HSCI 116

  1. Who is John Jacob Abel?
    The father of American pharmacology.
  2. What is the purpose of pharmacology?
    Improve the quality of life.
  3. What branch of medicine is concerned with the prevention of disease and treatment of suffering?
  4. What is Pharmacotherapy
    The application of drugs for the purpose of disease prevention and the treament of suffering.
  5. Biologics
    Agents naturally produced in the animal cells.
  6. Examples of biologics
    hormones, blood, plasma, vaccines, platelets.
  7. What is a formulary?
    A list of drugs and drug recipes.
  8. Pharmacopeia
    a medical reference summarizing the standards of drug purity, strength, and directions for synthesis.
  9. What are the 4 stages of FDA approval process?
    • 1. Preclinical trials
    • 2. Clinical investigation
    • 3. Review of the New Drug Application
    • 4. Postmarketing Surveillance
  10. What happens in the preclinical investigation stage?
    extensive lab research, including tests on humans and microbes.

    Results are always inconclusive.
  11. What happens in the clinical investigation stage?
    • Testing on humans known as the clinical phase trials.  Longest part of the approval process.
    • 1. Healthy volunteers to check dosage and adverse effects.
    • 2. Selected patients to check effectiveness, effect on other medical conditions, interactions with other drugs...
  12. What happens in the New Drug Application stage?
    The brand name is finalized.  Final approval is given.
  13. What happens in postmarketing surveillance?
    Checks for adverse effects in a larger population.  Ongoing.
  14. How does the Canadian drug approval process compare with the American drug approval process?
    • The canadian process has 6 steps.
    • 1. preclinical studies and clinical trials.
    • 2. an application is submitted to Health Canada.
    • 3. a committee of drug experts review the drug submission identifying potential benefits and risks.
    • 4. Health Canada reviews the information and passes on important details to health practitioners and consumers.
    • 5. Health Canada issues an NOC and DIN allowing the marketing of the drug.
    • 6. Health Canada monitors the effectiveness of the drug.
  15. Therapeutic Classification
    what a drug does.

    Example: anticoagulant, antihypertensive...
  16. Pharmacologic Classification
    how a drug works.

    Example: beta-blocker, diuretic
  17. Prototype drug
    A well understood drug model with which other drugs in its representative class are compared.

    Knowing the characteristics of the prototype drug allow you to predict the actions and adverse effects of other drugs in its class.
  18. bioavailability
    The physiologic ability of the drug to reach its target cells and produce its results.

    A way to compare brand-name drugs to their generic counterparts.
  19. Schedule I drug
    • High abuse potential,
    • high physical dependancy potential,
    • high psychological dependancy potential,
    • limited therapeutic use.

    Ex: marijuana, heroine, LSD
  20. Schedule II drug
    • High abuse potential,
    • high physical dependancy potential,
    • high psychological dependancy potential,
    • therapeutic use.

    Ex: morphine, cocaine, methadone
  21. Schedule III drug
    • Moderate abuse potential
    • moderate physical dependancy potential
    • high psychological dependancy potential,
    • therapeutic use.

    Ex: codeine, hydrocodone, anabolic steroids
  22. Schedule IV drug
    • low abuse potential, 
    • low physical dependancy potential,
    • low psychological dependancy potential, therapeutic use.

    Ex: diazepam
  23. Schedule V drug
    • lowest abuse potential, 
    • lowest physical dependancy potential,
    • lowest psychological dependancy potential,
    • used therapeutic without a prescription.

    Ex: OTC cough medications
  24. How does Canada's schedule of drugs differ from the U.S.'s?
    • 3 drug schedules.
    • I:  all prescription drugs
    • II:  all nonprescription drugs monitored for sale by pharmacists.
    • III: all nonprescription drugs NOT monitored for sale by pharmacists.
  25. Addiction
    overwhelming feeling that drives a person to use a drug repeatedly despite its negative health and social consequences.
  26. Dependence
    a strong physiologic or psychologic need for a substance.
  27. What are the 5 rights of drug administration?
    • 1. Right patient
    • 2. Right medication
    • 3. Right dose
    • 4. Right route of administration
    • 5. Right time of delivery
  28. What are the 3 checks of drug administration?
    • 1. check the drug with the MAR when retrieving.
    • 2. check the drug when preparing it.
    • 3. check the drug BEFORE administrating it.
  29. Compliance
    Taking medication in the manner prescribed.  Includes: time, route, dosage.
  30. STAT order
    given within 5 minutes, given only once
  31. ASAP order
    given within 30 minutes, given only once
  32. Single order
    given only once at a specific time

