Volume 1 Chapter 9 Pt. 1

  1. Drug
    Chemical used to diagnose, treat or prevent disease
  2. Pharmacology
    The study of drugs and their interactions with the body
  3. Drug Names
    • Chemical Name: States its chemical structure, not used in practice
    • Generic Name: Suggested by the manufacturer and confirmed by the government
    • Official Name: Name posted in the United States Pharmacopeia (USP)
    • Brand Name (Trade Name): Name given to the drug by the brand
  4. Sources of Drug Information
    • United States Pharmacopeia (USP)
    • Physicians Desk Reference
    • Drug Information
    • Monthly Prescribing Reference Guide
    • AMA Drug Evaluation
    • Internet or other outside sources
  5. Drug Profile
    • Name: Generic, trade, etc.
    • Classification: Broad group to which the drug belongs
    • Mechanism of Action: The way the drug causes its effects (Pharmacodynamics)
    • Indications: Conditions that make use of the drug appropriate, FDA set
    • Pharmacokinetics: How the drug is absorbed, distributed, and eliminated. Onset and duration
    • Side effects/Adverse reactions: The drug's untoward or undesired effects
    • Routes of Administration: How the drug is given
    • Contraindications: Conditions that make it inappropriate to give the drug
    • Dosage: The amount of the drug that should be given
    • How Supplied: Common concentrations and preparations
    • Special Considerations: How the drug may effect people of different ages or conditions
  6. Drug Laws and Regulations
    • Federal Law
    • State Laws and Regulations
    • Individual Agency Regulations
  7. The Pure Food and Drug Act, 1906
    Made to improve drug labeling. Named the USP
  8. Harrison Narcotic Act, 1914
    Limited the indiscriminate use of addictive drugs by regulating importation, manufacture, sale and use of opium, cocaine and their compounds or derivatives
  9. Federal Food, Drug and Cosmetic Act, 1938
    Empowered the FDA to enforce and set premarket safety standards for drugs
  10. Durham Humphrey Amendments to the 1938 act
    AKA Prescription Drug Amendments. Required pharmacists to have either a written or verbal prescription from a physician to dispense certain drugs. Also created the over-the-counter category
  11. Controlled Substances Act, 1970
    Created the five schedules of drugs.
  12. Schedules of Drugs
    • Schedule I: High abuse potential. No medical use. Research only.
    • Schedule II: High abuse potential. Some medical indications.
    • Schedule III: Less abuse potential. Some medical indications
    • Schedule IV: Low abuse potential. Accepted medical indications
    • Schedule V: Lower abuse potential. Accepted medical indications
  13. Assay
    Test that determines the amount and purity of a given chemical in a preperation in a laboratory
  14. Bioequivalence
    Relative therapeutic effictiveness of chemically equivalent drugs
  15. Bioassay
    Test to ascertain a drug's availability in a biological model
  16. Phases of human studies of drugs
    • Phase 1: Determine drug's pharmacokinetics, toxicity and safe dose
    • Phase 2: Tested in a small population of people who have the target disease. Find therapeutic level and watch for side-effects
    • Phase 3: Refine therapeutic dose and collect relevant data on side-effects
    • Phase 4: Postmarketing analysis during conditional approval. Monitoring of performance in actual cases
  17. Six Rights of medication administration
    • Medication
    • Dose
    • Time
    • Route
    • Patient
    • Documentation
  18. FDA Pregancy Categories
    • A: Adequate studies. No risk to fetus
    • B: Animal studies have not demonstrated risk to fetus OR Adequate studies have showed no risk to humans but animals have had adverse effects
    • C: Animal studies have demonstrated adverse effects but there are no adequate studies done on humans. However risk may be worth the gain OR No adequate studies in humans or animals
    • D: Fetal risk demonstrated. Some situations may be worth the risks
    • X: Fetal risk demonstrated. Risks outweigh any benefits
  19. Teratogenic Drug
    Medication that may deform or kill the fetus
  20. Free Drug Availability
    Proportion of a drug available in the body to cause either desired or undesired effects
  21. Pharmacokinetics
    How a drug is absorbed, distributed, metabolized (biotransformed), and excreted. How drugs are transported in and out of the body.
