Pharmacology Part 1

Front 1

define drug

Back 1

Any substance taken by mouth; injected into a muscle, blood vessel, or cavity of the body; inhaled, or applied topically to treat or prevent a disease or condition.

Front 2

Drugs are derived from five major sources

Back 2

Plants, Animals, Humans, Minerals or mineral products, and Chemical substance made in laboratory.

Front 3

Chemical name

Back 3

The most elemental name. Describes the chemical make-up of the drug.

Front 4

Generic name (nonpropritary name)

Back 4

Usually an abbreviated version of the chemical name. Not capitalized. Non-proprietary means not for profit.

Front 5

Trade name (brand or proprietary name)

Back 5

Brand name of the drug product. Always capitalized. Proprietary = for profit.

Front 6

official name

Back 6

Often the same as the generic name. This is the name listed in the US Pharmacopeia and the National Formulary which are used in research and for government regulated programs.

Front 7

What are the dif. drug names?

Back 7

Chemical name, generic name, trade name, official name.

Front 8

Comprenhesive Drug Abuse Prevention and Control Act, 1970

Back 8

Also known as Controlled Substances Act (CSA) classified drugs into five categories or schedules based on potential for abuse and physical and psychological dependence.

Front 9

Drug Schedules

Back 9

-Schedule I
High Abuse potential
No currently accepted medical use

-Schedule II
High abuse potential
Accepted medical use

-Schedule III Less abuse than above
-May lead to low physical dependence or high psychologic dependence

Schedule IV
Lower abuse potential
May lead to limited physical or psychological dependence

Schedule V
Low abuse potential
May lead to limited physical or psychologic dependence

Front 10

Who became the sole nation's drug enforcement agency in July 1973?

Back 10

DEA-Drug Enforcement Agency

Front 11

List drug regulatory agencies

Back 11

Drug Enforcement Agency
Food and Drug Administration
Public Health Service
Federal Trade Commission
Canadian drug control
International drug control

Front 12

How many phases are in the FDA approval of drugs?

Back 12

4

Front 13

Liquid drug forms

Back 13

-Solutions: Preparations that contain the drug dissolved in a solvent, usually water.
-Tinctures: Drug preparations whereby the drug was extracted chemically with alcohol.
-Suspensions: Drugs that do not remain dissolved and will separate. They must be shaken before admin.
-Spirits: Contains volatile chemicals dissolved in alcohol.
-Emulsions: Preparations in which an oily substance is mixed with a solvent into which it does not dissolve.
-Elixirs: Preparations that contain the drug in an alcohol solvent, with a flavor added.
-Syrups: Drugs that are suspended in sugar and water to improve the taste.

Front 14

Solid drug forms

Back 14

-Pills: Drugs that are shaped into a form that is easy to swallow.
-Powders: Drugs in powder form. Same as pills without the structure.
-Capsules: Consist of gelatin containers into which a powder is placed. Gelatin dissolves and allows the powder to be absorbed.
-Tablets: Similar to pills. Shaped to promote easy swallowing, however they have a sugar coating to improve taste.
-Suppositories: The drug is mixed into a base that is solid at room temp, when place in body (rectum and vagina) they dissolve absorbing into surrounding tissue.

Front 15

Drugs are given for either their ______ or _______ effect.

Back 15

local
systemic

Front 16

Gas drug forms

Back 16

Nebulized medication: Medication in liquid form that are made to mist when forced air or oxygen flow are introduced.

Front 17

List Routes of medication administration

Back 17

Sublingual
Buccal
Oral
Rectal
Nasogastric
Subcutaneous
Intramuscular
Intravenous
Pulmonary
Intradermal
Transdermal
Umbilical
Intraosseous
Nasal
Endotracheal
Paraenteral (any med route other than alimentary canal)

Front 18

Affinity

Back 18

The attraction between a medication and its receptors.

Front 19

Agonist

Back 19

Stimulation of a response in a receptor.

Front 20

Antagonism

Back 20

Signifies the opposition between two or more medications.
Narcan to morphine

Front 21

Bolus

Back 21

A single, oftentimes large dose of medications.

Front 22

Contraindications

Back 22

The medical or physiological conditions present in a pt that would make it harmful to administer a medication.

Front 23

Cumulative action

Back 23

Occurs when a drug is administered in several doses, causing an increased effect.

Front 24

Depressant

Back 24

A medication that decreases or lessens a body function or activity.

Front 25

Hypersensitivity

Back 25

A reaction to a substance that is normally more profound than seen in the normal population.

