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Pharmacology > Week 2:over the counter/problematic drugs > Flashcards

Week 2:over the counter/problematic drugs Flashcards

1
Q

Pregnancy: Pharmacokinetics

A
  1. 1st trimester is the period of greatest danger for drug-induced developmental defects
  2. Drugs cross the placenta by diffusion
  3. Last Trimester the greatest percentage of drugs are absorbed by the fetus
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2
Q

Category A for pregnancy

A

Studies indicate no risk to the human fetus

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3
Q

Category B for pregnancy

A

Studies indicate no risk to animal fetus, information for human fetus not available

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4
Q

Category C for pregnancy

A

Adverse effects reported in animal fetus but no information in humans

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5
Q

Category D for pregnancy

A

Possible fetal risk in humans reported; however consideration of potential benefit versus risk may in selected cases warrant use of the drugs in pregnant women

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6
Q

Category X for pregnancy

A

Fetal abnormalities reported and positive evidence of fetal risk in humans available from animal or human studies or both

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7
Q

Drug therapy effects and Lifespan Considerations:

A

Pregnancy

Breastfeeding

Children

Older Adults

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8
Q

Classification of younger than 38 w

A

Premature or pre term infant

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9
Q

classification of a younger than one month

A

Neonate or newborn

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10
Q

Classification of 1 month to 1 year old

A

Infant

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11
Q

Classification of 1 year to 12 years old

A

Child

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12
Q

Considerations for Children: Absoprtion

A

Gastric Ph less acidic and slow gastric emptying

Liver immaturely reduces first pass elimination

Intramuscular absorption faster and irregular

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13
Q

Considerations for Children: Metabolism

A

Liver is immature it doesn’t produce enough microsomal enzymes

Older children may have increased metabolism requiring a higher does than infants

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14
Q

Considerations of Children: Excretion

A

Kidney immaturity affects glomerular filtration rate and tubular secretion

Decreased perfusion rate of the kidneys may reduce excretion of drugs

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15
Q

Factors Affecting Drug Dosages for Children

A
  1. Skin in thin and permeable
  2. Stomach lacks acid to kill bacteria
  3. Lungs have weak mucus barrier
  4. Body temp are less regulated and dehydration occurs easily
  5. Liver and Kidneys are immature, impairing drug metabolism and excretion
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16
Q

Children Considerations: Distribution

A

The younger the reason the greater the percentage of total body water

Greater body water means fat content is lower

Protein binding is decreased

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17
Q

Dosage Calculation for Children

A

Body weight dosage calculations

  • use milligrams per kilogram of body weight
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18
Q

The Older Adult

A

Over 65

Use of OTC

Increased Chronic Illness

Polypharmcy

Increased risk of adverse drug reactions

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19
Q

Cardiovascular System in Older Adults

A

Decreased cardiac output = decreased absorption and distribution

Decreased blood flow = decreased absorption and distribution

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20
Q

GI in Older Adults

A

Increased PH (alkaline gastric secretions) = altered absorption

Decreased peristalsis = delayed gastric emptying

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21
Q

Liver in Older Adults

A

Decreased enzyme production = decreased metabolism

Decreased blood flow = Decreased metabolism

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22
Q

Kidneys In Older Adults

A

Decreased Function = decreased excretion

Decreased globular filtration rate = decreased excretion

Decreased blood flow = decreased excretion

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23
Q

The older adults: Absoprtion

A

Gastric Ph less acidic and slowed gastric emptying

Reduced blood flow to GI tract and reduced absorptive surface area due to flattened intestinal villi

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24
Q

The Older Adults: Distribution

A

Decreased proteins by liver, decreasing protein binding of drugs and increased circulation of free drugs
= Faster distribution