  22. Pharmacodynamics
    How a drug interacts with the body to cause its effects
  23. Active Transport
    Requires the use of energy to move a substance
  24. Carrier-Mediated Diffusion (Facilitated diffusion)
    Process in which carrier proteins transport large molecules across the cell membrane
  25. Passive Transport
    Movement of a substance without the use of energy
  26. Diffusion
    Movement of solute in a solution from an area of higher concentration to an area of lower concentration
  27. Osmosis
    Movement of solvent in a solution from an area of lower solute concentration to an area of higher solute concentration
  28. Filtration
    Movement of molecules across a membrane from an area of higher pressure to an area of lower pressure
  29. Pharmacokinetic Processes
    • Absorption
    • Distribution
    • Biotransformation
    • Elimination
  30. Ionize
    To become electrically charged or polar
  31. Bioavailability
    Amount of a drug that is still active after it reaches the target tissue
  32. Blood-Brain Barrier
    Tight junctions of the capillary endothelial cells in the central nervous system vasculature through which only non-protein-bound, highly lipid soluble drugs can pass
  33. Placental Barrier
    Biochemical barrier at the maternal/fetal interface that restricts certain molecules
  34. Metabolism
    The body's breaking down chemicals into different chemicals
  35. Biotransformation
    Special name for the metabolism of drugs
  36. Prodrug
    Medication that is not active when administered but whose biotransformation converts it into active metabolites
  37. First-Pass Effect
    The liver's partial or complete inactivation of a drug before it reaches the systemic circulation
  38. Oxidation
    The loss of hydrogen atoms or the acceptance of an oxygen atom. This increases the positive charge (or lessens the negative) on the molecule
  39. Hydrolysis
    The breakage of a chemical bond by adding water or by incorporating a hydroxyl (OH-) group into one fragment and a hydrogen ion (H+) into the other.
  40. Drug Routes
    • Enteral- Through the gastrointestinal tract
    • Parenteral- Outside of the GI tract
  41. Enteral Routes
    • Through the GI tract
    • -Oral (PO)- Swallowed
    • -Orogastric/Nasogastric tube (OG/NG)
    • -Sublingual (SL)- Under the toungue
    • -Buccal- Between the cheek and gum
    • -Rectal
  42. Parenteral
    • -Intravenous (IV)
    • -Endotracheal Tube (ET)
    • -Intraosseous (IO)
    • -Umbilical- Through the umbilical cord vein or artery
    • -Intramuscular (IM)
    • -Subcutaneous (SC)
    • -Inhalation/Nebulized
    • -Topical
    • -Transdermal
    • -Nasal
    • -Instillation-Directly into a wound or the eye
    • -Intradermal- Drug directly between skin layer
  43. Solid Drug Forms
    • -Pills- Spherically shaped for swallowing
    • -Powders
    • -Tablets- Powders compressed into a disklike form
    • -Suppositories- Drugs mixed with waxlike substance that melts at body temp for rectal or vaginal use
    • -Capsules- Gelatin containers filled with powders or tiny pills. Gelatin dissolves in GI tract
  44. Liquid Drug Forms
    • -Solutions- Most common liquid form. Generally water based, some oil
    • -Tinctures- Prepared using an alcohol extraction process. Some alcohol usually remains
    • -Suspensions- Preparation in which solid does not dissolve in solvent. If lefts alone they will separate
    • -Emulsions- Suspensions with an oily solvent. Oil will seperate from solution
    • -Spirits- Solution of a volatile drug in alcohol
    • -Elixirs- Alcohol and water solvent. Often with flavorings added to improve taste
    • -Syrups- Sugar, water and drug solutions
  45. Types of Drug Actions
    • -Binding to a receptor
    • -Changing the physical properties of cells
    • -Chemically binding with other chemicals
    • -Altering a normal metabolic pathway
  46. Receptor
    Specialized protein that combines with a drug resulting in a biochemical effect
  47. Affinity