Front 26

Idiosyncrasy

Back 26

An individual reaction to a drug that is usually different from that seen in the rest of the population.

Front 27

Potentiation

Back 27

The enhancement of one drug's effects by another drug.
Phenergan to Morphine

Front 28

Side effects

Back 28

The unavoidable, undesired effects frequently seen even in therapeutic doses.

Front 29

Stimulant

Back 29

A drug that enhances or increases a bodily function.

Front 30

Synergism

Back 30

The combined action of two drugs. The action is much stronger than the effects of either drug when administered separately.

Front 31

Therapeutic action

Back 31

Is the desired, intended effect of a drug given in the appropriate medical condition.

Front 32

Tolerance

Back 32

Occurs when pts are receiving drugs on a long term basis, they begin to need more and more to have the same therapeutic effect. The increased amount is know as tolerance.

Front 33

Untoward effect

Back 33

A side effect that is harmful to the pt.

Front 34

Allergic Reactions
Cross-reactivity

Back 34

One drug can trigger an allergic reaction in a pt who has never taken the drug, but has an allergy to chemically similar drug (uncommon).

Front 35

Allergic Reactions
Type I

Back 35

Anaphylactic reactions
Occurs soon after exposure to the drug. Caused by specific type of antibody attached to mast cells.

Front 36

Allergic Reactions
Type II

Back 36

Cytotoxic reactions
Delayed reactions that involve certain cytotox antibodies of the IgG class. Capable of lysing cells and commonly cause hemolytic reactions and destruction of platelets.

Front 37

Allergic Reactions
Type III

Back 37

Delayed reactions "serum sickness"
Like Type II reactions, specific antibodies are usually involved.
Symptoms include urticaria, joint pain, swollen lymph nodes, and fever.

Front 38

Allergic Reactions
Type IV

Back 38

Those in which constant dermatitis is produced by a topical application of a drug. Produced by T lymophocytes, not by the hormonal antibodies. Usually require more than 24 hours to become evident.

Front 39

Ganglia

Back 39

Specialize nerve fiber that "bunch in knots" all along the PNS and aid the ANS in transmitting nerve impulses to the target organs. Ganglia in the SNS are located close to spinal cord whine ganglia in the PNS are close to the target organs.

Front 40

Ganglia fibers

Back 40

Assist in moving nerve impulse along the nerve pathway.

Front 41

Neurotransmitters

Back 41

Specialized chemicals that are used to conduct the nervous impulse between nerve cells or between a nerve cell and its target organ. When release by a nerve ending they travel across the synapse and activate membrane receptors on the adjoining nerve or target tissue.
Two primary types of neurotransmitters is Acetylcholine and Norepinepherine.

Front 42

Fibers that release acetylcholine are known as

Back 42

cholinergic fibers

Front 43

Nicotinic

Back 43

Receptors that always fast. Before ganglion. Moves the nerve impulse from one axon to the other along the nerve pathway.

Front 44

Muscarinic

Back 44

Receptors that can be fast or slow. After ganglion. Moves the nerve impulse from the nerve pathway to the target.

Front 45

Cholinergic drugs

Back 45

A drug or other substance that causes effects like those of the PNS. This is done by stimulating the nicotnic and muscarinic receptors. Drugs that inhibit or block nicotinic and/or muscarinic receptors is knows as anticholenergic drugs, blocking the PNS also.

Front 46

Norepinepherine

Back 46

The neurotrasmitters between the sympathetic postganglionic fiber and the effector cell (of the target organ/area).

Front 47

Fibers that release norepinepherine are called

Back 47

adrenergic fibers.

Front 48

A majority of the neurons of the SNS are

Back 48

adrenergic.

Front 49

What are the three receptor sites of norepinepherine

Back 49

Alpha, Beta, and Dopaminergic

Front 50

Alpha 1 receptors

Back 50

-Cause constriction of vessels and bronchi.
-Stimulates metabolism.

Front 51

Alpha 2 receptors

Back 51

-Inhibits stimulation of the presynaptic norepinepherine. Slowing down neurotransmission/conduction.

Front 52

Beta 1 receptors

Back 52

Increase the heart rate, strength of contraction and the heart's ability to conduct its impulse when stimulated.

Front 53

Beta 2 receptors

Back 53

-Cause broncho and vasodilation when stimulated.
-Can inhibit uterine contractions when stimulated.
-Side effects of muscle tremors possible with over stimulation.

