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1
Q

Chemical Name

A

scientific name, describes atomic, molecular structure

2
Q

Generic Name

A

non-proprietary(brand) name. ex:ibuprofen

3
Q

Trade Name

A

(brand, proprietary) selected by drug company, copyright protected. ex: Advil

4
Q

Why/When use of generic name

A

1962, Federal government mandated used of ONE official name per drug. Listed in United States Pharmacopeia( book list of medicinal drugs w/their effects) and National Formulary

5
Q

Drug Classes:
Pharmacologic class:
Therapeutic class:

A
  • groups drugs with similar characteristics. Can be used for multiple uses.
    Beta-adrenergic blockers(B/P meds)
    Benzodiazepines.

-groups drugs by therapeutic use
Anti-hypertensives
Anti-fungals

6
Q

Drug sources are traditionally from natural sources:
Plants:
Animals:
Minerals:

A
  • alkaloids(contains nitrogen, ex: caffeine, nicotine), glycosides(restore circulation, ex digoxin), gums(seaweed extractions), resins, oils
  • hormones (insuline), oils (cod liver oil, enzymes(produced by living organism that acts as a catalyst (speeds up) biochemical reaction)(pepsin), vaccines(microorganisms)
  • metallic(lithium), non-metallic(iron, iodine, epsom salts)
7
Q

Today drugs are created..

A

synthetically in a laboratory by isolating and intensifying the active component and manipulate molecular structures.

8
Q

How drug is administered effected by what?

A

quantity given
absorption rate
distribution in body

9
Q

Administration Routs:
Oral

Sublingual

Translingual

Buccal

Rectal, vaginal

Inhalation

Topical

Transdermal

A
  • PO patient conscious, can swallow, drugs withstands stomach acids.
  • into capillary bed under tongue
  • on the tongue(trans is prefix for across, over, beyond)
  • placed in pouch between cheek and gums
  • PR suppositories, ointments, creams, gels
  • gases rapidly absorbed, metered-dose inhaler
  • local delivery through skin, mucous membrane (dermatologic, ophthalmic, nasal preparations)
  • “patch” applied to skin, drug enters blood through capillaries
10
Q

Drugs admin routes not destroyed by stomach acids? bypass stomach?

A

sublingual, buccal, translingual

11
Q

Administration routes:
Gastric

Intradermal

Intravenous

Intramuscular

Subcutaneous

A
  • goes directly into the GI system, patient can’t ingest orally
  • injected into skin (dermis)
  • IV rapid onset, injected directly into blood
  • IM injected into muscle, drug enters blood through capillaries
  • SubQ, SC injected into subcutaneous(deepest skin) tissue, drug enters blood through capillaries
12
Q

Parenteral

A

around gastrointestinal tract, involves skin puncture (IV, IM, SubQ)

13
Q

Who monitors drug development?

A

FDA Food and Drug Administration

14
Q

Phases of Drug Development:
First?

Second?

Third?
phase 1
phase 2 
phase 3
phase 4

Fourth?

A
  1. animal studies on safety, effectiveness
  2. IND( Investigational New Drug) new drug application after animal studies prove safety, effectiveness. yr 4
  3. human clinical trials
    phase 1-tested on healthy volunteers
    phase 2-tested on people with specific disease
    phase 3- more people, look for adverse effects
    phase 4 post-market surveillance, reports from doctors on therapeutic or adverse effects.
  4. NDA (new drug application years later) yr8-9

Invitro studies➡Animal testing➡Clinical testing➡Marketing➡generic available

15
Q

IND

A

Treatment Investigational New Drug- expedited approval due to public health threat (AIDS drugs)

16
Q

Pharmacokinetics deffinition

A

Study of what happens from time a drug enters the body until it, and all its metabolites, leave the body. The branch of pharmacology concerned with the movement of drugs within the body.

17
Q

Pharmacokinetics order of operations

A

Absobtion➡Distribution➡Metabolism➡Excretion➡Onset of action➡Peak concentration level➡Duration of action

18
Q

Pharmacokinetics- Absorption

  • slow
  • Fast
  • Slowest

Influenced by:

A

-rate drug leaves site of administration
Slow: oral, IM, SC
Fast: seconds to minutes (sublingual, IV, inhalation)
Slowest: hours to days (rectally, sustained-release)

blood flow, stress, diet, drug formulation, drug to drug interactions

19
Q

First-Pass Effect

A

Stomach-intestines-liver via portal circulation-metabolized by liver(first-pass effect)-remains put into systemic circulation. (is a phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced before it reaches the systemic circulation)

20
Q

Systemic circulation

A

IV 100% bio-available. The part of the cardiovascular system which carries oxygenated blood away from the heart to the body, and returns deoxygenated blood back to the heart.

