pharm exam 1

  1. pharmacology
    study of drugs and their interactions with living organisms
  2. pharmacodynamics
    study of the action of drugs on living tissue
  3. pharmacokenetics
    study of the process of drug absorption, distribution, metabolism and excretion
  4. pharmacotheraputics
    study of the use of drugs in treating disease
  5. pharmacy
    preparing and dispensing medications
  6. posology
    study of the amount of drug that is required to produce theraputic effects
  7. toxicology
    study of the toxic or poisionous efeects of drugs
  8. FDA definition of drug
    any substance used in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or animals
  9. 3 medical uses for drugs
    • 1. theraputic
    • 2. preventative
    • 3. diagnostic
  10. theraputic uses
    • antibiotics
    • analgesics
    • hormone replacement
  11. preventative uses
    • vaccination
    • "prevent motion sickness"
  12. diagnostic uses
    • radiopaque dyes
    • simulate cardiac excerise
  13. what should i know about the medications i will administer
    • use
    • dose
    • methods of admin
    • side/adverse effects
    • drug interactions
    • precautions
    • symptoms of OD
    • abuse
  14. responsibilities of administering meds
    • written order
    • should meds be held
    • id allergies
    • action and side effects
    • dosage
    • condition of patient
    • id patient
    • admin on time and proper method
    • stay w/ pt. for oral drugs
    • record info
    • family/pt teaching
    • 5 rights rule
  15. 5 rights rule
    • patient
    • drug
    • dose
    • route
    • time
    • (result)
    • (document)
    • (refuse)
  16. 11 precautions
    • 1. no distractions
    • 2. proper space and light
    • 3. check label 3 times
    • 4. unexpired meds
    • 5. prepare just prior to admin
    • 6. only admin meds you prepare
    • 7. properly labeled 
    • 8. prep techniques
    • 9. store as recomeneded
    • 10. keep narcotics and controlled meds locked
    • 11. acurate and complete records
  17. name the federally sanctioned unbiased compiliation of drug info in USA in 1906
    united states pharmacopeia
  18. 3 natural sources from which modern drugs are derived
    • 1. plants
    • 2. animals
    • 3. minerals
  19. recombiant dna technology
    - directs bacterium to produce mass amounts of a specific protien
  20. genetic engineering
    • "gene splicing"
    • -cell or virus may be administered to an individual who sufferes from the lack of that specific gene
  21. human genome project
    significance for revealing the gene or genes responsible for 1000's of genetic diseases and for synthesizing protiens or enzymes absent or deficent in each disease.
  22. 3 substances produced by recombiant dna technology
    • 1. growth hormone
    • 2. insulin
    • 3. clotting facor
  23. 3 diseases for human genome project
    • 1. huntingtons
    • 2. cystic fibrosis
    • 3. colon cancer
  24. most pharmaceutical milstones occured____
    in the 20th and 21st century
  25. drug legislation of 1906
    "federal food and drug act"
    • -first written source for medication formula
    • - first attemts to protect consumers of food and drugs
    • - dangerous drugs must be listed on label
    • - no enforcement agency
  26. "durham-humphrey amendment" 1951
    • - specified how prescription drugs could be ordered and dispensed
    • -OTC drugs that didnt need script
    • -warning labels for side effects
    • -legend drugs
  27. comprehensive drug abuse prevention and control act of 1970
    • - established the drug enforcement admin as a division of the department of justice
    • - drugs with potential for being abused were recognized as controlled substances
    • - isolated drugs w/ pot. to be abused were placed into 5 schedules
    • - security of controlled substance
    • - limitations of controlled subtance
    • - DEA numbers 
    • -DEA enforcement
  28. major difference between schedule I and schedule II
    Schedule I- not accepted for medical use

