Ch. 1 General Info
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Questions and Answers

What critical observation did William Withering make regarding the purple foxglove plant, which was a precursor to understanding its mechanism?

  • It has an unobserved effect on the heart's motion, distinguishing it from other medicines. (correct)
  • It alleviates dropsy by affecting multiple organ systems simultaneously.
  • It directly improves renal perfusion, leading to reduced edema.
  • It primarily acts as a diuretic, directly reducing fluid retention.

Why was the purple foxglove initially believed to be effective in treating dropsy?

  • Its active agents directly counteracted the underlying causes of dropsy.
  • It directly stimulated the kidneys to produce more urine.
  • Its effect on the heart improved renal perfusion, reducing edema. (correct)
  • It reduced inflammation in the tissues, alleviating swelling.

How did the understanding of digitalis glycosides' action evolve from the initial observations of purple foxglove's effects?

  • From a perceived direct diuretic effect to recognizing its impact on myocardial contractility. (correct)
  • From primarily affecting the kidneys to improving nervous system regulation.
  • From a general tonic to specifically targeting renal function.
  • From solely alleviating edema to addressing the underlying inflammatory processes.

What distinguished the approach to drug therapy after the Renaissance from earlier practices?

<p>A more scientific, observation-based approach to understanding drug effects. (D)</p> Signup and view all the answers

What is a key reason why digitalis glycosides are still prescribed today?

<p>Their ability to increase myocardial contractile force improves cardiac performance. (B)</p> Signup and view all the answers

How did the practice of medicine evolve from ancient times through the 18th century regarding drug use?

<p>From undocumented oral traditions to pharmacopeias documenting drug formulations. (C)</p> Signup and view all the answers

In what way did Edward Jenner's smallpox inoculations mark a significant development in medical treatments during the 18th century?

<p>It introduced the concept of using biological extracts for vaccination. (C)</p> Signup and view all the answers

Which statement accurately reflects the role of observation in the evolution of pharmacology as a distinct discipline?

<p>Systematic observation was crucial in separating pharmacology from general medicine. (D)</p> Signup and view all the answers

Which advancement most directly enabled the large-scale production of true human insulin, reducing reliance on animal sources?

<p>Recombinant DNA technology. (A)</p> Signup and view all the answers

What is the primary role of the World Health Organization (WHO) in international drug control?

<p>Providing technical assistance and encouraging research related to drug use. (C)</p> Signup and view all the answers

How does modifying the molecular structure of existing drugs, such as antibiotics, primarily benefit medical treatments?

<p>It makes the drug effective against different organisms. (D)</p> Signup and view all the answers

What is the main purpose of the animal and clinical patient studies that must be done before a drug can be marketed?

<p>To conduct extensive testing of the drug's safety and effectiveness. (B)</p> Signup and view all the answers

Why are alkaloids often converted into salts for medicinal use?

<p>To increase their solubility in body fluids. (D)</p> Signup and view all the answers

Which legislative act initially established the FDA and restricted the sale of medicinal preparations with little to no use?

<p>The Pure Food and Drug Act. (C)</p> Signup and view all the answers

What is the primary reason for the decrease in mortality and increased life expectancy observed after the introduction of antibiotics?

<p>Effective treatment of bacterial infections. (D)</p> Signup and view all the answers

Which of the following medication sources is most likely to provide inorganic materials not found in plants or animals?

<p>Mineral sources. (C)</p> Signup and view all the answers

What was the main requirement introduced by the truth-in-labeling clause of the Federal Food, Drug, and Cosmetic Act?

<p>Accurate descriptions of package contents, including drug names, quantities, and warnings. (B)</p> Signup and view all the answers

Why is the overuse of antibiotics a significant concern in modern medicine?

<p>It promotes the development of antibiotic-resistant organisms. (C)</p> Signup and view all the answers

What key requirement did the Kefauver-Harris Amendment add to the drug approval process?

<p>Proof of safety and effectiveness before a drug could be marketed. (C)</p> Signup and view all the answers

What primary substances did the Harrison Narcotic Act of 1914 aim to control?

<p>Opium plant derivatives and coca plant derivatives. (D)</p> Signup and view all the answers

Which characteristic of porcine insulin makes it a valuable source for human insulin production?

<p>It closely resembles human insulin and can be chemically altered. (B)</p> Signup and view all the answers

How did the introduction of sulfa-class antibiotics in 1935 impact medical practice?

<p>It provided the first effective therapy for infections. (C)</p> Signup and view all the answers

The Comprehensive Drug Abuse Prevention and Control Act of 1970 classifies drugs into how many schedules?

<p>Five (A)</p> Signup and view all the answers

What is a key difference between traditional pharmacognosy and modern medication development?

<p>Traditional pharmacognosy studies natural sources, while modern development includes laboratory-created sources. (D)</p> Signup and view all the answers

How did the Pure Food and Drug Act define official drug standards?

<p>By naming the United States Pharmacopeia (USP) and the National Formulary (NF) as official standards. (B)</p> Signup and view all the answers

A patient experiencing a life-threatening seizure disorder associated with pregnancy would most likely be treated with a medication derived from which source?

<p>Mineral source. (A)</p> Signup and view all the answers

Why was the Federal Food, Drug, and Cosmetic Act of 1938 enacted?

<p>In response to a public health crisis involving a toxic drug preparation. (B)</p> Signup and view all the answers

Why were physicians limited in their ability to effectively treat infections prior to 1935?