Front 54

Adrenergic drugs

Back 54

A drug or substace that causes effects like those of SNS. (AKA Sympathomemetic-Resembling SNS)

Front 55

Antiadrenergic drugs

Back 55

Is a drug or substance that blocks the actions of the SNS. (AKA Sympatholytic)

Front 56

Catecholamines

Back 56

Naturally occurring and synthetic adrenergic drugs.
Ex: Epinephrine, Dopamine, Isoproterenol, and Dobutamine

Front 57

Dopaminergic Reactions

Back 57

Not completely understood. Known to cause vasodilation in primarily in the renal, coronary and cerebral arteries. Primarily located in kidneys. The naturally occurring substance is Dopamine and synthetic is known as Dobutamine.

Front 58

PNS rises

Back 58

From the brainstem and sacral segments of the spinal cord.

Front 59

Stimulation of the PNS results in:

Back 59

-Pupillary constriction
-Secretion of digestive glands
-Increase smooth muscle activity in the digestive tract
-Bronchoconstriction
-Reduction in heart rate and cardiac contractility

Front 60

S
L
U
D
G
E

Back 60

Salivation
Lacrimation
Urination
Defecation
Gastric motility
Emesis

Front 61

SNS arise from the

Back 61

lumbar region of the spinal cord

Front 62

Stimulation of the SNS causes:

Back 62

-Secretion of sweat glands
-Constriction of blood vessels in the skin
-Increase in blood flow and heart rate
-Bronchodilation
-Stimulation of energy production (ATP)
-Reduction of blood flow to the abdominal organs
-Decreased digestive activity
-Relaxation of smooth muscle in the wall of the bladder
-Release of glucose from the liver

Front 63

Pharmacokinetic interactions vs Pharmacodynamic interactions

Back 63

Pharmacokinetic interactions deals with how the body handles the drug. Pharmacodynamic interactions deals with the drug's effect on the body.

Front 64

Pharmacokinetic

Back 64

The study of how the body handles a drug over a period of time including absorption, distribution, biotransformation, and excretion.

Front 65

List some variables that affect drug absorption

Back 65

-Nature of the absorbing surface
-Blood flow to the site of administration
-Solubility of the drug
-pH
-Drug concentration
-Dosage form
-Route of drug administration
-Bioavailability

Front 66

Entral route

Back 66

Drugs administered along any portion of GI tract.

Front 67

Oral absorption

Back 67

Oral cavity has rich blood supply, but little absorption occurs in the mouth. Like when nirtro dissolved is dissolves in salivary secretions and are absorbed by the oral mucosa entering the systemic circulation, initially bypassing GI fluids and the liver.

Front 68

Gastric absorption

Back 68

Length of time a drug remains in the stomach varies depending on:
-pH of the environment
-Gastric motility

Front 69

Small Intestine Absorption

Back 69

Rich blood supply and large absorption area, most absorption occur in the upper portion of the small intestine.

Front 70

Rectal absorption

Back 70

Very effective for some meds, vascular surface. Rectal meds do not undergo hepatic alteration on the first pass through the body, because blood vessles that perfuse rectal region bypass the liver.

Front 71

Subcutaneous Administration

Back 71

An injection given beneath the skin into the connective tissue or fat immediately beneath the dermis.
Small volumes ~0.5mL or less slow sustaining effect.

Front 72

Intramuscular Administration

Back 72

Injection given into skeletal muscle, greater blood flow therefore faster than SC.

Front 73

Intravenous Administration

Back 73

An injection given directly into the blood stream, bypassing the absorption process, almost immediate effect.

Front 74

Edotracheal Admistration

Back 74

Generally through ET tube, deliver into the pulmonary alveoli and systemic absorption via lung capillaries. Said to be almost as fast as IV. Last resort. LEAN

Front 75

Intraosseous Administration

Back 75

Injection directly into th bone marrow through an IO infusion system. ~ as fast as IV.

Front 76

Pulmonary route

Back 76

Drugs administered by inhalation in the form of gas or fine mist. Absorption is blood stream is rapid due to large surface area, rich capillary network adjacent to alveolar membrane.

Front 77

Topical Route

Back 77

Drugs applied topically to skin and mucous membrane. Use intact skin and messaging promotes absorption. Usually for local effect.

Front 78

Drug distribution

Back 78

The transport of a drug through the blood stream to various tissues of the body and ultimately to its site of action. Rate of distribution depends on the permeability of the capillaries to the drug molecule, cardiac output, and regional blood flow.

Front 79

Blood-Brain Barrier

Back 79

A single layer of capillary endothelial cells that line the blood vessels entering the CNS.

Front 80

Placental Barrier

Back 80

Membrane layers that separate the blood vessels of the mother and fetus. Does allow passage of certain non-lipid drugs (steroids, narcotics, anesthetics, and some antibiotics).

