BASICS OF PHARM
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| measure to reduce adverse reactions to medication administration | forewarn patients as to activities that may precipitate an adverse reaction
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| problems with trade names | one drug may have different trade names because of different formulations
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| problems with trade names | can be used for different products
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| why are highly lipid souble drugs are absorbed more rapidly than low-lipid soluble drugs | high lipid soluble drugs cross membranes that separate them from the blood
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| parenteral | outside the GI tract (injection by IV, subQ, IM)
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| at what rate should IV meds be administered | over one full minute
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| how long does it take an IV drug injected in the AC to reach the brain | 15 seconds
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| what are depot preparations | preparations from which the drug is absorbed slowly over an extended time
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| what kinds of compounds do not pass freely from the maternal bloodstream into the fetus bloodstream | ionized, highly polar, protein bound drugs remain in the bloodstream
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| benathine pcn G can be released at a therapeutical amount over one month from a single IM injection, what type of preparation would this be called | depot preparation
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| what types of compounds pass freely from the maternal bloodstream to fetus? | lipid soluble compounds and non-ionized compounds
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| what can occur when two highly protein bound drugs are given together | compete for sites on the protein
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| what happens when two highly protein bound drugs are given together and compete for sites | drug with weakest attraction becomes "free" and can reach toxic levels
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| high protein bound drug | warfarin, ASA, Paroxetine
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| drugs that are highly bound to protein may exhibit (increased/ decreased) levels in the blood when the patient is gound to be in a malnourished state | increased
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| biotransformation (drug metabolism) | enzymatic alteration of drug structure
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| where does most drug metabolism take place | liver
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| if two drugs are given that both utilize the same p450 hepatic microsomal system, the drug level in the blood of the drug that is not metabolized (increases/ decreases) | increases
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| what age does hepatic maturation occur | about 1 year after birth
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| drug metabolizing capacity in infants is (decreased/ increased) | decreased
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| how is the first pass effect circumvented | when a drug is given parenterally
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| what is an example of a drug that if given orally would be destroyed in the "first pass" through the GI tract | nitroglycerin given sublingual
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| what aspect of pharacokinetics (absorption, distribution, excretion, metabolism) is affected in pts with kidney disease? | excretion
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| the range of plasma drug level that falls between minimum effective concentration and teh toxic concentration is called what? | therapeutic range
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| drug with narrow therapeutic rang is (more/ less) dangerous | more
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| time requried for drug in the body to decrease by 50% is called? | half-life
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| how many half lives does it take for a drug to reach plateu | four half lives
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| drugs with long half-life need to be administered (more/ less) frequently than drugs that have a short half life | less frequently
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| agonists | molecules that activate receptors
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| antagonists | molecules that prevent receptor activation
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| drugs that mimic the body's own regulatory molecules are called | agonists
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| desensitizing occurs when teh receptors of a cell are continually exposed to an agonist; the cell becomes less responsive. | down-regulation
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| the does required to produce a defined therapeutic response in 50% of the population is | ED50
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| ratio of a drug's LD50 to its ED50 | therapeutic index (measure of drug safety)
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| drug with high therapeutic index is (safe/ unsafe) | safe
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| laxatives (reduce/ increase) absorption | reduce (speeds passage of drugs throough intestine)
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| drugs that decrease peristalsis and cause increased drug time (and increased absorption) in the intestines | morphine and atropine
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| When an inducing drug such as phenobarbital is taken concurrently with another medication, the metabolism of the other medications is (increased or decreased)? | The metabolism is increased and the drug is excreted more rapidly
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| Accelerated metabolism would lead to (increased or decreased) blood levels of other drugs | decreased
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| with inducing drug (more/ less) of the other medication would be needed | more
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| grapefruit juice can (inhibit/ induce) the matabolism of certain drugs, thereby (raising/ lowering) their blood levels | inhibit, raising
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| potential consequences when CCB's taken with grapefruit juice | inhibits metabolism; can cause toxicity
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| how to administer drug "on an empty stomach" | 1 hour before or 2 hours after meals
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| patient over what age account for over 50% of all adverse drug reactions (ADR's) | elders over the age of 65
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| when do side effects usually occur | soon after onset of drug, or in some cases weeks or months afterwards
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| can an allergic reaction occur without prior sensitizaiton to the immune system? | must have prior sensitizaiton
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| define idiosyncratic effect | uncommon drug response resulting from a genetic predisposition
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| succinylcholine is used to promote temporary paralysis. In some patients, the genes that code for succinylcholine-metabolizing enqymes are abnormal and lead to prolonged paralysis. | idiosyncratic effect
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| life threatening response characterized by bronchospasm, laryngeal edema, drop in BP | anaphylaxis
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| why is abrupt discontinuation of a medication discouraged | withdrawal reactions possible
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| why are women more at risk for prolonged QT interval | women have longer QT than men
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| what is the most common cause of acute liver failure and hepatoxicity | drugs
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| teratogenic | drug induced birth defect
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| 3 most common causes of fatal medication errors | human factor, communication mistakes, name confusion
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| why are elderly more sensitive | organ dysfunction, polypharmacy, comorbidities, cognitive decline
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| a patient with kidney or liver dieae would require (higher/ lower) dose of medication | lower
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| ability of a drug to reach the systemic circulation from its site of administration is known as what | bioavailability
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| component of a drug response that is caused by psychologic factors and not by the biochemical or physiologic properties of the drug is known as what | placebo
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| form of tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time is known as what? | tachyphylaxis
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| decreased responsiveness to a drug as a result of repeated drug administration | tolerance
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| a patient with glucose-6-phosphate dehydrogenase (G6PD) deficiency that takes aspirin or a sulfanilamide is at reisk for what disorder | hemolysis (red blood cell destruction)
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| during pregnancy, increased renal blood flow leads to accelrated excretion of drugs. thes process may reuire (increased/ decreased) drug amount | increase
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| SSRI's are schedule ______ drugs. | not scheduled
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| medications with black box warning | ssri's, salmeterol, avandia, metformin (sulfonlureas), antispychotics
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| which herbal remedy is an inducer and can decrease levels of warfarin, cyclosporine, ocp, antiretrovirals | st johns wort
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| name a drug that is an inducer | phenobarbital
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| diseae or condition produced by a doctor or other health care provider or drugs is known as what | iatrogenic effect
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| do pharmacokinetics change throughout the lifespan | yes
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| drugs that recommend genetic testing | warfarin, carbamazepine, tratuzumab, abacavir
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