<p>Effective antibiotic therapies were not yet available. (B)</p> Signup and view all the answers

What control mechanisms exist for international drug trade?

<p>Drug enforcement agencies cooperating on a voluntary basis. (C)</p> Signup and view all the answers

In emergency medicine, atropine sulfate, derived from the deadly nightshade plant, is primarily used for what purpose?

<p>To treat slow heart rates and certain toxicological emergencies. (A)</p> Signup and view all the answers

Which of the following best describes the role of enzymes, such as pancreatin and pepsin, as medication derived from animal sources?

<p>They function as catalysts to facilitate chemical reactions. (D)</p> Signup and view all the answers

What is the most significant challenge associated with narcotic analgesics derived from the opium plant, such as morphine and codeine?

<p>Their potential for abuse and dependence (D)</p> Signup and view all the answers

What is the primary purpose of using sodium bicarbonate (NaHCO3) in certain toxicological emergencies?

<p>To treat severe metabolic acidosis. (A)</p> Signup and view all the answers

In the context of medication orders, what does 'p.c.' typically signify?

<p>After meals (D)</p> Signup and view all the answers

Which of the following routes of medication administration is represented by the abbreviation 'SL'?

<p>Sublingual (D)</p> Signup and view all the answers

What does the abbreviation 'q.i.d.' stand for in medication prescriptions?

<p>Four times a day (D)</p> Signup and view all the answers

A patient's medication order reads 'NTG SL prn CP'. How should a nurse interpret this order?

<p>Administer nitroglycerin sublingually as needed for chest pain. (A)</p> Signup and view all the answers

What is the primary purpose of Phase I clinical trials in new medication development?

<p>To determine the medication’s pharmacokinetics, toxicity, and safe dose in humans. (D)</p> Signup and view all the answers

Which numerical classification, according to the FDA, is assigned to a new salt of a marketed drug?

<p>Type 2 (D)</p> Signup and view all the answers

What does 'NPO' indicate in patient care?

<p>Nothing by mouth (B)</p> Signup and view all the answers

A medication is classified by the FDA with the letter 'P'. What does this signify regarding its therapeutic potential?

<p>The drug offers an important therapeutic gain. (D)</p> Signup and view all the answers

Which route of administration is indicated by the abbreviation 'IO'?

<p>Intraosseous (B)</p> Signup and view all the answers

A patient's chart indicates 'Hx of COPD'. What does this signify?

<p>History of Chronic Obstructive Pulmonary Disease (A)</p> Signup and view all the answers

During drug development, animal studies are conducted. What is the main purpose of these preclinical trials?

<p>To evaluate a medication’s pharmacological use, dosage ranges, and possible toxic effects. (B)</p> Signup and view all the answers

What is the interpretation of the abbreviation 't.i.d.' in medication prescriptions?

<p>Three times a day (A)</p> Signup and view all the answers

In the context of emergency medical care, what does 'ACLS' stand for?

<p>Advanced Cardiac Life Support (D)</p> Signup and view all the answers

If a patient's lab results show elevated SpCO levels, what condition is indicated?

<p>Carbon monoxide poisoning (D)</p> Signup and view all the answers

What information is typically gathered during Phase III clinical trials of a new medication?

<p>Relevant data on side effects and refinement of the therapeutic dose. (B)</p> Signup and view all the answers

Which of the following best describes medications that are created by reordering genetic information to enable bacteria to produce a specific substance?

<p>Medications produced through recombinant DNA research. (C)</p> Signup and view all the answers

A patient with a known seizure disorder is experiencing a prolonged seizure. Which synthetically manufactured medication would be MOST appropriate to administer?

<p>Diazepam (Valium) (C)</p> Signup and view all the answers

Why is it recommended to use multiple sources of information when researching a medication?

<p>To cross-reference information and ensure accuracy. (D)</p> Signup and view all the answers

An EMS provider is unsure about the correct dosage of a medication. Which resource would provide the MOST rapid access to the needed information?

<p>A smartphone application designed for medications. (D)</p> Signup and view all the answers

Which role does the FDA play in bringing a new medication to the market?

<p>They evaluate the safety and efficacy of new medications. (C)</p> Signup and view all the answers

What is the purpose of animal studies during the medication development process?

<p>To test the medication's toxicity and pharmacokinetics. (B)</p> Signup and view all the answers

What is the significance of determining a medication's therapeutic index during the drug development process?

<p>It reflects the safety margin between effective and lethal doses. (A)</p> Signup and view all the answers

After the FDA designates a medication as an Investigational New Drug (IND), what is the next step in the medication development process?

<p>Testing the medication on human subjects. (B)</p> Signup and view all the answers

Why should abbreviations related to medications be used carefully?

<p>They can lead to confusion and medication errors. (B)</p> Signup and view all the answers

A new medication is being studied. Researchers find that in animal models, a dose of 50mg/kg is effective in treating a condition, but a dose of 500mg/kg is lethal. What is the therapeutic index of this medication in animals?

<p>10 (A)</p> Signup and view all the answers

A patient arrives in the emergency department with a suspected overdose. Accessing which resource would MOST quickly provide detailed information about the specific drug and potential treatments?

<p>Smartphone pharmacology/medication application (C)</p> Signup and view all the answers

A certain medication is derived from both natural sources and synthetic processes in the laboratory. Which of the following medications aligns with this description?

