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Questions and Answers

What is Pharmacology?

The study of the effects of drugs on the function of living systems.

What is a Pharmacist?

The person that prepares, makes, and dispenses drugs as ordered by a physician/dentist.

Define Medication.

Chemical compound / substance for administered for diagnosis, prevention, cure, treatment or relief of a symptom or for prevention of disease.

What is a Prescription?

<p>Written direction for the preparation and administration of a drug by a healthcare provider.</p> Signup and view all the answers

Which of these is NOT a drug name?

<p>Dosage name</p> Signup and view all the answers

What is a Chemical name?

<p>Describes drug structures, based on the atomic/molecular structure/functional group of drug, seldom used in medical practice.</p> Signup and view all the answers

What is a Generic name?

<p>Assigned by manufacturer (approval by regulatory body) used throughout drug's lifetime Selected &amp; recognized internationally A drug has only one generic name</p> Signup and view all the answers

What is Brand/Proprietary name?

<p>Usually short, easy to remember One drug may be manufactured by several companies, have several trade names</p> Signup and view all the answers

What is a Therapeutic effect?

<p>Expected Therapeutic effect = Desired effect MUST KNOW: Reason (Primary effect) for drug prescription</p> Signup and view all the answers

Which type of drug relieves symptoms of diseases but does not affect the disease itself?

<p>Palliative</p> Signup and view all the answers

Which type of drug cures a disease or condition?

<p>Curative</p> Signup and view all the answers

Which type of drug supports body function until other treatments or the body's response can take over?

<p>Supportive</p> Signup and view all the answers

Which type of drug replaces body fluids or substances?

<p>Substitutive</p> Signup and view all the answers

Which type of drug destroys malignant cells?

<p>Chemotherapeutic</p> Signup and view all the answers

Which type of drug returns the body to health?

<p>Restorative</p> Signup and view all the answers

Side effects are always predictable.

<p>False</p> Signup and view all the answers

An adverse drug reaction is always mild and does not require medical attention.

<p>False</p> Signup and view all the answers

Secondary effects always have a negative impact on the body.

<p>False</p> Signup and view all the answers

What does 'augmented reactions' mean?

<p>Increased sensitivity or excessive response to a drug.</p> Signup and view all the answers

What does 'drug toxicity' mean?

<p>Harmful effects caused by high levels of a drug in the body.</p> Signup and view all the answers

A patient with hypersensitivity will always have a lower-than-expected blood concentration level.

<p>False</p> Signup and view all the answers

What is a cumulative effect?

<p>An increasing response to repeated doses of a drug that occurs when the rate of administration exceeds the rate of metabolism or excretion.</p> Signup and view all the answers

To avoid toxic reactions, it's essential to know the patient's profile.

<p>True</p> Signup and view all the answers

Overdosing on a medication is always intentional.

<p>False</p> Signup and view all the answers

Iatrogenic effects are always intentional.

<p>False</p> Signup and view all the answers

Drug allergy is a hypersensitivity reaction that involves the immune system.

<p>True</p> Signup and view all the answers

Anaphylactic reactions to drugs are always mild and do not require immediate medical attention.

<p>False</p> Signup and view all the answers

Idiosyncratic effects are predictable and expected responses to a drug.

<p>False</p> Signup and view all the answers

Drug dependence can be psychological or physiological.

<p>True</p> Signup and view all the answers

Drug tolerance always leads to a complete loss of drug effect.

<p>False</p> Signup and view all the answers

Tachyphylaxis is a rapid decrease in drug effect that occurs over a long period of time.

<p>False</p> Signup and view all the answers

Drug resistance is primarily associated with antibiotics and is not a concern with other types of drugs.

<p>False</p> Signup and view all the answers

Drug interactions can only occur between two drugs.

<p>False</p> Signup and view all the answers

Grapefruit juice can inhibit the metabolism of certain drugs, potentially increasing the risk of side effects.

<p>True</p> Signup and view all the answers

Pharmacokinetics refers to the study of how the body affects a drug.

