Prescribing basics correct answers Prescribing is regulated by state BON Proper RX correct answers Providers name and address, Telephone DEA Pt name/DOB/Addres Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity and signature. Drug Schedules: Most addictive to least correct answers 1: Heroin,LSD, MJ 2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine, fentanyl, adderall, ritalin 3: codeine, ketamine, testosterone 4: xanax, valium, soma, ambient, tramadol 5: antidiarrheal, antitussives, lomotil, lyrica Pharmicodyamics correct answers The effects of drug on the body. Receptors are large molecules usually proteins, that interact and mediate the action of drugs agonist correct answers produce receptor stimulation and a conformational change every time they bind. Do not need all available receptors to produce a maximum response Partial agonist correct answers drugs that have properties in b/w those of full agonist and antagonist. They bind to receptors but when they occupy the receptor sites, they stimulate only some of the receptors. antagonist correct answers drugs with affinity for a receptor but with no intrinsic activity. Affinity allows the antagonist to bind to receptors, but lack of intrinsic activity prevents the bound antagonist from causing receptor activation. The block action of drugs (ex. Narcan) Bioavailabity correct answers % of administered dosage of the drug that survives the first pass through the liver and reaches the blood stream half life correct answers Time required for the amount of a drug in the body to decline by 50%, drugs with shorter half lives must be administer frequently. 4.5-5.5 times the half life to get steady state and to be limited from the body what the body does to the drug correct answers absorption, distribution, metabolism, excretion Distribution correct answers movement of absorbed drug in bodily fluids throughout the body to target tissue. Properties affecting: lipid/water solubility, PH affects ionization of drug, protein binding, size of molecule (smaller molecules are more able to diffuse) Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier (many drugs can pass) N5334 Final Exam Questions and Answers Latest Updated 2024 (A+ GRADED) Protein binding correct answers unbound drug is free which is active, crosses membrane. Low plasma proteins result in more free drug. Competition: when 2 highly bound drugs are given it increases the level of both drugs Metabolism correct answers take place in the liver mostly. Chemical change of a drug structure to: Enhance excretion, inactivate the drug, increase therapeutic action, active a prodrug (inactive until metabolized in the body into the active compound, ex: levodopa), increase or decrease toxicity CYP450 correct answers enzymes constitutes the most important of the phase I metabolizing enzymes (account for about 75% of drug metabolism in the liver) Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the substrates rendering them more readily excretable Substrate correct answers an agent that is metabolized by an enzyme into a metabolite and product and eventually excreted Inhibitors correct answers compete with other drugs for a particular enzyme affecting the metabolism (decreased) of the substrate and decreases the excretion of the substrate and increasing the circulating drug inducer correct answers competes with other drugs for a particular enzyme affecting metabolism of the substrate (increases) decreasing the efficacy of the drug excretion correct answers renal: passive glomerular filtration, active tubular secretion, tubular reabsorption, gi tract, lung, sweat and salivary, mammary genomics correct answers study of the complete set of genetic information present in a cell, an organism, or species pharmacogenetics correct answers the study of the influence of hereditary factors on the response of individual organisms to drugs, and the study of variations of DNA and RNA characteristics as related to drug response Pharmacogenetics tests correct answers Mentioned on drug labels can be classified as "test required," "test recommended," and "information only." Currently, four drugs are required to have pharmacogenetics testing performed before they are prescribed: cetuximab, trastuzumab, maraviroc and dasatinib wafarin, carbamazepine, valproic acid and abacavir are recommended to tests prior to initial dosing Carbamazepine and Asisans correct answers Initiating carbamazepine therapy in these patients (allele HLA-B*1502) are at high risk for developing Steven Johnson syndrome or toxic epidermal necrolysis (TEN) The ability of the anesthetic to penetrate the axon membrane is determined by 3 properties. What are they? correct answers Molecular size, Lipid solubility, degree of ionization at tissue pH Why is epinephrine given with local anesthetics? correct answers Decreases local blood flow (decreased risk of bleeding) Delays systemic absorption of the anesthetic prolongs anesthesia reduces the risk of toxicity What is the most widely used local anesthetic? correct answers Lidocaine What is a possible fatal reaction to benzocaine correct answers Methemoglobinemia What is included in application guidelines for topical anesthetics correct answers avoid wrapping the site and heating the site, avoid application to open skin Which medication will not cause rebound headaches from overuse? correct answers propranolol (preventative) What is the best option for menstural migraine? correct answers low dose estrogen about 3 days prior to menses What food can trigger migraines? correct answers Hot dog d/t nitrates What medication is a Seratonin 1B1D receptor agonist? correct answers Sumatriptan Butterbur can help as prevention for migraine therapy. What side effect can occur? correct answers Liver damage What are the 3 main classes of opiod receptors? correct answers Mu kappa delta Which of the following will reserve he effects caused by opioid agonist? correct answers naloxone Which of the medications are used to treat OIC? correct answers Naloxegol, methylinaltrexone, lubiprostone Tolerance is defined as correct answers increased does of a med needed to obtain the same response Which medication is used for opioid abuse? correct answers Naltrexone