Front 81

Biotransformation

Back 81

Process by which the drug is chemically converted to metabolite. Liver is primary site. Without it accumulation and cumulative drug effects may occur.

Front 82

Organs of excretion

Back 82

--Lungs
-Sweat and salivary glands
-Mammary glands
-Kidney
-Intestine

Front 83

Factors that Influence Actions of Drugs

Back 83

-Age
-Body Mass
-Gender
-Environment
-Time of administration
-Pathological state (how sick they are)
-Genetic factors
-Psychological factors

Front 84

Pharmacodynamics

Back 84

The study of how a drug acts on a living organism.

Front 85

Agonist

Back 85

Drugs that bind to a receptor and cause a physiological response.

Front 86

Antagonist

Back 86

Drugs that bind to a receptor and whose presence prevent a physiological response or other drugs from binding.

Front 87

Affinity

Back 87

The attraction of a medication to its receptors.

Front 88

Efficacy

Back 88

A drugs capacity to bring about its desire effect.

Front 89

Our pH is at

Back 89

7.35-7.45

Front 90

Be care with these drugs associated with clinically significant drug-drug interactions:

Back 90

-Blood thinners
-Tricyclic antidepressants
-Monoamine oxidase (MOA) inhibitors
-Amphetamines
-Digitalis glycosides
-Diuretics
-Antihypertensives

Front 91

Analgesics

Back 91

Relieve pain

Front 92

Narcotics

Back 92

Drugs that contain or are abstracted from opium. Work by binding with opioid receptors in the brain and other body organs. Alters the pt's pain perception and emotional response to pain.

Front 93

Narcotics may produce undesirable effects

Back 93

-N/V
-Constipation
-Urinary Retention
-Cough relax suppression
-Orthostatic hypotension
-CNS depression

Front 94

Nonarcotic Analgesics

Back 94

Act by a peripheral mechanism that interferes with local mediators released when tissue is damaged. The mediators that cause pain.

Front 95

Bezodiazepines

Back 95

Thought to work by binding to specific receptors in the cerebral cortex and limbic system. Four actions anxiety reducing, sedative-hypnotic, muscle relaxing, and anticonvulsant (primary EMS use).

Front 96

Barbiturates

Back 96

Divided into four classes according to duration of action. Help out with epilepsy, as a CNS depressant.
BIG SIDE EFFECTS

Front 97

What is the anticonvulsant of choice in EMS?

Back 97

Valium

Front 98

Psychotherapeutic drugs include:

Back 98

-Antipsychotic agents:block dopamine receptors in CNS
-Antidepressants:affect mood disturbances.
-Lithium:preferred tx of mania due to massive calming.

Front 99

Chronotropic drugs

Back 99

Cardiology drug that affect the heart rate.

Front 100

Dromotropic drugs

Back 100

Cardiology drug that affect conduction velocity through the conducting tissues of the heart. How quickly it can set through heart.

Front 101

Inotropic drugs

Back 101

Cardiology drug that affect force of contraction. How hard it contracts.

Front 102

Antidysrhythmics work by

Back 102

-Direct action of the cardiac cell membrane (lidocane)
-Indirect action that affects the cell (propranolol AKA Inderal)
-Or both

Front 103

Calcium Channel Blockers

Back 103

Reduce peripheral vascular resistance by inhibiting the contractility of vascular smooth muscle. Drugs in this class differ in degree or selectivity for coronary vasodilation or decreased cardiac contractility.

Front 104

Bronchodilators may be classified as:

Back 104

Sympathomimetic drugs-acting on alpha and beta receptors.
Xanthine dirivates specific actions of relaxing smooth muscle, stimulating cardiac muscle and CNS, etc.

Front 105

Mucokinetic drugs

Back 105

Used to move respiratory secretions, mucus and sputum along the tracheobronchial tree.

Front 106

What are two big respiratory depressants?

Back 106

Opium and barbiturate groups

Front 107

Histamine receptors

Back 107

H1-Act primary on blood vessels and bronchioles
H2-Act mainly on GI tract

Front 108

Order for tx major allergic reaction

Back 108

Albuterol
Epi
Benadryl

Front 109

Antibiotics

Back 109

Used to tx local or systemic infection. Kill or suppress growth of microorganisms.

Front 110

NSAIDS

Back 110

ASA is the prototype of the NSAIDS. ASA is not pure NSAID however it has NSAID properties.
NSAID are thought to act by inhibiting specific enzymes so that prostaglandins, substance that promote inflammation and pain, are not formed.