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Pharm Chapter 1
Chapter 1 Study
| Question | Answer | |
|---|---|---|
| pharmacodynamics | study of the biochemical and physiological effects of drugs | study of drugs' mechanisms of action |
| pharmacokinetics | study of the absorption, distribution, biotransformation (metabolism) and excretion of drugs | each of those factors is related to the concentration of the drug or its chemical by-products, in various body sites, as well as the time required for these drug concentrations to develop, change, or both |
| pharmocotherapeutics | study of how drugs may best be used in the treatment of illness | study of which drug would be most or least appropriate to use for a specific disease, what dose would be required etc. |
| toxicology | study of poisons and poisonings | as most all drugs are capable of being toxic under some circumstances, this science deals with the toxic effects of substances on the living organism |
| Ancient Egypt | is credited as being the cradle of pharmacology | 700 different remedies used to treat specific ailments. earliest documents devoted entirely to medicine |
| various uses for drugs | 1. symptomatic treatment, relieve disease symptoms (most common) 2. prevention drugs help the body avoid disease 3. diagnostic drugs, help the health care provider determine whether a disease is present | 4. curative drugs, eliminate the disease 5. health maintenance drugs, helpkeep the body functioning normally 6. contraceptive drugs, prevent pregnancy |
| examples of symptomatic treatment drugs | aspirin, pain reliever | |
| example of preventive drugs | vaccinations | |
| examples of diagnostic drugs | radiopaque dyes | |
| examples of curative drugs | antibiotics | |
| examples of contraceptives | birth control | |
| examples of health maintenance drugs | insulin | |
| tablet | the most popular dosage form and usually the easiest to administer. | most are compressed which have been formed by compressing a mixture of pure drug(s) with inactive components that serve to add bulk, shape, weight or other properties |
| enteric-coated (ec) | tablets that are designed to carry drugs that could irritate the stomach or be chemically destroyed by the acid environment of the stomach | avoid administering such dosage forms with antacids, milk, or other alkaline substances, do not break, crush or disolve |
| time or Sustained-Release Tablets | many different technologies exist for permitting drugs to be released from tablets in a controlled fashion | when these tablets come in contact with gastric fluid the fluid causes small amounts of the dissolved drug to leak through the channels in the wax matrix and promotes gradual release of the drug over several hours |
| osmotic pumps | have also been employed in providing a controlled release feature from some tablets | are polymer-coated tablets that allow water to enter into the tablet from the gastric fluid |
| capsules | usually absorbed by the stomach, two parts of the capsule break apart. | administered orally. some are sustained release and designed to release drugs at different rates and some are in gel caps. they can also be made of soft of hard shells, created commercially or medications combined by a pharmacist |
| trouches/ lozenges | absorbed by the mouth | hard disks that dissolve slowly. usually used to exert an antiseptic or anesthetic effect on the oral tissues |
| suppositories | absorbed in the external body orifices like the rectum, vagina or urethra | either dissolve slowly into tissues or melt at body temp. can have localized effects or enter the bloodstream |
| solutions | includes syrups, elixirs, tinctures. most given orally, but can be injected or inserted into a body cavity | a clear liquid preparation that contains one or more solvents, usually water and one or more dissolved components or solutes. when used orally flavor and color often added |
| syrups | sweetened solution that are often used to mask the unpleasant taste of certain drugs. | given for soothing effect |
| elixirs | contain a solvent mixture of alcohol and water as well as other components | often used as vehicles to dissolve drugs that do not dissolve in water alone |
| tinctures | solutions that contain alcohol as the primary solvent but which may contain some water as well | available for internal and external use, should be stored separately from other liquid medication |
| parenteral | by some means other than through the GI tract | ex: administration of medication into a muscle, vein, or subcutaneous tissue |
| solution | used for injection or ophthalmic us must be sterile, when administered by iv the solution must be free of solid particulate matter | |
| douche | one intended to be used in cleaning a body part or cavity, usually vagina | often prepared by diluting a liquid concentrate or soluble powder with water to make a solution of an appropriate strength |
| suspension | liquid dosage forms that contain solid drug particles that are suspended in suitable liquid medium | most administered orally although some are applied to the skin as lotions or liniments or administered by injection. NEVER BY IV, must be shaken thoroughly before administered |
| emulsions | dispersions of fine droplets of an oil in water or water in oil. those that contain an oil dispersed in water are primarily used orally | flavor can be added to mask taste and/or odor of oil. some IV for nutrient source. if contain water droplets dispersed in oil are used primarily for topical application. can provide protection to skin. must be shaken |
