Pharm 1 Quiz 1 – Drexel QUESTIONS AND QUESTIONS, Exams of Nursing

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Pharm 1 Quiz 1 – Drexel QUESTIONS AND QUESTIONS pharmacotherapeutics - CORRECT ANSWER_indication for the med, why, how it will help pharmacokinetics - CORRECT ANSWER_how drug moves throughout the body absorption, metabolized, excretion pharmacodynamics - CORRECT ANSWER_action of drug on the body and where it is working precaution - CORRECT ANSWER_taking action before it occurs if a worry or concern is presented contraindications - CORRECT ANSWER_would not give to the patient adverse effects - CORRECT ANSWER_side effects; unintended effects of a drug, can be common or serious drug interactions - CORRECT ANSWER_with other drugs, food, and alcohol properties of an ideal drug - CORRECT ANSWER_effective, safe, selective - works where we want it too anecdote predictability ease of admin minimal drug interaction chemical stability low cost anecdotes - CORRECT ANSWER_reversible action prototype agents - CORRECT ANSWER_typical of a group of agents within a drug class; variations within the same drug class will be reinforced in the clinical area BUN - CORRECT ANSWER_10 - 20 ml/d changes with hydration status renal bake half a dozen buns for 10 - 20 min creatinin - CORRECT ANSWER_0.6 - 1.2 renal; changes with compromised renal function; indirect measure of GFR bake half a dozen buns for 10-20 min CBC - CORRECT ANSWER_WBC, hemoglobin, hematocrits, platelets Platelets - CORRECT ANSWER_150,000 - 400,000 elevated = clotting WBC - CORRECT ANSWER_elevated = infection restrict distribution of a drug based on safety concerns drug nomenclature - CORRECT ANSWER_chemical : exact chemical nomenclature generic: nonproprietary name trade name: brand name, reviewed & approved by FDA absorption - CORRECT ANSWER_a drug moves from its site of administration into venous or lymphatic circulation rate of dissolution, surface area, blood flow, lipid solubility, pH partioning distribution - CORRECT ANSWER_the delivery of the drug into any & all body compartments it can penetrate factors: regional blood flow & capillary permeability , ability of a drug to exit the vascular system, ability of a drug to enter cells, volume, cardiac output, degree of plasma protein binding, drug reservoirs or storage sites, drug concentration tissue affinity physiological barriers: abscesses & solid tumors metabolism - CORRECT ANSWER_biotransformation; enzymatically mediated alteration of drug structure; the alteration of drug to more ionized or water soluble & less lipid soluble forms called metabolites. most takes place in the liver patients with hepatic dysfunction have a problem metabolizing drugs excretion - CORRECT ANSWER_movement of drugs & their metabolites out of the body usually begins in hepatic metabolism & is followed be renal excretion; most important organ = kidneys occurs through bile, sweat, saliva, expired air, breast milk glomerular filtration, passive reabsorption, active transport drug solubility - CORRECT ANSWER_ability of a drug to dissolve and form a solution ionization - CORRECT ANSWER_molecule dissociates into ions when it dissolves in water or other liquids; in dissociating, the molecule gives up or accepts a proton, thus converting some molecules into charged particles; ionized drugs are poorly absorbed, because they do not diffuse easily across lipid membranes; ionization is largely determined by the pH of surrounding medium pH partioning - CORRECT ANSWER_ion trapping; drug accumulates on the side of membrane where pH favors ionization non ionized drugs - CORRECT ANSWER_lipid soluble; easily pass through lipid membranes OTC - CORRECT ANSWER_over the counter drugs can be purchased without prescription new labels have to highlight active ingredients, uses, warnings, & directions DSHEA - CORRECT ANSWER_define herbals as dietary supplements & provide regulatory framework for their sale accelerated renal excretion - CORRECT ANSWER_polar compounds are more easily excreted; lipid soluble compounds undergo passive reabsorption MEC - CORRECT ANSWER_minimal effective concentration; plasma drug level below which therapeutic effects won't occur; drug has to be present at or above levels toxic concentrations - CORRECT ANSWER_plasma drug level at which toxic