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89 Cards in this Set
- Front
- Back
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any substance other than food used in the prevention,diagnosis, alleviation, treatment, or cure of disease or not for prevention of pregnancy
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DRUG
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_____ is a name based upon the molecular structure (ex. acetylsalicylic acid aka aspirin)
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Chemical names - based on the molecular structure
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____ is a name that is assigned to a drug by the U.S. Adopted Name Council. Ex: Acetylsalicylic acid - Aspirin
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Generic Name- assigned by U.S. adopted name council
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___ is a trade name adopted by the manufacturer & registered under the Federal trade mark law& the name is the property of the manufacturer
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brand name- designated by an r with circle around it after the name
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__ is the insert that comes with every medication and tells what the drug is, side effects, adverse reaction, chemical formula, what not to take with the drug, and is called the bible of the reference manuals
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PDR- Physicians' Desk Reference
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___ is 2 different chemicals that meet the same chemical & physical standards and do the same thing
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Chemically equivalent - have the same chemical&physical standards and do the same thing. Act the same way and do the same thing
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___ delivers the same concentration of the therapeutic agent in the blood and tissues.
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Biologically Equivalent
- deliver same concentration of therapeutic agent in blood & tissues |
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____ is 2 different compounds the produce the same therapeutic effects but may not do it in the same way
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Therapeutically Equivalent
- 2 different compounds that produce the same therapeutic effects but may not do it in the same way |
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What agency sets the physical and chemical standards of a drug and regulated the quality control in its manufacturing. Also this agency determines if drug is safe & effective
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FDA - determines if drug is safe & effective, sets physical / chemical standards of drug & regulates quality control in manufacturing
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What agency regulates the trade practices and advertising? in other words it regulates how drug is advertised not how it is made
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FTC - regulates drug advertisement and trade practices
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What agency regulates controlled substances?
Controlled substance- any drug that have the ability to produce abuse or addiction |
DEA- drug enforcement Administration - regulates controlled substances
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What are the 3 ways that drug actions are classified by?
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biochemical action, physiological effect, organ system (which organ system drug effects in accomplishing its action)
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___ action is how a drug works. ex: MAO inhibitors, calcium channel blocker - allows no constriction so the blood pressure doesn't rise
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Biochemical action- how a drug works
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__ is what a drug accomplishes in the body. It is what the end result is. Ex: Antihypertensive drugs reduce BP, Hypoglycemics regulate sugar levels
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Physiological effects- what is the end result- what drug accomplishes in body
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___ is the amount of drug is required to produce the desired effect
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potency- amt of drug required to produce desired effect
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__ is the maximum effect of a drug regardless of the dose.
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Efficacy- maximum effect of drug regardless of the dose. Not the same as potency
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___ is the dose of the drug needed to kill 50% of the test subjects. the toxic dose
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Lethal dose/ 50
- dose of a drug needed to kill 50% of test subjects |
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___ is a type of drug that ...
~has an affinity for a receptor ~binds the certain kind of receptor ~produces an effect |
AGONIST
drug that has an affinity for receptor binds the receptor & produces the effect |
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__ is a drug that counteracts the agonist. This type of drug is used to change the effect of a drug that is being taken
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Antagonist- counteracts the agonist
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__ has an affinity for same receptor as agonist but reduces effect of agonist. Can be reversed by increasing concentration of agonist. By itself this type has no effect .
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Competitive antagonist
- fights with agonist to bind so the agonist can't ex: benadryl reverses the effect of histamine when it competes with receptors to reverse effects |
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___ binds to different receptor sites but still reduces the effects of agonist. This tupe of antagonist reduces the max response of agonist.
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Noncompetitive antagonist
- doesn't fight for same spot instead it binds to different location |
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___ antagonist binds to a different recptor sit but produces an effect opposite from the agonist.
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PHYSIOLOGIC ANTAGONIST
- binds to different receptor site but produces effect opposite from agonist |
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__ means how long after administration it takes to notice an effect
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ONSET of a drug is how long after administration it takes to notice an effect
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the ___ is how long the effect of the drug will last it is related to 1/2 life
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DURATION of a drug - how long the effect of the drug will last
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____ means the passage from the route of administration into the circulation (oral,I.M.,Sub Q) this is how the drug gets into the bloodstream
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ADSORPTION- passage from route of administration into the circulation (bloodstream)
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___ means the passage of drugs into various body fluid compartments,plasma, interstitial fluid, intercellular fluid.
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DISTRIBUTION - where does drug end up after taking it - not metabolized
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__ is the time it takes a drug to fall to 1.2 of its blood level concentration. This determines the duration of action (how often drug can be taken)
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Half life
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What is the changing of a drug to allow for excretion? How the drug is changed and detoxified....
