HS 370 Exam I Review - Basic Pharmacology, Nervous System & Psychotropics

Vocabulary flashcards based on HS 370 Exam I Review notes covering basic pharmacology concepts, drug administration, autonomic nervous system, anxiety, mood, and seizure medications.

Pharmacology

The study of medicine.

Therapeutics

The science associated with the treatment of suffering and the prevention of disease.

Pharmacotherapeutics

The useful application of drugs for the purpose of fighting disease.

Pharmaceutics

Science of pharmacy involving preparation of drugs and dispensing of drugs to patients after they are examined by a licensed provider.

USP (US Pharmacopoeia)

First comprehensive publication of drug standards, established 1820; medical reference summary

National Formulary

List of drugs and pharmaceutical ingredients

Drugs

Chemical agents that produce biological responses within the body.

Sherley Amendment

Prohibited the sale of drugs labeled with false therapeutic claims (1912)

ISMP (Institute for Safe Medication Practices)

Nonprofit organization dedicated entirely to preventing medication errors and promoting safe medication uses.

Therapeutic Classificiation

Drug classifications based on a drug's clinical usefulness. Example: anticoagulant, antihypertensive

Pharmacologic Classification

Drug classifications based on a drug's mechanism of action. Example: diuretic, ACE inhibitor

Chemical Classification

Drug classifications based on the structure of the drug. Example: thiazides

Prototype Drug

A drug used to compare other drugs within the same classification.

Trade Name

A proprietary name assigned to a drug, granting exclusive rights to market the drug for 17 years.

Generic Name

The official scientific name of the active ingredient of the drug.

Bioequivalence

Two drug products that release their active ingredients into the body with the same rate and extent, producing identical effects

Bioavailability

The key property reflecting the physiological availability of a drug, which often accounts for differences between trade-name drugs and generic equivalents; important to determine drug efficacy and dosing.

Schedule I Drugs

Controlled substances categorized as having very high abuse potential, as well as high physical and psychological dependence.

Schedule II Drugs

Controlled substance categorized as having high abuse potential, as well as high physical and psychological dependence.

Schedule III Drugs

Controlled substance categorized as having moderate abuse potential, as well as moderate physical dependence and high psychological dependence.

Schedule IV Drugs

Controlled substance categorized as having low abuse potential, as well as low physical and psychological dependence.

Schedule V Drugs

Controlled substance categorized as having very low abuse potential, as well as low physical and psychological dependence.

Pregnancy Category A

The safest drug category regarding safety in pregnancy, where studies fail to demonstrate a risk to the fetus.

Pregnancy Category B

A drug category where animal studies have not shown a risk to the fetus or if they have, studies in women have not confirmed the risk.

Pregnancy Category C

A drug category where animal studies hav shown a risk to the fetus, but controlled studies have not been performed in women.

Pregnancy Category D

A drug category that may cause harm to the fetus, but it may provide benefit to the mother in a life-threatening situation or when a safer therapy is not available.

Pregnancy Category X

The most harmful drug category in pregnancy, where studies demonstrate clear teratogenic risk and the drug is strictly contraindicated.

Adverse Event

Adverse drug effect

Anaphylaxis

Allergic reaction

Right patient, Right medication, Right dose, Right route of administration, Right time of delivery, and Right documentation.

6 Rights of Drug Administration:

Routine Order

A scheduled prescription that is given regularly and continuously until a healthcare provider cancels or changes it.

STAT Order

A one-time emergency order that must be given immediately and without delay due to urgent circumstances.

PRN Order

An as-needed prescription given only when the patient requests it or shows specific qualifying symptoms.

Standing Order

A pre-established set of instructions or protocols approved for use by medical staff to treat specific clinical conditions under defined circumstances without needing a call to a provider first.

• Checking the drug label with the MAR when removing it from the medication drawer

• Checking the drug label with the MAR when preparing it

• Checking the drug label with the MAR once more before administering it to the patient

3 checks of drug administration:

First-Pass Effect

A phenomenon where orally administered drugs are absorbed across the intestinal wall into hepatic portal circulation and taken directly to the liver for metabolism before reaching general circulation; important because it reduces the concentration of a drug before it reaches the rest of the body.

