Pharmacology Flashcards

Pharmacology Exam 1 & 2 & Antibiotics Study Guide Flashcards

The Controlled Substances Act of 1970

Control over the coding of drugs and the enforcement of these codes given to the FDA and the Drug Enforcement Agency, a part of the U.S. Department of Justice

DEA Schedule I

High abuse potential, no accepted medical use (heroin, LSD)

DEA Schedule II

High abuse potential, severe dependence liability (narcotics, amphetamines, and barbiturates)

DEA Schedule III

Less abuse potential than schedule II, moderate dependence liability (nonbarbiturate sedatives, nonamphetamine stimulants, limited amounts of certain narcotics)

DEA Schedule IV

Less abuse potential than schedule III, limited dependence liability (some sedatives antianxiety agents, and nonnarcotic analgesic)

DEA Schedule V

Limited abuse potential. Primary small amounts of narcotics (codeine) used as antitussives or antidiarrheals.

CURES (Controlled Substance Utilization Review and Evaluation System)

Database for Schedule II, Schedule III, Schedule IV, and Schedule V controlled substance prescriptions dispensed in CA serving the public health, regulatory oversight agencies, and law enforcement

Pharmacokinetics

The way a medication travels through the body; how the body acts on a drug

Pharmacodynamics

The study of the interactions between the chemical components of living systems and the foreign chemicals, including drugs, that enter living organisms

Pharmacogenomics

Study of genetically determined variations in response to drugs

Pharmaceutics

Science of taking a chemical and putting it in a medication form so that it can be used by human beings

Pharmacotherapeutics

Science of using drugs and what they do to the individual’s body and their DNA

Factors Affecting Absorption

Degree of stomach acidity, time required for the stomach to empty, whether food is present, amount of contact with villi in the small intestine, flow blood to villi

Distribution

Drug’s movement through body fluids

Metabolism or Biotransformation

Chemical change of drug into a form that can be excreted

Excretion

Process by which the body removes a drug

Critical concentration

The amount of a drug that is needed to cause a therapeutic effect

Loading dose

A higher dose than is usually used for treatment, allowing drug to reach critical concentration sooner

Dynamic equilibrium

The actual concentration that a drug reaches in the body

Elixirs

Highest absorption medication delivery route

Enteral

Anything oral (through stomach or mucosa)

Parenteral

IV, IM, SC, ID/injections

Topical

Patches, Drops, Body surfaces, Enemas, Inhaler

Absorption processes

Passive diffusion, Active transport, Filtration

Factors affecting distribution

Lipid solubility, ionization, perfusion of reactive tissue

Biotransformation

Process by which drugs are changed into new chemicals

Bioavailability

Portion of drugs that reaches circulation

Inducers

Increase rate of drug metabolism but decreases bioavailability

Inhibitors

Decrease rate of drug metabolism, and increases bioavailability

Half-life

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

Therapeutic index

Ratio of the blood concentration at which a drug becomes toxic to the concentration at which drug is effective

Agonist

Supplements function

Antagonist

Blocks function

10 Rights of Medication Safety

Right Medication, Client/Patient, Dose, Route, Time, Assessment, Documentation, Evaluation, Education, To Refuse

Body Fluid Composition

Intracellular and extracellular fluids make up 50%-60% of body weight

Intracellular fluid

Fluid inside the cell

Extracellular fluid

Fluid outside the cell

Interstitial fluid

Between blood vessels and cells, ¾ of ECF

Intravascular

Whole blood volume (plasma), ¼ of ECF; inside blood vessels

Diffusion

Passive process of fluid moving in or out of cells

Hypertonic solution

High solute/low solvent; Flows out of cell; cell shrinks

Isotonic solution

Equal solute/solvent; No flow outside or inside of cell; cell stays the same

Hypotonic solution

Low solute/high solvent; Flow into cell; cell swells

NaCl 0.9%

Primary fluid of choice for dehydration and resuscitative efforts

Lactated Ringers (LR)

Good choice of fluid replacement for burn and surgical pts

D5W

Isotonic THEN become hypotonic

Role of LR in acidosis

Helps prevent development of lactic acid that contributes to acidosis

3% NaCl benefits

Decreases cellular edema - particularly in the brain, Immediate response

Major concerns for hypertonic fluid

High potential for intravascular fluid volume overload, pulmonary edema, hypernatremia

Allergic Transfusion Reaction (s/s)

Facial flushing, Hives/rash, Increased anxiety, Wheezing, Decreased BP

Febrile Transfusion Reaction (s/s)

