Download Pharmacology Chapters 1-13 questions with correct and verified answers - University of Cal and more Exams Nursing in PDF only on Docsity!
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Drug - correct answers Any substance that is taken to cure, or reduce symptoms of a medical condition. Pharmacology - correct answers The study of medicine. Pharmacotherapy/Pharmacotherapeutics - correct answers Application of drugs for the purpose of disease prevention and treatment of suffering. Indications and Contraindications - correct answers The conditions for which a drug is approved are its indications. Every drug has at least one indication. Some drugs are used for conditions for which they have not been approved; these are called unlabeled or off- label indications. Therapeutic classification - correct answers - Based on their usefulness in treating a specific disease
- The key to therapeutic classification is to simply state what condition is being treated by the particular drug.
- The prefix anti- refers to therapeutic classification. Pharmacologic Classification - correct answers - Addresses a drugs mechanism of action or how a drug produces its effect in the body.
- More specific than therapeutic
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- Requires biochemistry and pathophysiology Chemical name - correct answers - Assigned using standard nomenclature.
- A drug has only one chemical name
- Helpful in predicting a drugs physical and chemical properties. Generic name - correct answers Name assigned by the United States Adopted Name Council. Less complicated and easy to remember. Trade Name - correct answers Sometimes called the proprietary product, or brand name is assigned by the pharmaceutical company maketing the drug. Exclusivity - correct answers Typical length of exclusivity for a new drug is 5 years. Combination drug - correct answers Drugs with more than one active generic ingredient. Pros and Cons of Generic Drugs - correct answers Generic drugs are less expensive than brand name drugs, by they may differ in bioavailability. (The rate at which drug produces its effect.)
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Pharmacotherapy and the older adult (plasma levels drug concentration in tissues) - correct answers Age related increases in fat storage cause lipid soluble drugs to be stored in the body for extended periods, leading to lower plasma levels and increased drug concentrations in the tissues. Age related changes in the liver - correct answers Include reduced hepatic function, decreased liver mass, diminished blood flow, and alteration in the activity of hepatic enzymes. Frequency of administration for older adults - correct answers Should be decreased to avoid toxicity due to drug accumulation. Older adults and receptors - correct answers Pharmacodynamic changes are usually associated with drug receptors. Evidence suggests that older adults have a decreased number of receptors. The government agency that is responsible for regulating drugs in the United States. - correct answers FDA-Food and Drug Administration. o Protect the public health. o Speeding innovations that make medicines and food more effective. o Helping the public get more accurate information.
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Overall process to get new drugs on the market. - correct answers o Step 1-Pre- Clinical research: Involves extensive lab testing by the parmacutical company. If the drug appears promising the pharmaceutical company submits an investigational New drug (IND) application. (contains animal testing) o Step 2: After animal testing comes clinal phase trials which is the longest part of the approval process. The clinical trial has three different phases.
- Phase 1- testing is conducted on 20-80 healthy volunteers for several months to determine proper dosage and to assess for adverse effects. If unaccepted levels of toxicity are noted, trials are stoped.
- Phase 2- Several hundred patients with the disease are treated with drug. Compared with a placebo to test effectiveness. Also can be compared to a drug already available.
- Phase 3- Large numbers of patients with the disease are given the drug to determine patient variability. Patients with chronic conditions are given the drug to determine safety. o Step 3: If the new drug shows promise a New Drug application is submitted to the FDA. If accepted, manufacturer may be able to start selling the drug. o Step 4- Post market surveillance: Occurs after the NDA review has been completed. The purpose of stage 4 is to survey for harmful drug effects in a larger population. Difference between over the counter and prescription drugs. - correct answers o Prescription medications are judged by the FDA to be potentially addictive or too harmful for self administration o Prescriptions give an opportunity for a doctor to assess your problem and treat more complex problems. o OTC drugs allow patients to treat themselves and are obtained much easier.
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Prn q4n - correct answers Administer drug only once every 4 hours. Enteral Medications - correct answers Includes drugs delivered to the GI tract, either orally or through nasogastric or gastrostomy tubes. o Most common, most convenient and least costly o Intended for absorption to the general circulation. o Extended release formulations: contain a high amount of medication that is intended to be released over an extended period. Opening the capsule or crushing the tablet will release the entire drug immediately, possibly resulting in a toxic effect. Enteric-Coated drugs - correct answers When crushed or opened these drugs are exposed to stomach acid, which may destroy them. The drugs may irritate the stomach mucosa and cause nausea or vomiting. Topical medications - correct answers Applied to the skin or mucous membranes. o Includes medications applied to the skin or the membranous linings of the eye, ear, nose, respiratory tract, urinary tract, vagina, and rectum. o Dermatologic are applied to the skin o Instillations and irrigations are applied to the body cavities or orifices (eyes, ears, nose, bladder, rectum, and vagina) o Inhalations are drugs applied to the respiratory tract by inhalers, nebulizers, or positive pressure breathing machines.
