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Pharmacology: U1
Unit 1 terms/data
| Question | Answer |
|---|---|
| Pharmacology | the study of drugs and their interactions with living organisms. |
| 6 fields of pharmacology | pharmacodynamics, pharmacokinetics, pharmacotherapeutics, pharmacy, posology, toxicology |
| Pharmacodynamics | study of the action of drugs on living tissues (mechanism of action) |
| Pharmacokinetics | study of the processes of drug absorption, distribution, metabolism, excretion |
| Pharmacotherapeutics | stud of the use of drugs in treating disease |
| Pharmacy | science of preparing and dispensing medicines |
| Posology | study of the amount of drug that is required to produce therapeutic effect (desired effect) |
| Toxicology | study of the toxic/poisonous effects of drugs |
| FDA definition of a drug | any substance used in the diagnosis, cure, mitigation, treatment, or prevention of disease in humans or animals |
| 3 medical uses for drugs | therapeutic, preventative, diagnostic |
| Therapeutic use | drugs are used to control/cure symptoms, conditions, or diseases of a physiological or psychological nature; ex. Antibiotics, analgesics, hormone replacement therapy. |
| Preventative use | drugs are used to prevent the occurrence of symptoms, conditions, or diseases. Ex. Vaccination for immunization against childhood diseases (extends lifespan); drugs taken to prevent motion sickness prior to flying |
| Diagnostic use | drugs are used by themselves or in conjunction w/ radiological procedures & other types of medical tests to provide evidence of a disease process. Ex. Radiopaque dyes used during x-ray procedures; drugs given to stimulate cardiac exercise |
| Why do people take drugs?: | To aid in religious practices, explore the self, alter mood, treat cause/symptoms of disease, promote and enhance social interaction, enhance sensory experience, stimulate artistic creativity/performance, improve physical performance, make money |
| Responsibilities of health professionals administering meds | ck written order, if med s/b held prior to admin; ID allergies; know drug action/side effects, usual dosages; know pt. condition; ID pt; stay until oral meds swallowed; record necessary info immediately; family and pt teaching; admin using 5 rights rule |
| Five rights rule | right—patient, drug, dose, route, time |
| Precautions in drug administration | no distractions; proper lighting; ck label 3x; use current meds (no expired); prep meds just before admin; admin drugs you prepare; admin properly labeled drugs; use proper prep tech; store as recommended; keep narcotics locked up; keep accurate records |
| Source of drug information | United States pharmacopoeia |
| United States Pharmacopoeia | est.1906; official drug reference; unbiased. Several volumes; v1 for health professionals, v2 for pts; has drug monographs w/ practical info; highlights risks, monthly updates, updated annually; highly recommended reference for all health professionals. |
| Natural sources of drugs | plants, animals, minerals |
| Genetic engineering | experimental manipulation of the genome to produce certain characteristics; ex. Gene splicing technique; |
| Recombinant DNA technology | piece of DNA extracted from one organism that is then inserted into another (i.e. single-cell bacterium); if inserts, organisms will produce large amounts of specific protein, allowing valuable proteins to be produced for mass distribution |
| Schedule drugs | drugs with potential for abuse/dependence; 1970 leg Controlled Substances Act est. by DEA created 5 categories for controlled substances; label and packaging for controlled sub must show drug’s assigned schedule (big “C” w/ roman numeral of schedule) |
| Federal Food & Drug Act of 1906 | est US Pharmacopoeia & Nat’l Formulary as compendia of approved drugs, 1st official written source for meds; 1st gov’t attempt to protect consumers of foods/ drugs; drug prep w/ any “dangerous” drugs must show ingred on label; no enforcement agency |
| Durham-Humphrey Amendment of 1951 | specified how prescription drugs could be ordered/dispensed; recognized OTC drugs; required warning labels for drowsiness, nervousness, etc; created “legend drugs”—drugs that bear label “caution |
| Comprehensive Drug Abuse Prevention & Control Act of 1970 | est. DEA; drugs w/ potential for abuse indicated as controlled substances; created five schedules; sets security, reg of inventory, limitations for use of controlled substances; prescribers must have DEA number. |
| Schedule I drug | high abuse potential; no accepted medical use; approved protocol necessary for dispensation; ex. opioids (heroin); cannabis, psychedelics |
| Schedule II drug | high abuse potential; accepted medical uses, may lead to dependence; script necessary; emergency verbal scripts must be confirmed w/in 72 hours; no refills allowed; warning label; ex opioids, barbiturates, stimulants |
| Informed consent | mandatory; must be given to volunteers of research studies; form includes detailed info about the study, potential side effects, benefits. |
| Double-blind clinical study | third party knows who receives active drug; neither the patient or investigators know which patients are receiving the drug or placebo |
| Steps in development of new drugs | drug tested for toxicity, pharmacokinetics, useful effects;animal testing, then FDA review;gets chemical name, generic name; human clinical trials for safety, therapeutic use, dosage; approval leads to brand name; drug released for observation of patients |
| Pregnancy safety categories | FDA assigned categories for drugs |
| Category X | pregnancy safety categories; fetal abnormalities reported, positive evidence of fetal risk in human; risks involved clearly outweigh the potential benefits. Drugs should not be used in pregnant women. |