21
Q

Distribution

A

drug delivery to site of action (body tissues, fluids)

22
Q

Distribution places and rates depend on?

A

Blood Flow: faster to heart, liver, kidneys, slower to internal organs, skin, fat, muscle

Solubility: lipid-soluble crosses cell membranes and blood to brain barrier; water-soluble can’t cross cell membranes

Protein binding: bound part therapeutically inactive; free (unbound) portion active (the more free the drug remains from proteins in the blood the more effective it becomes)

23
Q

Metabolism

A

When the body changes drugs from dosage form to excretable water-soluble form:

  • into inactive metabolites
  • into active metabolites with own pharmacologic action
24
Q

Pro-drugs

A

when drugs are given in inactive form and become active after they metabolize.

25
Q
Excretion:
Kidneys
Lungs
Exocrine (excrete)glands
Skin
Intestinal tract
A
Drug elimination from body
urine
exhalation
sweat, saliva, milk
sweat
feces
26
Q

Half-Life

Steady state:

A

the length of time it takes for 1/2 of the drugs original dose to be removed from plasma by biological processes. This can help determine dosage frequency

Drug administration by the time drug excretion has begun. drug administration equals drug excretion.

27
Q

Onset of Action

A

time interval from drug administration to therapeutic effect

28
Q

Peak Concentration

A

absorption rate is equal to elimination rate

29
Q

Duration of action

A

length of therapeutic effect

30
Q

Pharmacodynamics

Drug successfully binds receptor on cell surface ➡message sent to cell nucleus to perform action.

A

study of mechanism(processes) of drug action of biological system

-Drug forms chemical bond with specific receptor sites on surface of cell

31
Q

Pharmacodynamics:

Agonist drugs:

Antagonist drugs:

A

-initiate cell response after binding to a cell receptor. After complete binding, cell responds to message sent to nucleus. ACTIVATION

incomplete binding, BLOCKING to prevent cell responses. no message sent to nucleus from body

32
Q

Antagonist

Competitive:

Non-competitive

A
  • competes with agonist for receptor site, REVERSABLE binding. prevents the activity of other drugs already in the system. (Naloxone or Narcan is used to reverse opioid overdose caused by Heroin for example)
  • binds receptor, blocking agonist binding, IRREVERSABLE binding
33
Q

Receptors

A

present on cell surface. different organs, tissues have different types of receptors

34
Q

Non-Selective drugs

A

work at multiple receptors➡ widespread effects

35
Q

Selective drugs

A

work at specific receptors ➡ specific effect..localized

36
Q

Potency

Dose-response curve

A

amount of drug required to produce desired response

ex: if smaller dose of morphine than codeine required to achieve same effect, then morphine is more potent than codeine.
- Graphic representation of dosage and response

37
Q

Therapeutic index

Small(low)therapeutic index

Large (high) therapeutic index

A

ratio b/t therapeutic and toxic dose, measure of a drug’s safety

  • narrow range b/t safe and lethal dosage (warfarin). dosage is critically important
  • wide margin of safety, low risk of toxic effect (penicillin)
38
Q

Therapeutic window

A

dosage range b/t minimum effective and minimum toxic dose

39
Q

Pharmacotherapeutics

Tolerance

Dependence

   - physical
    - psychological
A

use of drugs to treat disease. reasoning.

-decreased response to repetitive drug doses

  • physical or psychological need for drug, withdrawal symptoms when drug stopped
    * physiologic need for drug (opioid in patient with cancer-related pain)
    * desire for euphoric effect, typically in recreational drug use.
40
Q

Controlled Substances Act of 1970

Drugs are categorized:

A

also known as Comprehensive Drug Abuse Prevention and Control Act: Regulates manufacture, distribution, dispensing of drugs with abuse potential.

in 5 schedules, based on abuse potential, physical/psychological dependence.

