nurs 116 lecture 1

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what is pharmacology?

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119 Terms

1

what is pharmacology?

the study of medicines

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2

what medicine is made from the bark of the willow tree?

aspirin

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3

what originally made penicillin?

molds

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4

what drug does the digitalis plant make?

digoxin

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5

what drug does the bark of the pacific yew tree make?

cancer drug taxol

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6

what does poppy milk make?

morphine

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7

what is pharmacotherapeutics?

the use of medicines (drugs) to heal of manage pt care

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8

how many drugs are prescribed per year?

500, 000 (10/person, 18% of healthcare spending)

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9

T or F: all drugs are medication

F. drugs are chemical agents. medications are drugs which have a therapeutic purpose

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10

what does biologic mean

naturally produced by animal cells

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11

examples of biologics

hormones, antibodies (vaccines), blood products, genetic treatment modalities

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12

natural health products (NPH)

naturally occurring, used as an adjunct (supplement)

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13

examples of NPH

vitamins, minerals, dietary supplements

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14

what does health canada do?

evaluates and monitors pharm products for safety, efficacy, quality and advertising

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15

what did the canadian pharmaceutical association publish?

compendium of pharmaceuticals and specialties: compilation of drug information and all adverse affects

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16

hierarchy for pharm regulation

  1. health canada

  2. health products and food branch (hpfb)

  3. therapeutic products directorate, biologics & genetic therapies directorate, natural health products directorate

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17

what are preclinical trials?

laboratory testing on non-humans for 3-5 years

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18

what are the 3 clinical trial phases

  1. 100 healthy people

  2. 300 people with disease

  3. 3000 people

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19

what % of drugs makes it to phase 3 of clinical trials?

10%

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20

new drug submissions (NDS)

-80 per year

-only 10% approved

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21

if a drug is approved after the NDS, what happens?

an NOC (notice of compliance) and DIN (drug ID) are assigned

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22

T or F: after a drug is approved by health canada, it is no longer monitored

F. the drug is continuously monitored by 2 MHDP (marketed health product directorate) databases for adverse reporrts

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23

what is the special access program?

allows for not yet approved drugs to be used in special cases

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24

what is a placebo?

substance that may have an affect because of subjective belief

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25

therapeutic nonemclature

name specifies treatment of specific disease

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26

pharmacological nomenclature

molecular and tissue activity: how it works

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27

antihypertensive

lowers blood pressure

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antiemetic

decreases vomiting

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29

if non-active ingredients are not exactly the same, is the amount of drug absorbed into circulation affected?

yes, the inert/added ingredients may interfere

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30

what is prototype drug?

a single drug from a drug class that serves as a reference to predict actions, adverse affects of other drugs in its class

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31

T or F: the prototype is not the most utilized drug

F

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32

schedule 1

available only by prescription and provided by a pharmacist

-all prescription drugs

-drugs with no potential for abuse

-controlled drugs: narcs

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33

how are narcotics prescribed?

with 2 prescriptions by a physician

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34

schedule 2

available only from a pharmacist, must be retained in an area with no public access

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35

schedule 3

available via open access in a pharmacy or pharmacy area (OTC)

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36

unscheduled drugs

can be sold in any store without professional supervision

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37

considerations for evaluating medication admin

  • therapeutic outcomes

  • side effects

  • medication self-admin teaching

  • understanding of medication

  • necessary monitoring req’d

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38

factors affecting choice of admin route

  1. target tissue

  2. clinical setting

  3. medical situation (urgency)

  4. drug dynamic

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contradindication

situation where drug should not be used/is harmful to pt

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40

endogenous

naturally found in body (ex. antibodies, hormones, ions)

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41

exogenous

not naturally found in body (ex. most synthetic drug)

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42

how long does it take po meds to have an affect?

20 min

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43

types of liquid drugs

suspension, syrup, elixir, tincture

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44

what does enteral mean?

passes through the GI tract

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45

what is enteral feed

feeding a patient via a tube into the GI tract

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46

what is special about enteric coated tablets?

you cannot crush them because they will irritate the stomach/become inactivatede

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47

what is challenging about taking po drugs?

-acidic environment of stomach

-gastric motility + secretions

-first pass metabolism: a lot of the drug is broken down

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48

is po or sl faster?

sl is faster

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49

T or F: sl med admin goes through the GI system?

