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PHTH 7111 Summer 2014 > Exam 2: medications powerpoint from Summer 2014 > Flashcards

Exam 2: medications powerpoint from Summer 2014 Flashcards

1
Q

Definintion: Pharmacology

A

study of the effects of drugs on the body and the effect of the body on the drugs

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2
Q

Definition: pharmacotherapeutics

A

sub-category of pharmacology. use of specific drugs to prevent, treat, or diagnose a disease

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3
Q

definition: Pharmacokinetics

A

subcategory of pharmacotherepeutics (which is a subcategory of pharmacology):

how the body deals with the drug in terms of how it is absorbed, distributed, and eliminated

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4
Q

definition: pharmacodynamics

A

subcategory of pharmacotherepeutics (which is a subcategory of pharmacology):

Analysis of what the drug does to the body

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5
Q

Definition: Toxicology

A

study of harmful effects of chemicals

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6
Q

definition: Pharmacy

A

preparation and dispensing of medications

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7
Q

definition: drug

A

chemical demonstrated effective for preventing or treating disease

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8
Q

3 types of drug names:

A
  • Chemical
  • Trade/brand
  • genaric
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9
Q

Definition: Chemical name

A

non-proprietary, no owner, specific compound’s structure, generally loooooooong.

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10
Q

definition: trade/brand name

A

owned by a company or companies

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11
Q

definition: genaric name

A

official or non-proprietary name, often derived from chemical name

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12
Q

Drug approval agency in USA:

A

FDA (food and drug administration)

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13
Q

4 phases of human testing and attributes of each:

A
  • Phase 1: determine effects & safe dosage;
  • Phase 2: assess drug’s effectiveness, 200-300 with disorder
  • Phase 3: assess safety & effectiveness in larger sample, 1000-3000 with disorder
  • Phase 4: monitor any problems that occur after approval
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14
Q

What type of testing is performed before human trials commence?

A

Preclinical testing, lab tests to determine drug effects and safety

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15
Q

what is the minimum amount of time it can take for a drug to be approved

A

3 years (but it is usually 7 or more)

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16
Q

How many drug schedules are there?

A

five (V)

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17
Q

Schedule I drugs: description and 2 examples

A

highest potential for abuse. not normally used for medical treatment

(marijuana, heroin)

(I thought marijuana was in a lower risk class - look up later)

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18
Q

Schedule II drugs: description and 1 example

A

approved for specific medical use, high potential for abuse and addiction (morphine)

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19
Q

Schedule III drugs: description and 3 examples

A

mild-moderate physical dependence, strong psychologic dependence. (opioids, anabolic steroids, amphetamines)

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20
Q

Schedule IV drugs: description and 2 class examples

A

lower potential for abuse (depressants, stimulants)

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21
Q

Schedule V drugs: description and 2 examples

A

lowest relative abuse potential (low dose opioids in cough medicine, antidiarrheal preparations)

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22
Q

Five ways to categorize drugs

A
  1. Drug action
  2. chemical
  3. therapeutic category
  4. Non-prescription (OTC) - FDA approved
  5. Prescription - FDA approved
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23
Q

Pharmacokinetics terminology: site of action

A

where the interaction takes place

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24
Q

Pharmacokinetics terminology: onset of action

A

where enough drug causes a response

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25
Q

Pharmacokinetics terminology: duration of action

A

time between onset and termination

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26
Q

Pharmacokinetics terminology: half-life

A

time required for 50% of drug to be eliminated from body

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27
Q

Pharmacokinetics terminology: clearance rate

A

measure of efficiency of metabolism or excretion (both are ways of drug removal)

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28
Q

Pharmacokinetics terminology: bioavailability

A

the amount of drug absorbed and rate of absorption through blood stream

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29
Q

Pharmacokinetics terminology: volume of distribution

A

target tissue for distribution (for instance, increased body weight might mean a larger dosage is needed to create an effect)

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30
Q

pharmacokinetics is . . .