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Metabolism(biotransformation)
- how the drug is changed in body to allow for excretion and detoxified? |
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Where are drugs secreted at in the body?
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Where are drugs secreted in body.....Kidneys, Lungs (respiration), Sweat, Saliva, GI, Breast Milk, Semen, Stool
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___ is a natural mechanism that prevents some drugs from entering the brain from the circulation.
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Blood brain barrier
- the natural mechanism that prevents some frugs from entering the brain from the circulation |
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___ is a mechanism that prevents some drugs from reaching the developing fetus
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Transplacental barrier- a mechanism that prevents drugs from reaching the fetus
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___ is a drug effect that is the desired effect of a drug. this is what you want the drug to do. Ex: take aspirin reduce headache
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Therapeutic effect- the desired effect of a drug
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___ is the undesired effect of a drug. Ex: when medicine makes a person nausea
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Adverse Effect- the undesired effect of a drug
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___ is an adverse effect of a drug resulting in birth deformities.
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Teratogenic Effect
- adverse effect resulting in birth deformities |
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___ is type of adverse effect. It is excessive, undesired effect, this may result from too high of dose or decreased metabolism (as in a person with kidney, liver disease) causing the drug to build up in body
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TOXIC REACTION - and excessive, undesired effect, results from too high a dose or decreased metabolism of a drug
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__ is type of adverse effect. It is an effect other than the desired therapeutic effect and is dose related
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SIDE EFFECT - an effect other than the desired therapeutic effect, dose effect
Ex: gastric upset with aspirin, drowsiness |
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__ is type of adverse effect. It is a side effect that is unique to 1 individual or race. It is unpredictable. Ex: Direct japanese decent can't take chlorhexidine
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Idiosyncratic Reaction
- side effect unique to one individual or race |
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___ is a type of adverse effect. This type of effect is immune system mediated reaction not dose related.
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ALLERGIC REACTION
- immune system mediated reaction |
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__ is a type of adverse effect. This is when one drug or food potentiates or diminishes the action of another drug
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Drug Interaction - when 2 or more drugs cause diferent reaction from the combo of the 2 and diminishes the action of the drug
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This type of reaction is immediate, serious reaction in a previously sensitized patient. Sensitized B cells produce IgE, which leads to degranulation of mast cells leading to generalized vasodilation, increased permeability and constriction of smooth muscle in the bronchioles & produces edema
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Type 1 Hypersensitivity (Anaphylaxis) - immediate, serious reaction in a previously sensitized patient.
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this reaction occurs when a Bcell and G attaches to a surface of tissue cells complement is activated and cell lysis & tissue destruction occurs
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Type 2 hypersensitivity
- cells combine, attach to tissue cell surface, complement is activated- cell lysis and tissue destruction occurs |
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This type of reaction is when ab-ag complexes are trapped in blood vessel walls, complement is activated and stimulates acute inflammation leading to tissue destruction
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TYPE 3 hypersensitivity
Ex: strep throat infection an ab-ag enter circulation and filter out in the glomerulus of kidney resulting in acute glomerulonephritis |
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In this type of reaction T cells stimulated by relatively harmless antigen attached to a tissue cell. When an immune response leads to tissue destruction ex:Tb test, poison ivy
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Type 4 Hypersensitivity
- when T cells are stimulated by harmless antigen attached to tissue cell. |
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__ means how safe the drug is. It is a ratio of the LD50xED50. The greater the number the more sage the drug is expected to be.
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THERAPEUTIC INDEX
= ratio of LD50: ED50. Tells how safe a drug is. Drugs that are therapeutically beneficial require a TI of 10 or greater |
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What does the heading on a prescription have to include?
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Heading includes....
Name, address, phone of Dr & patient, DOB, and date of Rx |
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What part of the Prescription includes the Rx, name & dosage strength and form of drug(liquid,tabs,caps), amt to dispense,&pt instructions- how often to take Rx?
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The body of the Prescription
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What does the closing on the prescription have to include?
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Closing includes....
Dr. signature, # of refills, DEA # if a controlled substance |
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What scedule of controlled substances has the highest probability for abuse?
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Schedule 1
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What schedule of controlled substance does this describe...
___ : no accepted therapeutic value, highest potential for abuse. Ex: marijuana __: Moderate abuse potential. Phone Rx permitted,only 5 refills within 6 month period |
Schedule 1 - no accepted therapeutic value, highest potential for abuse
Schedule 3- moderate abuse potential (codeine, hydrocodone, valium) |
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What schedule of controlled substance are these...
___ has high potential for abuse- requires wriiten signed Rx no refills (morphine,oxycotin, demoral) ____ has less abuse potential (tylenol 2) ___ has least potential for abuse and is least restrictive of controlled substance (cough syrup with codeine) |
Schedule 2 - morphine,demoral,oxycotin, has high potential for abuse
Schedule 4- less abuse potential - tylenol 2 Schedule 5- has least potential for abuse & least restrictive of controlled substance (cough syrup w codeine) |
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What are the requirements of medicine on the bottle label?