F. bypasses GI and 1st pass metabolism

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50

intranasal (insufflation) meds go where?

into the nasal cavity for capillary absorption

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51

direct CNS affect of intranasal admin occurs how?

diffusion across mucosa and distribution along CNS nerve networks

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52

what % of med given intranasally reaches system circulation when it is supposed to be local?

34% reaches systemic circulationw

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53

what effects can intranasal admin have?

local, systemic, direct CNS (preparation dependent, size of molecules)

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54

why does inhalation admin have a rapid affect?

the pulmonary capillary network

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55

when is et admin used?

er/icu situations (ex. epinephrine). ultimately is inhalation

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56

intranasal drug examples

  1. local - rhinocort spray

  2. systemic - flu vaccine

  3. direct CNS - cocaine

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57

inhalation drug examples

  1. local - asthma drugs

  2. systemic - general anesthesia

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58

top systemic presence

-minimal

-can be contraindicated

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59

top drug example

retinoid creams (wrinkle tx)

  • local effect at reticular layer of dermis (collagen fiber repair and synthesis)

  • low systemic effect but contraindicated in pregnancy

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60

rank for safety for pregnant women

A (safe), B, C, D, X (not safe)

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61

td capillary absorption

-passive diffusion

-systemic effect desired

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62

td drug examples

nicotine, morphine patch

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63

rectal drugs are given where?

lower GI into the rectum

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64

why does the rectal route have a lower first pass metabolism effect?

the venous return is not transported by the liver

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65

why is the system effect of the rectal admin route unreliable?

peristalsis, the presence of poo

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66

what do parenteral routes require?

injections

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67

why are IV’s risky?

infection risk

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68

what is the fast IM prep?

aqueous. moves into bloodstream more easily

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69

what is the slow IM prep?

depot prep. meds are stored at the injection site

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70

most important im injection site

ventrogluteal

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71

all the main im injection sites

deltoid, ventrogluteal, rectus femoris, vastus lateralis

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72

why is the dorsogluteal site not recommended?

too close to sciatic nerve

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73

where is sc injection made?

into adipose tissue of hypodermis

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74

angle of im vs. sc

im: 90

sc: 45

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75

insulin injection sites

upper outer arms/thighs, tummy, butt

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76

what is intrathecal admin?

epidural + spinal: bypasses BBB

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77

implanted port admin

port with meds that stays in place and is connected to circulation

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78

intraosseous admin

into bone (ex. top of tibia) in emergencies

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79

pharmacokinetics vs dynamics

kinetics: what body does to drug

dynamics: what drug does to body

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80

where does absorption primarily occur?

tummy, *sm int

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81

where does distribution occur

bloodstream

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82

where does metabolism primarily occur

liver

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83

where does excretion primary occur

urinary system, lg int

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84

what happens when a molecule becomes ionized?

not likely to absorb because it can’t cross the plasma membrane

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85

what happens to drugs that aren’t easily permeable?

they can become 2nd messengers

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86

characteristics for easy absorption?

lipophilic, non-ionized, small

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87

characteristics for easy excretion?

hydrophilic, ionized

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88

what is bioavailability?

systemic circulation’s plasma drug concentration

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89

where can you measure bioavailability?

blood (plasma) tests. rarely urine

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90

how can you adjust bioavailability?

titrate (give meds) to patient until desired effect achieved

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91

what is heavy first pass effect?

a very small % of po drugs reach systemic circulation

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92

amount of po dose vs. iv dose?

po dose is 3x bigger than iv dose because of heavy first pass effect

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93

what is hepatic biliary secretion?

drug goes into bile, secreted from duodenum

or is reabsorbed into circulation - prolongs life of drug in body

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94

path of drug in first pass metabolism

mouth —> esophagus —> tummy —> lumen of GI tract —> capillary network —> hepatic portal vein —> liver/gallbladder —> systemic circulation —> hep vein —> inf vena cava —> RA

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95

fast absorption =?

faster onset

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96

drugs with extensive first pass metabolism

My Mom Does My Laundry Perfectly Everytime

morphine - pain

meperidine (demerol) - opiod

diazepam - anxiety

midazolam - sedative

lidocaine - numbing

propanolol - heart

etoh - alc

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97

morphine iv vs. po dose

iv dose 5-10 mg q4h

po up to 30 mg q4h

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98

onset of action

drug reached systemic circulation

drug/route specific

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99

what is the therapeutic range?

amount of drug + time it takes to achieve desired affect

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100

cmax peak highest to lowest (im, po, iv)

iv (15-30 min)

im (30-60 min)

po (60 min)

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