| Generic drug substitution | pharmacists are permitted to sub the generic drug for brand name drug; prescribing physician can specify if trade name drug is preferred; use of generics offers considerable savings, but for certain critical drugs, physicians prefer trade names. |
| Phases affecting drug activity | dosepharmaceutical phase, pharmacokinetic phase, pharmacodynamic phaseeffect |
| Pharmaceutical phase | disintegration of dosage form, dissolution |
| Pharmacokinetic phase | absorption, distribution, metabolism, excretion; most drugs ionized so water soluble; influence of pH on these compounds is crucial to absorption; lipid soluble drugs easily pass through membrane. |
| Passive transport | most drugs are transported by this system (no energy required) |
| Active/carrier transport | necessary for transport of amino acids, glucose, and a few drugs (energy required); active transport usually more rapid than passive diffusion. |
| Pharmacokinetic absorption variables | nature of absorbing surface, blood flow, solubility, pH, drug concentration, pharmaceutical preparations |
| Pharmacodynamic phase | drug-receptor interaction |
| Routes of drug administration | enteral, parenteral, percutaneous |
| Enteral | administration into the gastrointestinal tract |
| Enteral administrations | oral, nasogastric, rectal (have first hepatic pass); buccal, sublingual |
| Parentral | administration into sites other than gastrointestinal tract; usually via needle; has no first pass |
| Parentral administrations | IV, intrapleural, intra-arterial, intra-articular, intracisternal, intraperitoneal, intraspinal, intraosseous, intrathecal, intramuscular (90 degree), subcutaneous (45 degree), intradermal (15 degrees) |
| Percutaneous | administration through the skin or mucous membranes; no hepatic first pass |
| Percutaneous administrations | transdermal, topical, intraocular, intrarespiratory, intravaginal, intrauterine, intraurethral, intranasal, otic, intravesical |
| Distribution | transport of a drug in body fluids from the bloodstream to various tissues of the body and ultimately to site of action; rate depends on permeability of capillaries, cardiac output, regional blood flow; first distribution to heart, liver, kidney, brain |
| Plasma protein binding | protein binding decreases concentration of free drug in circulation, so limits amount that travels to site of action; deems any drug as not approved by FDA |
| Drugs and adipose tissue | lipid-soluble drugs have a high affinity for adipose tissue, so women have harder time coming out from under anesthesia |
| Bones and drugs | some drugs have an unusual affinity for bones and/or teeth |
| Barriers to drug distribution | specialized structures composed of biologic membranes can serve as barriers to the passage of drugs at certain sites in the body |
| Blood-brain barrier | row of capillary endothelial cells covered by fatty sheath of glial cells joined by tight junctions; allows distribution of lipid-soluble drugs into brain, cerebrospinal fluid |
| Placental barrier | separate blood vessels of mother & fetus; does not give complete protection to fetus; nonselective passage of drugs across placenta to fetus, so drugs that produce response in mother can act on fetus; steroids, narcotics, anesthesics, antibiotics. |
| Metabolism/biotransformation | process of chemical inactivation of a drug by conversion into more water-soluble compounds or metabolites, which can then be excreted |
| Drug microsomal metabolizing system (DMMS) | vast majority of drugs that are metabolized in the liver by this enzyme system; key element is cytochrome p-450 system |
| Hepatic first pass effect | orally admin drugs absorbed travel first to portal system & liver before entering general circulation; some drugs significantly metabolized before ever reaches circulation, so only a small fraction of the dose is available for a pharmacologic effect |
| Excretion | drugs continue to act in the body until they are biotransformed and/or excreted; primarily by kidneys; also via biliary excretion, lungs, sweat, saliva, breast milk |
| Drug-receptor interaction | drugs are selectively active substances; have high affinity for specific chem group/cell; drug w/ best receptor fit will produce greatest response |
| Receptor | reactive cellular site with which a drug interacts to produce a pharmacologic effect |
| Affinity | propensity of a drug to bind or attach itself to a given receptor site |
| Efficacy | intrinsic activity; drug’s ability to initiate biologic activity as a result of such binding |
| Agonist | drug that combines w/ receptors & initiates a sequence of biochemical and physiologic changes; possesses both affinity and efficacy |
| Antagonist | agent designed to inhibit or counteract effects produced by other drugs or undesired effects caused by cellular components during illness. |
| Drug-enzyme interaction | interaction b/t drugs & enzymes; drugs can inhibit action of a specific enzyme and alter physiologic response; drugs can combine w/ enzymes, as well |
| Nonspecific drug interaction | drugs demonstrate no structural specificity & act by more general effects on cell membranes and cellular processes; may penetrate into cells or accumulate in cellular membranes and interfere w/ physical/chem means w/ cell function/processes |
| Drug-response relationship | after administration, each drug has own pharmacokinetic effects that can be analyzed via plasma level profile; info used to alter dose, scheduling, or rte of admin |
| Onset of action/latent period | interval b/t time a drug is administered and first sign of effect |
