PharmacologyHSC1149
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| any chemical substance taken into the body for the purpose of affecting body function | drug
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| were the primary source of drugs used on the human body | plants
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| four ways that drugs are obtained | source of drugs
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| iron, sulfur, potassium, silver, & gold are some of the ___ used to prepare drugs | minerals
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| research lead to the use of substances from ___ as effective drugs | animals
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| substances lacking in the human body can be replaced with similar substances from the | glands, organs & tissues of animals
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| origin of drugs from an animal source even now includes ___ ___ | human extractions
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| can be used to make a drug for treatment of growth disorders | pituitary gland from cadavers
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| chemists use __ __ to make drugs to market for human consumption | synthetic sources
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| evolved with human skills in labs & advanced understanding of chemistry; most actively pursues source of drugs by major companies today | synthetic (manufactured) sources
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| produced from artificial rather than natural substances | drug compounds
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| numerous antibiotics are | synthetic or semisynthetic
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| 1990s, development of drugs for treatment of life-threatening or other various conditions | investigational new drugs (INDs)
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| slows progression of HIV infection in some patients; IND of 1990s | Zidovudine (AZT) (Retrovir)
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| used to treat many different malignancies & also management of AIDS-related Kaposi's sarcoma; IND of 1990s | Interferon (Roferon A)
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| used to slow progression of dementia in some Alzheimer patients; IND of 1990s | Tacrine (Cognex)
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| combines Norvasc & Lipitor for simultaneous treatment of high blood pressure & high cholesterol; 1st to treat these 2 conditions with a single tablet; 21st century IND | Caduet
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| first-line treatment for metastatic colorectal cancer; prevents formation of new blood vessels denying necessary nutrients needed for growth & metastasis; 21st century IND | Avastin
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| physiological changes that occur in response to a drug | effect of drug
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| reaches widespread areas of the body | systemic effect
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| limited to area of body where administered | local effect
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| four biological changes drugs undergo in the body | drug processes
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| drug gets into the blood stream | absorption
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| drug moves from bloodstream into tissues & fluids of the body | distribution
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| physical & chemical alterations that a substance undergoes in the body | metabolism
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| eliminating waste products of drug metabolism from the body | excretion
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| if any of the four drug processes is hampered the drug __ and __ will be hampered | actions; effects
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| mucosa of stomach, mouth, small intestine, or rectum; blood vessels in muscles/subcutaneous tissues; or dermal layers are the | primary site of absorption
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| circulatory system, through capillaries & across cell membranes are the | primary site of distribution
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| liver is the | primary site of metabolism
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| kidneys, sweat glands, lungs, or intestines are the | primary site of excretion
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| specific directions that accompany each drug are given to __ the absorption, distribution, metabolism, & excretion of the drug | enhance
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| varies according to pH, lipid solubility, & presence/absence of food in the stomach | site of absorption of a drug
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| drugs of a slightly acidic pH are absorbed well through the | stomach mucosa
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| drugs of an alkaline pH are readily absorbed in the | small intestine
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| given on an empty stomach so that the pH is not altered; if dairy, milk or antacids present it will not properly be absorbed | tetracycline
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| oral medication for infants may not be absorbed well after feeding because the milk or formula ___ the acidity of the stomach | acidity
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| substance ___ in lipid solubility are easily absorbed through the mucosa of the stomach | high
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| alcohol and substances containing alcohol are soluble in | lipids
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| substances soluble in lipids are rapidly absorbed through the __ __ | GI tract
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| substance ___ in lipid solubility are absorbed best when given by means other than the GI tract | low
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| not lipid soluble but given orally for suppression of intestinal bacteria before intestinal/bowel surgery or in treatment of bacterial diarrhea | neomycin
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| food in the stomach tends to slow absorption due to a | slower emptying of the stomach
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| if a fast drug effect is desired, an __ __ will facilitate quicker absorption | empty stomach
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| medications that are irritating to the stomach can be buffered by the presence of | food
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| reaching sites beyond the major organs may depend of the drugs ability to | cross a lipid membrane
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| composed of high-density cells restricting passage of substances from the bloodstream much more than endothelial cells in capillaries elsewhere in the body | blood-brain barrier