    Force of attraction between a drug and a receptor
  48. Efficacy
    A drug's ability to cause the expected response
  49. Second Messenger
    Chemical that participates in complex cascading reactions that eventually cause a drug's desired effect
  50. Down-Regulation
    Binding of a drug or hormone to a target cell that causes the number of receptors to decrease
  51. Up-Regulation
    A drug that causes the formation of more receptors than usual
  52. Agonist
    A drug that binds to a receptor and causes it to initiate the expected reaction
  53. Antagonist
    Drug that binds to a receptor but does not cause it to initiate the expected response
  54. Agonist-Antagonist (Partial agonist)
    Drug that binds to a receptor and stimulates some of its effects but blocks others
  55. Competitive Antagonism
    One drug binds to a receptor and causes the expected effect which also blocking another drug from triggering the same receptor
  56. Noncompetitive Antagonism
    The binding of an antagonist causes a deformity of the binding site that prevents an agonist from fitting and binding
  57. Irreversible Antagonism
    A competitive antagonist permanately binds with a receptor site
  58. Side Effect
    Unintended response to a drug
  59. Reponses to Drug Administration
    • Allergic Reaction-Hypersensitivity
    • Idiosyncrasy-A drug effect that is unique to the individual and not seen in general population
    • Tolerance-Decreased response to the same amount of drug after repeated administrations
    • Cross Tolerance- Tolerance for a drug that develops after administration of a different drug
    • Tachyphylaxis-Rapidly occuring tolerance to a drug. May occur after one dose
    • Cumulative Effect- Increased effectiveness when a drug is given in several doses
    • Drug Dependence- Patient becomes accustomed to the drug and will suffer withdrawal if discontinued
    • Drug Interaction- The effects of one drug ALTER response to another
    • Drug Antagonism-The effects of one drug BLOCK the response to another
    • Summation- Two drugs with same effects given together
    • Synergism-Two drugs with same effect given together and produce a response greater than the expected sum
    • Potentiation-One drug enhances the effects of another
    • Interference-The direct biochemical interaction between two drugs. One drug effects another
  60. Drug-Response Relationship
    Correlation of different amounts of a drug to clinical response
  61. Plasma-Level Profile
    Describes the lengths of onset, duration, and termination of action as well as the drug's minimum effective concentration and toxic levels
  62. Onset of Action
    The time from administration until the time the drug reaces its minimum effective concentration
  63. Minimum Effective Concentration
    Minimum level of drug needed to cause a given effect
  64. Duration of Action
    Length of time the amount of drug remains abouve its minimum effective concentration
  65. Termination of Action
    Time from when the drug's level reaches its minimum concentration til it is eliminated from the body
  66. Therapeutic Index
    Ratio of ta drug's lethal dose for 50 percent of the population to its effective dose for 50 percent of the population
  67. Biological Half-Life
    Time the body takes to clear one half of a drug
  68. Factors Affecting Drug-Response Relationship
    • -Age
    • -Body Mass
    • -Sex
    • -Environment
    • -Time of Administration
    • -Pathology
    • -Genetics
    • -Psychology
  69. Drug Interactions
    • -One drug alters the rate of intestinal absorption
    • -Two drugs compete for plasma protein building resulting in one accumulating
    • -One drug alters the other's metabolism
    • -One drugs receptor site action could be antagonistic or synergistic to the other drug
    • -One drug could alter the others excretion rate
    • -One drug could alter the balance of electrolytesw neccessary for the other to work
Card Set
Volume 1 Chapter 9 Pt. 1
Volume 1 Chapter 9 Pt. 1