| topical | semisolids used in treatment of dermatological disorders, some greasy and insoluble in water, others not greasy and wash off easily. rub on skin | patches- topical drugs pass through the skin into the bloodstream where they exert systemic effects |
| implants | may be administered for extended periods of time, sometimes as long as 5 years, in a small capsule made of Silastic polymer. surgically implanted subdarmally often in upper arm. surgically removed | |
| ampules | sterile, sealed glass or plastic containers containing a single liquid dose. | |
| vials | either single or multiple dose glass or plastic containers that are sealed with a rubber diaphragm | |
| chemical name | during early stage of development the first name given. a systematically derived name which identifies the chemical structure of the drug | |
| code designation | chosen for the drug during early period of its development, temporary name generally discarded once drug becomes commercially available | |
| generic/nonproprietary name | assigned to the drug by the US Adopted Names (USAN) council meant to be easier pronounce remember then chemical name, reflects some important pharmacological or chemical characteristic of the drug | |
| brand name/trade name | drug appears to be ready for commercial distribution. name is usually followed with superscript R, registered by the US Patent Office, approved by FDA. | only permitted to be used by the company that has registered the drug for 17 yrs, before name released to be freely used under own trademark |
| Food and Drug Act 1906 | requires that all drugs marketed in the US meets minimal standards of strength, purity and quality. official legal standards for drugs in the US | |
| legend drugs | requires certain drugs be classified | labeled "caution- federal law prohibits dispensing without prescription" |
| comprehensive Drug Abuse Prevention and Control Act 1970 | drugs further classified according to their potential for causing abuse, regulated the manufacture and distribution of drugs considered capable of causing dependence. | federal statutes all drugs be classified into 4 categories: 1. prescription or legend drugs. 2. nonpresctiption or OTC. 3. invesigational drugs 4. illicit of "street" drugs |
| schedule I drugs | drugs have high potential for abuse and no accepted medical use in the US | heroin, LSD |
| Schedule II | have high potential for abuse, but do have a currently accepted medical use in US. been determined that abuse of a drug included in this schedule may lead to a sever psychological or physical dependence | meperidine, morphine, cocaine, oxycodone, Ritalin |
| Schedule III | have accepted medical uses in US but have lower potential for abuse | Tylenol with codeine, hydrocodone |
| Schedule IV | low potential for abuse, may lead to limited physical/psychological dependence | Librium, Valium |
| Schedule V | have lowest abuse potential of the controlled substances. consist of preparations containing limited quantities of certain narcotic drug generally use for antitussive and antidiarrheal properties | Lomotil, Robitussin A-C |
| Schedule VI | some states have adopted a schedule VI for marijuana which is the only drug on this schedule. reason marijuana has limited medicinal use by prescription in selected situations | |
| prescription/ legend drug | must be prescribed by legally authorized health practitioners that have been determined by the FDA to be safe and effective | |
| Nonprescription/OTC | may be legally acquired by client without a prescription and are considered to be relatively safe for the layperson to use when taken according to directions | |
| how do drugs interact with the body? | alter composition of a body fluid | most common: drugs form a chemical bond with specific receptors in teh body. the better the molecules fit in the receptors the better the patient response will be. (lock & key) |
| agonist effect | drugs that interact with a receptor to produce a response | |
| antagonistic effect | drugs that inhibit/prevent the action of an agonist | |
| adverse drug effect | negative side effect | |
| therapeutic effect | when a drug had the desired effect on the body with minimal side effects | |
| toxicity | predictable adverse drug effected related to the does given being to high | |
| anaphylaxis | severe allergic response that requires immediate medical attention | |
| teratogenesis | drugs that will cause a congenital defect in an infant whose mother took the drug while pregnant | |
| half-life | the time interval required for eliminated process to reduce concentration of a drug in the body by half | |
| hypersensitivity/allergy | a response to the immune system to presence of a drug. relatively uncommon, can be very serious. (type of drug reaction) | |
| idiosyncratic | result of abnormal reactivity to a drug caused by genetic differences | |
| side effect | result from the normal pharacological effects of a drug | |
| anaphylaxis | severe allergic reaction that can affect breathing | |
| steps of Pharmacokinetics | Absorption- distribution, metabolism/biotransformation, elimination, liver, kidneys, first pass effect | |
| absorption | drugs can be absorbed through the tongue, under, on surface tissue, lining of cheek, digestive tract, rectum, injection into fat, muscle or sub q | |
| distribution | process by which a drug is carried from its site of absorption to its site of action | |
| metabolism/biotransformation | most drugs must first be metabolized before they can take an effect in the body, most often drugs are metabolized by the liver | |
| elimination | how the drugs are excreted, most often through the kidneys, but can be in stool, respiratory tract, breast milk, saliva, sweat | |