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| affinity/attraction of a drug to a specific organ/cell | selective distribution
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| selective distribution to CSF | amphetamines
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| selective distribution to the ovaries, as a fertility drug | human chorionic gonadotropin (hCG)
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| by virtue of their properties some drugs are distributed __ __ than others | more slowly
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| 2 drugs categorized in the same classification may be known to | act on the cells & achieve the effect more quickly
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| biotransformation means transformed in | the liver
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| drug is broken down to more water-soluble by-products, making it more easily secreted by the kidneys, during | biotransformation
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| a patient may exhibit toxic effects of drug if | hepatic disease is present
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| it is possible for some drugs to by pass the | process of metabolism
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| drugs that are able to by pass the process of metabolism reach the kidneys unchanged and may later be | detected in the urine
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| most drugs are excreted by | the kidneys
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| refers to a condition that results from exposure to either a poison or a dangerous amount of a drug that is normally safe when given in a smaller amount | toxicity
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| increased effect of a drug demonstrated when repeated doses accumulate in the body | cumulative effect
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| cumulative effect may build to a dangerous/toxic level & can be of particular concern in | older adults
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| to give just enough of the drug to cause the desired/therapuetic effect while keeping the amount below the level where toxic effects are observed | goal of drug therapy
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| cardiac drug that must be given cautiously because of its potential for causing a cumulative effect | Digoxin
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| must be adequate or digoxin will accumulate, leading to digoxin toxicity | circulation & renal function
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| factors that affect speed & efficiency of drugs processed by the body | variables
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| are slower in older adults, so attention must be paid to possible cumulative effects | metabolism & excretion
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| have a lower threshold of response and react more rapidly/in unexpected ways; frequent assessment is imperative | children
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| many drug dosages are always calculated on the basis of | the patient's weight
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| because the ratio of fat per body mass differs and so do hormone levels women respond | differently than men to some drugs
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| most drugs are contraindicated or dosage must be adjusted, if the | female is pregnant or nursing
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| the more positive the patient feels about the medication, the more positive the | physical response
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| beneficial effect in patient following particular treatment arising from patient's expectations about the treatment rather than from the treatment itself | placebo effect
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| inactive substance that resembles a medication, although no drug is present (i.e. a sugar tablet or saline injection) | placebo
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| attitudes towards medicines can be influenced positively/negatively by | cultural or religious beliefs
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| when more than one medication is taken | combination
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| combination may __ alter the normal expected response of each individual drug | alter
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| action of 2 drugs working together in which one helps the other simultaneously for an effect that neither could produce alone | synergism
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| action of 2 drugs in which one prolongs/multiplies the effect of the other | potentiation
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| opposing action of 2 drugs in which 1 decreases/cancels out the effect of the other | antagonism
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| important for prescribing physician to know all medications a patient is taking in order to | prevent undesirable drug interactions
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| by giving small amounts of 2 drugs together effect can be achieved more safely than by giving a larger amount of one/other by itself, would be | desired synergism
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| 2 drugs given in combination can depress the CNS to dangerous levels, depending on strengths of each would be | undesirable synergism
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| building up a high/safe level of an antibiotic in the blood, then simultaneously giving a drug that slows the kidney's excretion rate | desirable potentiation
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| toxic effect that may result from a drug potentiating the level of another drug's concentration in the blood | undesirable potentiation
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| narcotic antagonist cancels out effects of an overdoes of narcotics | desirable antagonism
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| a drug that lowers the pH and prevents absorption of another drug | undesirable antagonism
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| may bring about variations in speed of drug action or effectiveness | drug dosages
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| amount of drug given for particular therapuetic or desired effect | dosage
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| smallest amount of a drug that will produce a therapuetic effect | minimum dose
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| largest amount of a drug that will produce a therapuetic effect without producing symptoms of toxicity | maximum dose
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| initial high dose used to quickly elevate the level of the drug in the blood | loading dose
