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Flashcards in 6: Pharmacology Deck (22)
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1

Pharmacokinetics: body's action on the drug - ADME

(Absorption, distribution, metabolism, excretion)

 

Pharmacodynamics: drug's action on the body

2

A patient's ___ has an effect on the concentration of drugs they are administered.

age

3

Different drugs can ___ to change their metabolism.

interact

4

The ___ of the environment a drug is in affects its absorption.

pH

acidic drugs require an acidic environment for absorption

basic "" for ""

5

The route of delivery of a drug is important when talking about older patients.

Why?

Difficulty swallowing

Nasogastric or PEG tubes - tablets need to be suitable for them

Delirious patients won't tolerate tablets, injections etc.

Pre-op patients may be nil-by-mouth

6

? how much of this we need to know

7

Name an example of an acidic drug.

Aspirin

Penicillin

8

Name an example of a basic drug.

TCAs

Opioids

Benzos

9

revise volume of distribution

high vd means more drug is stored in fatty tissue

dangerous when cachexic - fat broken down, drug released into circulation

10

Older patients have greater ___ stores than younger patients.

fat stores

11

high Vd means drug is lipophilic and most is absorbed into fat

low Vd means drugis hydrophilic and tends to be absorbed by the plasma

12

biological half life is the time taken for the activity of a drug to half

t1/2 = 0.693 (or ln2) x Vd all over clearance

lipophilic drugs have a large Vd so therefore their t1/2 is greater

13

older patients have a lower clearance and less body water (i.e plasma), so combined with a high Vd they take ages to clear lipophilic drugs

14

older people have reduced liver and kidney function so excretion is impaired

15

serum creatinine dependent on muscle mass, so not reliable for measuring renal function - use eGFR instead obviously

16

therapeutic index = toxic dose / effective dose

narrow therapeutic index (i.e <2) is bad

drug dose required to produce an effect decreases as you age, so therapeutic index narrows as you age

17

Opioids - think constipation

Steroids - think osteoporosis

Calcium supplements and T3 need to be taken at morning/night - interact with one another

18

Avoid long-term NSAIDs, risk of peptic ulcers, renal impairment, gammy other drugs

Opioids and benzos (e.g lorazepam) increase risk of falls

4 Cs and C. diff

19

ask about OTC medication and herbal remedies

20

go over drug side effects

21

stopp-start tool

22