Comprehensive Pharmacology and Drug Safety for Healthcare Providers

What are drugs?

Chemicals introduced into the body to cause some sort of change.

What is pharmacology?

The study of biological effects of chemicals, focusing on how they act on living organisms.

What is pharmacotherapeutics?

The use of drugs to treat, prevent, and diagnose disease.

What are the two types of drug effects?

Therapeutic effects and adverse effects.

What are the responsibilities of a nurse regarding drug administration?

Administer drugs, assess drug effects, intervene to make regimens tolerable, provide patient teaching, and monitor overall patient care.

What are the natural sources of drugs?

Plants (e.g., morphine, codeine), animals (e.g., insulin, thyroid hormone), and inorganic substances (e.g., magnesium salts).

What are synthetic drugs?

Drugs that are genetically engineered.

What is the purpose of drug evaluation?

To ensure drug safety and efficacy, especially during pregnancy.

What does Category A indicate in drug safety during pregnancy?

No demonstrated risk to the fetus in studies of pregnant women.

What does Category B indicate in drug safety during pregnancy?

Animal studies show no risk to the fetus, but there are limited human data.

What does Category C indicate in drug safety during pregnancy?

Animal studies show adverse effects on the fetus, but benefits may outweigh risks.

What does Category D indicate in drug safety during pregnancy?

Evidence of human fetal risk, but potential benefits may be acceptable.

What does Category X indicate in drug safety during pregnancy?

Studies show fetal abnormalities, and the risks outweigh any possible benefits.

What is the Pregnancy and Lactation Labeling Rule (PLLR)?

Replaces the letter system, providing detailed summaries based on available data regarding pregnancy and lactation.

What is the purpose of the Controlled Substances Act of 1970?

To monitor the prescription, distribution, storage, and use of drugs based on their abuse potential.

What is Schedule I in controlled substances?

High abuse potential with no accepted medical use (e.g., heroin, LSD).

What is Schedule II in controlled substances?

Severe dependence liability (e.g., narcotics, amphetamines).

What is Schedule III in controlled substances?

Moderate dependence liability with less abuse potential than Schedule II (e.g., nonbarbiturate sedatives).

What is Schedule IV in controlled substances?

Limited dependence liability with less abuse potential than Schedule III (e.g., some sedatives, antianxiety agents).

What is Schedule V in controlled substances?

Limited abuse potential, primarily small amounts of narcotics used as antitussives or antidiarrheals, which may be purchased without a prescription.

What is the minimum age for a purchaser to buy drugs?

At least 18 years of age.

What does the chemical name of a drug reflect?

The chemical structure of the drug.

What is a generic name?

The original designation given to a drug when the company applied for approval.

What is a brand name?

The name given by the pharmaceutical company, which is usually simpler.

What are generic drugs?

Chemicals produced by companies involved solely in drug manufacturing that must be bioequivalent.

What is the Orphan Drug Act of 1983?

Legislation for drugs that are discovered but not financially viable for adoption by drug companies.

What are over-the-counter drugs?

Products available without a prescription for self-treatment of various complaints.

What is a potential problem with OTC drug use?

They can mask signs and symptoms of underlying diseases, making diagnosis difficult.

What is pharmacodynamics?

The study of how drugs affect the body and their interactions with living systems.

What are receptor sites?

Specific sites on cell membranes where drugs act, often in a 'lock and key' fashion.

What are agonists?

Drugs that interact directly with receptor sites and activate them to produce effects similar to natural chemicals.

What are competitive antagonists?

Drugs that block normal stimulation of receptor sites without producing an effect.

What is selective toxicity?

The ability of a drug to act only on foreign pathogens while minimizing harm to host cells.

What does pharmacokinetics study?

The absorption, distribution, metabolism, and excretion of drugs.

What is a loading dose?

A higher than usual dose given to quickly reach critical concentration.

What is the first pass effect?

The metabolism of a drug in the liver that reduces its concentration before it reaches systemic circulation.

What is the half-life of a drug?

The time it takes for the amount of drug in the body to decrease to half its peak level.

What are adverse effects of drugs?

Undesired effects that may be unpleasant or dangerous.

What is a drug allergy?

An immune response to a drug that occurs upon re-exposure.

What is a black box warning?

A warning indicating that certain medications carry serious safety risks.

What is the nursing process in drug therapy?

A decision-making process that includes assessment, diagnosis, planning, implementation, and evaluation.

What is subjective data in nursing assessment?

Information obtained through questioning that cannot be measured, such as pain or nausea.