    Schedule II- accepted for medical use
  29. drug categories in schedule I
    • opioids
    • canabis
    • psycedelic
    • methaqualone
  30. define prescription drug
    not safe for use unless under the supervision of a medical professional
  31. name the drug approved for OTC sale in 1983
  32. define chemical name
    describes its molecular structure and distinguishes it from all other drugs
  33. example of chemical name
  34. define generic name
    • second name for the drug
    • common name
  35. example of generic name
  36. define trade or brand name
    third name given when the FDA gives final approval for marketting
  37. example of trade name
  38. what is the offical name worldwide
  39. which name is in CAPS and which is not
    generic- no caps

  40. define informed consent
    contain detailed info about study, potential benifits, side and adverse effects.
  41. define placebo
    "sugar pill"
  42. define double blind clinical studies
    • -using the drug and placebo
    • - neither the pt nor the physician knows which pt is recieving which
  43. how many phases of human clinical trails
  44. Phase I
    • - normal volunteers are treated w/ new drug
    • - tests for metabolism of drug and effects in humans
  45. Phase II
    • -subjects are patients
    • - tests for therapeutic use, dosage range and safety
  46. Phase III
    • -subjects are patients
    • - tests for safety and effectiveness 
    • (usually 500-3000 subjects in II and III)
  47. where is a major site for phase III
    austin, tx
  48. __ established pregnancy safe categories __ through ___ in __
    • sweeden
    • A-D
    • 1978
  49. USA adopted a similar pregnacy safe categorie in __ but added category __
    • 1979
    • X
  50. describe category X
    fetal abnormalities and positive evidence of fetal risk

    should not be used in pregnant women
  51. what other category was added
    • N
    • -drugs in this category have not been classified
  52. are generic and brand name drugs the same?
    everything is exactly the same in both except the fillers
  53. define pharmceutical phase
    "How we get drug into body"

    study of the ways in which various drug forms influence pharmacokinetic and pharmacodynamic activities
  54. define disinigration
    breakdown of solid dosage forms
  55. define dissolution
    process by which drug goes into solution and becomes available for absorption
  56. define pharmacokinetic phase
    "what does the body do to the drug"

    study of the concentraion of a drug during the process of absorption, distribution, metabolism or biotransformation and excretion
  57. define absorption
    movment of drug molecules into circulating fluids

    drug enters bloodstream from site of admin
  58. define distribution
    transport of drugs from bloodstream to various tissues and eventually site of action
  59. define metabolism
    chemical inactivation of a drug by converting into a water soluble compund to be excreted from body

  60. define excretion
    drugs active or inactive metabolites exit the body

  61. define pharmcodynamic phase
    "what does the drug do to the body"

    study of the mechanism of drug action(MOA) on living tissue 

    response of tissue to specific chemical agents
  62. 3 major MOA
    • 1. drug receptor inter action
    • 2. drug enzyme interaction
    • 3. nonspecific interaction
    joining of drug molecule w/ a reactive site on the surface of cell tissue yeilding biological effect
  64. drug enzyme interaction
    drug inhibits action of specific enzyme
  65. nonspecific interaction
    drug interfers or alters cellular proccess
  66. 3 general properties of drugs
    • 1. drugs do not confer any new functions on a tissue or organ; they only modify
    • 2. they exert multiple actions rather than a single effect
    • 3. drug action results from a physiochemical interaction between drug and a functionally important molecule in the body
  67. name the 3 phases of drug activity that influence the concentration of a drug by the time it reaches site of action
    • 1. pharmaceutical
    • 2. pharmacokenetic
    • 3. pharmacodynamics
  68. define pharmaceutics
    study of the ways in which various drug forms influence pharmacokenetic and pharmacodynamic activities
  69. which form of drugs is most effective
    oral drugs in liquid form
  70. 4 factors for pharmacokenetic is the rate and extent to which a drug is
    • absorbed
    • distributed
    • biotransformed or metabolized
    • excreted
  71. physichemical properties of drugs
    most drugs are water soluble and they are either weak acids or weak bases
  72. the more ionized or charged the drug for is, the more________
    it attracts water molecules and therefore the more water soluble it is
  73. which structures are highly lipid
    • cell membrane
    • body compartments
    • BBB
    • placental barrier
  74. to cross a lipid structure the drug must be_________
    less charged(less ionized) to become lipid soluble
  75. the enviornment in which the drugs will be absorbed must be ____ for acidic drugs and ____ for basic drugs so that the drugss will become __ ___ in order to be ___ soluble
    • acidic
    • alkaline
    • less charged
    • lipid
  76. phisiochemical properties of cell membrane
    the extent to which a drug attains pharmacokenetic activity depends on the rate at which it crosses the cell membrane
  77. most drugs are comprised of __ molecules and can cross the cell membrane by __ transport
    • small
    • passive
  78. drugs that have huge molecules rely on ___ transport
  79. name the variables that affect drug absorption
    • 1. nature of absorbing surface
    • 2. blood flow at site
    • 3. soulubility of drug
    • 4. pH
    • 5. drug concentration
    • 6. pharaceutical prep(dosage forms)
  80. weak acid in acid media=
    weak basic in basic media=
    weak acid in basic media=
    weak basic in acid media=
    • nonionized(fat souluble)
    • nonionized(fat souluble)
    • ionized(water soluble)
    • ionized(water soluble)
  81. multiple drug forms/preperations
    aeresol,capsules, lotion, losange, powders, pills, etc
  82. Route: Intravenous