Headache, Tachycardia, Tachypnea, Fever/chills, Anxiety

Hemolytic Transfusion Reaction (s/s)

Decreased BP, Increased RR, Hemoglobinuria, Chest pain, Apprehension, Lower back pain, Fever, Tachycardia, Chills

Procedure: Blood

Collect blood for type and cross to determine pt’s blood type and Rh type

Procedure: Verify

Verify doctor’s order, Verify signed consent unless emergency, Verify pt’s religious/cultural beliefs regarding limitations on receiving blood and/or blood products

Procedure: Question

Question pt on history of blood transfusion; Has pt ever had a transfusion reaction

The Rh system

Based on presence/absence of major D antigen on the RBC surface

The ABO system

Type A blood has A antigen, Type B blood has B antigen, Type AB blood has both A and B antigen, Type O blood has no antigens

Type O-

Universal donor

AB+

Universal recipient of blood

Albumin

Increases fluid volume using oncotic pressure (volume expander without using volume)

Infiltration

Vein will burst or nurse may blow the vein by puncturing it; sometimes fluid will back up and go out of vein

Extravasation

An infiltration that is extreme, rupture of vein; outside of tissue, caused by damaging medication

Phlebitis

Usually caused by antibiotics, could be too small of vein as well; swelling of vessels

Cause of Fluid Overload

Fluid in lungs lead to pulmonary edema, lack of oxygen

S/S of Fluid Overload

Weight gain, Normothermic, Bounding pulses, Moist lung sounds, HTN, Pale, cool, clammy skin, Peripheral edema, Distended neck veins, Low Hgb/Hct, Restless

Intrinsic pathway

Converts prothrombin to thrombin to seal system

Extrinsic pathway

Clots the blood that has leaked out of vascular system

Anticoagulants

Interfere with clotting cascade and thrombin formation

Antiplatelets

Alter formation of platelet plug

Thrombolytic drugs

Break down the thrombus that has formed by stimulating plasmin system

Protamine Sulfate

Reversal for Heparin

Lab value indicates a supratherapeutic heparin dosing

aPTT (prothrombin time) lab value (measures how fast blood clots)

Drug treatment for suspected hemorrhage or uncontrolled bleeding with warfarin

K-Centra or prothrombin complex

Drug treatment for suspected overdose of warfarin

Vitamin K

Lab value indicates a supratherapeutic warfarin dosing

PT lab value and INR (internationalized normal ratio) lab value

Thrombolytics: Alteplase (TPA) and Tenecteplase (TNKase)

Primary treatment for hyperacute ischemic stroke

Alpha 1 (Generally excitatory effects)

Vasoconstriction

Beta (Inhibitory effects)

Smooth muscle relaxation

B1

Primarily in heart muscle, Causes positive chronotropic, dromotropic, inotropic effects

B2

Smooth muscle of airways, blood vessels, Causes vasodilation, bronchodilation

Adrenergic Agonists

Epinephrine, Norepinephrine, Dopamine

Adrenergic Antagonists

Prazosin/Minipress, Tamulosin/Flomax

Alpha 2 Adrenergic Agonists

Clonidine

Beta 1 Adrenergic Agonists

Epinephrine, Norepinephrine, Dopamine, Dobutamine

Beta Blockers (Adrenergic Antagonists)

Propranolol (Inderal), Metoprolol (Lopressor)

Beta 2 Adrenergic Agonists

Epinephrine, Albuterol, Terbutaline, Magnesium

Sympatholytic

Drug that lyses, or blocks effects of SNS

Sympathomimetic

Drugs that mimics SNS

Dopamine receptor site

Low levels of dopamine: dopamine receptors, Mid levels of dopamine: B1, High levels of dopamine: A1

Monoamine Oxidase (MAO)

Norepinephrine that is unused is recycled and undergoes metabolism with an enzyme MAO

COMT

A Catechol-O-Transferase another enzyme that actually eats or destroys the unused norepinephrine

Catecholamines

Epinephrine, Norepinephrine, Dopamine

Antitussives

Block cough reflex

Decongestants

Decrease blood flow to Upper RT = decrease secretions

Antihistamines

Block histamine (increases secretions & narrows airways)

Expectorants

Increase productive cough to clear airway

Mucolytics

Increase respiratory secretions/liquify to clear airway

Bronchodilators

Dilate airways

Xanthines

Effect smooth muscle

Sympathomimetics

Mimic SNS