Enteral Route

Drug administration route given orally or via nasogastric (NG) or gastrostomy (G) tubes.

Oral Route

By mouth, slow onset, convenient/safe, first-pass metabolism.

Topical Route

By skin

Ophthalmic Route

By eyes, fast onset, produces local effect, NO first pass metabolism.

Nasal Route

By nose

Vaginal Route

By vagina

Rectal Route

By butt, slow onset, useful if patient cannot take medication orally; can be local or systemic, partial first-pass metabolism.

Parenteral Route

Drug administration route delivering medications directly into tissues or blood vessels (such as intradermal, subcutaneous, intramuscular, or intravenous), bypassing the first-pass effect.

Intradermal

Very small volume, sites: skin surfaces of the upper back, superficial areas overlying the scapulae, the superior upper chest, and the anterior forearm; slow onset, injected into dermis, small amounts, and commonly used for skin testing, no first pass metabolism.

Subcutaneous

Deeper tissue under skin (rapid absorption), sites: Posterior upper arm (above the triceps muscle), Middle two thirds of the anterior thigh area, Subscapular areas of the upper back, Upper dorsogluteal and ventrogluteal areas, Abdominal areas, above the iliac crest and below the diaphragm, 2 inches out from the umbilicus; moderate on set, sustained absorption, no first-pass effect

Intramuscular (IM)

More rapid onset, larger volume of medication; injected into muscle, sustained absorption, no first pass metabolism

Intravenous

Directly into bloodstream, very rapid onset, bypass first pass effect

Large-volume infusion (fluid maintenance), Intermittent infusion, IV bolus (push) administration

Pharmacokinetics

The branch of pharmacology focusing on what the body does to the drugs, comprising four components: absorption, distribution, metabolism, and excretion (ADME).

• Absorption

• Distribution

• Metabolism

• Excretion

4 Components of Drug Transport:

Absorption

Movement of a drug from its site of administration across body membranes

Distribution

How drugs are transported throughout the body

Albumin

Drugs bound to this plasma protein are transported in the blood and required to unbind to reach a target

Metabolism

Process whereby drugs are made less or more active

Plasma Protein Binding

How medications attach to proteins in the blood plasma; important because only the unbound portion of a drug in the blood can cross the cell membrane.

Half-Life

The time required for the concentration of a substance in the body or bloodstream to decrease by 50%; important because it dictate how often you need a dose and how long a drug stays in the body

Onset of Action

The time is takes for a medication to start producing its therapeutic effect after administered.

Duration of Action

The time period that a medication is effective in the body.

Peak Concentration

The highest level a medication reaches in the bloodstream after you take it; important because it dictates whether a drug will work and if it will cause harm.

Pharmacodynamics

The branch of pharmacology focusing on what drugs do to the body.

Receptor Theory

Most response in the body are caused by interactions of drugs with specific receptors

Receptor

Structural component of a cell to which a drug binds in a dose-related manner; may be located on the plasma membrane, or they may be found in the cytoplasm or nucleus of the cell.

Potency

Relates to the concentration or amount of a drug required to produce a maximum response.

Efficacy

Refers to how great the maximal response of a drug will be.

Therapeutic Range

The blood concentration or dosage of a medication that safely produces the desired healing effect without causing dangerous side effects

Agonist

A drug or substance that activates specific receptors to produce a dose-related biological response.

Antagonist

A drug or substance that blocks or prevents receptor activation, inhibiting a biological response.

Central Nervous System

Consists of brain and spinal cord

Peripheral Nervous System

Consists of a sensory portion and motor portion

Somatic

Voluntary motor

Autonmic

Involuntary motor

Sympathetic Nervous System

Stimulation of this NS causes symptoms of the fight-or-flight response

Parasympathetic Nervous System

Stimulation of this NS induces rest-and-digest response.

