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Pharmaceutical Care Midterm > Lecture 3 - Drug Interactions and Drug Information > Flashcards

Lecture 3 - Drug Interactions and Drug Information Flashcards

1
Q

What is the first step in providing quality drug information?

A

knowing the most appropriate resource for information

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2
Q

what is evidence based medicine

A

the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients

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3
Q

What are primary sources?

A

ORIGINAL CONTENT
often provide the most in-depth information about a topic. Allows readers to draw their own conclusions. Requires strong literature evaluation skills and a lot of time

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4
Q

what are some examples of primary sources (in a science context)

A

clinical research studies
scientific experiments
journal articles

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5
Q

what are secondary sources?

A

secondary sources synthesize findings FROM MULTIPLE PRIMARY RESOURCES

mainly are in the form of searchable databases that enable the retrieval of primary or tertiary resources

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6
Q

what are some examples of secondary resources

A

embase, Pubmed, meta analyses, systematic review articles

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7
Q

What are tertiary sources?

A

tertiary sources include information from BOTH PRIMARY AND SECONDARY sources.
They are typically condensed into a more digestible format

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8
Q

what are some examples of tertiary sources

A

textbooks
lexicomp, micromedex (compendia)
package inserts
websites (CDC, clinical trials.gov)
other online databases

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9
Q

Prescription medications are labeled with…

A

PI (Prescribing information)
or
USPI (United States Prescribing information)

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10
Q

What does the PI/USPI contain?

A

the FDA’s findings regarding the safety and efficacy of the prescription drug on humans under the label conditions of use

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11
Q

which should you look at 1st — primary, secondary, or tertiary sources

A

TERTIARY

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12
Q

Indexing or abstracting services are ____ sources

A

secondary

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13
Q

clinical studies are ___ sources

A

primary

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14
Q

textbooks, databases, and review articles are ___ sources

A

tertiary

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15
Q

Do clinical practice guidelines provide a “one size fits all” approach?

A

no

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16
Q

what are clinical practice guidelines and give an association who publishes them

A

clinical practice guidelines are statements that include recommendations intended to optimize patient care. These recommendations are formed by a systematic review of benefits and the assessment of the benefits and harms of alternative care options

ex: American Diabetes Association Standards of Care

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17
Q

Are internet searches allowed?

A

yes - internet searches can be useful in certain situations.

however, it’s important to evaluate the quality of all information provided

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18
Q

What internet websites are more likely to contain high quality information?

A

-educational institutions
-nonprofit medical organizations
-a division of the US gov

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19
Q

there is limited info on the internet — where should you reach out to to find the answer you’re looking for?

A

an expert in the field

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20
Q

what websites should we be recommending to consumers (patients)

A

health care organizations (mayo clinic, cleveland clinic)

disease or professsional societies (american diabetes association)

consumer-specific sections from tertiary resources (micromedex, lexicomp_

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21
Q

What is a drug interaction?

A

when 1 drug modifies the action of another drug in the body

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22
Q

when is there an increased incidence of interactions?

A

-in elderly patients
-in patients taking many medications

23
Q

T/F —–

there are hundreds of interactions for drugs, but few are clinically significant enough to be contraindicated or require a change in dosage

A

true

24
Q

what is pharmacokinetics?

A

pharmacokinetics refers to the effect the BODY HAS ON THE DRUG as it travels through ADME (absorption, distribution, metabolism, excretion)

25
Q

pharmacokinetic interactions occur when…

A

one drug alters the ADME processes of another drug

26
Q

absorption from the GI tract may be influenced by…

A

-agents that bind drugs

-agents that increase/decrease GI motility

-drugs that alter the p-glycoprotein and organic anion transports in the membran e

27
Q

How can distribution of a drug be altered?

A

the distribution of a drug can be altered by other drugs that compete for binding sites on plasma proteins

28
Q

Give an example of the distribution of a drug being altered

A

highly protein-bound drugs can be displaced from binding sites on albumin , leading to INCREASED DRUG CONCENTRATION IN THE BLOOF

29
Q

Excretion of drugs by the kidney can be changed by…

A

drugs that reduce renal blood flow OR inhibit renal transport mechanisms

30
Q

Give a specific example of excretion interactions

A

drugs that alter the pH of the urine can alter the ionization state of drugs that are weak acids or bases, leading to changes in renal tubular reaborption

31
Q

most pharmacokinetic drug interactions occur during….

A

metabolism

32
Q

what is metabolism?

A

the process of converting a drug into a form that can be excreted

33
Q

in which 2 organs do enzyme-catalyzed metabolism reactions happen?

A

the liver and the intestines

34
Q

the SUBSTRATE is…

A

the drug that is subject to the reaction

35
Q

what is the name of the liver enzymes that metabolize most drugs?

A

cytochrome P450 isoenzymes

36
Q

How many CYP enzymes are there?
how many of them metabolize most drugs?

A

50
5

37
Q

which CYP metabolizes ~34% of all CYP 450 isoenzymes?

A

CYP 3A4

38
Q

What do enzyme inducers do?

A

DECREASE THE CONCENTRATION OF SUBSTRATE DRUGS, which in turn, RAISES ENZYME ACTIVITY

39
Q

if someone has a slow metabolism, will they have more or less drug in their body compared to the average person?

A

more drug in the body

40
Q

if someone has a fast metabolism, will they have more or less drug in their body compared to the average person?

A

LESS drug in their body

41
Q

what do enzyme inhibitors do

A

enzyme inhibitors INCREASE concentration of the substrate drugs which causes LESS functional enzymes and a DECREASE in the rate of drug metabolism

42
Q

sometimes, inhibitors are used to….

A

PURPOSELY BLOCK DRUG METABOLISM

43
Q

What is pharmacodynamics

A

the effect a drug has on some organism (the human body)

44
Q

what are 3 pharmacodynamic interactions?

A

antagonism
additive effectives
synergism
potentiation

45
Q

what is the pharmacodynamic interaction of antagonism?

A

interactions based on OPPOSING effects or actions

46
Q

What is the pharmacodynamic interactions of additive effects

A

the algebraic summing of the effects of 2 drugs
(1+1 = 2)

47
Q

What is the pharmacodynamic interaction of synergism?

A

when the result of an interaction is GREATER THAN THE SUM of the drugs used alone

(1+1=5)

48
Q

what is the pharmacodynamic interaction of potentiation?

A

when one drug’s effect is increased by another agent that has no such effect

49
Q

categorize the following pharmacodynamic interaction….

warfarin and aspirin causes an increased risk of bleeding

A

additive

50
Q

categorize the following pharmacodynamic interaction….

Beta agonists (asthma) and beta blockers (cardiovascular) together cause potential for decreased efficacy of beta agonists

A

antagonism

51
Q

categorize the following pharmacodynamic interaction….
sulfamethoxazole + trimethoprom when taken together, the effects of both antibiotics increase

A

synergism

52
Q

categorize the following pharmacodynamic interaction…..

Amoxicillin works as an antibiotic; clavulanic acid helps overcome antibiotic resistance

A

potentiation

53
Q

Besides drugs themselves, what else can result in drug interactions

A

herbal products/supplements/vitamins

alcohol and smoking can increase/decrease levels and effects of medications

54
Q
A

Pharmaceutical Care Midterm (5 decks)

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