What is objective data in nursing assessment?

Information that can be observed or verified, such as temperature or edema.

What is the goal of antibiotic therapy?

To decrease the population of invading bacteria to a level that the human immune system can effectively handle.

What are bactericidal antibiotics?

Antibiotics that kill bacteria.

What are bacteriostatic antibiotics?

Antibiotics that limit or slow the growth of bacteria.

What is the mechanism of action of penicillins?

They inhibit cell wall synthesis and are bactericidal.

What are common side effects of penicillins?

Diarrhea, nausea, vomiting, and temporary blackening of the tongue.

What is the significance of culture and sensitivity testing?

It helps identify the specific organism causing an infection and its susceptibility to antibiotics.

What is the role of the liver in drug metabolism?

The liver detoxifies chemicals and produces necessary enzymes and structures.

What is nephrotoxicity?

Kidney injury caused by drugs, indicated by changes in urinary patterns and elevated kidney function tests.

What is hypoglycemia?

A condition of low blood sugar characterized by fatigue, drowsiness, and anxiety.

What is hyperkalemia?

A condition of high potassium levels that can cause cardiac rhythm changes.

What is teratogenicity?

The ability of a drug to cause harm to a developing fetus or embryo.

What is the importance of patient teaching in drug therapy?

To ensure patients understand their medications, potential side effects, and the importance of adherence.

What are common side effects of antibiotics?

Nausea, vomiting, diarrhea, headache, rash, fever.

What adverse reaction is commonly associated with Vancomycin?

Flushing and hypotension, as well as red man syndrome.

What CNS effects can Carbapenems cause?

CNS effects include potential neurotoxicity.

What serious effects can high doses of Vancomycin and Carbapenems produce?

Nephrotoxicity and ototoxicity.

What is the suffix for Tetracyclines?

-cycline.

What are the uses of Tetracyclines?

Effective for acne, UTIs, skin/respiratory infections, Lyme disease, and stomach ulcers.

What are the side effects of Tetracyclines?

Nausea, vomiting, diarrhea, photosensitivity, and yeast infections.

What adverse reactions can Tetracyclines cause?

Permanent tooth discoloration, liver toxicity, and contraindications in pregnancy, lactation, and children under 8.

What food interactions should be avoided with Tetracyclines?

Dairy products, aluminum, magnesium, and calcium.

What is the bactericidal effect of Macrolides?

They can be either bacteriostatic or bactericidal.

What are the uses of Macrolides?

Alternative to penicillin and for treating Mycoplasma pneumoniae and chlamydia infections.

What side effects are associated with Macrolides?

Abdominal pain, nausea, and photosensitivity.

What adverse reactions can occur with Macrolides?

Impaired liver function (jaundice) and phlebitis.

What nursing implication is important for Macrolides?

One type of erythromycin tablet should not be substituted for another.

What are Aminoglycosides primarily used for?

Serious aerobic gram-negative infections and to sterilize the bowel before surgery.

What side effects are common with Aminoglycosides?

IV drugs can irritate veins, and other effects include nausea, vomiting, rash, and lethargy.

What adverse reactions can Aminoglycosides cause?

Nephrotoxicity, ototoxicity, and neurotoxicity.

What is a key nursing implication for Aminoglycosides?

Monitor BUN and creatinine levels and perform frequent hearing tests.

What do Sulfonamides do?

They prevent bacteria from making the final form of folic acid.

What are the uses of Sulfonamides?

Broad spectrum for chronic UTIs, respiratory infections, and community-acquired MRSA in children.

What side effects can Sulfonamides cause?

Minor headaches, drowsiness, fatigue, dizziness, and allergic reactions.

What adverse reactions are associated with Sulfonamides?

Nephrotoxicity, allergic reactions, skin reactions, and bone marrow suppression.

What is a critical nursing implication for patients on Sulfonamides?

Ensure adequate hydration to prevent crystallization.

What do Fluoroquinolones inhibit?

Two enzymes needed for DNA synthesis and reproduction.

What is a significant adverse reaction of Fluoroquinolones?

Rupture of tendons and life-threatening arrhythmias when used with certain antiarrhythmic drugs.

What is the first-line treatment for uncomplicated active tuberculosis?

A combination of isoniazid, rifampin, pyrazinamide, and ethambutol.

What are common side effects of antitubercular drugs?

Nausea, vomiting, diarrhea, and specific drug-related side effects like discoloration of urine.

What is a key nursing implication for patients on antitubercular drugs?

Do not drink alcohol and take medications at regular intervals.