    1. bioavailability
    2. charecturistics
    • 1. 100%
    • 2. most rapid onset
  83. Route: Intramuscular

    1. bioavailability
    2. charecturistics
    • 1. 75%
    • 2. large volumes often
  84. Route: subcutaneous

    1. bioavailability
    2. charecturistics
    • 1. 75%
    • 2. smaller volumes than IM; painful
  85. Route: Oral(PO)

    1. bioavailability
    2. charecturistics
    • 1. 5%
    • 2. most convenient; first pass effect may be significant
  86. Route: Rectal(PR)

    1. bioavailability
    2. charecturistics
    • 1. 30%
    • 2. less first pass effect
  87. Route: Inhalation

    1. bioavailability
    2. charecturistics
    • 1. 5-100%
    • 2. often very rapid onset
  88. Route: Transdermal

    1. bioavailability
    2. charecturistics
    • 1. 80%
    • 2. usually very slow; used for lack of first pass effect
  89. define enteral route
    administration into GI tract
  90. list enteral routes
    • oral
    • nasogastric
    • buccal
    • sublingual
    • rectal
  91. Route: Oral

    1. site
    2. Pass
    • 1. Mouth
    • 2. yes
  92. Route: nasogasatric

    1. site
    2. Pass
    • 1. stomach
    • 2. yes
  93. Route: buccal

    1. site
    2. Pass
    • 1. oral mucosa
    • 2. no
  94. Route: sublingual

    1. site
    2. Pass
    • 1. under tongue
    • 2. no
  95. Route: rectal

    1. site
    2. Pass
    • 1. rectum
    • 2. yes(slight)
  96. define hepatic first pass
    orally administered drugs absorbed through the GI tract and absorbed by the liver before entering general circulation
  97. hepatic portal system
    responsible for directing blood from GI to liver
  98. define parenteral route
    into sites other than GI usually by needle
  99. which route of drug administration where NONE have a hepatic first pass
    parenteral and percutaneous
  100. list the parenteral routes
    • intravenous (vein)
    • Intrapleural( pleura)
    • intra-arterial(artery)
    • intracisternal(synovial fluid, joint)
    • intracardiac(heart)
    • intraperitoneal(abdomen)
    • intraspinal(spinal column)
    • intraosseous(bone marrow)
    • intrathecal(spinal fluid)
    • intramuscular(muscle)
    • subcutaneous(beneath skin)
    • intradermal(dermis)
  101. define distribution
    transport of a drug in body fluids from the bloodstream to various tissues of the body and then the site of action
  102. list the factors that affect the rate at which a drug enters diff. areas of the body
    • 1. permeability of capillaries
    • 2. cardiac output
    • 3. regional blood flow
  103. define drug resivour
    allow a drug to accumulate by binding to specific tissues in the body
  104. list the 2 types of drug resivors
    • 1. plasma protien binding
    • 2. tissue binding
  105. list 2 barriers to drug distribution
    • 1. BBB
    • 2. placental barrier
  106. define metabolism/biotransformation
    process of chemical inactivation of a drug by conversion into more water soulble compound or metabolites which can then be excreted from the body
  107. name the major organ the accomplishes metabolism
  108. define percutaneous
    administration through the skin or mucous membranes
  109. list percutaneous
    • transdermal(epidermis)
    • topical(epidermis)
    • intraocular(eye)
    • intrarespiratory(lung)
    • intravaginal(vagina)
    • Intrauterine(uterus)
    • Intraurethral(urethra)
    • intranasal(nose)
    • otic(ear)
    • intravesicle(bladder)
  110. the ___ converts fat souluble components into_____ so they can be_____
    • liver
    • water soluble
    • excreted
  111. what does DMMS stand for
    drug microsomal metabolizing system
  112. describe the DMMS
    vast majority of drugs are metabolized in the liver by this system