<p>Anistreplase (A)</p> Signup and view all the answers

In prehospital care, what is the primary reason for EMS providers to have a strong understanding of commonly prescribed medication classes?

<p>To accurately predict interactions with emergency medications. (B)</p> Signup and view all the answers

What is the initial step in testing a new medication, according to the FDA's guidelines?

<p>Studying both male and female mammals to assess toxicity. (B)</p> Signup and view all the answers

New research indicates a revolutionary drug can halt cancer but causes severe liver damage in 30% of test subjects. What is the MOST LIKELY regulatory outcome, based solely on the information provided?

<p>Rejection due to significant risk, requiring further refinement of the drug. (B)</p> Signup and view all the answers

Why is standardization of drugs considered necessary by the federal government?

<p>To enforce uniform quality and consistency, even though biological or therapeutic differences may still exist. (B)</p> Signup and view all the answers

Which of the following scenarios violates the restrictions on Schedule II drug prescriptions as mandated by the Controlled Substances Act?

<p>A physician faxes a prescription for oxycodone to a pharmacy. (B)</p> Signup and view all the answers

In the context of drug standards, what does bioavailability describe?

<p>The extent to which a drug is absorbed into the general circulation. (C)</p> Signup and view all the answers

A physician wishes to prescribe a Schedule III drug. According to the Controlled Substances Act, what is the maximum number of refills allowed within a 6-month period?

<p>Five refills (B)</p> Signup and view all the answers

Why are unlabeled uses of medication not included in package inserts or discussed by pharmaceutical sales representatives?

<p>The FDA restricts manufacturers from promoting medications for unlabeled indications. (B)</p> Signup and view all the answers

A new medication has just been developed. Which name is selected by the United States Adopted Names (USAN) Council?

<p>Generic name (D)</p> Signup and view all the answers

What does the symbol ® after a drug's trade name indicate?

<p>The drug is registered and exclusive to the drug manufacturer. (A)</p> Signup and view all the answers

What is the core principle behind medical oversight in prehospital care?

<p>Prehospital care providers act as delegates of a physician, operating under their medical license. (C)</p> Signup and view all the answers

In Canada, which legislative act empowers the governor-in-council to prescribe drug standards?

<p>The Food and Drug Act (D)</p> Signup and view all the answers

Which of the following best describes the role of a medical director in prehospital care?

<p>Overseeing medical control guidelines, education, quality assurance, and competency assessments. (A)</p> Signup and view all the answers

A physician prescribes a medication using its generic name. In a state where generic substitution is allowed, what is the pharmacist permitted to do?

<p>Substitute a less expensive generic medication, if available. (D)</p> Signup and view all the answers

How does the Canadian Narcotic Control Act impact the prescribing of narcotic drugs?

<p>It sets requirements for authorized practitioners who prescribe methadone. (D)</p> Signup and view all the answers

An EMS system discovers that its morphine supply has been compromised through tampering. What immediate action should be taken, according to guidelines for controlled substances?

<p>Report the incident to the DEA and local law enforcement. (A)</p> Signup and view all the answers

What is the potential medicolegal implication for a medical director in prehospital care?

<p>Potential liability in cases of litigation involving prehospital care. (C)</p> Signup and view all the answers

Which factor primarily explains why generic medications are typically less expensive than trade name medications?

<p>Generic medications are produced by lesser known companies with minimal advertising costs. (C)</p> Signup and view all the answers

Medications such as thiazides and beta-blockers are grouped therapeutically as antihypertensives. Which statement best explains this classification?

<p>They are both used for the same therapeutic purpose, lowering blood pressure. (C)</p> Signup and view all the answers

How does on-line medical control differ from off-line medical control?

<p>On-line control involves direct physician orders, whereas off-line control includes system design and education. (C)</p> Signup and view all the answers

What requirements must be met for physicians to prescribe scheduled drugs in the United States?

<p>Physicians must be approved by the DEA and indicate their DEA number on the prescription. (B)</p> Signup and view all the answers

What is the primary purpose of Phase III clinical trials in the drug approval process?

<p>To identify rare or infrequent adverse effects in a large patient population. (B)</p> Signup and view all the answers

What is the role of standing orders or protocols in prehospital care?

<p>To allow care providers to administer treatments without directly consulting a physician. (C)</p> Signup and view all the answers

In the context of controlled substances, what action is most critical when a discrepancy is identified during routine counting?

<p>Immediately reporting the discrepancy according to established protocols. (C)</p> Signup and view all the answers

What is the primary concern regarding medication storage in EMS systems, as highlighted in the provided material?

<p>Protecting medications temperatures outside their tolerance (A)</p> Signup and view all the answers

How does a 'double-blind' study design minimize bias in clinical trials?

<p>By preventing both the patients and the researchers from knowing who receives the treatment or placebo. (B)</p> Signup and view all the answers

An assay is conducted to measure the purity of a chemical in a drug preparation. Where is this procedure performed?

<p>In a laboratory setting (in vitro). (B)</p> Signup and view all the answers

What factors are emphasized by treat-and-release protocols recently implemented by some EMS systems?

<p>The importance of education, judgment, and critical-thinking skills. (A)</p> Signup and view all the answers

Which of the following drugs is classified as a Schedule I controlled substance in the United States due to its high abuse potential and lack of recognized medical use?

