification

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method for organizing drugs on the basis of their mechanism of action

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prototype drug

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an original, well-understood model drug from which other drugs in a pharmacological class have been developed

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scheduled drug

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in the US, a term describing a drug placed into one of five categories (I through V) based on its potential for misuse or abuse

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therapeutic classification

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method for organizing drugs on the basis of their clinical usefulness

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trade name

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proprietary name of a drug assigned by the manufacturer; also called the brand name or product name

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withdrawal

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physical signs of discomfort associated with drug abuse

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In order for a nurse to be involved with patient care, and to be active in educating, managing, and monitoring the proper use of drugs to clients in many settings, she must have a strong knowledge of

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Pharmacology

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In the FDA approval process, clinical investigators from many different medical specialties address concerns such as

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whether the drug is effective.

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The FDA approves drugs in four phases. The phase of Post-Marketing Surveillance is best described as

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final stage of the approval process

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How long can the Review of the New Drug application take before moving to the final stage?

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6 months

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What can be one of the advantages of a client purchasing over the counter medicine (OTC) rather than going to a physician?

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Drugs can be obtained more easily

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A clinical pharmacologist begins looking for healthy, young individuals. In what phase of the Food and Drug Administration (FDA) approval process will these individuals be involved?

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Phase 2 = clinical investigation phase.

It is in this phase that individuals are given drugs in the review process to appraise for adverse drug effects

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Which of the following reasons contributes to why the FDA approval process of new drugs can be time consuming?

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It can be time consuming due to outdated guidelines, poor communication, and not enough staff to handle the workload

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All of the following laws have been passed to prevent the sale of drugs that have not been carefully tested with the exception of which law?

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The 1938, Food, Drug, and Cosmetic Act

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What is Pharmacotherapeutics

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Pharmacotherapeutics is the application of drugs for the purpose of disease prevention and treatment of suffering.

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Drug companies measure how long it takes for the physiological ability of the drug to reach the target cells and produce its effect. Which of these applies to this principle?

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Bioavailability

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A client says to a nurse, "My nurse practitioner said the pharmacist should give me the generic drug instead of Tylenol. How will I know if it is the same drug?" Which response should the nurse make to the client?

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"There is only one generic name for each drug. In this case it is acetaminophen so your pharmacist will give you that drug."

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A client, who is physically dependent on a drug prescribed by a physician, stops taking the drug. A nurse should anticipate that the client will experience

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This is a classic definition of withdrawal from a physical dependence on a drug.

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A client is receiving a schedule II drug and is angry that the physician always says, "You must return to the office before I can give you another prescription." Which response by a nurse is most appropriate?

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"You are receiving a drug that by law cannot be refilled until you have another physician visit."

There are no refills for schedule II drugs without first being seen by the health care provider.

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By learning the prototype drug, students may predict the actions and adverse effects of other drugs in the same class. A prototype drug is

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the original well-understood drug model from which other drugs in a pharmacological class have been developed.

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Mrs. Jones has a malignant brain tumor. What property of pharmacokinetics may cause difficulty in treating her tumor?

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Blood-brain barrier

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Flouroquinolones is an example of

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a chemical group name.

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What organ of the body is the primary site of drug metabolism?

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Liver

Primary site of drug metabolism is the liver

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Which category of scheduled drugs has the lowest potential for abuse?

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Schedule V

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Mrs. Smith, a 66-year-old client with cirrhosis of the liver, exhibits decreased metabolic activity. This will require what possible change in her drug regimen?

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A reduction in the dosage of drugs

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Scheduled Drugs are classified according to

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popularity

Scheduled Drugs are classified according to their potential for abuse

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Mr. James is a 56-year-old client with chronic renal failure. The nurse should recognize that this client will be at particular risk for which condition?

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Rapid development of drug toxicity

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By what process does the primary pharmacokinetic factor determine the length of time it takes a drug to produce its effect?

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Absorption

Absorption is the primary pharmacokinetic factor that determines the length of time.

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Mr. James is a 56-year-old client with chronic renal failure. The nurse should recognize that this client will be at particular risk for which condition?

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Rapid development of drug toxicity

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The "therapeutic range" of a drug is considered to be which of the following?

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The plasma drug concentration between the minimum effective concentration and the toxic
concentration

The therapeutic range is the plasma drug concentration between the minimum effective concentration and the toxic concentration.

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The common description of a drug's duration of action in the body is considered?

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Plasma half-life

A common description of a drug's duration of action is considered to be the plasma half-life

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In situations in which it is critical to raise drug plasma levels quickly, the nurse should be prepared to administer what?

