Pharmacology Study Guide: Prescriptive Authority & Drug Interactions, Exams of Medicine

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NURS 5334 - M1 examination

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1. Prescriptive Authority - answers>legal route to prescribe independently and without limitation
2. Parts of a prescription - answers>- prescriber name a. license number b. contact information c. DEA number (prescriber and supervising) d. patient name e. DOB f. allergies g. name of medication h. indication i. strength j. frequency k. signature
3. SIG - answers>"let it be labeled"; instructions for the prescription
4. Pharmacokinetics - answers>the study of the drug movement throughout the body
5. Ways for drugs to cross the cell membrane - answers>1. Channels
6. 2. Pore transport systems - P-glycoprotein system
7. 3. Direct penetration
8. Absorption - answers>the drug's movement from the site of administration into the blood
9. Factors that affect absorption: - answers>rate of dissolution, surface area, blood flow, lipid solubility, pH partitioning
10. pH partitioning or ion trapping - answers>drug molecules tend to accumulate on the side of the membrane where pH most favors ionization - i.e. Acidic drugs accumulate on the alkaline side, and basic drugs accumulate on the acidic side
11. Distribution - answers>the drug's movement from the blood into the interstitial space of tissues and from there into the cells

12. Factors that affect distribution: - answers>circulation, membrane permeability, protein binding
13. Metabolism (biotransformation) - answers>enzymatically mediated alteration of drug structure
14. Substrate - answers>drugs that are metabolized by the P hepatic enzymes
15. Inducer - answers>increase the rate of metabolism
16. Inhibitor - answers>decrease the rate of metabolism
17. "First-pass effect" - answers>rapid hepatic inactivation of certain oral drugs
18. Excretion - answers>drugs and their metabolites move out of the body
19. Elimination - answers>the combination of metabolism of excretion
20. Minimum effective concentration - answers>amount of drug required to produce a therapeutic effect
21. Therapeutic range - answers>that concentration of drug in the blood serum that produces the desired effect without causing toxicity
22. Drug half-life - answers>the time required for the amount of drug in the body to decrease by 50%
23. Pharmacodynamics - answers>- study of what drugs do to the body, and how they do it a. study of biochemical and physiologic effects of drugs b. the molecular mechanisms by which effects are produced
24. Dose-response relationship - answers>relationship between the size of an administered dose and the intensity of the response produced
25. Dose-response relationship determines: - answers>- the amount of drug needed to elicit a response a. the maximum response that a drug can elicit b. how much to increase the dosage to produce the desired response

26. Maximum efficacy - answers>the largest effect that a drug can produce
27. Relative potency - answers>the amount of drug we must give to elicit an effect
28. Selectivity - answers>ability to elicit only the response for which the drug is given
29. ***highly desirable
30. Occupancy Theory - answers>a drug receptor-interaction that states that the intensity of the response to a drug is proportional to the number of receptors occupied by the drug, and a maximum response will occur when all available receptors are occupied
31. Modified Occupancy Theory - answers>Affinity and intrinsic activity
32. Affinity - answers>strength of the attraction between the drug and its receptor
33. Intrinsic activity - answers>ability of a drug to activate the receptor after bonding
34. Agonists - answers>drugs that mimic the action of the endogenous regulatory molecules
35. Antagonists - answers>drugs that block the action of the endogenous regulatory molecules
36. Partial agonists - answers>mimic the actions of endogenous regulatory molecules, but also produce moderate intrinsic activity
37. Non-competitive antagonists - answers>- bind irreversible to receptors a. decrease the number of receptors available for activation b. reduce the maximal response that an agonist can elicit
38. Therapeutic index - answers>- measure of drug safety a. ratio between LD50/ED
39. wide therapeutic index means the drug is safe and easy to dose; a narrow therapeutic index indicates that a drug is relatively unsafe and hard to regulate the dose

40. Intensification/potentiated - answers>when one drug intensifies or potentiates the effects of the other
41. Inhibitory effects - answers>interactions that result in reduced drug effects
42. Mechanisms for drug-drug interactions - answers>- direct chemical or physical interactions a. pharmacokinetic energy interactions - altered absorption, distribution, metabolism and renal excretion b. pharmacodynamic interactions - interactions in which the drugs act at the same site, and interactions at which the drugs act at separate sites c. combined toxicity
43. Pharmacogenomics - answers>study of how genes affect a person's response to drugs
44. Adverse drug reactions - answers>- Side effect a. Toxicity b. Allergic reaction c. Idiosyncratic effect d. Iatrogenic disease e. Paradoxical effect f. Physical dependence g. Carcinogenic effect h. Teratogenic effect
45. Side effect - answers>unavoidable secondary effect produced at therapeutic doses
46. Toxicity - answers>degree of detrimental physiologic effects caused by excess of drug dosing
47. Allergic reaction - answers>immune response
48. Idiosyncratic effect - answers>an uncommon drug response resulting from a genetic predisposition
49. Paradoxical effect - answers>the opposite of the intended drug response
50. Iatrogenic disease - answers>occurs as the result of medical care or treatment

51. Physical dependence - answers>a state in which the body has adapted to drug exposure in such a way that abstinence syndrome will result if drug use is discontinued
52. Carcinogenic effect - answers>the ability of certain medications and environmental chemicals to cause cancers
53. Teratogenic effect - answers>drug induced birth defect
54. Black box warning - answers>- strongest safety warning a. serious or life threatening risks b. warning provides a concise summary of the adverse effects of concern - this has to appear on the package insert, product label, and advertising
55. Medication error causes - answers>- prescribing practices (verify appropriate drug and dosage, ensure clear labeling instructions and legible writing) a. oversight (failure to keep up to date medication list, failure to discontinue or continue medications) b. communication (clear and precise instructions, verify sound alike drugs, and give adequate patient education)