<p>Heroin (D)</p> Signup and view all the answers

What is the significance of the letter 'N' appearing on labels and professional advertisements in Canada, according to the text?

<p>Signifies a stringently restricted drug under the Narcotics Schedule. (D)</p> Signup and view all the answers

Which of the following is considered part of off-line medical control?

<p>Developing and implementing protocols for patient care. (C)</p> Signup and view all the answers

What does the term 'efficacy' refer to when evaluating a drug?

<p>How well the drug works in terms of treatment effect. (A)</p> Signup and view all the answers

What action does the FDA take after Phase III trials of a new medication are completed?

<p>The FDA evaluates the results and, if favorable, the company completes a New Drug Application (NDA). (B)</p> Signup and view all the answers

Which of the following is an example of a drug's chemical name?

<p>Ethyl 1-methyl-4-phenylisonipecotate hydrochloride (B)</p> Signup and view all the answers

Why is ongoing education increasingly important in prehospital care?

<p>To manage the increasing complexity of care, medications, and equipment. (C)</p> Signup and view all the answers

What is the primary focus of Phase IV testing of a newly approved medication?

<p>Monitoring the medication's performance in the general population after it has been marketed. (C)</p> Signup and view all the answers

What action does the U.S. Drug Enforcement Administration (DEA) enforce concerning the prescription of controlled substances?

<p>Approving physicians to write prescriptions for scheduled drugs. (B)</p> Signup and view all the answers

A medication is identified as 'Meperidine hydrochloride, USP'. What type of drug name is this?

<p>Official name (C)</p> Signup and view all the answers

What is the primary purpose of routine medication inventory audits, particularly for controlled substances, in emergency medical services?

<p>To protect patients and personnel by preventing drug diversion and adulteration. (C)</p> Signup and view all the answers

What is the significance of a 'black box' warning on a medication's labeling?

<p>It highlights a risk of death or serious injury associated with the medication. (C)</p> Signup and view all the answers

What contributes to medical control having the authority to discipline providers?

<p>Adherence to protocols ensures best care for patients. (B)</p> Signup and view all the answers

A pharmacy in Canada receives a prescription for a Schedule G drug. According to the information presented, what is the primary reason these drugs are controlled?

<p>Due to the high potential for abuse. (C)</p> Signup and view all the answers

Which of the following best describes the role of the Food and Drug Administration (FDA)?

<p>Approving medications for public use after rigorous evaluation. (B)</p> Signup and view all the answers

What is the role of a medical advisory board in some EMS systems?

<p>To provide input to the medical director, with physician representation from various institutions. (B)</p> Signup and view all the answers

In an EMS system, which measure directly helps prevent the diversion or adulteration of controlled substances stored for immediate use?

<p>Tagging jump bags with a tamperproof tag or seal. (A)</p> Signup and view all the answers

Under what circumstances might a medication receive 'expedited approval' from the FDA?

<p>When the medication addresses a significant public health threat, such as AIDS. (B)</p> Signup and view all the answers

A medication log should contain specific information for each administration. Which of the following elements is typically recorded in this log?

<p>Quantity administered (C)</p> Signup and view all the answers

What distinguishes on-line medical control from off-line medical control in an EMS system?

<p>On-line control involves direct communication with a physician for immediate guidance, while off-line control includes protocols and standing orders. (D)</p> Signup and view all the answers

Two generically equivalent drug preparations contain the same amount of active chemical but may still have different therapeutic effects. What is the procedure to ascertain their bioequivalence?

<p>Bioassay (C)</p> Signup and view all the answers

In Canada, under what circumstances can a drug be classified under the Nonprescription Drug Schedule (Group 3)?

<p>When it is available only in the pharmacy and used on a physician’s recommendation. (D)</p> Signup and view all the answers

What is the significance of prehospital care providers acting under the medical license of a physician?

<p>It establishes the physician as the ultimate authority in medical control and competency issues. (D)</p> Signup and view all the answers

What is a key incentive provided by the Orphan Drug Act of 1983?

<p>Substantial tax credits for companies that develop drugs for rare diseases. (D)</p> Signup and view all the answers

What does 'potency' of a drug refer to?

<p>The strength or power of a drug to produce the desired effect. (C)</p> Signup and view all the answers

In the context of medical control, what does 'base' physician refer to?

<p>A physician in the emergency department who provides orders to prehospital care providers. (A)</p> Signup and view all the answers

Why is it essential for paramedics to be familiar with commonly used emergency medications, terminology, and abbreviations?

<p>To ensure efficient and professional communication with other medical personnel. (C)</p> Signup and view all the answers

How do Schedule V drugs in the United States differ from Schedule II drugs in terms of prescription refills, according to the Controlled Substances Act?

<p>Schedule V drugs may be refilled at the physician's discretion, while Schedule II drugs cannot be refilled. (C)</p> Signup and view all the answers

What challenges do manufacturers often face when developing orphan drugs?

<p>High development costs with limited potential for financial return. (D)</p> Signup and view all the answers

A doctor prescribes phenobarbital in the United States. Based on the provided information, in which schedule is phenobarbital categorized?

<p>Schedule G (C)</p> Signup and view all the answers

What does the term 'unlabeled use' of a medication refer to?

<p>Using a medication for an indication not yet approved by the FDA. (C)</p> Signup and view all the answers

What determines acceptable limits of medication use in a society?