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Parenteral Administration - correct answers Dispensing of drugs by routes other than enteral or topical. A needle is used to deliver drugs into the skin layers, subcutaneous tissue, muscles, or veins. More invasive than topical or enteral because of the potential for introducing microbes directly to blood and tissues. Pharmacokinetics - correct answers - Derived for the root words pharmaco, which refers to medicines and kinetics, which means "movement" or motion. Pharmacokinetics is the study of drug movement throughout the body.
- Majority of drugs produce their effects in target cells. First they must cross the plasma membrane and enter cells to produce their effects. The process of pharmacokinetics is grouped into 4 categories... - correct answers Absorption, distribution, metabolism, and excretion. Absorption - correct answers - Process by which drug molecules move from their site of administration to the blood.
- Absorption is the primary pharmacokinetic factor determining the onset of drug action The faster the absorption... - correct answers the faster the onset time. Drugs administered by IV route bypass... - correct answers absorption entirely.
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For a drug to be absorbed there must be... - correct answers Be adequate blood flow. Therefore drugs are absorbed faster where blood flow is high. Large muscles have high blood flow which maximize absorption. Distribution - correct answers Movement of pharmacologic agents throughout the body after they are absorbed The simplest factor in determining drug distribution. - correct answers The amount of blood flow to the body tissues. Heart, liver, kidneys receive greatest % of blood flow so these organs receive the highest exposure to absorbed drugs. Skin, bone and adipose tissue receive little blood flow. Drug solubility - correct answers Lipid solubility determines how quickly a drug is absorbed, mixes in the blood stream, crosses membranes, and becomes localized in body tissues. Are lipid soluble drugs more distributed to the body tissues? - correct answers Yes- they are not limited by barriers that water soluble drugs are so thus they are more distributed by body tissues.
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Protein binding - correct answers Many drugs bind reversibly to plasma proteins to form drug-protein complexes which are too large to cross capillary membranes. The drugs the continue circulation in the bloodstream and are unavailable for distribution to their site of action. Drugs remain trapped in the bloodstream until they are released or displaced. Only unbound or free drugs can reach their target cells or be excreted by the kidneys. Metabolism - correct answers Also known as biotransformation is the process used by the body to chemically change a drug molecule. • Prodrug- Agents that require metabolism to produce their action. Ex: enalapril (vasotec) is converted in the liver to enaliprat which has more of an effect on lowering blood pressure than the original drug. Role of enzymes/factors that impact metabolism - correct answers Most metabolism in the liver is accomplished by the hepatic microsomal enzyme system. (P450 system named after cytochrome P450 (CYP) which is a key component of the system.) First pass effect - correct answers Mechanism whereby drugs are absorbed, enter into the hepatic portal circulation, and are inactivated by the liver before they reach the general circulation. Excretion - correct answers Drugs will continue to act on the body until they are either metabolized to an inactive form or removed from the body by excretion.
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Pharmacogenetics - correct answers The branch of pharmacology that examines the role of genetics in drug response. Therapeutic index - correct answers Describes a drug's margin of safety. Median lethal dose (LD50) - correct answers is a value often determined in lab animals in preclinical experiments during the drug development process. It will only kill half. Median effective dose (ED50) - correct answers is a value showing the production of a therapeutic response in half of test subjects. Therapeutic index ratio - correct answers is defined as the ratio of a drugs LD50 to its ED50. o If the difference between an effective dose and a lethal dose is very small for drug z then the drug has a narrow safety margin. There are two fundamental ways to compare medications within therapeutic and pharmacologic classes. - correct answers o Potency- the strength of a drug at a specified concentration or dose. A drug that is more potent will produce its therapeutic effect at a lower dose. (amount and strength given) o Efficacy- the greatest maximal response that can be produced form a particular drug. (the max response of drug)
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Receptor theory - correct answers o Most drugs produce their actions by activating or inhibiting specific cellular receptors. o Drugs rarely create new actions in the body, instead they enhance or inhibit existing physiological and biochemical processes. o A cellular molecule to which a medication binds to produce its effects is called a receptor. o Receptor theory predicts that the response of a drug is proportional to the concentration of receptors that are bound or occupied by the drug. The theory explains the mechanisms by which most drugs produce their effects. o Drugs that have the ability to bind to a receptor and produce a strong action are said to have high intrinsic activity. Agonist - correct answers A drug that activates a receptor and produces the same type of response as the endogenous substance is called an agonist. Partial Agonist - correct answers Partial agonist is used to describe a medication that produces a weaker, or less efficacious, response than an agonist. Antagonist - correct answers A second possibility is that a drug will occupy a receptor and prevent the endogenous chemical from binding to produce its action. This type of drug, an antagonist, often competes with agonists for receptor binding sites.
