final pathophys/pharm - general
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Science of drugs including their orientation, composition, pharmacokinetics, therapeutic use, and toxicology
Chemical that affects the psychological process of living organism
Generic name =
nonproprietary; given by US gov
4 sources of drugs
- 1. Plants
- 2. Animals and Humans
- 3. Minerals
- 4. Chemical substance
1906 Federal Pure Food and Drug Act
drug manufacture must list dangerous and addictive substances
Five Rights of medication administration
- 1. drug
- 2. time
- 3. patient
- 4. route
- 5. dose
- 6. documentation
1912 Sherley Admendment:
Prohibit fraudulant claims - can't say it does something it doesn't
1914 Harrison Narcotic Act:
legal term narcotic; regulate addictive substances
Drug therapy in elderly
- increased sensitivity due to
- physiological changes
- admin problems
What is the main job immune system:
recognize foreign substances and determine they are "non-self"
What is key to the immune response?
What is the primary cell of immune system?
Key to immmune response= Lymphoid Organs!!
Primary cell = Lymphocytes
What are the primary first responders in Inflammatory response?
Bodies 1st, 2nd, & 3rd LINE OF DEFENSE
immunity- skin, mucous membrane, chemical barriers (earwax, fatty acids, tears)
- Second= Inflammatory response- local response to tissue injury; WBCs; neutrophils first... rapid, non-specific
- Third= Specific immunity, slow- memory, cell-mediated: T lymphocytes, Humoral: B Lymphocytes (can be indirect)
- Facilitator of humoral response.
- "Cascade-like" process
a class of immunoglobulins including antibodies that function especially in allergic reactions
What are antibiotics?
Used to treat bacteria only!
Well known infections caused by bacteria include:
TB, Salmonella, syphillis, and some forms of meningitis
4 common mechanism of action for antibiotics
- 1. Interfere with cell-wall synthesis
- 2. Interfere with protein synthesis
- 3. Interfere with DNA and RNA replication
- 4. Disruption of metabolic reactions w/n cell
Three general uses of antibiotic therapy:
- 1. Empiric- treat before bac known (haven't tested yet)
- 2. Definitive- bacteria is known, specific drug to kill it
- 3. Prophylactic- used to prevent
bacteriocidal-- kills offending bacteria
How do antibiotics become resistant?
bacterial genes mutate
Penicillins and Cephalosporins:
Antibiotic works by inhibition of cell wall synthesis.
- Broad spectrum antibiotic
- Interferes with protein synthesis
- Most common side effect is stomatitis
- first totally "man-made" antibiotic
- cannot kill bac, stops from growing
- often used in combination with others
- Work by disrupting fungal cells protein making machinery
- - Tends to affect immunocompromised ppl
Systemic drug therapy:
goes through the whole system - not localized like nasal spray
Normal platelet range:
- 150,000- 400,000
platelet count less than 100,000
-increased susceptibility to bleeding
platelet count greater than 400,000
- hypercoaguability (blood is thickened) , can cause clots .
Leukemia: uncontrolled increase in leukocytes
Normal WBC= 4.5-10.5
Types: ALL, CLL, AML, CML
- Acute lymphocytic leukemia- Child
- Chronic Lymphocytic leukemia- Elderly men
- Acute myelogenous leukemia- adults
- Chronic myelogenous leukemia- adults
2 most common causes of death in cancer patients:
- 1. Infections
- 2. Hemorrhage
What is anemia and what are some causes?
- to few RBC. (less than 3.6 in women and 4.2 in men)
- a symptom more than a disease need to find out why
Causes: excessive blood loss, RBC destruction, decreased RBC production, bone marrow failure,
- Grow slowly in a well defined capsule.
- Well-differentiated (resemble origin)
- Non invasive and do not metastasize
- Reoccurence is rare and only fatal if left untreated
- Grow rapidly
- Non-incapsulated so able to invade and spread (metastasize)
- Poorly differentiated- looks nothing like tissue origin
- Almost always fatal
Seven Warning Signs of Cancer
- Change in bowel or bladder
- A sore that won't heal
- Unusual bleeding or discharge
- Thickening or lumps
- Obvious change in mole
- Nagging cough or hoarsness
- I = Well differentiated (look like origin)
- II = Moderately differentiated (less resemblance)
- III= Poorly Differentiated (minimal resemblance)
- IV= Very Poorly Differentiated ( NO resemblance to origin)
What is chemotherapy and what is the goal?
- Drugs to treat cancer. Non-specific (effects all cells in body).
- Goal = Kill rapidly mulitplying cells.
What is radiation therapy?
Kill cancer in TARGET cells by damaging DNA.
What is the goal of Immunotherapy and what is an example of this?
- Goal is for the body to develop specific immune response to cancer cells.
- An example is interferon--> Similar to a VACCINE
- NSAIDS: Ibuprofen and NSAIDS: anti-inflammatory, pain and fever reducer, (Aspirin antiplatelet)
Morphine- Opiate Analgesic
- ~Schedule II
- ~Esp effective againts cont. dull chronic pain
- ~Binds with Mu and Kappa in CNS and alters perception of pain
- ~SE: veritgo, faint, lighthead, fatigue, SLEEP, N&V, ^sweat, constipation, hypotension, dry mouth, HA, ab cramp, nervous, confused, low UO, visual disturbances
Schedule 1 drug =
HIGH potential for abuse
Schedule V drug=
LOW potential for abuse
Sedative versus Hypnotic
Sedative - produce calming effect -- reduce nervousness, excitability, irritability
Hypnotic - induce sleep
Major difference is degree of CNS depression produced
- Restoril- 1-2 before HS
- Halicon- also for psyc dist. !
- Dalmane- accumulation, "Hangover"
- Dripivan- Only IV -- Best with ventilated ICU patient
Sympathetic Nervous System
- Autonomic nervous system preparing the body to react to situations of stress or emergency
- "Fight or Flight"
3 Naturally occuring catecholamines:
- 1. Dopamine (intropin)- precurser of epi and norepi
- 2. Epinephrine (adrenaline)- principal blood-pressure-raising hormone also used medicinally as a heart stimulant, vasoconstrictor, & bronchodilator.
- 3. Norepinephrine (Levophed) - precurser of epi
What is a seizure?
- Sudden, excessive and disorderly discharge of cerebral neurons with alterations in brain function and LOC.
- Symptom of an underlying disorder.
Types of seizures
- Epilepsy: recurrent seizures - cause not determines
- Grand Mal Seizure: most common "gen. tonic-clonic"
- Partial: brief alteration in brain function
Phases of Grand Mal =
- 1. Aura - sense of impending seizure
- 2. Tonic - muslce contration w. ^ tone
- 3. Clonic - alt contraction w. relax muscles
- 4. Postical - disoriented, amnesia
- Stabilize cell membrane by altering Na, K, and Ca transport.
- Dilatin and Tegretol - stabilize cell excitability
- Barbituates (Luminal) - inhibit spread of rep. neuron firing
Chronic Neuromuscular disorders.
- Parkinson's: Tremors caused by Deficient Dopamine
- Multiple Sclerosis: Painful inflammation caused by demylination
- Myasthenia Gravis: muscle weakness w/o atrophy caused by ACH receptor destruction
- Amyotrophic Lateral Sclerosis (ALS): Muscle weakness with atrophy. May be fatal in less than a year
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