<p>A society's attitude and values, as well as formal controls. (D)</p> Signup and view all the answers

What is the significance of a 'black box warning' on a medication label?

<p>It alerts users to potentially life-threatening or serious adverse effects. (D)</p> Signup and view all the answers

In pharmacology, what is the difference between a solute and a solvent?

<p>A solute is the powder that is dissolved, while a solvent is the liquid doing the dissolving. (B)</p> Signup and view all the answers

Why is post-market surveillance (Phase IV) crucial, even after a drug has been approved by the FDA?

<p>To identify any side effects or long-term risks that weren't apparent during clinical trials. (B)</p> Signup and view all the answers

Which description aligns with the role of a medical director?

<p>A licensed physician active in emergency medicine with prehospital care experience. (A)</p> Signup and view all the answers

How did the Pure Food and Drug Act influence medication standards in United States?

<p>It recognized the National Formulary (NF) and the United States Pharmacopeia (USP) as official standards. (A)</p> Signup and view all the answers

In the context of drug approval, what is the purpose of administering a placebo?

<p>To control for psychological responses and emotional involvement that influence symptom relief. (D)</p> Signup and view all the answers

What is the primary goal of treatment protocols and standing orders in prehospital care?

<p>To provide guidelines for patient care that can be initiated before or without contacting medical control. (A)</p> Signup and view all the answers

What does the FDA consider when determining if a medication benefits a specific segment of the population?

<p>Whether the potential advantages of the medication outweigh the risks associated with it. (A)</p> Signup and view all the answers

What does the term 'bioequivalence' refer to in the context of medications?

<p>The relative therapeutic effectiveness of chemically equivalent medications. (C)</p> Signup and view all the answers

Which of the following is a characteristic of a crossover study design in clinical trials?

<p>Patients receive the medication for some time and a placebo for the rest. (A)</p> Signup and view all the answers

How did the FDA respond to manufacturer contentions concerning the antidepressant tranylcypromine (when it was withdrawn)?

<p>The FDA reinstated tranylcypromine in the market for use by patients with severe depression, but with certain restrictions. (B)</p> Signup and view all the answers

Which activity falls under the purview of the Drug Enforcement Administration (DEA)?

<p>Enforcing the Controlled Substances Act. (B)</p> Signup and view all the answers

After a physician discovers that a medication approved for hypertension also decreases angina, what is the most appropriate course of action?

<p>Share the findings with colleagues and in medical publications, allowing for potential 'unlabeled use'. (B)</p> Signup and view all the answers

Which of the following is the MOST accurate definition of a medication's 'mechanism of action'?

<p>The specific way in which a medication produces its therapeutic effect on the body. (C)</p> Signup and view all the answers

A medication is said to be contraindicated in a patient with a specific condition. What does this imply?

<p>A predictable harmful event may occur if the medication is administered to the patient. (A)</p> Signup and view all the answers

Which section of a medication profile contains information about how the drug is absorbed, distributed, and eliminated by the body, including its onset and duration of action?

<p>Pharmacokinetics (D)</p> Signup and view all the answers

Why is knowledge of medication classifications essential for paramedics?

<p>It is essential to understanding the properties and expected effects of medications. (B)</p> Signup and view all the answers

Which of the following BEST describes the difference between a medication indication and a contraindication?

<p>An indication suggests potential benefits, while a contraindication suggests potential harm. (D)</p> Signup and view all the answers

Which of the following medication forms typically has the slowest onset of effect?

<p>Oral (C)</p> Signup and view all the answers

What is the PRIMARY advantage of using prefilled syringes in emergency medical care?

<p>They save time by eliminating the need to draw medication from an ampule or vial. (D)</p> Signup and view all the answers

Why must parenteral medications be sterile?

<p>To prevent infection, since they are introduced directly into the body. (A)</p> Signup and view all the answers

A solution is a type of liquid medication. What differentiates a solution from a suspension?

<p>Solutions contain medication that is completely dissolved, while suspensions contain undissolved particles. (B)</p> Signup and view all the answers

Before administering a suspension, why is it important to shake the container well?

<p>To ensure that the medication is evenly distributed throughout the liquid. (C)</p> Signup and view all the answers

Which liquid medication preparation uses alcohol to chemically extract the medication?

<p>Tinctures (D)</p> Signup and view all the answers

A vial is sealed with a rubber diaphragm. What is the PRIMARY purpose of this?

<p>To allow for easy insertion of a needle to withdraw the medication. (B)</p> Signup and view all the answers

Nitroglycerin can be administered sublingually (under the tongue) or as a topical ointment. What is the MOST significant difference between these two routes of administration?

<p>The sublingual route provides a much faster onset of action compared to the ointment. (A)</p> Signup and view all the answers

Which of the following liquid medication preparations is MOST likely to contain cherry flavoring?

<p>Elixir (A)</p> Signup and view all the answers

What is the solute in a liquid medication?

<p>The medication that is dissolved in a liquid (A)</p> Signup and view all the answers

What is the primary distinction between multi-dose and single-dose vials concerning their composition?

<p>Multi-dose vials contain preservatives to prevent microbial growth. (D)</p> Signup and view all the answers

How are medications like salbutamol and ipratropium bromide typically administered, and why is this route chosen?

<p>Via nebulizer, for direct delivery to the respiratory tract. (B)</p> Signup and view all the answers

Why might a medication be formulated as a suppository rather than an oral tablet?

