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Ideal Drug
Q: What are the three primary properties of an ideal drug?
A: Effectiveness, Safety, Selectivity
Q: Which property of an ideal drug is considered the most important?
A: Effectiveness
Q: What does drug selectivity mean?
A: The drug produces only the desired response without side effects.
Q: Name three additional desirable characteristics of an ideal drug.
A: Predictability, Ease of Administration, Low Cost (also Chemical Stability, Freedom from Interactions)
Therapeutic Objectives
Q: What is the primary goal of drug therapy?
A: Maximum benefit with minimal harm.
Q: Can drugs create new functions in the body?
A: No, they only modify existing functions.
Q: Does any drug have only one action?
A: No, all drugs have multiple effects.
Sources of Drugs
Q: What are the five major sources of drugs?
A: Plants, Animals, Minerals, Synthetic Chemicals, Genetic Engineering
Q: Digitalis is derived from what source?
A: Plants (Purple Foxglove)
Q: Which source of drugs uses biotechnology and genomics?
A: Genetic Engineering
Drug Nomenclature
Q: What is a chemical name?
A: Name describing the exact molecular structure.
Q: What is a generic name?
A: Official nonproprietary name.
Q: What is a trade name?
A: Manufacturer’s brand/proprietary name.
Q: Why are medications commonly prescribed using generic names?
A: To reduce medication errors and standardize communication.
Q: What is the generic name for Advil?
A: Ibuprofen
Q: What is the trade name for acetaminophen?
A: Tylenol
Drug Classifications
Q: What are the three major ways drugs are classified?
A: Chemical, Physiologic, Therapeutic
Q: What does a therapeutic classification describe?
A: What condition the drug treats.
Q: What does a physiologic classification describe?
A: How the drug works in the body.
Q: What does a chemical classification describe?
A: Molecular structure/composition.
Prototype Drugs
Q: What is a prototype drug?
A: Representative drug of a drug class.
Q: Why are prototype drugs useful?
A: They help predict effects, side effects, contraindications, and nursing implications of similar drugs.
Clinical Trials
Q: What is the purpose of Phase I clinical trials?
A: Determine safety and dosage in healthy volunteers.
Q: What is the purpose of Phase II clinical trials?
A: Determine effectiveness in patients with the disease.
Q: What is the purpose of Phase III clinical trials?
A: Compare safety and effectiveness in large populations.
Q: What is the purpose of Phase IV clinical trials?
A: Monitor long-term and rare adverse effects after FDA approval.
Memory Trick:
Phase 1 = Safe?
Phase 2 = Works?
Phase 3 = Compare?
Phase 4 = Follow-up?
Bioavailability
Q: What is bioavailability?
A: Fraction of administered dose reaching systemic circulation.
Q: Which route has 100% bioavailability?
A: IV
Q: Why do oral drugs usually have lower bioavailability?
A: Incomplete absorption and first-pass effect.
First-Pass Effect
Q: What is the first-pass effect?
A: Drug metabolism by the liver before reaching systemic circulation.
Q: Which route is most affected by first-pass metabolism?
A: Oral (PO)
Q: Why might an oral dose be larger than an IV dose?
A: First-pass metabolism decreases bioavailability.
Protein Binding
Q: Which form of a drug is active?
A: Free (unbound) drug
Q: Which form of a drug is inactive?
A: Protein-bound drug
Q: What protein binds most medications?
A: Albumin
Q: What happens when albumin levels decrease?
A: More free drug → increased toxicity risk.
Q: Why are patients with liver failure at increased risk for drug toxicity?
A: Reduced albumin production causes increased free drug levels.
Competitive Binding
Q: What is competitive binding?
A: Two highly protein-bound drugs compete for albumin binding sites.
Q: What happens when one drug displaces another from albumin?
A: Increased free drug and increased toxicity risk.
P-Glycoprotein
Q: What is the function of P-glycoprotein?
A: Pumps drugs out of cells.
Q: What does P-glycoprotein do in the brain?
A: Limits drug entry into the CNS.
Q: What does P-glycoprotein do in the placenta?
A: Protects the fetus by transporting drugs back to maternal blood.
Memory Trick:
P-Glycoprotein = Protector
Geriatric Pharmacology
Q: Why are older adults at increased risk for medication toxicity?
A: Increased body fat, decreased albumin, decreased kidney function.
Q: How does increased body fat affect fat-soluble drugs?
A: Drugs remain in the body longer.
Q: How does decreased albumin affect drug action?
A: More free drug available.
Q: How does decreased renal function affect medications?
A: Increased drug accumulation and toxicity.
Renal Disease
Q: What happens to drugs when kidney function declines?
A: Drug accumulation increases.
Q: What lab value often indicates impaired renal function?
A: Elevated creatinine.
Q: Why are dose reductions often needed in kidney disease?
A: Reduced drug excretion.
Liver Disease
Q: How does liver failure affect drug clearance?
A: Drug clearance decreases.
Q: How does liver failure affect albumin production?
A: Albumin decreases.
Q: What is the overall effect on drug toxicity?
A: Increased risk of toxicity.