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25
The Older Adult: Metabolism
Aging liver produces fewer microsomal enzymes Blood flow to liver is reduced
26
The Older Adult: Excretion
Decreased glomular filtration rate Decreased number of intact nephrons
27
Drugs to avoid if older adults have Bladder Flow Obstruction
Antihistamines Antidepressants Decongestants Anticholinergics
28
Drugs to avoid if older adults have Chronic Constipation
Calcium Channel Blockers Antidepressants Anticholinergics
29
Drugs to avoid if older adults have Chronic Obstructive Pulmonary Disease
Sedatives Narcotics B-Blockers
30
Drugs to avoid if older adults have Clotting Disorders
NSAIDS Aspirin Anti platelet drugs
31
Drugs to avoid if older adults have Depression
Anti hypertensives
32
Drugs to avoid if older adults have Heart Failure and Hypertension
Sodium Decongestants Amphetamines OTC cold products
33
Drugs to avoid if older adults have Insomina
Decongestants Bronchodilators MAO Inhibitors
34
Drugs to avoid if older adults have Parkinson's Disease
Antipsychotics Phenothiazines
35
Drugs to avoid if older adults have Syncope
Sedatives Hypnotics Narcotics CNS depressants Muscle Relaxants Anti hypertensives
36
What does the Health Protection Branch do?
Regulates the sale and use of foods, drugs, cosmetics and medical devices Administers and enforces the Food and Drugs Act
37
Controlled Drugs and Substances Act
Passed in 1997 replacing the Narcotic Control Act of 1952 and changing parts 3 and 4 of the food and drugs act Prohibits possession, possession for the purpose of illegal trading, importing and exporting
38
Controlled Drugs and Substances Act Schedule 1
Opium Heroin Morphine Cocaine Methamphetamine
39
Controlled Drugs and Substances Act Schedule 2
Cannabis related drugs
40
Controlled Drugs and Substances Act Schedule 3
Amphetamines LSD
41
Controlled Drugs and Substances Act Schedule 4
Barbiturates Anabolic Steroids
42
Controlled Drugs and Substances Act Schedule 5 and 6
Precursors required to produce controlled substances
43
Controlled Drugs and Substances Act Schedules 7 and 8
Amounts of cannabis and cannabis resin required for charge and sentencing purposes
44
What Schedule is the worst in the Controlled Drugs and Substances Act
Schedule 1
45
New Drug Development
Investigational New Drug Application is needed to prove drug safety and efficacy Submit drug name: chemical, generic and trade name Informed consent is needed before procedures can be performed in a research study
46
Health Canada Drug Approval Process
Preclinical Investigational drug studies 4 Clinical phases of drug studies Priority review process
47
Legal and Ethical Principals
Autonomy Beneficence Confidentiality Justice Non Maleficence Veracity (Tell the truth)
48
Ethnic Cultural Influences
Drug Polymorphism Adherence to Therapy Environmental Considerations Genetic Factors Varying Responses to specific drugs Changing National Demographics Influence of Ethnicity and Genetics
49
Ethnic Cultural Assessment
Past uses of medicine Use of over the counter drugs Use of natural health products Responsiveness to medical treatment Religious practices and beliefs Dietary Habits
50
What is OTC?
Medicine that is legally available to the consumer without a prescription
51
What is Complimentary Medicine
Used in conjunction with Western Medicine
52
Criteria for OTC meds:
Indications for use: the consumer must be able to diagnose Condition and monitor effectiveness Safety Profile: The drug should have limited drug interaction info Low Potential Misuse Favourable Adverse Event Profile Practicality: Easy to use and easy to monitor
53
What is Iatrogenic Effects?
Unintentional effects caused by action of physician or health care provider
54
What's a Mineral?
An inorganic substance that is ingested and attaches to enzymes and other organic molecules
55
Fat Soluble Vitamins
A D E K
56
Water Soluble Vitamins
B | C
57
What's a Vitamin?
An organic compound essential in small quantities for normal physiological and metabolic functions of the body
58
Vit B1
Thiamin - yeast, liver, whole grain products, beans
59
Vit B2
Riboflavin - meat, dairy products, eggs, nuts
60
Most important B vitamins?
B1 B6 B12
61