<p>To bypass the digestive system, preventing degradation of the medication or when the patient cannot swallow. (C)</p> Signup and view all the answers

How do inhalants facilitate rapid absorption of medication into the bloodstream?

<p>The lungs have a rich supply of capillaries providing a large surface area for absorption. (D)</p> Signup and view all the answers

What distinguishes an 'adverse effect' from a 'side effect' of a medication?

<p>Adverse effects prove harmful to the patient, whereas side effects are undesired but frequently seen even at therapeutic dosages. (A)</p> Signup and view all the answers

What does the term 'antagonism' refer to in the context of pharmacology?

<p>The opposition between two or more medications. (A)</p> Signup and view all the answers

In what scenario would giving a medication as a 'bolus' dose be most appropriate?

<p>When a patient requires a large, single dose of medication to achieve a rapid therapeutic effect. (A)</p> Signup and view all the answers

What is the significance of understanding contraindications for a given medication?

<p>To identify medical or physiological conditions that would make administering the medication harmful. (C)</p> Signup and view all the answers

How does 'cumulative action' of a medication typically occur, and what is its effect on the patient?

<p>By the medication building up in the blood due to repeated doses, causing an increased effect. (D)</p> Signup and view all the answers

Differentiate between 'habituation' and 'tolerance' in the context of long-term medication use.

<p>Habituation is physical or psychological dependence, while tolerance involves needing larger doses for the same effect. (A)</p> Signup and view all the answers

What is the key characteristic of an 'idiosyncratic' reaction to a medication?

<p>It is an individual reaction that is unusually different from what is typically seen. (B)</p> Signup and view all the answers

What does 'potentiation' describe in pharmacology, and how does it affect the action of medications?

<p>The enhanced effect of one medication when combined with another. (D)</p> Signup and view all the answers

What does it mean if a patient is described as 'refractory' to a particular medication?

<p>The patient does not respond to the medication. (D)</p> Signup and view all the answers

How does 'synergism' differ from 'potentiation' in the context of combined medication effects?

<p>Synergism produces a combined effect greater than the sum of individual effects, while potentiation enhances the effect of one medication. (A)</p> Signup and view all the answers

What is the significance of the Field Training Officer (FTO) inspecting controlled substances with Rachel during her orientation?

<p>To ensure proper accounting, storage, and handling of controlled medications. (A)</p> Signup and view all the answers

Flashcards

Early medicine

Using herbs/minerals for medical disorders, dating back to ancient Egypt.

Hippocrates

Father of modern medicine; wrote extensively on drug use, but rarely used them.

Purple Foxglove

A common additive to early medications, first described in 1250 AD; contains digitalis.

William Withering

Described the use of purple foxglove for dropsy in 1785.

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Digitalis glycosides

Increase myocardial contractile force, improving heart performance and reducing body swelling.

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Vaccination (early)

Treatment using biological extracts; began with smallpox inoculations.

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Atropine, Chloroform...

Common substances in use by the 19th century for various purposes.

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17th/18th Century

Tinctures of opium, coca and digitalis were widely available

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Laboratory-Produced Medications

Medications created in a lab, can be natural, synthetic, or a combination.

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Recombinant DNA Technology

Reordering genetic information to enable bacteria to produce substances like human insulin.

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Synthetically Derived Medications

Medications artificially created through chemical synthesis.

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Multiple Medication Information Sources

Using multiple sources to confirm medication information.

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EMS Medication Guides

Guides with medication details that EMS providers can carry easily.

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FDA Medication Approval Process

Process by U.S. FDA to ensure the safety and efficacy of new medications.

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Pharmacokinetics

The study of how a medication is absorbed, distributed, metabolized, and excreted by the body.

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Therapeutic Index

The ratio of a medication's lethal dose to its effective dose.

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Investigational New Drug (IND)

Medication cleared for human testing during the FDA approval process.

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Abbreviations in Pharmacology

Representations of medical terms to save time.

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Pharmacopoeia

Official listing of medications; examples include USP and BP.

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Pharmacokinetics (ADME)

The study of what the body does to a drug (absorption, distribution, metabolism, excretion).

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United States Pharmacopeia (USP)

The official U.S. compendium of drug information.

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Medication Research

A systematic investigation to establish facts and reach new conclusions.

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Compendia

A compilation of data on pharmaceutical products.

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Pharmacognosy

The study of drugs derived from natural sources like plants, animals, and minerals.

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Synthetic Medication Sources

The use of laboratory processes to create medications, including synthetic versions of natural substances or modifications of existing drugs.

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Plant-Based Medications

Medications originating from plants.

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Active component

The active part of a plant that causes the medication's effect.

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Alkaloids

A class of active components in plants that act as alkali and form salts with acids.

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Atropine

A medication derived from the deadly nightshade plant, used to treat slow heart rates and toxicological emergencies.

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Morphine

A medication made from the opium plant and used to treat moderate to severe pain.

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Animal-Based Medications

Medications derived from animal body fluids, glands, oils, fats or enzymes.

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Insulin

A hormone derived from animals (or synthetically) used to treat diabetes mellitus.

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Oxytocin

A hormone derived from animals used to induce labor and treat vaginal bleeding.

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Cod-liver oil

An oil derived from animals (fish) used as a source of vitamins.

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Mineral-Based Medications

Medications derived from inorganic elements and compounds found in nature.