A

the study on the impact of the body on drugs

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31
Q

Chemical structure will …

A

determine biological effect. structures with different chemical make-ups will have different indications, effects, dosage

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32
Q

definition: soluablility

A

time to dissolve in GI, absorbed in bloodstream, distribution to target tissue, excretion

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33
Q

polarity of drugs is important because

A

most drugs are both water and fat soluble to some degree (iontophoresis)

34
Q

Ionization does what for drugs

A

enhancing the chemical charge, either positive or negative. disolving in solution alters strength of the charge

35
Q

Administration, absorption, distribution, excretion

A

part of pharmacokinetics

36
Q

2 main Routes of administration

A
  1. Enteral (oral, sublingual/buccal, rectal)
  2. Parenteral (intravenous, intramuscular and subcutaneaous, intrathecal [tendon sheath injection], topical, transdermal, inhalation)
37
Q

First pass effect

A

occurs when drugs are administered orally and must pass through liver where significant amount of drug may be metabolized prior to reaching site of action

(means oral drug dose might need to be higher than injected drug)

38
Q

3 types of cell absorption

A
  • Passive diffusion (just need gradient, no ATP, cannot go up gradient)
  • facilitated diffusion (need transporter protein, no ATP, cannot go up gradient) - example: glucose entering cell
  • Active transport (need transporter protein and ATP, can go up gradient) - example Na+K+ pump
39
Q

Distribution factors:

A
  • Tissue permeability (think blood-brain barrier) Blood flow to area
  • How much of drug is bound to plasma proteins (it will not be available to enter cell if bound in blood)
  • binding to subcellular components (how much of drug is stuck inside cells where it cannot leave to be distributed to other locations)
40
Q

2 ways for excretion

A
  1. Renal (most common) - Pee
  2. Billary (liver bile to small in intestine) - Poop
41
Q

pharmacodynamics definition

A

study of impact of drugs on the body

Includes

  • molecular mechanisms by which drugs exert therapeutic actions and adverse side effects,
  • and Therapeutics, the study of the parameters that determine the most appropriate therapy for a patient)
42
Q

4 things to consider for Therapeutic parameters

A
  1. presence of diseases
  2. other drugs a person is taking
  3. dosage regiment of each drug
  4. impact of potential adverse effects
43
Q

additive effect

A

response of 2+ drugs used together: synergistic or antagonistic

44
Q

Placebo vs placebo effect

A

placebo: dosage with no active ingredient

placebo effect: response that cannot be attributed to potency of drug

45
Q

tolerance

A

diminished response to drug with continued use

46
Q

3 factors that may cause drug tolerance

A
  1. drug metabolizing enzymes - quicker metabolism
  2. receptor change in number - responsiveness of receptors altered
  3. affinity to drug: opioids and CNS stimulators (uppers)
47
Q

agonist vs antagonist drug

A

agonist drug: causes same effect as body normally produces (but may be larger effect)

antagonist drug: causes the body’s normal reaction to not occur by blocking a receptor

48
Q

Must have _____ & ______ present for an drug to work.

A

drug

receptors

49
Q

4 dose types

A
  1. single dose: dose required for a certain response
  2. multiple dose: greater blood concentration increase than single dose, levels off when bio-availability = clearance rate
  3. Maintenance dose: regular interval in repetitive basis
  4. Loading dose: starter dose to get a higher blood level quicker and then return to maintenance dose
50
Q

5 therapeutic considerations

A
  1. patient compliance
  2. dose
  3. therapeutic monitoring
  4. age (children are smaller, elderly have decreased organ functioning)
  5. liver/kidney function testing
51
Q

2 types of drug interactions

A
  1. synergistic (additive/agonistic effect): increases effect of drug
  2. Detrimental/antagonistic effect: decreases effect of drug (think antibiotics with birth control)
52
Q

ADR

A

Adverse Drug Reactions

53
Q

7 Adverse drug reactions (ADR)

A
  1. side effects (non-therapeutic effects)
  2. Allergic reaction
  3. Organ cytotoxic effects
  4. idiosyncratic reaction (strange reaction)
  5. Drug-drug interactions
  6. Drug-food interaction
  7. Drug-herbal interaction
54
Q

What is an example of a medication highly influenced by food?

A

Coumadin (Warfarin)

55
Q

Muscle relaxants are for what (general category & 2 subcategories)?

A

Hyperexcitability:

  • muscle spasm,
  • spasticity
56
Q

Do muscle relaxants prevent muscle contraction?

A

no. They just normalize muscle excitability to decrease pain and increase function

57
Q

What is a muscle spasm?

A

increased tension most seen in skeletal muscle after MSK injuries and inflammation

58
Q

what is the most common route of administration for muscle relaxants?