| Termination of action | point at which a drug effect is no longer seen |
| Duration of action | period from onset of drug action to the time when response is no longer perceptible |
| Minimal effective concentration | lowest plasma concentration that produces the desired drug effect |
| Peak plasma level | highest plasma concentration achieved from a dose |
| Toxic level | plasma concentration level at which drug produces serious adverse effects |
| Therapeutic range | range of plasma concentrations that produce desired drug effect w/out toxicity |
| Drug response curve | used to evaluate concentration needed to produce a desired therapeutic effect |
| Time response curve | used to determine frequency of administration of meds to maintain effective drug response |
| Therapeutic drug range | used to determine safety and effectiveness of a drug |
| Biologic half life | time required to reduce by one half the amount of unchanged drug that is in the body at the time equilibrium is established; longer the half-life, the longer it stays in the body |
| Therapeutic index | provides measure of relative safety of drug; presents ratio between lethal does and effective dose—ld50/ed50; closer to 1, the greater the danger involved |
| Drug bioavailability | percentage of active drug substances absorbed and available to reach the target issues after drug administration |
| Side effects | usually predictable and undesirable effects produced at therapeutic drug dosages (i.e. nausea, vomiting, dizziness, drowsiness) |
| Adverse reactions | unintended, undesirable and often unpredictable effects that are sometimes immediate while at other times they may take weeks or months to develop; depend on age, body mass, gender, pathologic state, etc. |
| Unpredictable adverse reactions | allergic drug reactions; altered state of reaction to a drug, resulting from previous sensitizing exposure and development of immunologic response |
| Type I (analphylactic) | massive vasodilation in peripheral body; fatal if not recognized quickly |
| Type II (cytotoxic) | involves a drug and IgG or IgM; sometimes called autoimmune response |
| Type III (arthus) | sometimes called serum sickness; drug forms complex w/ blood antibodies resulting in angioedema, arthralgia, fever, swollen lymph nodes |
| Type IV (cell mediated/delayed hypersensitivity reaction) | sensitized T lymphocytes and macrophages; dermatitis from direct skin contact b/t drug and sensitized cells |
| Tolerance | decreased physiologic or therapeutic response to a drug after repeated drug administration; necessitates an increase in drug dosage to maintain given therapeutic effect |
| Addiction | condition of drug abuse/dependence that is characterized by compulsive drug behavior |
| Dependence | condition of reliance on use of particular drug, characterized as physical and/or psychological dependence |
| Cumulation | condition in which the body cannot excrete one dose of a drug before the next dose is administered resulting in increasing levels of the drug in the body; toxicity can result |
| Iatrogenic | unintentional drug effect or disease induced by a physician’s prescribed therapy |
| Idiosyncratic | drug effect unique to an individual that is totally unexpected |
| Drug interactions | occurs when the effects of one drug are modified by the prior or concurrent administration of another drug; can be beneficial or detrimental. |
| Incompatibility | usually refers to physical alterations of drugs that occur before administration when different drugs are mixed in the same syringe or container (cloudy) |
| Additive | when combined effect of two drugs, each producing the same biological response by the same mechanism of action, is equal to the sum of their individual effects (1+1=2) |
| Summative | when combined effect of two drugs each producing the same biological response by different MOA, is equal to the sum of their individual effects |
| Synergism | when combined effect of two drugs is greater than the sum of their individual effects (1+1=3) |
| Antagonism | when combined effect of two drugs is less than the sum of their individual effects (1+1=0) |
| Polypharmacy | the indiscriminate use of numerous meds concurrently |
| Contraindications | situations or conditions when a certain drug should not be administered |
| Dose | exact amount of drug that is administered in order to produce a specific effect |
| Lethal dose | dose that causes death |
| Loading dose | first dose given, higher than subsequent doses to elevate blood level rapidly to achieve therapeutic drug concentrations |
| Maintenance dose | dose required to maintain drug blood levels in therapeutic range |
| Maximum dose | largest amount of a drug that will produce a desired effect |
| Minimum dose | smallest amount of drug that will produce a therapeutic effect |
| Toxic dose | does that will produce harmful effects |
| Usual dose | dose that is generally appropriate for the patient |
| Absorption | entrance of a drug into the bloodstream from its site of administration |
| Drug distribution | passage of a drug from the blood to the tissues and organs of the body |
| Enzyme induction | increase in the amount of drug-metabolizing enzymes after repeated administration of certain drugs |
| ED50 | effective dose 50, or dose that will produce an effect that is half of the maximal response |
| Indication | illness disorder for which a drug has documented usefulness |
| Individual variation | difference in the effects of drugs and drug dosages from one person to another |
| LD50 | lethal dose 50; or dose that will kill 50 percent of animals tested |
| Mechanism of action | explanation of how a drug produces its effects |
Created by:
mbtrimm
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