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Nursing knowledge and behaviors to help prevent/minimize side effects - correct answers o Take a thorough medical history o Thoroughly assess the patient and all diagnostic data o Prevent medication errors o Monitor pharmacotherapy carefully o Know the drugs o Be prepared for the unusual o Question unusual orders o Teach patients about adverse effects Adverse event reporting system - correct answers A voluntary program that encourages health care providers and consumers to report suspected adverse effects directly to the FDA or the product manufacturer. Drug allergy - correct answers Common events, comprising 6% to 10% of all adverse drug effects. o All are caused by a hyper-response of body defenses. o Signs and symptoms of drug allergies are non-specific Teratogen - correct answers a drug that causes birth defects
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Drug interaction - correct answers Occurs when a substance increases or decreases a drugs action. Potential outcomes for such interactions... o The actions of the drug can be inhibited, resulting in less therapeutic action. o The actions of the drug may be enhanced, causing a greater therapeutic response. o The drug interaction my produce a totally new and different response. Additive effect - correct answers The pharmacodynamics drug interaction that is easiest to visualize. In this reaction two drugs from a similar therapeutic class produce a combined summation response. Using lower doses of two drugs compared to a high dosage of one drug helps avoid adverse side effects. Synergistic effect - correct answers The effect of the two drugs is greater than would be expected from simply adding the two individual drugs response. Used extensively in treating infections. Antagonist effect - correct answers Occurs when adding a second drug results in a diminished pharmacologic response. This effect can result in drug actions being cancelled. Can be used to treat symptoms of a drug overdose. Interactions between grapefruit juice and medications - correct answers o Grapefruit juice contains substances that increase the absorption of certain oral drugs. This occurs because grapefruit juice inhibits the enzyme CYP3A4 in the wall of the intestinal tract. As drugs are absorbed, they are not inactivated by CYP3A4, and higher amounts reach the circulation.
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Addiction - correct answers an overwhelming compulsion that drives someone to repeat drug-taking behavior, despite serious health and social consequences. Physical dependence - correct answers Occurs when the body adapts to repeated use of the substance by altering normal physiology. Physiological dependence - correct answers Produces no signs of physical discomfort after the agent is discontinued. Tolerance - correct answers a biologic condition that occurs when the body adapts to a substance after repeated administration. Withdrawal syndrome - correct answers Once a patient becomes physically dependent and the substance is abruptly discontinued. Controlled substance - correct answers A drug whose use is restricted by the Comprehensive Drug Abuse Prevention and Control Act of 1970 and later revisions. Title II of this law, known as the Controlled Substances Act (CSA), is the legal basis for regulating drugs of abuse. The CSA created five categories or schedules for drugs of abuse. These scheduled drugs are classified according to their potential for abuse and toxicity. Schedule I - correct answers Abuse Potential + Physical Dependence + Physical/Psychological Dependence=HIGH
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Heroin, GHB, LSD, Maijuana, MDMA, mescaline, methaqualone, methcathinone, peyote, and psilocybin. No prescriptions may be written. Schedule II - correct answers AP + PD + Psy.P = High Potent opioids (such as codeine in high doses, fentanyl, methadone, morphine, oxycodone, meperidine), amphetamine, cocaine, methamphetamine, methylphenidate, PCP, short-acting barbituates. Used therapeutically with prescription; some drugs are no longer used; normally no refills are permitted (but there are a few exceptions). Schedule III - correct answers AP: Moderate PD: Moderate PsyP:High. Anabolic steroids, buprenorphine ketamine, codeine (lower doses compounded with aspirin or acetaminophen), hydrocodone (lower doses compounded with aspirin or acetaminophen), and intermediate-acting barbituates. Used therapeutically with prescription; five refills allowed in a 6 month period. Schedule IV - correct answers Lower + Lower + Lower. Benzodiazepines (such as alprazolam, diazepam, midazolam, temazepam), long-acting barbituates, meprobamate, pentazocine, and zolpidem. Used therapeutically with prescription; five refills allowed in a 6 month period. Schedule V - correct answers Lowest + Lowest + Lowest. Over-the-counter (OTC) cough medicines with codeine, antidiarrheal medicines with small amounts of opioids. In some cases, these may be dispensed by a pharmacist in small amounts without prescription.