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Sodium Bicarbonate (NaHCO3)

A mineral compound used to treat severe metabolic acidosis and as an adjunct in toxicology.

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Magnesium Sulfate (MgSO4)

A mineral compound used to treat eclampsia and some cardiac emergencies.

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Vaccines

A suspension of killed, modified, or attenuated microorganisms used to stimulate the immune system.

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Unlabeled Use

Use of medication for purposes not approved by the FDA.

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Medical Oversight

Supervision of prehospital care by physicians.

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Medical Director

Physician assuming medical oversight responsibility.

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Medical Director Responsibilities

Development/implementation of guidelines, education, quality assurance, equipment and medication review, and assessment of competency.

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Medical Control

Component of medical oversight with on-line and off-line aspects.

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On-Line Medical Control

Orders given directly to prehospital providers by a physician.

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Base Physician

Orders from a physician speaking with a prehospital provider in the emergency department.

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Off-Line Medical Control

All aspects of medical oversight that do not involve direct medical control.

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Off-Line Protocols Include:

System design, protocol development, education, and quality improvement.

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Medical Protocols

Guidelines for treating patients in the field.

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Standing Orders

Protocols allowing treatment without physician contact.

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Protocols focus on:

Treatments are tailored to presenting signs and symptoms rather than diagnoses.

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Treat and Release

Protocols allowing release of patients who respond to treatment.

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Medication Regulations

Controls regulating the manufacture, distribution, and use of medications.

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Treatments Ordered By

Treatments and interventions provided under physician orders.

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ACh (Acetylcholine)

A neurotransmitter that enables muscle action, learning, and memory.

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ACLS

Advanced Cardiac Life Support: A set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies.

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ACS (Acute Coronary Syndrome)

A syndrome encompassing a range of conditions associated with sudden, reduced blood flow to the heart.

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APAP

Acetaminophen, a common over-the-counter pain reliever and fever reducer.

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ASA (Aspirin)

Acetylsalicylic acid, commonly known as aspirin, used as a pain reliever, fever reducer, and anti-inflammatory.

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COPD

Chronic Obstructive Pulmonary Disease: A group of lung diseases that block airflow and make it difficult to breathe.

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EtCO2 (End-tidal CO2)

The concentration of carbon dioxide at the end of an exhaled breath, used to assess ventilation.

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ETOH (Ethyl Alcohol)

Ethyl alcohol, the intoxicating ingredient found in alcoholic beverages.

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GCS (Glasgow Coma Score)

Glasgow Coma Scale: A neurological scale used to assess level of consciousness.

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HHN (Handheld Nebulizer)

A device used to deliver medication in a mist form for inhalation.

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HPI

History of Present Illness: A detailed account of the patient's current medical problem.

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LR (Lactated Ringer’s)

Lactated Ringer’s solution: A sterile solution of electrolytes used for intravenous fluid replacement.

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MDI

Metered-Dose Inhaler: A device that delivers a specific amount of medication to the lungs.

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NPO

Nothing by mouth. No food or liquid should be ingested.

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NS (Normal Saline)

Normal Saline: A solution of sodium chloride in water, commonly used for IV hydration and medication administration.

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WHO's role in drug control

International health influenced by providing assistance and encouraging research.

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Drug testing phases

Testing on animals and clinical patient studies are required before marketing a drug.

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FDA's role

Federal agency responsible for approving drugs before public availability.

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Pure Food and Drug Act of 1906

Prohibited sale of ineffective medicinal preparations and restricted sale of potentially abused drugs in 1906.

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USP and NF

Official drug standards, ensuring purity, preparation and dosage.

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Federal Food, Drug, and Cosmetic Act

Enacted in 1938; includes truth-in-labeling clause.

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Kefauver Harris Amendment (1962)

Requires proof of safety and effectiveness before drug approval.

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Harrison Narcotic Act

Controlled the importation, manufacture, and sale of opium and coca derivatives in 1914.

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Controlled Substances Act of 1970

Classifies drugs into five schedules.

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Schedule I Drugs (Controlled)

Drugs with a high potential for abuse and no accepted medical use.

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Phase III Testing

Testing in which large numbers of patients receive a medication to identify rare adverse effects.

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Placebo

A medically inert substance given to patients to control for psychological responses, such as the placebo effect.

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Double-blind Study

A study where neither the patient nor the physician knows who receives the medication or placebo.

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Crossover Study

A study where patients receive the medication for some time and a placebo for the rest of the time.

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Phase IV Testing

Monitors the medication's performance in the general population after it has been marketed.

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New Drug Application (NDA)

A formal request to the FDA to approve a new medication for marketing.

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Expedited Medication Approval

A process to speed up the availability of promising experimental drugs during clinical testing.

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Orphan Drugs

Drugs used to treat rare diseases affecting fewer than 200,000 people.

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Orphan Drug Act

Offers tax credits to companies that develop medications for rare diseases.

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Black Box Warning

A prominently displayed warning in labeling material about special problems with a medication that may lead to death or serious injury.

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Unlabeled Uses of Medications

Uses for a medication that have not been formally approved by the FDA.

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FDA Approval

When the FDA approves a medication, it signifies its acceptance for specific indications based on clinical studies.

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Post-Market Surveillance

The manufacturer monitors the performance of a medication once it is being used by the general population.