<p>True</p> Signup and view all the answers

Pharmacodynamics refers to the study of how a drug affects the body.

<p>True</p> Signup and view all the answers

The primary site for drug metabolism is the kidneys.

<p>False</p> Signup and view all the answers

The first-pass effect refers to the process where an oral drug is metabolized by the liver before entering the systemic circulation.

<p>True</p> Signup and view all the answers

Intravenous administration is the safest route for all medications, as it bypasses the first-pass effect.

<p>False</p> Signup and view all the answers

The time course for ADME (Absorption, Distribution, Metabolism, Excretion) is always consistent across all individuals.

<p>False</p> Signup and view all the answers

Drug half-life is the amount of time it takes for half of the drug to be eliminated from the body.

<p>True</p> Signup and view all the answers

A drug given as a single dose will be completely eliminated from the body after 3-4 half-lives.

<p>False</p> Signup and view all the answers

Drugs with shorter half-lives tend to have longer durations of action.

<p>False</p> Signup and view all the answers

Steady state occurs when the rate of drug administration equals the rate of drug elimination.

<p>True</p> Signup and view all the answers

Loading doses are typically used to quickly achieve the desired therapeutic effect of a drug.

<p>True</p> Signup and view all the answers

Infusion pumps deliver medication in units of milligrams per hour (mg/hr).

<p>False</p> Signup and view all the answers

When converting between units, it is crucial to ensure that the units are the same.

<p>True</p> Signup and view all the answers

When splitting tablets, it is not necessary to check if the tablet is scored.

<p>False</p> Signup and view all the answers

Rounding dosage numbers is always acceptable and does not impact patient safety.

<p>False</p> Signup and view all the answers

Receptors are always located on the surface of cells.

<p>False</p> Signup and view all the answers

Agonists are drugs that enhance the activity of a receptor, while antagonists block or inhibit receptor activity.

<p>True</p> Signup and view all the answers

The binding of agonists to receptors is always irreversible.

<p>False</p> Signup and view all the answers

Noncompetitive antagonists bind to the same site as the natural ligand, preventing its binding.

<p>False</p> Signup and view all the answers

Irreversible antagonists have a short duration of action because they are quickly removed from the body.

<p>False</p> Signup and view all the answers

Drug excretion is the process by which the body removes drugs from its system.

<p>True</p> Signup and view all the answers

The kidneys are the only organs involved in drug excretion.

<p>False</p> Signup and view all the answers

Drug excretion rates are always constant and do not vary based on individual factors.

<p>False</p> Signup and view all the answers

Study Notes

Basic Concept

  • Drug Names:
    • Chemical names: Describe drug structures (atomic/molecular structure, functional groups). Rarely used in clinical practice.
    • Generic names: Assigned by manufacturers (regulatory approval). Used globally throughout the drug's lifetime. Each drug has only one generic name.
    • Brand names/Trade names/proprietary names: Usually short and easy to remember. One drug can have several brand names from different companies.
  • Drug Effects:
    • Therapeutic effect: Expected outcome (desired effect).
    • Side effect: Unintended, typically predictable. Range from mild to severe.
    • Adverse drug reactions: Harmful and undesirable responses to medications.
    • Drug allergy: Abnormal immune response to a drug. Symptoms can appear within minutes to 2 weeks after administration.
    • Drug Interactions:
      • Effects of drugs on each other or with food/supplements.
      • Can affect the action of one or both drugs (beneficial or harmful).

Overview

  • Pharmacology: Study of drug effects on living systems.
  • Pharmacy: Place for preparing, compounding, and dispensing drugs.
  • Pharmacist: Person who prepares, makes, and dispenses drugs as ordered by a physician/dentist.
  • Medication: Chemical compound/substance used for diagnosis, prevention, cure, treatment, or symptom relief/prevention of disease.
  • Prescription: Written instructions for drug preparation and administration (by a professional).

