Pharmacology week 1 study guide
1. 1970 Comprehensive Drug abuse and prevention and control act:
promote education and research, treatment for drug addiction and rehab, and design schedule
or categories of controlled substances
2. Schedule and categories of controlled substances:
I: no accepted medical use
II: highest potential for abuse
III: less abuse than I or II; moderate physical and high psychological dependence
IV: low abuse potential (benzodiazepines)
V: lowest potential for abuse (OTC cough syrups)
3. Nurses’ responsibility with controlled substances:
verify order
account for all the drugs
keep a log witness and document discard
document in pts chart
keep drugs locked
4. What are the three names for a drug?
Chemical, generic and brand/trade name
Ex) chemical: Acetyl salicylate (ASA) generic: aspirin brand: Bayer
5. The brand/trade name can also be known as the proprietary name
6. What info must OTC labels include?
-active and inactive ingredients with amount in each dosage unit
-purpose of product
-uses of product
-specific warnings
-dosage instructions
7. Pharmacokinetics: absorption, distribution, metabolism, and excretion
Absorption: meds into the blood stream
PO meds move from GI tract into blood stream
enteric coated drugs resist disintegration in stomach and creates sustained release (drug is
digested by small intestine)
where are receptors located? Cell membrane
is the drug lipid soluble? How much food is in stomach?
drug moves to the liver VIA the hepatic portal vein
8. Factors that affect bioavailability:
drug form
route
gastric mucosa and motility
Administration with food and other drugs,
change in lover metabolism
PO < IV
9. Distribution:
once in blood the medication moves into the tissue
-how much drug is bound to protein in the blood
- “free drug” not in protein and is free to go to tissues.
-drugs have a hard time moving across blood brain barrier, and can move across the placenta
10. Metabolism:
breaking the drug down and converting to waste (liver/plasma)
-biotransformation
-each drug has a half life which is how long it take for half of the drug to be metabolized
-liver is the primary site of metabolism for drugs
-sometimes a loading dose is required to build up an adequate concentration of drug in the
body and to reach an adequate therapeutic dose.
11. Excretion:
kidney excretion through urine (some after metabolism some before)
-kidneys are the main route of drug excretion
-kidney test of functioning BUN, creatinine
-drugs can also be excreted via the liver (bile), feces, lungs, and saliva sweat and breast milk
12. Pharmacodynamics: study of the ways drugs affects the body
13. Primary effect: the reason the drug was prescribed and its intended reason for being prescribed
14. Secondary effect: not the intended reason the drug was prescribed, but the effect may be
desirable or undesirable. i.e. taking Benadryl before bed. Could be adverse
15. Potency: how strongly drug does what you want it to do
16. Morphine is more potent that Vicodin
17. Effective dose: when a drug is in the therapeutic dose
18. Toxic dose: above therapeutic dose
19. Therapeutic dose: that fine line between therapeutic effect and toxic effect. Drugs that have a
slimmer therapeutic index require frequent blood testing. i.e. heparin, warfarin
20. Onset: time is takes for drug to reach minimum effective concentration
21. Peak: highest concentration of drug in the blood
22. Duration: length of time taken for a drug to exert a therapeutic effect
23. Trough: when drug is at the smallest range of being therapeutic
24. Receptor theory: drugs bind to receptors to produce a response
-agonists: activate a receptor to produce a response
-antagonists: inactivate a receptor to block a response
25. We have these receptors for naturally occurring hormones in out bodies such as dopamine or
endorphins
26. Cholinergic receptors: acetyl choline (bethanechol is a cholinergic agonist)
-eye: constrict pupils
-heart: decreased HR
-blood vessels: decrease BP
-stomach: increase gastric secretions
-bronchus: constrict bronchioles
-bladder: increase bladder contraction
27. Adrenergic receptors: epinephrine
-alpha1: increase BP
-beta1: increase HR
-beta 2 relax bronchioles
28. Mechanisms of drug action:
-stimulation: raise or lower the activity organ (CNS drugs)
-depression: lower brain activity
-irritation: laxatives. Irritate system to increase stool output
-replacement: think of thyroid hormones for hypothyroidism
-cytotoxic action: cancer/chemotherapy
-antimicrobial action: kill bacteria
-modification of immune status: immune disorders/ vaccines?
29. Side effects: secondary drug effects
30. Adverse reactions: more severe that side effects (undesirable)
31. Drug toxicity: drug level exceeds therapeutic range
32. Biologic variations: study of genetic factors influencing individual response: pharmacogenetics
33. Tolerance: decreased drug responsiveness over time (i.e. narcotics)
34. Drug interactions: altered drug effect due to interaction with another drug
35. Pharmacokinetic interaction: changes occurring in absorption, distribution, metabolism, and
excretion of drugs
-drug nutrient reactions: food may increase or delay drug response
-drug-laboratory interactions: drugs may cause misinterpretation of test results
-drug induced photosensitivity skin reaction caused my skin exposure
36. If you have bad liver, you need less drugs, so toxicity does not build up in the body
37. PO: by mouth (slower onset)
38. Parenteral: less first pass effect and quicker absorption (more drug available)
39. IV: intravenous
40. SQ: subcutaneous
41. TD: transdermal
42. IM: intramuscular
43. NG: nasogastric tube
Chapter 17