01_01-05 - Exam I Review - Nursing
326-Graded A
Drug - ANS-Any chemical that affects living processes, not all are therapeutic
Pharmacology - ANS-Study of drugs and interactions with living systems
Clinical Pharmacology - ANS-Study of drugs in humans
Pharmacotherapeutics - ANS-Use of drugs to diagnose, prevent, or treat disease
Types of Drug Names - ANS-I) Chemical: complex, rarely used
II) Generic: non-proprietary, one name
III) Trade: proprietary, name requires FDA approval, many names
Properties of Ideal Drug - ANS-- Effectiveness: elicits intended response, most
important
- Safety: no harmful effects (not 100% possible)
- Selectivity: produces only responses for which it is given
Factors that Determine Intensity of Response - ANS-- Administration: dose, route,
timing
- Pharmacokinetics: how body reacts to drug. Includes absorption, distribution,
metabolism, and excretion
- Pharmacodynamics: impact on body, drug receptors
- Individual variation: physiological, pathophysiological, genes
Drug Transport Methods - ANS-- Direct penetration: lipid-soluble, most common
- Transport system: selective (i.e. P-glycoprotein)
- Passage through channels and pores: need to be really small
Absorption Overview - ANS-A pharmacokinetic factor involving movement of drug from
site of administration to the blood
Bioavailability - ANS-The extent to which a drug is absorbed/transported to cells. Never
100%, depends
Factors Which Affect Absorption - ANS-- Rate of dissolution (dissolving)
- Surface area
- Blood flow
- Lipid solubility
,- pH partitioning (pH of blood vs. pH at site, greater difference leads to greater
availability)
- Site of administration
Site of Drug Administration (list only) - ANS-- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous
- Oral
Intravenous Drug Administration Overview - ANS-Directly into bloodstream, no barrier.
100% absorption.
- Pros: rapid onset, control level easily, can use larger amount of fluid
- Cons: can be dangerous (too fast, etc.), costly
Intramuscular Drug Administration Overview - ANS-- Pros: easily absorbed, alternative
to IV, can be used for depot preparation (large amount to be absorbed slowly)
- Cons: painful, tissue/nerve damage
Subcutaneous Drug Administration Overview - ANS-Similar to intramuscular, uses
smaller needle
Oral Drug Administration Overview - ANS-Absorbed in stomach and small intestine.
- Pros: convenient, less expensive
- Cons: can cause GI irritation, absorption variable (presence of food, slow GI emptying,
etc.), not all medications can be oral
Oral Drug Administration Types - ANS-- Tablets: mixture of drug and binders/fillers, can
vary by manufacturer
- Enteric-coated (EC): coating dissolves in intestines, not stomach. Protects drug from
stomach or stomach from drug
- Sustained-release (SR, EX): capsules, filled with coated spheres. Dissolve at variable
rates, released steadily. Expensive
Distribution Overview - ANS-A pharmacokinetic factor involving movement of drug from
blood to cells
Distribution Factors - ANS-I) Blood flow to tissue: increased blood flow leads to
increased delivery
II) Ability of drug to exit vascular system: exit at capillary beds. Certain things reduce
this
, III) Ability of drug to enter cells
Factors that Affect Ability of Drug to Exit Vascular System - ANS-- Blood-brain barrier:
some lipid-soluble drugs can pass, others use transport systems
- Placenta: some can cross (can be unsafe for pregnancy)
- Protein binding: can bind with protein, usually albumin, too big to cross membrane
Metabolism Overview - ANS-A pharmacokinetic factor involving enzymatic process that
affect drug (biotransformation). Mostly in liver, usually with hepatic microsomal enzyme
system (P450)
Metabolism Effects - ANS-- Accelerated renal excretion
- Drug inactivation (i.e. anesthesia)
- Increased therapeutic effects
- Activation of drugs
- Increased or decreased toxicity
Factors that Influence Metabolism - ANS-- Age: liver development/decline
- Induction of drug-metabolizing enzymes: some drugs cause liver to increase enzyme
production
- First-pass effect: rapid hepatic inactivation, only with oral medications. Inactivated on
first pass to liver, may do sublingual (i.e. nitroglycerine) or different route
- Nutrition
- Drug competition: if same metabolic pathway
Excretion Overview - ANS-A pharmacokinetic factor involving movement of
drug/metabolites out of body, usually kidneys
Excretion Steps - ANS-I) Glomerular filtration (all except bound to albumin)
II) Passive tubular reabsorption:
- Lipid-soluble reabsorbed in blood
- Non-lipid-soluble excreted
III) Active tubular secretion:
- Pump drugs into urine
Factors that Affect Renal Excretion - ANS-- pH-dependent ionization: can speed up
excretion (i.e. induced pH change from aspirin poisoning)
- Competition for active transport (may be used on purpose)
- Age
MEC - ANS-Minimum effective concentration