41
Q

Controlled Substances

Schedule 1

Schedule 2

Schedule 3

Schedule 4

Schedule 5

A

C-1 High abuse potential, no accepted medical use in the US (heroin, LSD, marijuana???, peyote)

C-II Potential for high abuse with severe physical or psychological dependence (meperidine, methadone, morphine, oxycodone, amphetamines, barbiturates)
C-III Potential for moderate physical or psychological dependence (non-barbiturate sedatives, non-amphetamine stimulants)
C-IV Limited dependence potential (some sedatives and anxiety agents, non-narcotic analgesics)
C-V Limited abuse potential (small amounts of narcotics (codeine) used as anti-tussives or anti-diarrheals)

42
Q

Dispensing Regulations
C-I

C-II

C-III

C-IV

C-V

A

1 only with approved protocol

2 written prescription (if telephoned in, written prescription within 24 hours), no prescription refills, container warning label

  1. written or oral prescription that expires in 6 months, maximum 5 refills in 6-month period, container warning label
  2. written or oral prescription that expires in 6 months, maximum; 5 refills in 6 month period, contaner warning label
  3. written prescription or OTC (varies with state law)
43
Q

Pregnancy Concerns

Teratogen:

A

prescription, non-prescription medications carry risk of causing birth defects in developing fetus

-any substance that causes abnormal development in fetus

44
Q

There are 5 Drug categories effecting pregnancy

Category A

Category B

Category C

Category D

Category X

A

A. Studies indicate no risk to fetus

B. Studies indicate no risk to animal fetus, information on humans not available

C. Adverse effects reported in animal fetus, information in humans not available

D. Possible fetal risk in humans reported, select cases may warrant use when consider potential benefit versus risk

X. Fetal abnormalities reported, positive evidence of fetal risk in humans available from animal and/or human studies, these drugs should not be used in pregnant women.

45
Q

Drug Interactions:

Additive effect:

Synergistic effect:

Antagonistic effect:

A
  • effect of 2 similar drugs together = higher sum of either drug alone ; allows for smaller doses of each drug, avoiding toxic effect of either
  • combined effect of 2 drugs is greater than the sum of either alone.
  • combined effect of 2 drugs less than either alone. Cancel each other out.
46
Q

Interactions

Food:

Drug:

A
  • alters rate/ amount of drug absorbed in GI tract

- impairs vitamin/mineral absorption

47
Q

Adverse Effects can be?

  • Dose-related=
  • Secondary Effect
  • Hypersensitivity
  • Overdose

Iatrogenic effect

*Sensitivity-related

A

undesirable drug response, either a side-effect or a harmful effect

majority of reactions come from this

  • constipation, sedation
  • patient’s immune system sees drug as dangerous foreign substance
  • toxic reaction with excessive dose
  • unintentional effect, physician or treatment-induced, mimics pathological disorder
  • rare; drug allergy, genetically determined.
48
Q

Prescription Drugs

A

designated by federal government as potentially harmful

Must be prescribed by a licensed health care provider

49
Q

Prescription must contain:

A
name of drug
dosage
method and times of administration
signature of prescriber
other info('Dispense as Written' to ensure brand name dispensing)
50
Q

a.c

A

before meals

51
Q

ad lib

A

as desired

52
Q

b.i.d.

A

2 times a day

53
Q

C with a line above it

A

with

54
Q

cap

A

capsule

55
Q

d.c.

A

discontinue

56
Q

dil.

A

dilute

57
Q

elix.

A

elixir

58
Q

ext

A

extract

59
Q

fld.

A

fluid

60
Q

gt(t)

A

drop(s)

61
Q

h

A

hour

62
Q

h.s.

A

at bedtime

63
Q

IM

A

intramuscular

64
Q

IV

A

intravenous

65
Q

NS (N/S)

A

normal saline

66
Q

OD

A

right eye

67
Q

os

A

mouth

68
Q

OS

A

left eye

69
Q

OU

A

both eyes

70
Q

p with a line over it

A

after

71
Q

p.c.

A

after meals

72
Q

per

A

by

73
Q

p.o.; per os

A

by mouth

74
Q

p.r.n.

A

when necessary/required

75
Q

q.

A

every

76
Q

q.a.m.

A

every morning

77
Q

q.d.

A

every day

78
Q

q.h.

A

every hour

79
Q

q.2.h.

A

every two hours

80
Q

q.h.s.

A

every night at bedtime

81
Q

q.i.d.

A

4 times a day

82
Q

q.o.d.

A

every other day

83
Q

q.s.

A

as much as required

84
Q

s with a line over it

A

without

85
Q

soln.

A

solution

86
Q

stat.

A

immediately

87
Q

s.q.; s.c.

A

subcutaneous

88
Q

supp,

A

suppository

89
Q

susp.

A

suspension

90
Q

syp.

A

syrup

91
Q

tab.

A

tablet

92
Q

t.i.d.

A

3 times a day

93
Q

tr. or tinct.

A

tincture

94
Q

ung.

A

ointment