    Ex: STAT, ASAP
  33. PRN order
    given as the patient needs it
  34.  standing order
    written in advance of a situation, carried out under specific circumstances.
  35. allergic reaction
    an acquired hyper-response of the body's defenses to a foreign substance.  Varies in severity.
  36. What is the nurses job for allergic reactions?
    alert all personnel by documenting the allergy in the patient's medical record; labeling the patient's medical record and MAR record.
  37. What are the 3 main routes of drug administration?
    • 1. enteral
    • 2. topical
    • 3. paraenteral
  38. What are the 4 main methods of enteral drug administration?
    • 1. tablets, capsules, and liquids
    • 2. sublingual
    • 3. buccal
    • 4. nasogastric and gastric tubes
  39. What is a main consideration of administering medications enterally?
    The medications will go through first pass metabolism.
  40. What forms of enteral administration do not go through first pass metabolism?
    sublingual and buccal
  41. What are the main ways to administer a medication topically?
    • 1. creams, lotions, or gels
    • 2. transdermal patches
    • 3. optic drops and ointments
    • 4. otic drops and irrigations
    • 5. nasal drops and sprays
    • 6. vaginal suppositories, creams, jellies, or foams.
    • 7.  rectal suppositories and enemas.
  42. Do topical medications go through first pass metabolism?
    No, they are absorbed through the skin or mucous membranes.
  43. What are the primary routes of parenteral drug administration?
    • 1. intradermal
    • 2. subcutaneous
    • 3. intramuscular
    • 4.intravenous
  44. When would you typically give an intradermal injection?
    allergy shots, disease (PPD) screening, or local anesthetic delivery
  45. When would you typically give a subcutaneous injection?
    insulin shots, heparin shots, vaccines and other medications
  46. What are the three main ways of giving an IV?
    • 1. large volume infusion - typically for fluid replacement/maintenance.  
    • 2. intermittent infusion (aka tandem or piggyback IV) - to instill adjunct medications over a short period of time.
    • 3. IV bolus (push) administration - to deliver a concentrated does directly to the circulation by syringe one-time.
  47. Pharmacokinetics
    The study of drug movement throughout the body.
  48. What are the 4 categories of pharmacokinetics?
    • 1. absorption
    • 2. distribution
    • 3. metabolism
    • 4. excretion
  49. What is absorption?
    The process of moving a substance from its site of administration, across body membranes, to circulating fluids.

    It is also the primary factor in determining how long it takes a drug to produce its effect.
  50. Active transport
    movement of a chemical against a concentration or electrochemical gradient.
  51. Passive transport (diffusion)
    movement of a chemical from an area of higher concentration to an area of lower concentration.
  52. Factors that affect absorption
    • pill vs liquid
    • route of administration (IV quickest)
    • blood flow
    • dosage
    • enzymes in digestive tract
    • speed of digestive motility
    • degree of ionization
    • drug-drug or drug-food interactions
  53. distribution
    the transport of pharmacologic agents throughout the body
  54. blood-brain barrier
    fetal-placental barrier
    anatomic barriers that prevent many chemicals and medications from entering
  55. drug-protein complex
    some drugs have an affinity for binding to plasma proteins.  Once these drugs bind to a protein, they are tied up and unable to reach their target cell.  Only unbound drug molecules can reach their target cell or be excreted by the kidneys.
  56. metabolism (biotransformation)
    process of converting a drug to a form more easily removed from the body.  Primarily the job of the liver.
  57. prodrugs
    drugs that have no pharmacologic activity until they are metabolized
  58. first pass metabolism
    drugs that enter the bloodstream through the stomach or small intestine, must first pass through the liver before they are distributed.  Much or the drug will be metabolized as it passes through the liver.
  59. excretion
    the process through which drugs are removed from the body
  60. What is the primary site of excretion?
    the kidneys
  61. How can we measure the therapeutic response of most drugs?
    By seeing how much drug is in the plasma.
  62. minimum effective concentration
    the amount of drug required to produce a therapeutic effect
  63. toxic concentration
    the level of drug that will result in serious adverse effects
  64. therapeutic range
    the plasma concentration level between the minimum effective concentration and the toxic concentration.
  65. plasma half-life (t1/2)
    length of time required for the plasma concentration of a medication to decrease by one-half after administration.
  66. T or F
    USP is an official lexicon for drug quality standards in the United States.
  67. T or F
    USP was formed as a private enterprise in 1820 with no government authority or oversight.
  68. Who signed off on the Pure Food and Drug Act?
    President Theodore Roosevelt
  69. What year was the Pure Food and Drug Act signed?
  70. What was the main provision to come out of the Pure Food and Drug Act?
    created a prescription drug category
  71. What was the primary impetus behind the Pure Food and Drug Act?
    Upton Sinclair's "The Jungle"
  72. In what year was the Harrison-Narcotics Act enacted?
  73. For what purpose could physicians prescribe narcotics?
    medical purposes only
  74. pharmacodynamics
    how a medicine changes the body
  75. median effect dose (ED50)
    the dose required to produce a specific therapeutic response in 50% of a group of patients
  76. median lethal dose (LD50)
    the dose of the drug that will be lethal in 50% of a group of animals
  77. therapeutic index
    ratio between LD50 and ED50.  The higher the value the larger the margin of safety.
  78. median toxicity dose (TD50)
    the dose that will produce a given toxicity in 50% of a group of patients.
  79. potency
    a way to compare medications within the same therapeutic or pharmacologic class.  A more potent drug will produce a therapeutic response at a lower dose.
  80. efficacy
    magnitude of maximal response produced by a drug (how well it works).
  81. which is more important efficacy or potency?
    efficacy is more important
  82. How do drugs act?
    They bond to a receptor that then changes or modulates the existing physiologic and/or biochemical process.
  83. Agonist
    a drug that produces the same type of response as the endogenous substance.  It mimics the body's natural response.
  84. Antagonist
    a drug that prevents the endogenous chemical from acting.  Often competes with agonists for the receptor binding site.
  85. idiosyncratic responses
    unpredictable and unexplained drug reactions
  86. pharmacogenetics
    the area of pharmacology that examines the role of heredity in drug response.
Card Set
HSCI 116
Test 1