Pharm Basics

Question 1

What is pharmacokinetics?

Answer 1

What our body does to the drug

Question 2

What is pharmacodynamics?

Answer 2

How the drug affects our body

Question 3

What is the difference between therapeutic and pharmacologic drug classifications?

Answer 3

Therapeutic: usefulness in treatment; how the drug treats
Pharmacologic: physiological effect on molecular/tissue level; how the drug works

Question 4

Difference between chemical, generic, and brand/trade names of drugs.

Answer 4

Chemical: structure
Generic: name of actual medication (important for tests/NCLEX)
Brand: name given to drug by the pharmaceutical company

Question 5

Process in which drugs are developed and come to market.

Answer 5

Preclinical phase: tested on lab animals
Phase I: tested on healthy human volunteers
Phase II: tested on clients with disease
Phase III: large sample size approved by FDA
Phase IV: usually 2+ years post market, new or adverse affects — recall

Question 6

What are the responsibilities of the Food and Drug Administration (FDA)?

Answer 6

Protects public health by ensuring safety, efficiency, and security of drugs, biological products & medical devices.
— Also includes safety of food supply, cosmetics & products that emit radiation

Question 7

Function of the DEA (Drug Enforcement Agency)

Answer 7

Regulates manufacturing, distribution, and dispensing of drugs with known abuse potential (controlled substances).
*Nurses must be familiar with regulations and standard of practice.

Question 8

Schedule I drugs:

Answer 8

— high abuse potential
— not for medical use
Ex: heroin

Question 9

Schedule II drugs:

Answer 9

— high abuse potential
Ex: narcotics

Question 10

Schedule III drugs:

Answer 10

— moderate
— less abuse
Ex: sedatives

Question 11

Schedule IV drugs:

Answer 11

— moderate
— less abuse
Ex: anxiety agents

Question 12

Schedule V drugs:

Answer 12

— limited abuse
Ex: codeine

Question 13

What is a teratogenic drug?

Answer 13

Drugs that can cause birth defects
— cross placental barrier

Question 14

Primary adverse effect:

Answer 14

Overdose; extension of desired effect

Question 15

Secondary adverse affect

Answer 15

Undesired effect, must be tolerated
— undesired effect produced in addition to pharmacologic effect

Question 16

How does toxicity effect the liver?

Answer 16

Fever, nausea, jaundice

Question 17

How does toxicity affect the kidneys?

Answer 17

— oliguria
— increased BUN
— increased creatinine

Question 18

How does toxicity effect the nervous system?

Answer 18

Change in LOC, cognition & behavior

Question 19

What is happening to the body during an allergic reaction?

Answer 19

Anaphylaxis: bronchoconstriction, response to histamine
— delayed allergic reactions can also occur

Question 20

What are contradictions in drug therapy?

Answer 20

Example: having a bleeding disorder is a contradiction for taking aspirin due to excess bleeding

Question 21

Drug-food interactions:

Answer 21

— acid production: speeds breakdown of drug
— milk products: calcium binds to drug, decreases absorption
— chemical reaction: iron binds with tetracycline
— liver enzymes: grapefruit juice (48hr after ingesting), enzyme inhibitor: toxic drug effects

Question 22

What are the 6 rights of medication administration

Answer 22

Right:
Drug, dose, route, time, patient, documentation

Question 23

What are the four phases of pharmacokinetics?

Answer 23

1. Absorption: drug to blood
2. Distribution: drug to tissue
3. Metabolism: breaking drug down
4. Excretion: getting drug out of body

Question 24

What are factors that alter absorption of an oral drug?

Answer 24

— composition of drug is too big, cannot pass thru membrane
— highly lipid soluble drugs: dissolve before absorbed correctly
— foods and fluids (binding)
— multiple drugs (interaction)
— enteric coating tablets

Question 25

What factors alter drug distribution?

Answer 25

— blood flow to tissue — ability to cross blood-brain barrier — protein binding: albumin; molecule gets too big — water-soluble: stays in blood stream — lipid-soluble: rapidly passes membrane and deposits into adipose tissue

Question 26

Explain the “first pass effect”

Answer 26

Oral drug—absorbed across intestinal mucosa—enters portal circulation, travels to liver—drug is metabolized to less active form—leaves liver to distribute to tissues *less active

Question 27

What is the liver’s role in metabolism of drugs?

Answer 27

— transforms drug into active form — breakdown drug for excretion — hepatic microsomal enzyme system — metabolism

Question 28

What organs are primarily involved with excretion of drug byproducts?

Answer 28

Kidneys

Question 29

Explain therapeutic response

Answer 29

Response after treatment of any kind, usually a useful and favorable response

Question 30

What is onset, peak, and duration of drugs?

Answer 30

Onset: time for drug to elicit a therapeutic response Peak: time for drug to reach maximum therapeutic response Duration: time of drug concentration sufficient to therapeutic response

Question 31

What is an agonist?

Answer 31

Causes the same activity of a natural chemical Ex: insulin, beta-agonist

Question 32

What is an antagonist?

Answer 32

Blocks normal stimulation of receptor Ex: beta-blockers, anti-histamines

Question 33

What is peak and trough?

Answer 33

Trough: lowest drug level needed to reach therapeutic range; lowest level of drug in bloodstream — drawn 1hr prior to start of next medication Peak: highest level of drug in bloodstream — drawn 1hr after infusion is completed

Question 34

What information should be included in patient education?

Answer 34

— name of drug — dosing — action — timing — storage and prep — measuring — what to avoid — monitoring symptoms and vitals — adverse effects — toxicity — warnings — special considerations *verify patient understanding

Question 35

What is the difference between medication error and adverse effect?

Answer 35

Adverse drug effect: side effect; anticipated or unanticipated Medication error: error in process that leads to adverse effect — ex: higher than acceptable dose given; drug-drug interaction

Question 36

What are the functions of the sympathetic nervous system?

Answer 36

— “fight or flight” — decreased urination (retention) — decreased digestion — increased feelings of stress, anxiety, & danger — system’s activity increases

Question 37

What receptors are involved in the sympathetic nervous system?

Answer 37

Adrenergic AGONIST: sympathomimetic; used for cardiac + respiratory — tachycardia — vasoconstriction — bronchodilation — decreased GI activity — glycogenolysis (increased blood glucose) — constricts bladder sphincter Adrenergic ANTAGONIST: blocking normal action; Adrenergic blocking, alpha-beta blocker; used for HTN — slows HR — decreases BP — bronchoconstriction — hypoglycemia — urinary incontinence

Question 38

What are the functions of the parasympathetic nervous system?

Answer 38

— “rest and digest” — decreases HR — constricts bronchioles — increases digestions — increases urination

Question 39

What receptors are involved with the parasympathetic nervous system?

Answer 39

Cholinerigic AGONIST: mimics acetylcholine; used for Alzheimer’s — increased saliva production — deceased HR — constricts bronchioles — increases digestion — increased urination ANTAGONIST: anti-cholinergic; cholinergic blocking; used for bowel & bladder disease, Parkinson’s, and asthma — decreased saliva — increased HR — relaxes bronchioles — slows digestion — decreased urination