effects begin therapeutic range - CORRECT ANSWER_objective of drug dosing is to maintain drug levels within therapeutic range; enough drug present to produce an effect without toxic results plateau - CORRECT ANSWER_steady state; evenly distributed concentration of a drug, occurs when the administration rate equals the rate of drug elimination half life - CORRECT ANSWER_time needed for a plasma concentration of a drug to be reduced by 50% peak concentration - CORRECT ANSWER_highest serum level after administration; must be kept below toxic level trough concentration - CORRECT ANSWER_lowest serum level after administration; must be kept above MEC; right before the next dose loading dose - CORRECT ANSWER_to achieve plateau more quickly; an initial large dose may be given, used for drugs with long half lives maintenance doses - CORRECT ANSWER_plateau maintained via smaller doses given after a loading dose decline from plateau - CORRECT ANSWER_most of the drugs in the body will be eliminated over an interval or approximately 4 half lives - same interval to reach plateau intravenous (IV) - CORRECT ANSWER_bypasses GI tract & variability of absorption from other areas maximal efficacy - CORRECT ANSWER_largest effect a drug can produce relative potency - CORRECT ANSWER_amount of drug given to elicit an effect (dosing) two drugs can be equally effective but have different potency properties of receptors - CORRECT ANSWER_drugs either mimic or block action of own body's function; do not give cells new function; produce therapeutic effects by helping body use its preexisting capacities nonselective - CORRECT ANSWER_when drug interacts with a receptor type which regulates multiple processes and when a drug interacts with multiple receptors selectivity - CORRECT ANSWER_does not guarantee safety affinity - CORRECT ANSWER_strength of attraction between a drug & its receptor high affinity - CORRECT ANSWER_drugs have strong attraction & are very potent low affinity - CORRECT ANSWER_have to be present in high concentrations to elicit response intrinsic activity - CORRECT ANSWER_ability of a drug to activate a receptor upon binding high intrinsic activity = high maximal efficacy = intense response agonists - CORRECT ANSWER_activate receptors; have high affinity & high intrinsic activity mimic action of endogenous regulators antagonists - CORRECT ANSWER_prevent receptor activity; high affinity, no intrinsic activity lack of intrinsic activity prevents receptor activity effect determined by how much agonist is present competitive antagonist - CORRECT ANSWER_produce receptor blockers by competing with agonists receptor is occupied by whichever agent is in higher concentration antagonist for opiod - CORRECT ANSWER_narcan - blocks opoid receptors partial agonists - CORRECT ANSWER_an agonist with moderate intrinsic activity; maximum effect is lower than a full agonist can act as agonist & antagonists desensitization - CORRECT ANSWER_refactoriness; results from continuous exposure of cell receptors to an agonists hypersensitivity - CORRECT ANSWER_occurs from continuous exposure of cell receptors to an antagonist monitor for an adverse effect average effective dose - CORRECT ANSWER_ED80; dose requires to produce a defined therapeutic response in 50% of population; patients must be elevated individually for the proper dosing therapeutic index - CORRECT ANSWER_ED50 : LD50; ratio between average effective dose and average lethal dose wide = relatively safe narrow = relatively unsafe adverse effects - CORRECT ANSWER_effect other than desired; may occur during drug therapy side effect - CORRECT ANSWER_usually refers to a minor effect; such as nausea nearly unavoidable secondary drug; effect produced at therapeutic dosing: untoward effect toxicity - CORRECT ANSWER_is caused by excessive dosing altered metabolism - CORRECT ANSWER_CYP inducers & inhibitors altered renal excretion - CORRECT ANSWER_BI & creatinin renal function - check urine output grapefruit juice effect - CORRECT ANSWER_grapefruit inhibits an isoenzyme responsible for intestinal metabolism of multiple drugs; this inhibitory effects is dependent on the amount of juice consumed & can persist for up to 3 days; increases amount of drug available for absorption which increases the blood level of drugs hypersensitivity