Pharmacology Exam 1 Games

Drugs that are available to consumers without a prescription

The 1906 law that was the first federal law that attempted to protect the public from dangerous, addicting, and mislabeled products
Federal Food and Drug Act

The law that established the legal term “narcotic”
Harrison Act of 1914

Differentiated between prescription drugs and OTC medications
Durham-Humphrey Amendent

the law that requires drugs to be proved both safe and effective before being granted approval for use
Kefauver-Harris Amendment of 1962

This law prohibited the labeling of medicines with fraudulent claims
Sherley Amendment of 1912

an inactive or inert substance that may be used in experimental studies

special category of drugs that has been identified to help patients with rare diseases
orphan drugs

drug not approved for marketing by the FDA but available for use in studies to determine its safety and efficacy
investigational new drug

another name for prescription drugs
legend drugs

doing or active promotion of good

duty to do no harm to a patient

also known as the proprietary name of drug
trade name

length of time that a drug concentration is sufficient to elicit a therapeutic response

time it takes for a drug to reach its maximum therapeutic response in the body
peak effect

time it takes for a drug to elicit a therapeutic response
onset of action

physiologic or psychologic needs for a drug

decreasing response to repeated drug dose

drug interaction in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given along

drug interaction in which the effect of a combination of two or more drugs with similar actions is equivalent to the sum of the individual effects of the same drugs give alone

these drugs effects result in structural defects in the unborn fetus

these drugs effects are permanent changes in the genetic composition of living organisms

these drugs effects cause cancer

drug therapy used for the treatment of chronic illness
maintenance therapy

therapy that is used to make a patient as comfortable as possible, and often used in the end stages of an illness

genetically determined abnormal response to ordinary doses of a drug

initial metabolism in the liver of a drug that is absorbed from the gastrointestinal tract, before the drug reaches systemic circulation through the bloodstream
first pass effect

what are the 4 phases of pharmacokinetics?

what are cytochrome P450 enzyme systems?
CYP-450 enzymes comprise a large class of enzymes systems that metabolize drugs in the liver. When a patient takes several drugs metabolized by these enzymes, drug interactions may be a problem.

Explain first-pass effect
Drugs entering the stomach or intestine are absorbed into the portal circulation and routed to the liver where they undergo some degree of metabolism prior to entering the systemic circulation

What if half-life?
time it takes for half of the drug in the body to be eliminated. It takes about 4 half-lives to eliminate 94% of a drug

What is a prodrug and how are they different in regard to biotransformation?
Drug metabolism (biotransformation) usually converts active drugs to an inactive metabolite that can be readily excreted. Prodrugs are inactive drugs precursors which when metabolized are converted to the active form

How is pharmacodynamics different from pharmacokinetics?
Pharmacodynamics studies the effects of drugs on the body (how drugs elicit various response)

Pharmacokinetics studies the effects of the body on drugs (how cell membrane properties control where a drug can go or how protein binding controls drug distribution)

Explain the primary difference between an agonist, a partial agonist, and an antagonist
Agonist-combines with a receptor to stimulate a response

Partial Agonist-binds to a receptor but elicits a weaker response than an agonist would elicit

Antagonist-combines with a receptor to block a response “blockers”

Explain the concept of drug potency and address whether more potent drugs are more effective
Potency refers to the dosage required to achieve an effect. For example, it may take 50mg of Drug A to obtain the same effect as 5mg of Drug B. A common misunderstanding is that potent drugs are superior in some way. They are not. In this example, Drug B is not more effective; it simply requires a smaller dosage to obtain that effect

What is meant by the term “therapeutic index”
therapeutic index (TI) is a measure of drug safety. Drugs with a low therapeutic index have a small margin of safety. These drugs require close monitoring of both the patient and any pertinent lab studies

Explain what is meant by potency.
Potency is a measure of affinity. Affinity refers to the strength of attraction between a receptor and a drug molecule. Drugs with high affinity are more potent because these drugs bind effectively at lower concentration; therefore, lower doses are needed

What is drug interaction and what is the relationship between interaction and polypharmacy?
Drug interactions occur when one drug affects another drug. The effects may be additive, synergistic, or antagonistic. They may result in chemical changes that inactivate drugs. Polypharmacy occurs when a patient is taking numerous drugs. The more drugs taken, the more likely an interaction will occur.