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Therapeutic Medication Reports

A report from physicians about the therapeutic results when using medications on patients.

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Labeled Indications

A process where a medication is approved for specific uses based on phase II and III clinical studies.

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Schedule I Drugs (US)

Drugs with no accepted medical use and high abuse potential; used for research only.

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Schedule II Drugs (US)

Drugs requiring a written prescription, with restricted refills and renewal options.

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Schedule III Drugs (US)

Medications requiring prescriptions that must be rewritten after 6 months or five refills

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Schedule IV Drugs (US)

Medications requiring prescriptions that must be rewritten after 6 months or five refills.

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Schedule V Drugs (US)

Medications dispensed as any nonnarcotic prescription, with some available without a prescription unless state regulations apply.

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Schedule H Drugs (Canada)

Restricted drugs with no recognized medicinal properties; includes hallucinogens.

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Narcotics Schedule (Canada)

Stringently restricted drugs; labels and advertisements must include the letter N.

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Schedule G Drugs (Canada)

Prescription drugs controlled due to abuse potential, including narcotic analgesics and stimulants.

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Schedule F Drugs (Canada)

Prescription drugs with low abuse potential; labels must display the symbol Pr.

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Nonprescription Drug Schedule (Group 3) - Canada

Drugs available only in pharmacies, used on a physician’s recommendation, with limited public access.

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Controlled Substances Act (US)

US law regulating controlled substances; enforced by the DEA; dictates prescription rules.

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Food and Drug Act (Canada)

Canadian law empowering the governor-in-council to prescribe drug standards.

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Canadian Narcotic Control Act

Canadian act restricting the sale, possession, and use of narcotics.

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Schedule II refills

Controlled Substances Act mandates that prescriptions for Schedule II medications cannot be refilled.

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Controlled Substance Storage

Store in a locked safe/cabinet; tag for immediate use; limit access; and maintain a perpetual log.

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Medication Administration Log

A record of medication administration including date, patient name, drug, strength, dosage form, quantity, wastage, and personnel involved.

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Controlled Substance Handling

Daily counts and immediate reporting of discrepancies. Audits ensure compliance.

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Drug Standards

Ensuring consistent drug quality through government oversight.

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Assay

Lab test determining the purity of a chemical in a drug.

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Bioassay

Assessment of a drug's therapeutic effectiveness.

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Purity (Drug)

Uncontaminated state of a drug with only one active component.

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Bioavailability

The degree to which a drug is absorbed into the circulation.

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Potency (Drug)

A drug's strength or ability to produce a desired effect.

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Efficacy (Drug)

How well a drug works in terms of treatment effect.

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Safety and Toxicity (Drugs)

Determined by the incidence and severity of adverse reactions.

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Chemical Name (Drug)

Precise description of a drug's atomic and molecular structure.

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Generic Name (Drug)

Abbreviated version of the chemical name.

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Trade Name (Drug)

Name selected by the manufacturer, based on its chemical one, protected by copyright.

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Pharmacological Class

Medications grouped by similar characteristics.

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Adulteration

To make impure by adding extraneous, improper, or inferior ingredients.

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Ampule

A sterile glass container with a thin neck, designed for a single dose.

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Bioequivalence

Relative therapeutic effectiveness of chemically equivalent medications.

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Controlled Substances

Medications controlled by law due to potential for misuse and dependence.

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Diversion

The use of prescription medications for recreational or nontherapeutic purposes.

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Drug

Any substance introduced into the body that changes a body function.

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Parenteral Medications

Medications administered into the body without going through the digestive tract.

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Medication Profile

Information about a medication, including names, classification, mechanism of action, etc.

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Medication Classification

The broad category a medication belongs to; understanding this helps predict its properties.

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Mechanism of Action

How a medication produces its effects on the body.

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Indications

Conditions for which a medication is appropriate to administer.

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Side Effects / Adverse Reactions

Undesired effects of a medication.

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Routes of Administration

How a medication is administered (e.g., orally, intravenously).

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Contraindications

Conditions where a medication should NOT be given because it will cause harm.

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Dosage

The amount of medication to be given.

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How Supplied

The available forms and concentrations of a medication.

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Special Considerations

How a medication may affect specific patient populations (e.g., children, elderly, pregnant women).

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Unit-Dose Form

One dose of a medication in a labeled container or wrapper.

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Bulk Form

Multiple doses of a medication packaged together.

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Solutions (Medication Form)

Medication dissolved in a solvent, usually water.

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Tinctures

Medication preparations extracted with alcohol.

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Multidose Vials

Contain preservatives, allowing multiple uses.

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Single-Dose Vials

Lack preservatives, intended for single use only.

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Nebules

Premixed medications administered via nebulizer.

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Powders (Medication)

Medications in powdered form.

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Capsules

Medication enclosed in a gelatin shell.

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Tablets

Compressed powder medication, often sugar-coated.

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Suppositories

Medication in a solid base that melts at body temperature, administered rectally or vaginally.

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Inhalants

Powered or liquid medications given via the respiratory route for rapid absorption.

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Adverse Effect

Harmful, unintended effect of a medication.

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Antagonism (Medication)

Opposition between two or more medications.

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Bolus

A single, often large dose of medication.

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Cumulative Action

Increased medication effect from multiple doses.

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Habituation

Physical or psychological dependence on a drug.

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Therapeutic Action

Desired action of a medication in a specific condition.

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