326-Graded A
Drug - ANS-Any chemical that affects living processes, not all are therapeutic
Pharmacology - ANS-Study of drugs and interactions with living systems
Clinical Pharmacology - ANS-Study of drugs in humans
Pharmacotherapeutics - ANS-Use of drugs to diagnose, prevent, or treat disease
Types of Drug Names - ANS-I) Chemical: complex, rarely used
II) Generic: non-proprietary, one name
III) Trade: proprietary, name requires FDA approval, many names
Properties of Ideal Drug - ANS-- Effectiveness: elicits intended response, most
important
- Safety: no harmful effects (not 100% possible)
- Selectivity: produces only responses for which it is given
Factors that Determine Intensity of Response - ANS-- Administration: dose, route,
timing
- Pharmacokinetics: how body reacts to drug. Includes absorption, distribution,
metabolism, and excretion
- Pharmacodynamics: impact on body, drug receptors
- Individual variation: physiological, pathophysiological, genes
Drug Transport Methods - ANS-- Direct penetration: lipid-soluble, most common
- Transport system: selective (i.e. P-glycoprotein)
- Passage through channels and pores: need to be really small
Absorption Overview - ANS-A pharmacokinetic factor involving movement of drug from
site of administration to the blood
Bioavailability - ANS-The extent to which a drug is absorbed/transported to cells. Never
100%, depends
Factors Which Affect Absorption - ANS-- Rate of dissolution (dissolving)
- Surface area
- Blood flow
- Lipid solubility
,- pH partitioning (pH of blood vs. pH at site, greater difference leads to greater
availability)
- Site of administration
Site of Drug Administration (list only) - ANS-- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous
- Oral
Intravenous Drug Administration Overview - ANS-Directly into bloodstream, no barrier.
100% absorption.
- Pros: rapid onset, control level easily, can use larger amount of fluid
- Cons: can be dangerous (too fast, etc.), costly
Intramuscular Drug Administration Overview - ANS-- Pros: easily absorbed, alternative
to IV, can be used for depot preparation (large amount to be absorbed slowly)
- Cons: painful, tissue/nerve damage
Subcutaneous Drug Administration Overview - ANS-Similar to intramuscular, uses
smaller needle
Oral Drug Administration Overview - ANS-Absorbed in stomach and small intestine.
- Pros: convenient, less expensive
- Cons: can cause GI irritation, absorption variable (presence of food, slow GI emptying,
etc.), not all medications can be oral
Oral Drug Administration Types - ANS-- Tablets: mixture of drug and binders/fillers, can
vary by manufacturer
- Enteric-coated (EC): coating dissolves in intestines, not stomach. Protects drug from
stomach or stomach from drug
- Sustained-release (SR, EX): capsules, filled with coated spheres. Dissolve at variable
rates, released steadily. Expensive
Distribution Overview - ANS-A pharmacokinetic factor involving movement of drug from
blood to cells
Distribution Factors - ANS-I) Blood flow to tissue: increased blood flow leads to
increased delivery
II) Ability of drug to exit vascular system: exit at capillary beds. Certain things reduce
this
, III) Ability of drug to enter cells
Factors that Affect Ability of Drug to Exit Vascular System - ANS-- Blood-brain barrier:
some lipid-soluble drugs can pass, others use transport systems
- Placenta: some can cross (can be unsafe for pregnancy)
- Protein binding: can bind with protein, usually albumin, too big to cross membrane
Metabolism Overview - ANS-A pharmacokinetic factor involving enzymatic process that
affect drug (biotransformation). Mostly in liver, usually with hepatic microsomal enzyme
system (P450)
Metabolism Effects - ANS-- Accelerated renal excretion
- Drug inactivation (i.e. anesthesia)
- Increased therapeutic effects
- Activation of drugs
- Increased or decreased toxicity
Factors that Influence Metabolism - ANS-- Age: liver development/decline
- Induction of drug-metabolizing enzymes: some drugs cause liver to increase enzyme
production
- First-pass effect: rapid hepatic inactivation, only with oral medications. Inactivated on
first pass to liver, may do sublingual (i.e. nitroglycerine) or different route
- Nutrition
- Drug competition: if same metabolic pathway
Excretion Overview - ANS-A pharmacokinetic factor involving movement of
drug/metabolites out of body, usually kidneys
Excretion Steps - ANS-I) Glomerular filtration (all except bound to albumin)
II) Passive tubular reabsorption:
- Lipid-soluble reabsorbed in blood
- Non-lipid-soluble excreted
III) Active tubular secretion:
- Pump drugs into urine
Factors that Affect Renal Excretion - ANS-- pH-dependent ionization: can speed up
excretion (i.e. induced pH change from aspirin poisoning)
- Competition for active transport (may be used on purpose)
- Age
MEC - ANS-Minimum effective concentration