Drug Effects- Therapeutic

  • Palliative: Relieves symptoms without affecting the disease itself.
  • Curative: Cures a disease or condition.
  • Supportive: Supports body function until other treatments take over.
  • Substitutive: Replaces body fluids or substances.
  • Chemotherapeutic: Destroys malignant cells.
  • Restorative: Returns the body to health.

Drug Effects - Side Effects & Adverse Reactions

  • Side effect: Unintended, usually predictable, ranging from mild to severe.
  • Adverse drug reactions: Harmful and undesirable responses.
  • Secondary effects: Additional effects (can be beneficial or harmful).

More Terms

  • Augmented reactions (drug toxicity): Patient with altered pharmacokinetics (absorption, metabolism, and excretion) may have higher-than-expected drug concentration levels.
  • Increased receptor sensitivity: Increased patient's response to therapeutic or adverse effects or impaired metabolism/excretion.
  • Cumulative effect: Increased response to repeated doses of a drug when the rate of administration exceeds the metabolism/excretion.
  • Overdose: Excessive dose, intentionally or accidentally.
  • Iatrogenic effects/disease: Unintended effects from medical treatment or drug therapy (e.g., aspirin-induced GI irritation or bleeding).
  • Drug Allergy: Abnormal immune response to a drug resulting in various symptoms, ranging from mild to severe.

Drug Allergy

  • Hypersensitivity: Abnormal response from an immunologic reaction to a drug.
  • Symptoms: Can appear in minutes to a few weeks, often identifiable by allergic history and related symptoms.
  • Severe reactions: Life-threatening, possibly fatal reactions such as wheezing, dyspnea, swelling of respiratory tissue, acute hypotension, and tachycardia.
  • Mild reactions: Skin rash/urticaria, itching, angioedema, diarrhea, vomiting.

What Nurses MUST DO?

  • Check patient's allergy status.
  • Properly monitor the drug's effect on the patient.
  • Evaluate drug effects and side effects.
  • Identify potential drug allergies.
  • Provide pertinent patient education on their medication profile.

Drug Effects - Adverse Reactions

  • Idiosyncratic effect: Unexpected, unexplained, abnormal response to a drug, sometimes due to genetics.
  • Examples: Stevens-Johnson syndrome (SJS).
  • Dependence:
    • Physiological dependence (biochemical changes): Body tissues become dependent on the drug for normal functioning and require the substance. Drug cessation leads to withdrawal symptoms.
    • Psychological dependence (emotional reliance): emotional reliance to maintain well-being, accompanied by needs or cravings for the drug.
  • Loss of drug effect
    • Drug tolerance: Gradual decrease in responsiveness to a drug with time; increased dosage needed for similar response.
    • Tachyphylaxis: Rapid decrease in responsiveness to a drug with repeated doses.
    • Drug resistance: Loss of drug effect due to repeated use over time; usually observed with antibiotics.

Drug Interactions

  • Interactions between drugs, food, or other supplements.
  • Possible effects: Decrease or increase drug action, cause adverse effects.

Drugs-Food Interactions Example

  • Milk interferes with the absorption of tetracycline antibiotics.

Drug Interactions - Grapefruit Juice

  • Grapefruit juice contains furanocoumarins.
  • Inhibits the cytochrome CYP3A4 enzyme in the liver.
  • Decreases metabolism of some drugs.
  • Increases the risk of developing side effects.

How to Prevent Drug Interactions

  • Use appropriate monitoring.
  • Identify potential drug interactions and allergies early.
  • Provide patient education

Pharmaco-kinetics vs. Pharmacodynamics

  • Pharmaco-kinetics: What the body does to the drug (movement).
    • Absorption
    • Distribution
    • Metabolism
    • Excretion (ADME)
  • Pharmaco-dynamics: What the drug does to the body (effects).
    • Efficacy
    • Toxicity

Pharmaco-kinetics

  • Absorption: Process of drugs entering the bloodstream.

  • Distribution: Movement of drugs throughout the body.

  • Metabolism: Biotransformation of drugs in the body.