Explain how competition for protein binding sites can result in a drug-drug interaction
When drugs compete for limited protein binding sites, the end result will be an increase in free (unbound) drug. Only free drug can leave the systemic circulation for distribution; therefore, there will be increased distribution which can result in a relative over-dose and possible toxicity

What is a substrate?
substrate is a drug that is acted upon by an enzyme. Common enzymes that act on drugs include those of the CYP450 enzyme system. CYP450 enzymes metabolize drugs

Explain the difference between drugs that function as CYP450 inducers and CYP450 inhibitors
Inducers are drugs that speed up metabolism

Inhibitors are drugs that slow down metabolism

Explain how drugs acting as CYP450 inducers and inhibitors affect metabolism of substrates
When inducers speed up metabolism of substrates, they speed up conversion of the drug to an inactive form which decreases drug activity and increases elimination

When inhibitors slow metabolism of substrates, they slow conversion of the drug to an inactive form which prolongs drug activity.

What is ethnopharmacology?
Ethnopharmacology is the study of racial differences that affect pharamcokinetics (drug metabolism) and pharmacodynamics (drug response)

What is meant by culture, ethnicity, and race?
Culture- integrated and shared system of beliefs, values, and customs associate with a group of people and transmitted from generation to generation

Ethnicity- refers to an affiliation based on a shared culture and/or a genetic heritage

Race- refers to a shared phenotype

What is pharmacogenomic?
pharmacogenomic is a branch of pharmacogentics that examines determinants of drug responses based on a person’s genome. An application of pharmacogenomics is the development of personalized medicine

What would be the appropriate response if a patient refuses to take a drug because doing so would conflict with the patient’s cultural beliefs?
The nurse would explain the reason the drug is prescribed and provide necessary education in a nonjudgmental manner if the patient. If the patient still refuses, the nurse should honor the patient’s beliefs and would document the education along with the reason the patient refuses the drug

What is Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency and why is it important?
G6PD is an enzyme that reduces the risk of RBC hemolysis when they are exposed to oxidizing drugs. When those with G6PD deficiency take drugs such as sulfonamides, aspirin, and antimalarials, they may experience RBC hemolysis, which may be life threatening. It is estimated that 13% of men and 20% of women who are of African ancestry carry the gene that results in this deficiency. Other populations affects include Kurdish Jews and Sardinians.

What is polypharmacy?
Polypharmacy is the taking of several different drugs. It is particularly common in older persons who have several different problems. This puts them at increased risk of drug-drug interactions, increased number of adverse effects, decreased ability to afford treatment, and problems adhering to multiple dosage regimens

What sensory changes put aging people at greater risk for problems related to drugs?
Decreased vision may making it difficult to read directions or to count out meds

Decreased hearing may prevent them from understanding direction given verbally

What is meant by “FDA Pregnancy Categories”?
This is a rating system used to identify the risk that taking a drug has on the fetus

Category A: controlled studies show no risk
Category B: there is no evidence of risk in humans
Category C: risk can’t be ruled out
Category D: Positive evidence of risk
Category X: contraindicated in pregnancy

Adults often use topical medications such as corticosteroids and do not have significant systemic effects. Why is this different for children?
Infants and young children have a thinner skin and large body surface in relation to size. When used in the treatment of diaper rash, the occlusive diaper covering increases absorption even more, so the likelihood of having systemic effects is increased

When medications are correctly given to infants, choking and sputtering will not be problems: yet, we know choking on medicine is commonplace. What should parents (and nurses) be taught?
The most common problems is squirting the medicine over the tongue which can cause choking and can increase the likelihood that medication is spit out. Medication should be administered by small amounts into the side of the mouth (cheek area) so that it flows in for shallowing

Identify three physiologic changes in elderly patients that alter pharmacokinetics.
1. decreased cardiac output + decreased perfusion = decreased absorption and distribution
2. increased gastric pH = altered absorption
3. decreased hepatic enzyme production + decreased blood flow = decreased metabolism
4. decreased renal blood flow + decreased renal function + decreased glomerular filtration rate = decreased excretion

What is the “golden rule” that should be applied anytime a patient develops a new problem?
Get a drug history and consider if the problem is possibly drug-related in assessing new problems, be sure to consider not only prescribed drugs but also herbal remedies and OTC medicines

What is acute therapy, prophylactic therapy, and palliative therapy?
Acute therapy- treatment of an acute illness with the goal of returning to a pre-illness state

Prophylactic therapy- treatment to prevent an illness

Palliative therapy- treatment to maintain comfort

What is meant by the term “therapeutic range” and is it best to have a wide therapeutic range or a narrow therapeutic range?
Therapeutic range is the range between the minimum effective concentration of a drug and the toxic concentration of a drug. With a wide therapeutic range, toxicity is less likely

Explain the concept of peak and trough levels.
Peak and trough levels are laboratory studies conducted to determine if drug dosage levels are maintained at both sage and therapeutic levels

Blood for the peak level is typically drawn 30-60 minutes following an IV infusion

Blood for the trough level is drawn about 15 minutes before the next dose.

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