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| the initial high dose, of a loading dose, is often | the maximum dose
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| the initial dose, of a loading dose, is often followed by a series of | lower maintenance doses
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| dose required to keep the drug blood level at a steady state in order to maintain desired effect | maintenance dose
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| amount of drug that will produce harmful side effects or symptoms of poisoning | toxic dose
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| dose that causes death | lethal dose
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| customarily given based on adult body weight of 150 lb; adjusted according to variations from the norm | therapuetic dose
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| most significant factor in the speed of drug action | route of administration
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| sometimes based on degree of speed, cost, or safety | the route of administration
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| some medications can be given only by one route because | absorption occurs by that route only
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| some medications, given by one route only, can be ___ or ___ when given by another route | dangerous; toxic
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| oral (PO), nasogastric tube (NG), and rectal (R) are | GI tract routes
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| include any route of administration other than gastrointestinal tract | parenteral routes
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| sublingual (SL)/buccal, Injection, topical, & inhalation are all | parenteral routes of administration
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| intravenous (IV), intramuscular (IM), subcutaneous (subQ), intradermal (ID), intracardiac, intraspinal, intracapsular are all | injection routes of administration
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| dermal (D) & mucosal | topical (T) routes of administration
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| may depend on (1) desired effect, (2) absorption qualities, & (3) how supplied | doctor's choice of route of administration
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| is easiest, but effects are slower due to time required for disintegration of drugs in alimentary canal before absorption | oral route of administration
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| fastest, given in small amounts, effects immediate, dangerous if given in amounts intended for other routes; administered by IV push or bolus, or diluted solutions infused by IV drip | IV route of administration
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| concentrated drug solution | bolus
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| administered by a physician, RN, or paramedic | IVs
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| IVs are the best route for treatment of emergencies because of | speed of action
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| when a patient can take nothing by mouth or the drug is not suitable for GI absorption it is given | parenterally
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| because the muscles are highly vascular the __ __ is fairly rapid | intramuscular route
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| any unexpected or dangerous reaction to a drug; unwanted effect; onset may be sudden or develop over time | adverse drug effects
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| effect from maternal drug administration that causes development of physical defects in a fetus | teratogenic effect
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| unique, unusual response to a drug | idiosyncrasy
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| opposite effect from what is expected | paradoxical
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| decreased response to drug that develops after repeated doses are given; drug dosage must be increased or drug replaced, in order to achieve desired effect | tolerance
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| acquired need for drug that may produce physiological/physical symptoms of withdrawal when drug discontinued | dependence
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| no physical symptoms of withdrawal other than anxiety; craving | physiological dependence
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| when cells actually have a need for the drug; withdrawal symptoms include retching, nausea, pain, tremors, & sweating | physical dependence
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| immune response to a drug; may be of varying degrees | hypersensitivity
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| hypersensitivity may develop after previous __ __ of a drug | uneventful uses
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| hypersensitivity more likely to exist in patient with | other known allergies
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| nausea, vomiting, & diarrhea are not considered | signs of allergies
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| severe, possibly fatal, allergic response | anaphylactic reaction
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| include itching, uticaria, hyperemia, vascular collapse, shock, cyanosis, laryngeal edema, & dyspnea | signs of anaphylactic reaction
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| includes CPR if indicated & drugs as required, such as epinephrine to raise blood pressure, corticosteroid to reduce inflammation and body's immune response, or antihistamine to reduce redness, itching & edema | treatments for anaphylactic reaction
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| antibiotics especially penicillin; x-ray dyes containing iodides; & insect stings have been noted often to cause | anaphylaxis
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| knowledge of adverse drug reactions should be included in the | patient's history
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| getting accurate drug history & listing known allergies is a __ __ of the health care worker | critical function
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| absorption is the __ biological change process that drugs undergo when they are ingested | initial
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| drugs whose actions are limited to a __ __ of the body have local effects | specific location
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| the pharmacokentic affect of a medication taken with food is that food tends to | slow drug absorption
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| age, weight, psychological state, & sex are the __ __ that affect the speed & efficiency of drug processing | major variables
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