  • Excretion: Removal of drugs and metabolites from the body.

Why Absorption, Distribution, Metabolism, and Excretion Important?

  • Understand time required for these processes.
  • Drug type, individual health, and other factors can affect these processes.

ADME- Absorption

  • Process by which a drug enters the bloodstream
  • Requires crossing semipermeable cell membranes
  • Types of drug absorption: Passive diffusion, Facilitated diffusion, Active transport, Endocytosis.

ADME- Distribution

  • Transportation of a drug from its absorption site to its site of action
  • Determined by factors like:
    • Blood flow: Organs (brain, liver, kidneys) with high blood flow receive large amounts of drug quickly. Low blood flow organs receive drug later.
    • Solubility: Drugs that are lipid soluble accumulate in fatty tissue. Drugs that are water-soluble bind to plasma proteins.

ADME- Metabolism

  • Liver, primarily via CYP450 enzymes, chemically alters drugs.
  • Convert pro-drugs to active form or inactive forms.
  • Metabolites may require further metabolism.
  • Metabolites are eventually excreted from the body.

ADME - Excretion

  • Removal of drugs and metabolites from the body.
  • Most important route is renal excretion.
  • Other ways: sweat, breast milk, and lungs.

Drug Administration Routes

  • Oral (PO)
  • Intravenous (IV)
  • Intramuscular (IM)
  • Subcutaneous (SC)
  • Buccal
  • Sublingual (SL)
  • Rectal (PR)
  • Inhalation
  • Topical
  • Transdermal (TD).

Drug Absorption (oral-limitations)

  • Rate of absorption varies.
  • Food can delay dissolution and absorption.
  • Acid medium in the stomach varies.
  • Some drugs don't dissolve well in GI fluids.

Drug Absorption (oral, intravenous, intramuscular, subcutaneous, rectal)

  • Advantages and disadvantages for each route.
    • IV is rapid, 100% bioavailability.
    • IM is faster than oral and gives larger amounts.
    • Oral has a lot of variability in drug absorbtion and is frequently used.

What Nurses Do - Bioavailability

  • Alert for suitable routes
  • Monitor liver function tests (important regarding metabolism)
  • Monitor renal function tests (important for excretion).

Drug Half-life

  • Time required for drug concentration to decrease by 50%.
  • Factors affecting half-life: Rate of absorption, metabolism, and excretion rates.
  • Determine dosage frequency.

Steady State

  • Rate of drug availability equals rate of drug elimination from the body.
  • Takes four to five regular doses to reach steady state.
  • Crucial, consistent drug concentration for effective symptom management.

Loading Dose and Maintenance Dose

  • Loading dose: Higher initial dose to quickly reach the therapeutic threshold.
  • Maintenance dose: Subsequent doses to maintain therapeutic plasma concentration of the drug.

Basic Concepts Of Pharmacodynamics

  • Receptor and non-receptor mechanisms
  • Agonists: Drugs that activate receptors (similar to "natural ligand").
    • Complete agonists
    • Partial agonists
    • Inverse agonists
  • Antagonists: Drugs that block receptors.
    • Competitive antagonists
      • Non-competitive antagonist

Receptor and Non-receptor Mechanisms

  • Receptor: Drug's specific target ("lock and key").
  • Binding is reversible
  • Drug action terminates once the drug leaves the receptor.
  • Types of receptors: Ion channel, G protein-coupled, Enzyme-linked.

Dosage Calculation (Examples)

  • Converting units (pounds to kilograms, grams to milligrams, etc.).
  • Universal Formula: Dose = (Desired amount) x (Quantity) / (Amount on hand)
  • Ratio and proportion (calculate amounts based on ratios)
  • Incorporating body weight in dosage calculation.
  • Infusion pump settings (mcg/kg/min).

SMART Nursing Tips

  • Capsule cannot be divided.
  • Some drugs cannot be chewed/cut.
  • Proper drug dispensing tools and techniques.
  • Correct rounding of dosage numbers.

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