A

oral

59
Q

Diazepam (Valium)

4 things

A
  1. Oldest medication to treat muscle spasms.
  2. also treats spasticity.
  3. can cause physical dependance
  4. also used for anxiety
60
Q

Diazapam negative effects (4)

A
  1. sedation
  2. general reduction in psychomotor ability
  3. tolerance –> dependence
  4. withdrawal symptoms if stopped suddenly (seizures, anxiety, agitation, tachycardia, DEATH)
61
Q

Polysynaptic inhibitors are used for what?

A

muscle relaxants used for short term relief of muscle spasms associated with acute, painful MSK

62
Q

Adverse effects of polysynaptic inhibitors (a muscle relaxant class)? (4 main categories)

A
  1. Drowsiness
  2. Dizziness
  3. Nausea, light-headedness, vertigo, ataxia
  4. Long term use may cause tolerance and physical dependence.
63
Q

Polysynaptic Inhibitors often have what in their brand name

A

flex or x

64
Q

7 Poly-synaptic inhibitors - ways to remember and beginning of generic name

A
  • 4 C’s, 2 M’s, 1 O.
  • 4 Cs: Girl’s names + monster: Cari, 2 Chlo (e), Cyclo (pse).
  • 2 Ms: Meta and Meth. Meta-ex-alone (alone because of ex) & Meth-o-carb (meth and carbs are bad to some people)
  • 1 0: Orphen (all alone as an orphan)
65
Q

Which polysynaptic inhibitors does Dr. Henderson use the most?

A

Flexeril & Robaxin

Cyclo (pse) & Meth-o-carb

66
Q

Three things about Opioid Analgesics

A
    1. naturally occurring, semisynthetic & Synthetic relieve moderate to severe pain
  2. bind to specific neuronal receptors in CNS
  3. controlled substances (usually schedule II or III)
67
Q

4 Classifications of opioids

A
  1. Strong agonists
  2. mild-moderate agonists
  3. mixed agonist-antagonist
  4. antagonists
68
Q

Opioids: Strong Agnonist,

purpose and

characteristics of generic name.

2 common brand names

A

For: Severe Pain

Name: Morph (morphine, -morphone)

Brand: Demoral, Hydrostat

69
Q

Opioids: mild-moderate Agnonist,

purpose and

characteristics of generic name.

1 common brand name

A

Purpose: moderate intensity pain

Name: Code (codine, codone)

brand: OxyContin

70
Q

Opioids: mixed Agnonist-antagonist,

attributes (why use/different) and

characteristics of generic name.

A

Safer, not common, not as strong as others.

Name: lots of Bu (But-, Bup-, Nal-Bup)

71
Q

Opioids: antagonists,

purpose and

characteristics of generic name.

A

Treat Overdose

Name: Nal- (nalmefene, naloxone, naltrexone)

72
Q

Adverse effects of opioids (7 descriptions):

A
  1. Strong physical dependance risk
  2. Potential for abuse
  3. Sedation,
  4. respiratory distress
  5. Constipation
  6. psychotic effects
  7. Cardiovascular effects (our friend orthostatic hypotension)
73
Q

Opioids: clinical applications (6)

A
  1. Effective for treating moderate-severe pain that is constant in duration.
  2. Not as effective for treating sharp, intermittent pain
  3. Work on altering perception of pain rather than eliminating pain sensation
  4. Parenteral routes may be more beneficial for chronic or severe pain
  5. Influenced by dosing schedules
  6. In-dwelling catheters can be implanted
74
Q

NSAIDs: purpose and not the same as ______

A

Used to decrease inflammation, relive pain, reduce fever, decrease blood clotting

Not the same as glucocorticoides (which are also used to treat inflammation). Glucocorticoids are steroids.

75
Q

Two types of NSAIDs based on mechanism of action:

A

Non-selective (block COX-1 and COX-2)

Selective (block COX-2 only)

76
Q

COX-1 vs COX-2

A

both work on prostaglandins.

COX-1 related to stomach lining protection, renal function, and platelets.

COX-2 only mediate pain and inflammatory response

77
Q

What are two side effects of non-selective NSAIDs?

A

Primary: GI damage

Renal Damage

78
Q

What is the only selective COX-2 inhibitor on the market now (and do you need a prescription)?

A

Celebrex

Prescription needed

79
Q

Is Tylenol (acetometaphin) an NSAID, and where is it metabolized?

A

No

In the liver

80
Q

Therapists should watch out for multipharmacy and interaction concerns missed by other caregivers. We spend the most time with patient.

A

cheers (you get this one free)

PHTH 7111 Summer 2014 (2 decks)

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