    group of enzymes
  113. what is the key element of the DMMS system
    cytochrome P-450
  114. some drugs may be taken up to the DMMS so that______
    a significant drug dosage is metabolized before the drug ever reaches the systemic circulation
  115. define enzyme induction
    increase in the amt of drug-metabolizing enzymes after repeated admin of certain drugs

    decrease plasma concent.
  116. define enzyme inhibition
    • -decrease in amt of drug metabolizing enzymes
    • -adverse effects due to increased plasma
  117. define hepatic first pass effect
    phenomenon of drug metabolism where the concentration of the drug is greatly reduced before it reaches systemic circulation
  118. define excretion
    drugs and pharmacologically active and inactive metabolites are eliminated from the body
  119. name the major organ that accomplishes excretion
  120. other sites that excrete
    • breast
    • lungs
    • sweat
    • tears
    • saliva
  121. describe drug-receptor interaction
    • -drugs are selectively active
    • -specific
    • -drug w/ best fit to receptor will produce the greatest response from cell
  122. define receptor
    reactive cellular site where drug interacts

    specific location on cell membrane or w/in cell
  123. define affinity
    propensity of a drug to bind to a receptor
  124. define efficacy
    drugs ability to initiate biologic activity as a result of binding
  125. define agonist
    drug that combines with receptors and produces a sequence of biochemical and physiologic changes

    is both efficacy and affinity
  126. define antagonist
    agent designed to inhibit or counteract effects produced by other drugs caused by cellular components during illness
  127. define drug-enzyme interaction
    • -interaction of drugs and cellular enzymes
    • -drugs can inhibit action of specific enzymes and alter physiologic response
  128. example of drug-enzyme interaction
    antineoplastic(anticancer) drugs
  129. define non-specific drug interaction
    drugs that demonstrate no structural specificity and act by general effects on cell membranes and cellular process
  130. example of nonspecific drug interaction
    • anesthetics
    • antibiotics
  131. define plasma level profile
    used to analyze drugs characteristic pharmacokinetic effects
  132. define onset of action
    interval b/t time drug is admin and first sign of effect
  133. define termination of action
    point where drug effect is no longer seen
  134. define duration of action
    period from onset of drug to when the response is no longer perceptible
  135. define minimal effect concentration
    lowest plasma concentration that produces desired drug effect
  136. define peak plasma level
    highest concentration attained
  137. define toxic level
    plasma concentration produces serious adverse effects
  138. explain dose response curve
    • -used to compare and evaluate drug response among different drugs that are similar
    • -also for drug potency
    • -strength needed to produce therapeutic effect
  139. explain time response curve
    determine frequency of admin of meds in order to maintain an effective drug response
  140. explain therapeutic drug range
    determine safety and effectiveness of a drug
  141. therapeutic effect=
    desired effect
  142. define biological half life
    time required to reduce by one half the amt of unchaged drug that is in the body at the time that equilibrium is reached
  143. the longer the half life,_______
    the longer the drug stays in the body
  144. biologic half life is determined by
    the rate of biotransformation and excretion of drug
  145. duration of a dose can be determined by
    the biologic half life
  146. define therapeutic index
    provides a quantitative measure of the relative safety of a drug
  147. therapeutic index represents a ration between___
    lethal dose and effective dose
  148. the closer the dose to___, the greaterthe danger involved in admin of drug
  149. define drug bioavailability
    percentage of active drug substances absorbed and available to reach the target tissues after drug admin
  150. drugs are considered to be biologically equivalent if______
    they attain similar concentrations in blood and tissue at similar times
  151. define side effects
    predictable and undesireable effects produced at therapeutic drug dosages