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has drug dispensed, Strength, Dosing Instructions, Date filled, Quantity or number of doses dispensed, Name of pt & Dr, # of refills
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What is a drug whose intended therapeutic effect is to reduce pain or the perception of pain?
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ANALGESICS - drug whose intended therapeutic effect is to reduce pain or perception of pain
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__ is a physical or mental senation of distress or suffering usually due to an underlying etiology physical or emotional damage. It is a protective reflex for self preservation.
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Pain
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Nonnarcotic or nonopioid acts on the peripheral nervous system but hasa an antipyretic effect on the ___
narcotic acts on the ___ |
nonnarcotic acts on hypothalamus
narcotic acts on the brain |
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nonnarcotics inhibit ___ synthesis.
Narcotics depress the ___ and it's perception of pain. |
- Nonnarcotics inhibit PROSTAGLANDIN synthesis.
- Narcotics depress the CNS & it's perception of pain |
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Nonnarcotics are classified into ____ & ____.
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Nonnarcotics are classified into SALICYLATES (aspirin based) & NSAIDs (nonsteroid Antiinflammatory Drugs)
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How do nonnarcotics work?
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Nonnarcotics work by the tissue causes release of histamines, bradykinin, prostaglandins and serotonin, vasodilation,chemotaxis, and edema
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Some of the beneficial effects of ___ include: Most commonly used analgesic, antipyretic(reduces fever), anti inflammatory, and prolongs bleeding due to anti platelet effects. It relieves mild to moderate pain
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Aspirin - ASA
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What are some of the adverse effects of aspirin (ASA)?
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GI (most common)- nausea & gastric bleeding; prolonged bleeding;Reye's syndrome(swelling of brain can lead to death); if pregnant can lead to stillbirths, hemorrhages, delayed birth; Hypersensitivity (allergic reaction rare)
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What are some of the toxicity symptoms of overdose of aspirin ASA? LD50: adults 10-30gm Pedo 4gm(grams)
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Toxicity symptoms of ASA:
- tinnitus (ringing of ears) - headache - nausea -vomiting - loss of vision |
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How do nonsteroidal antiinflammatory drugs (NSAIDs) work?
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Mechanism of action is similar to aspirin (inhibit prostaglandin synthesis) the drug works in the bloodstream @the site of injury. they metabolize in the liver excreted through kidney
- most peak @ 1-2 hours - useful for mild/moderate dental pain |
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What are some of the adverse reactions of to much intake of NSAIDs?
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GI irritation, bleeding, pain, Renal damage, CNS effects such as dizziness, headache,vertigo, confusion,ect; oral ulcerations, xerostomia, prolonged gestation
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The use of NSAIDs are contraindicted in what type of patients?
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those with asthma, CV or renal disease with fluid retention, bleeding disorders, peptic ulcer or ulcer colitis
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What are some drugs that have interactions with NSAIDs?
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Lithium toxicity- used foor bipolar disease
Digoxin toxicity- used for CHF Cyclosporin toxicity- transplant Antagonize ACE inhibitors, diuretics and beta blockers |
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What are some of the most common NSAIDs on the market?
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Common NSAIDs...
- Ibuprofen(motrin,advil) (more effective than ASA) - Naproxen (Aleve,Naprosyn) -Acetaminaphen (tylenol) equal to ASA in dose&therapeutic effec w/o antiplatelet or gastric bleeding effect, however has no effect on reducing inflammation and may cause liver and kidney damage. |
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How are most OPOIDS (narcotics) absorbed?
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opoids are absorbed orally, transmucosally, transdermally, onset normally within an hour
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Opoids (narcotics) are distributed by binding to plasma proteins and affected by "first pass" effect on bioavailability. What is the "first pass" effect?
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First pass effect- opoids are abdorbs by mouth into the stomach then liver, then the liver takes out a certain% of drug & each time the drug passes through the liver since that first pass it takes more of drug out. this is how drug is metabolized
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Opioids (Narcotics) are metabolized in conjugated with glucuronic acid in the liver, the duration of action is 4-6 hours. How are opiods excreted?
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metabolites and unchanged opioids are excreted in the urine
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What are some therapeutic effects of Opioids (narcotics)?
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~Analgesia (relieves pain)
~Sedation/ Euphoria ~Cough Suppression- depresses the suppression @medulla@ low doses ~Gastrointestinal muscle relaxation - treats diarrhea by depressing paristalsis |
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___ is the standard of measure for opiods and ___ is the weakest
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Morphine- standard of measure
Codeine- weakest |
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What are some adverse reaction to opioids (narcotics)?