| liver | if doses of drugs normally metabolized by the liver are not reduced the drugs may accumulated in the body and produce toxicity | |
| kidneys | main organ responsible for secreting most drugs, if there is renal damage then the drugs may build up in the system causing toxicity | |
| first pass effect | drug concentrations are greatly reduced before they reach the system due to the process of absorption and metabolism | |
| monitoring drug therapy | peak- when a drug concentration is the highest in the body trough- when the drug concentration is lowest plasma concentration- can indicate the amount of the drug in the system by checking doe systemic levels | |
| herbal and botanical medicines | not approved by the FDA | |
| garlic | Use: dietary measures, used for hyperlipidemia and age related vascular changes Condraindications diabetes mellitus, pregnancy effectiveness:decreases bp and cholesterol levels | adverse reaction: heartburn, flatulence,allergic reaction, diaphoresis, painful menstruation drug interaction: increase risk for bleeding in clients taking anticoadulants and decreases serum levels of antivirial agents |
| gingko | use: treatment for disturbance in cerebral tissue perfusion, memory loss, mood, swings, intermittent claudication condraindications: none effectiveness: seven well-defined studies demonstrated effectiveness in improving (CNS) function, with Alzheimers | Adverse Effects: nausea, vomiting, diarrhea, headache, dizziness, vertigo: toxic levels can cause seizure activity Drug interaction: bleeding if taken with aspirin |
| echinacea | Use: support therapy for upper respiratory infection and UTI, external use for hard-to-heal wounds Contraindications: infections and autoimmune disease, TB, allergies to sunflowers family | Effictiveness: 26 controlled clinical trails evaluating echinacea's ability to improve or strengthen the immune system Adverse effect: none drug interactions: none |
| St. Johns Wort | Use: anxiety and depression contraindication: use with caution in fairskinned individuals pregnancy effectivness: placebo-controlled studies have shown as effective as low-dose tricyclic agents | adverse effect: photosensitivity and dermatitis, allergic reaction, restlessness, fatigue drug interaction: antidepressants, antiretrovirals, cyclosporine, digoxin, oral conraceptiveds, theophylline |
| steps of medication administration | assessment, nursing diagnosis, planning, implementation, evaluation | very similar to nursing process with verification steps, assessing patient, administering the does, and evaluating the outcome |
| medication rights | right drug, right dose, right client, right time, right route, right documentation, patients right to refuse | |
| parenteral routes | IM: imtramuscular, into a skeletal muscle Sub q- subcutaneous, into the subcutaneous tissue ID- intradermal or intracutaneous, into the dermal layer of the skin IV- intravenous, into a vein | |
| Oral medication (nursing responsibilities) | do not touch tablets or capsules as you transfer them from container to med cup, do not disrupt structure of enteric coated, sustained released or similar medication, check placement of NG tube if applicable prior to administering meds, | do not administer meds through NG or feeding tube unless specifically ordered |
| intramuscular (nursing responsibilities) | check anatomic landmarks and verify tissue suitability. rotate injection sites | |
| subcutaneous (nursing responsibilities) | generally insulin and heparin are administered with a 90 degree angle and other meds at a 45 degree angle | |
| eye medication (nursing responsibilities) | each patient should have their own sterile medication container. never touch the cornea, most medications are instilled in the conjunctical sac | |
| vaginal medication (nursing responsibilities) | patients can administer meds themselves if they are capable and after teaching, have patient lay down for 20 min post administration | |
| types of meds that should NOT disrupt | enteric-coated, sustained-action, encapulated beads, or wax-matrix medication and sublingual or buccal products | |
| physiological changes of aging that affect medication | absorption- decreases and hydrochloric acid production decreases. gastric emptying prolonged GI: gastric emptying is slower,reduction in blood flow and muscle tone causes meds to remain in system longer metabolism- decreases ` | renal- decreases greatly slowing the excretion rate for drugs and they build up on system quicker distribution- total body water content is diminished causing decreased distribution and total body fat is increased alter the distribution of fat-soluble me |
| common drug reaction in the elderly | older adults have a decrease in the function of multiple systems, so many drugs remain in the system longer and have a prolonged effect. nurses should always get baseline vitals before meds administered to compare. | |
| orthostatic hypotension | more common in older adults which is when the blood pressure drops when the pt sits or stands and increases the risk for falls, dizziness, etc. | |
| excessive sedation | due to the prolonged effects of medication pts should be monitored. can affect anything from overall functioning to respiratory systems | |
| polypharmacy | concurrent use of multiple medications. drastically increases the potential for medication errors and drug interactions | |
| pharmacology | study of history, sources, and physical and chemical properties of drugs | also includes how drugs affect living systems |
Created by:
lkolich85
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