    not harmful

    effect other than therapeutic
  152. name some predictable side effects
    • nausea
    • vomiting
    • diarehha
    • dizzy
  153. define adverse effect
    unintended, undesired, and unpredictable

    some are immediate some take time
  154. name some predictable adverse
    • age
    • body mass
    • gender
  155. name the four unpredictable adverse reactions
    • type I- anaphylactic
    • type II- cytoxic
    • type III- Arthus, an immune complex
    • type IV- cell-mediated or delayed hypersensitivity
  156. describe type I
    • -anaphylactic
    • -immedieate w/in minutes of exposure to chemical in previously sensitized person
    • - may be fatal
    • - mediated by IgE antibodies on mast cell
  157. define drug interactions
    when effects of one drug are modified by the prior or concurrent admin of another drug
  158. define tolerance
    decreased response
  159. define adiction
    compulsive drug abuse/dependence
  160. define dependence
    reliance on drug use
  161. define cumulation
    the body can not excrete one dose of a drug before the next dose is given, resulting in high levels of drug in body; toxicity
  162. define iatrogenic
    unintentional drug effect or disease induced by physicians prescribed therapy
  163. define idiosyncratic
    drug effect unique to an individual that is unexpected
  164. describe incompatability
    physical alterations that occur before admin when dif drugs are mixed in same syringe

  165. describe additive
    combined effect of 2 drugs, each produce same biological response and same MOA, = to sum of individual effects
  166. 1+1=2
    • additive
    • summative
  167. define summative
    combined effect of 2 drugs, same biological, diff MOA, equal to sum
  168. define synergism
    combined effect of 2 drugs is greater than sum of individual
  169. 1+1=3
  170. define antagonism
    combined effect of 2 drugs is less than sum
  171. 1+1=0
  172. define polypharmacy
    indiscriminate use of numerous meds concurrently
  173. define alternative medicine
    • non scientific
    • no support data
  174. define indication
    an illness disorder for which a drug has a documented usefulness
  175. Drug (general)
    chemical substance that produces change in body function
  176. define contraindications
    situations where a certain drug should NOT be admin
  177. ED-50
    • effective dose
    • dose that will produce an effect that is half of the max response
  178. LD-50
    • lethal dose
    • dose that will kill 50% of animals tested
  179. site of action
    location w/in body where drug exerts therapeutic effect

    specific receptor
  180. therapeutic index
    ration of LD50 to ED50
  181. doses
    • 1. intitial
    • 2. lethal
    • 3. loading- first dose, higher, elevate blood, therapeutic range
    • 4. maintenance
    • 5. max
    • 6. min
    • 7. toxic
    • 8. usual
  182. what is the result of enzyme induction
    decreased pharmacologic effect in body
  183. name this example:

    st. johns wort induces enzymes that metabolize warfarin. result is decreased effectiveness of warfarin
    enzyme induction
  184. enzyme inhibition results
    toxicity due to increased pharmacologic effect in body
  185. name the example

    Prilosec inhibits 3 enzymes that metabolize warfarin
    enzyme inhibition
  186. angle of a needle for IM
    90 degree
  187. angle of a needle for intradermal
    15 degree
  188. angle of a needle for subcutaneous
    45 degree
Card Set
pharm exam 1