- these reactions are related to analgesic strength and dose |
adverse reactions:
- respiratory depression - nausea/ emesis (vomiting) - Constipation - Myosis- pinpoint pupils - Urinary retention - cardiovascular: vagus stimulation result in bradcardia -stimulatres histamine resulting in itching/ urticaria - depress fetal respiration during delivery- withdrawal symptoms seen in child |
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When is in contraindicated to give a patient opiods(narcotics) for pain?
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Contraindiction: If a patient has suffered head injuries the drug may increase intrcranial pressure
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What are some withdrawal symptoms a person who is addicted to opiods may go through?
tolerance to drug develops to euphoria not to CNS |
Withdrawal symptoms:
- perspiration - piloerection:hair standing erect - irritability - nausea - vomiting - tachycardia - tremors - chills |
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What are some common Opiods
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-Morphine: 10mg standard of measure for all opiods (Avinza, Kadian)
- Oxycodone: relieves moderate to severe pain alone or in combo with ASA (Oxycotin, Oxyfast, Roxicodone) - HYdrocodone: relieves moderate pain with or w/o ASA(Lortab, Lorcet |
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Codeine is a ____ it is most common of this type of drug. It's efficacy is questionable usually used in combo with ASA or acetominiphine (tylenol 1,2,3 Empirin 1,2,3)
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Opiods
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SPECIFIC OPIODS....
____: used in combo w/ ASA or acetominophine (Darvon, Darvocet) ___: 100mg Demerol same as 10mg of morphine, Abused by health pros High first pass effect with short duration (Demerol) |
~ Propoxyphene- Darvocet, Darvon used in combo ASA or acetominophine
~ Meperidine- Demerol abused by health pros, 100 mg of demoral same as 10mg morphine |
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Specific Opoids....
____- Dilaudid. no use in dentistry high abuse potential. outlawed in many states equivalent to cocaine _____ - frequently used for withdrawal from morphine (methadose) |
Hydromorphone- Dilaudid
Methadone- used for morphine withdrawal (methadose) |
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What are 2 antagonists with opiods?
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Antagonist...
~Naloxone - Narcan competes w/ opioids for receptor sites.Used for overdose reversal. ~ Naltrexone- used to detox addicts to maintain opioid free state also used to maintain alcohol abstinence |
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When is in contraindicated to give a patient opiods(narcotics) for pain?
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Contraindiction: If a patient has suffered head injuries the drug may increase intrcranial pressure
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What are some withdrawal symptoms a person who is addicted to opiods may go through?
tolerance to drug develops to euphoria not to CNS |
Withdrawal symptoms:
- perspiration - piloerection:hair standing erect - irritability - nausea - vomiting - tachycardia - tremors - chills |
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What are some common Opiods
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-Morphine: 10mg standard of measure for all opiods (Avinza, Kadian)
- Oxycodone: relieves moderate to severe pain alone or in combo with ASA (Oxycotin, Oxyfast, Roxicodone) - HYdrocodone: relieves moderate pain with or w/o ASA(Lortab, Lorcet |
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Codeine is a ____ it is most common of this type of drug. It's efficacy is questionable usually used in combo with ASA or acetominiphine (tylenol 1,2,3 Empirin 1,2,3)
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Opiods
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SPECIFIC OPIODS....
____: used in combo w/ ASA or acetominophine (Darvon, Darvocet) ___: 100mg Demerol same as 10mg of morphine, Abused by health pros High first pass effect with short duration (Demerol) |
~ Propoxyphene- Darvocet, Darvon used in combo ASA or acetominophine
~ Meperidine- Demerol abused by health pros, 100 mg of demoral same as 10mg morphine |
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Specific Opioids...
___: Dilaudid -not used in dentistry high abuse potential, outlawed in many states. Equivalent to cocaine ___: frequently used for withdrawal for morphone (Methadose) |
Hydromorphone- Dilaudid
Methadone- used for withdrawal from morphine |
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What are some antagonists of opiods?
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~ Naloxone - Narcan competes w/ opiods for receptor sites. Used for overdose reversal
~ Naltrexone- used to detox addicts to maintain opiod free state. Also used to maintain alcohol abstinence |
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What do these abbreviations mean....
ac bid disp gm |
ac- before meals
bid- twice a day disp- dispense gm- gram |
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what do these abbreviations mean....
a with line over it- c with line over it - h hs |
a with line over it- before
c with line over it- with h- hour hs- at bedtime |
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what do these abbreviations mean...
p w/ line over it- pc PO prn q |
p w/ line over it - after
pc- after meals PO- by mouth prn- as required, if needed q- every |
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what do these abbreviations mean...
qid- s w/ line above it- sig- stat tid- |
s w/ line above it- without
sig- write (label) stat- immediately (now) tid- 3 times a day |