reaction - CORRECT ANSWER_marked by abnormal sensitivity or an exaggerated response by the body to the stimulus of a foreign agent cardiotoxicity - CORRECT ANSWER_irregularity in cardiac & conductions & possible heart damage; adverse effect; transient cardiac dysrhythmias, depression of myocardial function ototoxicity - CORRECT ANSWER_affects the 8th cranial nerve & result is inner ear & auditory damage cochlea, vestibule, and semicircular canals may be damaged synergistic effects - CORRECT ANSWER_occurs when two or more unlike drugs are used together to produce a combined effect & outcome is greater than either of them alone potentiation - CORRECT ANSWER_particular type of synergistic interaction in which the effect of only one of the two drugs is increased additive effect - CORRECT ANSWER_two or more alike (effect) drugs are combined & the result it the sum of the individual drugs effect inhibitory interactions - CORRECT ANSWER_opposite of synergism; therapeutic effect that is less than the effect of either drug alone because the second drug either diminishes or cancels the effect of the first drug; also known as antagonist interaction toxic effect of drug interactions - CORRECT ANSWER_occurs when a drug effect exceeds its therapeutic level; can be additive or synergistic mechanisms of drug to drug interactions - CORRECT ANSWER_GI absorption, altered metabolism, altered distribution, renal excretion Lispro (Humalog) (Short- Duration: Rapid Acting) - CORRECT ANSWER_Onset: 15 - 30 min Peak: 0.5- 2.5 hours Duration: 3- 6.5 hours Patient titrates dose delivered depending on their glucose level Insulin aspart (Novolog) & Insulin glulisine (Apidra) are short duration, rapid acting as well Regular Insulin (Short- Duration: Slower Acting) - CORRECT ANSWER_Onset: 30-60 minutes Peak: 1-5 hours Duration: 6-10 hours Used for post prandial coverage intravenous insulin infusions treatment of hyperkalemia (with IV dextrose) NPH Insulin (Intermediate-Duration) - CORRECT ANSWER_Onset: 1 - 2 hours Peak: 6 - 14 hours Duration: 16 - 24+ hours Available as combination with regular insulin 70/30 (70% NPH and 30% regular) Onset: 30-60 min Peak: 1.5 - 16 hours Duration: up to 24 hours DO NOT confuse with 70/30 aspart mix (NovoLog Mix 70/30) Insulin Detemir (Levemir) (Intermediate-Duration) - CORRECT ANSWER_Onset: 6-8 min Duration: 12 - 24 hours, duration is dose dependent Low dose 0.2 units/kg effect persist 12 hours High dose 0.4 units/kg effects persist 24 hours NOT: for post prandial control to be mixed with other insulins to be given IV Lantus (Long-Acting) Insulin - CORRECT ANSWER_Onset: 70 minutes Peak: none Duration: 24 hours Usually given at bedtime NOT to be administered in same syringe with other insulins to be given IV Do NOT confuse with Lente Insulin Lente (Intermediate-Acting) Insulin Ultralente (Long-Acting) Insulin - CORRECT ANSWER_Lente insulin: time course similar to NPH Ultralente Onset: 4-6 hours Use oral glucose tablets if hypoglycemia occurs, because sucrose found in candy and orange juice will not be absorbed. Adverse Effects: GI! Gliptins - CORRECT ANSWER_Prototype: sitagliptin (Januvia) Enhances actions of icretin hormones Stimulates glucose dependent release of insulin Suppresses post prandial release of glucagon Oral administration- first pass metabolism? Which patients are candidates for use? Type 1 has no insulin so NOT A CANDIDATE FOR USE. This drug is for type 2 to stimulate insulin release. Incretin Mimetics - CORRECT ANSWER_Prototype: exenatide (Byetta) Acts like endogenous incretins Slows gastric emptying Stimulates glucose dependent release of insulin Inhibits post prandial release of glucagon Supresses appetite Given subcutaneously PRIOR to meals Adverse effects: Risk of hypoglycemia with sulfonylureas therefore... Pancreatitis - signs Diabetic ketoacidosis (type 1) - CORRECT ANSWER_Causes- infection, not taking proper amount of insulin Signs- urinate a lot, polyuria, kussmauls respirations, ketones in urine & blood. Expressed as a ratio Hyperosmolar Hyperglycemic Nonketotic Syndrome - CORRECT ANSWER_making enough insulin to prevent from making ketones; just enough insulin to prevent from becoming acidotic Blood sugar can be in thousands Treatment IV hydration first, insulin, electrolyte replacement - Common is 10mEq/100mL/60min