Lehne's Pharmacology Test 1
3 main properties of an ideal drug - ANS-Effectiveness, safety, selectivity
4 Primary Receptor Families: - ANS-1) Cell membrane-embedded enzymes 2) ligand-gated
Ion channels 3) G protein-Coupled Receptor Systems 4) Transcription Factors
5 categories of controlled substances - ANS-Schedules I, II, III, IV, V. Schedule I have no
accepted medical use in the US and are deemed to have a high potential for abuse.
Schedule V is the lease addictive.
5 Rights of drug administration - ANS-Right drug, Right patient, Right route, Right dose,
Right time.
5 steps of the Nursing Process - ANS-1) assessment 2) analysis 3) planning 4)
implementation 5) evaluation
6 possible consequences of drug metabolism: - ANS-1) accelerated renal excretion of drugs
2) drug inactivation 3) increased therapeutic action 4) activation of "prodrugs" 5) increased
toxicity 6) decreased toxicity.
Absorption - ANS-The movement of a drug from its site of administration into the blood.
Accelerated Renal Drug Excretion: - ANS-The kidneys, the main site of drug excretion, are
unable to excrete highly lipid-soluble drugs. Conversion of lipid-soluble drugs into more
water-soluble forms can accelerate renal excretion. Some lipid-soluble drugs will be excreted
by bile into the feces.
Active Tubular Secretion: - ANS-Active transport systems pump drugs from the blood into
the tubular urine via p-glycoprotein, organic acid pumps, and organic base pumps.
Additional Properties of an ideal drug - ANS-Reversible action, predictability, ease of
administration, freedom from drug interaction, low cost, chemical stability, possession of a
simple generic name
Additional rights of drug administration - ANS-Right assessment, Right documentation, Right
evaluation, Right patient education, Patient's right to refuse.
Affinity: - ANS-Drugs with high affinity are strongly attracted to their receptors and vice versa.
The affinity of a drug for its receptor is reflected in its potency. High affinity = high potency
Agonists: - ANS-Molecules that activate receptors. Drugs bind to receptors and mimic the
actions of the body's own regulatory molecules. An agonist has both affinity and high intrinsic
activity.
Analysis: Nursing Diagnoses includes.. - ANS-The analysis of the information gathered from
the assessment to determine actual and potential health problems. Physiological,
psychological, or sociological.
Antagonists: - ANS-Produce their effects by preventing receptor activation by endogenous
regulatory molecules and drugs. It has affinity but no intrinsic activity. They can block the
actions of endogenous regulatory molecules or drugs.
Assessment includes.. - ANS-patient interview, medical and drug-use histories, physical
examination, observation of the patient, lab tests.
Blood Brain Barrier (BBB): - ANS-The term refers to the unique anatomy of the capillaries in
the central nervous system. The capillary walls Tight Junctions prevent drugs from passing
through. Therefore, drugs must be able to pass through the cells. Only lipid soluble or
transport active drugs can pass. P-glycoprotein also inhibits access of drugs to the brain.
, Blood Flow to Tissues: - ANS-Typically good except in tumors and abscesses.
Cell Membrane-Embedded Enzymes: - ANS-Receptors span the cell membrane and are
located on the cell surface. Binding of an agonist drug activates the enzyme inside the cell.
Clinical Pharmacology - ANS-The study of drugs in humans.
Clinical Testing Phase I - ANS-2-10 years. Phase I: conducted in healthy volunteers or in
volunteer patients who have the disease. Evaluates drug metabolism, pharmacokinetics, and
biologic effects.
Clinical Testing Phase II and III - ANS-Drugs are tested in patients. Determining therapeutic
effects, dosage range, safety, and effectiveness. 500-5000 patients receive the drug. Phase
III is application to the FDA for drug approval and distribution to the public (phase IV)
Clinical Testing Phase IV - ANS-The drug is released for general use, permitting observation
of its effects in a large population.
Competitive Antagonists: - ANS-These bind reversibly to receptors. They compete with
agonists for blockade. Whichever molecule is present in greater number will out compete the
other.
Controlled Substances Act of 1970 - ANS-It set rules for the manufacture and distribution of
drugs considered to have the potential for abuse.
Distribution- - ANS-The movement of drugs throughout the body. Determined by blood flow
to tissues, the ability of the drug to exit the vascular system, the ability of a drug to enter
cells.
Dose-Response Relationship: - ANS-The relationship between the size of an administered
dose and the intensity of the response produced. The minimum amount of drug needed to
elicit a response.
Drug - ANS-Any chemical that can affect living processes.
Drug Competition: - ANS-Because the number of binding sites is limited, drugs with the
ability to bind albumin will compete with one another for those sites. One drug can displace
the other, causing "free-drug" levels to increase, potentially causing toxicity.
Drugs must cross membranes, how?(3 ways) - ANS-1)Channels and pores that allow small
specific molecules into the cell. Such as small ions (potassium/sodium). 2) Transport
Systems are carriers that can move drugs from one side of the membrane to the other. Very
selective. Depends on the drug's structure. P-glycoprotein transports drugs out of cells. 3)
Direct Penetration of the Membrane requires drugs to be lipid soluble.
Effect of age on drug metabolism: - ANS-drug metabolization of infants is limited. The liver
isn't fully developed until 1 year of age. Older adults may not be able to metabolize drugs as
efficiently and drug doses may need to be reduced.
Effect of Nutritional Status on Metabolism: - ANS-Hepatic drug-metabolizing enzymes
require cofactors to function. These cofactors are provided by our intake of food.
Effectiveness - ANS-a drug that elicits the responses it was designed for.
Enteric-coated Preparations: Oral - ANS-Drugs that have been covered with a material
designed to dissolve in the intestine but not the stomach. Used to protect drugs from acid
and pepsin in the stomach, and to protect the stomach from some drugs.
Entering Cells: - ANS-Most drugs can produce their effects by binding to activation sites on
cell membranes, others must actually enter the cell.
Evaluating Therapeutic Responses - ANS-evaluation of the patient before, during, and after
treatment to ensure that treatment is or isn't working. Also monitoring for toxicity/adverse
effects
Evaluation - ANS-Determines the degree to which treatment was successful.
Excretion: - ANS-The removal of drugs from the body.