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A loading dose

The nurse should be prepared to administer a loading dose.

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Some drugs may be completely metabolized by the liver circulation before ever reaching the general circulation. This effect is known as what?

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First-pass

This effect is known as the first-pass effect.

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A client, who is in renal failure, may have a diminished capacity to excrete medications. It is imperative that this client be assessed for what development?

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Drug toxicity

The client should be assessed for the development of drug toxicity.

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Generic drugs are required to be:

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Therapeutically equivalent and less expensive than trade-name drugs.

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Nursing responsibilities relative to working with controlled substances include:

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1) Recording on agency narcotic sheets each dose given
2) Reporting discrepancies to the proper authorities
3)Administering them only to people for whom they are prescribed

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Drug groups considered teratogenic include:

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Antiepileptic drugs and "statin" cholesterol-lowering drugs.

A teratogen is an agent that can distrub the development of the embryo or fetus. Teratogens halt the pregnancy or produce a congenital malformation.

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The route medication must be given to achieve 100% bioavailablity is given:

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IV

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The protion of a drug that is pharmacologically inactive is known as:

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A protein boung drug.

Drug molecules bound to plasma proteins are inactive because the large size prevents their leaving the bloodstream. Only the free or unbound portion of the drug acts on the body cells.

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Drugs related to the chemical or offiicial name and independent of the manufacturer are called

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Generic name drugs

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The law requiring that official drugs must meet standards of purity and strength as determined by chemical analysis or by animal response to specified doses is known as:

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The Food, Drug, and Cosmetic Act of 1938

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Define drug therapy or pharmacotherapy ...

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Pharmacotherapy includes prevention, diagnosis, and treatment of disease process

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Dosage form is a major determinant of a drug's:

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Bioavailability

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Newly developed drugs must include gender-related effectiveness and safety information in the initial Food and Drug Adminsitration (FDA) application, based upon which legislative act?

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Federal Food, Drug, and Cosmetic Act

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Drugs are chemicals that alter basic processes in body cells. That means that:

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Drugs can stimulate or inhabit normal cellular functions; they cannot add functions.

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Function of metabolism

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Convert fat-soluble drugs into water-soluble metabolites.

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How are drugs classified?

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Their effects on particular body systems, therapeutic uses, and chemical characteristics and potential for abuse.

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A method that describes the process of absorption, distribution, and elimination of a drug in the body is known as:

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Pharmacokinetics

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Drugs that produce effects similar to those produced by naturally occuring hormones, neurotrnasmitters, and other substances are called:

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Antagonists

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What is the name for how a drug is introduced?

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Route of administration

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What are systemic drug effects?

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Effects on body cells distant from the site of administration.

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Example of an opioid analgesic prototype drug

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Morphine

Morphine is the prototype for all opioids. Class 2 drug

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Example of schedule 3 drugs include

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Lortab and Tylenol with codeine

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Examples of schedule 4 drugs

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Valium and Chloral Hydrate

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Only drugs that are lipid soluble or have a transport system have the ability to ______________

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Cross the blood -brain barrier

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Addiction

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Physical dependance on a drug

Compulsive drug use

Durg craving and drug seeking are all characteristics of addiction.

When a drug is discontinued - withdrawl physical effects occur

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Critical concentration

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The amount needed to cause a therapeutic effect

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habituation

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Physicologic dependence... it is an interest or craving if the drug is not avaailable. Person WILL NOT have physical or withdrawl effects if drug is stopped.

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Duration of action

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The length of time the drug has a pharmacologic effect

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Loading dose

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a loading dose refers to an initial higher dose of a drug that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose

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Minimum effective concentration (MEC)

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The minimal blood level at which a systemic drug exerts the desired effect

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Onset of action

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The length of time it takes for a medicine to start to work

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Peak Level

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The highest plasma concentration of a drug at a specific tiime. Peak levels indicate the absorption of a drug. Depending on the route and the drug, peak levels are drawn 1-3 hours after the drug is given.

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Pharmaceutic Phase (Disintergration/Dissolution)

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First phase of drug action. In the GI tract, drugs need to be in solution so they can be absorbed. A drug in dolid dorm (tablet or capsule) must disintegrate into small particles to dissolve into a liquid, a process known as dissolution. Drugs in liquid form are already in solution. After the drug is a liquid, absorption can begin. Tablets first disintegrate then dissolve into a liquid.

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Therapeutic range

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The concentration of the drug in plasma. This concentration should be between MEC and the MTC

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Trough level

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Lowest plasma conocentration of a drug. Trough measures the rate at which the drug is eliminated. Trough levels are drawn immediately before the next does, regardless of the route of administration.