Vit B3
Niacin- liver, turkey, tuna, peanuts, beans
62
Vit B5
Pantothenic Acid
63
Vit B 6
Pyroxidine - meat, organ meats, poultry, fish
64
Indications for Vit D
Hypocalcaemia Rickets Hyperparathyroidism
65
Indications for Vit K?
Hemorrhagic disease in newborn
66
Indications for Vit B12
Long standing infection Hepatic Disease Alcoholism Malignancy
67
Indications for Vit B6
People taking oral contraceptives, isoniazid, hydralazine
68
Indications for Vit B12
Anemia
69
Action of Vit D
Regulate and absorb Calcium. Help with parathyroid and calcitonin production Calcification of normal bones
70
What vitamin isn't stored in the body
Vit K intestional flora makes it
71
What Vitamin is a coenzyme and can't absorb on its own?
Vit B12 Required for Nucleoprotein Maintenance of normal erythropoisesis *Absorption needs intrinsic factor or gastric intrinsic factor. Intrinsic factor is a glycoprotein produced by the partial cells of the stomach. Vit B12 is then absorbed by the small intestine.
72
3 Main Minerals
Calcium Magnesium Phosphorus
73
4 Types of Substance Abuse Dependance:
Physical Dependance Psychological Dependance Habituation Addiction
74
Commonly Abused Substances
Opioids Depressants Alcohol Nicotine Stimulants
75
Opioids
Also known as narcotics Used because they cause euphoria
76
Natural Opiates
Heroin Opium
77
What are natural opiates?
Codeine Morphine
78
Opiate Mechanism of Action
Block receptors in the CNS and block pain perception There are 3 main types of receptors where opioids bind
79
Areas Opiods affect outside of the CNS?
Skin GI Genitourinary
80
Indications of Opioids?
Relieve pain Reduce cough Relieve diarrhea Induce anaesthesia
81
3 ways heroin can be taken?
Injected Sniffed Smoked
82
Opioid Drug Withdrawal duration and signs
Peak period: 1-3 days Duration: 5-7 days Signs: drug seeking, elevated blood pressure, diarrhea, lacrimation , mydriasis, rhinorrhea, diaphoreisis, muscle cramps, vomiting, anxiety
83
Drugs for Opioid Withdrawal
Opioid antagonist Patient should be free from Opiods for 1 week before using meds These drugs block Opiod receptors so that the euphoria isn't produced Cloned one substitutions and methadone
84
2 Types of Amphetamine Stimulants
1. Methamphetamine: Comes in pill, powder or crystallized (meth) forms Smoking it is more powerful 2. MDA
85
Cocaine Mechanism of Action
Work by releasing biogenic amines from its storage site in nerve terminals Primary biogenic amine released is norepinephrine. Main effect on CVS
86
Withdrawal of Cocaine Signs and Symptoms
Peak: 1-3 days Social withdrawal, psychomotor retardation, suicidal thoughts, depression, paranoid Death may occur during intoxication or withdrawal
87
Depressant Withdrawal Peak Period
Short-Acting Drugs: 2-4 days Long -Acting Drugs: 4-7 days
88
Depressant Withdrawal Duration
Short-Acting Drugs: 4-7 days Long-Acting Drugs: 7-12 days
89
What are Depressants?
Relieve anxiety, irritability and tension Benzodiazepine: "Date rape drug" Used to enhance a heroin high or to ease the coming down of a Occitan high Produces disinhibition and amnesia when used with Alcohol
90
Signs and Symptoms of Depressant Withdrawal
Muscular weakness, delirium, convulsions, tremors, anxiety, depression, suicidal thoughts etc.
91
What do you take if you overdose on Depressants?
Flumazenil
92
Alcohol/Ethanol (ETOH)
CNS Depression Respiratory Stimulation or depression Diuretic effects Vasodilation, producing warm flushed skin
93
Chronic Alcoholism Problems
Vitamin Def especially Vitamin B Seizures Cirrhosis Polyneuritis Wernicke's Encephalopathy Korsakoff's Psychosis Nicotinic Acid Deficiency Encephalopathy
94
Fetal Alcohol Syndrome Signs and Symptoms
Craniofacial Abnormalities CNS Dysfunction Pre and postnatal growth retardation
95
Mild Alcohol Withdrawal S & S
Insomnia Tremors Agitation Temp greater than 37.7 Pulse greater than 110 beats
96
Moderate Withdrawal Alcohol S&S
Temperate 37.7 to 38.3 Tremors, insomnia, agitation Pulse 110 to 140 BPM
97
Drugs to help with Alcohol withdrawal symptoms
Diazepam (Valium) Lorazepam (Ativan)
98
What's the drug for helping aid smoking cessation?
Bupropion (Zyban)

Pharmacology (6 decks)

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