Synapses

Junction between two nerve cells that consists of a presynaptic nerve and a postsynaptic nerve

Synaptic Cleft

Space between the presynaptic and postsynaptic nerve; Neurotransmitters cross this to generate a nerve impulse

Norepinephrine

The neurotransmitter at the organ level in the sympathetic nervous system that acts on alpha or beta receptor subtypes.

Acetylcholine

The neurotransmitter located at the end of all presynaptic nerves (ganglia), at sweat glands, and in skeletal muscle, binding to nicotinic or muscarinic receptors.

Adrenergic Drugs

Medications that stimulate sympathetic target organs to cause symptoms of the fight-or-flight response.

Cholinergic Drugs

Medications that primarily stimulate parasympathetic target organs to induce rest-and-digest responses.

Adrenergic Blockers

Inhibit actions of the sympathetic nervous system

Cholinergic Blockers

Inhibit actions of the parasympathetic nervous syste,m

Selective Serotonin Reuptake Inhibitors (SSRIs)

Preferred antidepressants that slow the reuptake of serotonin into presynaptic nerve terminals, producing fewer sympathomimetic and anticholinergic effects.

Anxioolytics

Drugs that have the ability to relive anxiety and provide treatment

Sedatives

Drugs that suppress impulses traveling through the limbic and reticular activating systems, reducing symptoms of stress, drowsiness, and promoting sleep.

Antidepressants

Have the ability to enhance mood by altering the levels norepinephrine and serotonin

Serotonin Syndrome

A potentially life-threatening reaction resulting from excessively high doses of SSRIs or combining them with other serotonin-increasing drugs, causing confusion, tremors, hypertension, fever, and incoordination.

Benzodiazepines

Schedule IV controlled substances (such as diazepam and chlordiazepoxide) that intensify the effect of GABA to provide short-term treatment for anxiety and insomnia.

Barbiturates

Schedule II, III, and IV drugs derived from barbituric acid that depress CNS function by binding to GABA receptor-chloride channel molecules; primarily used for procedural sedation, pre-anesthesia, or uncontrolled convulsions.

Tricyclic Antidepressants (TCAs)

Antidepressants that inhibit the reuptake of both norepinephrine and serotonin into presynaptic terminals while also blocking muscarinic, alpha-adrenergic, and histaminic ($H_1$) receptors.

Monoamine Oxidase Inhibitors (MAOIs)

Antidepressants that limit the breakdown of norepinephrine, dopamine, and serotonin by inhibiting MAO; require strict avoidance of tyramine-containing foods and caffeine.

Lithium (Eskalith)

A mood stabilizer used to treat bipolar disorder through complex effects on glutamate, dopamine, serotonin, and secondary messenger cell signaling.

Extrapyramidal Symptoms (EPS)

Adverse motor reactions caused by conventional antipsychotics, including muscle spasms (dystonia), inability to remain seated (akathisia), and unusual tongue and facial movements (tardive dyskinesia).

Conventional Antipsychotics

Neuroleptic medications that treat positive signs of schizophrenia primarily by blocking postsynaptic dopamine ($D_2$) receptors.

Atypical Antipsychotics

Preferred antipsychotic medications that treat both positive and negative signs of schizophrenia with fewer adverse extrapyramidal effects.

Succinimides

A class of antiseizure drugs, such as ethosuximide (Zarontin), that treat absence seizures by blocking calcium channels and delaying calcium entry into neurons.

Hydantoins

Antiseizure medications, including phenytoin (Dilantin), that depress CNS activity by desensitizing sodium channels to manage partial and tonic-clonic seizures.

• Situational depressi9on

• Dysthymic disorder

• Disruptive mood dysregulation

• Premenstrual dysphoric disorder

• Postpartum depression

• Season affective disorder

• Psychotic depression

7 types of depression:

• Blocking the enzymatic breakdown of norepinephrine

• Slowing the re-uptake of serotonin and norepinephrine

2 majors ways that antidepressants work:

• SSRIs

• TCAs

• MAOIs

3 major classes of antidepressants:

bipolar disorder

Extreme and opposite moods