Patho & Pharmo Wk 1 Inflammation & Wound healing & Introduction to Pharmocology
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I am the study of structual and functional changes in cells, tissues and organs in response to disease states. What am I?
What does Etiology mean?
The cause of a disease
Describe the difference between CM (Clinical Manifestations) and Clinical course?
CM is the sign and symptoms that are indicative of structual and functional changes associated with disease, it can be specific or not. CC is the three catagorgies of disease, acute, subacute or chronic
What is inflammation?
Inflammation is a protective response that attempts to eliminate injurious agents or necrotic cells and tissues. Therefore destroying or neutralizing harmful agents (microbes or toxins)
When can the inflammation process be negative on the body?
Anaphylactic shock also Rheumatoid arthritis
I am a form of inflammation that reacts within minutes to a few days. What am I?
Describe the vascular changes during acute inflammation?
- Arteriolar dilation
- Increase BF (Redness)
- Increase capillary permeability
- Increase exudation of plasma into affected tissues
- Swelling (edema)
Name the time line during inflammation?
Neutrophils commence emigrating from the capilliaries with in 90 mins of injury. Monocytes commence to predominate in the 24-48hr period.
Are macrophages and nuetrophils similar?
Yes, they are both phagocytes but macrophages are much larger
Name the 8 acute inflammation mediators?
- Nitric Acid
I am a mediatior involved in the inflammation process I am similar to histamine in my function which is to vasodilate and increase permeability but my source is not mast cells or basophils. What mediator am I?
What is bradykinin?
- A. Activated during the Kinin system
- B. A part of a systemic Mediator
- C. Increases capillary permability
- D. All of the above
- E. A & B
Name hallmarks of acute inflammation?
- Redness ( Vasodilation)
- Swelling (increased capillary permeabiltiy)
- Heat (Vasodilation)
- Pain (Bradykinin, prostagladins and tissues swelling)
- Loss of function (Associated with the above)
Can chronic inflammation stem from a viral infection?
Yes, also persistant infections, chronic exposure to toxic agents or even auto-immune diseases
What is the difference between serous and fibrinous inflammation?
Serous is watery; low in protein whereas fibrinous is higher in protein and is related to severe injury and if not removed will lead to scarring
I am often referred to as an abscess which type of inflammatory pattern am I?
Supporative (purulent). I contain neutrophils, necrotic cells and fluid. Some bacteria that is pus forming (pyogenic)
I am a erosion on the epithelial surface. I am related to the inflammation process?
What is the acute-phase reaction?
When the inflammatory mediators move away from the locialised infection and enter the circulation.
What is Fever and how does it protect the body?
- It is a raise in body temperature (37)
- Fever is a systemic manifestation of inflammation.
- Growth retardation of patogens which prefer normal body temperature for optimal gowth
Name the 2 processes involved in wound healing?
- Regeneration - in the tissues by parenchymal cells
- Replacement - injured tissue with scar tissue (connective tissue)
Name the four components of fibrosis?
- Formation - growth of new blood vessels
- Migration - Proliferation of fibroblasts
- Deposition - Extracellular matrix
- Maturation - Reorganisation of the fibrous tissue
What is the difference between primary and secondary intention?
- Primary involves minimal tissue loss and the tissue edges can be brought together ie a surgical wound
- Secondary involes larger wounds and more extensive granulation tissue infiltration and scarring
Name the 3 phases of wound healing?
- Inflammatory phase - Growth factors released to stimulate epithelial cell growth. Matrix formation and Fibroblast immigration.
- Proliferative phase - Granulation tissue formation
- Remodeling phase - Occurs from 3 wks > 6mths
Name factors affecting wound healing?
- BF and O2 delivery
- Inflammation/Immune function
- Foreign body
- Wound separation
Name the definations of a drug?
Drug - A checmical that can affect the living process. Pharmocology - Pharmakos = medicine; poison Logos is the study of drugs; interactions with living systemsClinical phramocology - Study of drugs in humansPharmacotherapies - medical use of drugs
Name the 5 rights of drugs?
- Right drug
- Right patient
- Right dose
- Right route & time
What is the chemical name of drugs?
This is the long and complex name and inappropriate for clinical use.
How does a nurse encourage adherence or compliance in regard to allocated drugs?
Name the 3 ideal properties of drugs?
- Effectiveness - Produces the response for which it was given
- Safety - Does not produce harmful effects even in high doses (no drugs are safe)
- Selectivity - Only produce the response for which it was given
What does Pharmacodynamics mean?
What drugs do and how drug receptors interact (physical/chemical drug actions)
What does Pharmacokinetics mean?
- Drug movement through the body.
- Drug absorption into the blood or the lymph
- Drug distribution from blodd
- Drug metabolism and excretion
Name the 3 movements of drugs through the membranes
- Channels & pores - Sml molecules and atoms to pass therefore very few drugs use this route.
- Transport systems - Selectively transport molecules across the membrane.
- Direct Membrane Penetration - Most popular for lge drug molecules that are lipid soluble. Polar or ionic molecules are water and poor lipid soluble and therefore do not pass through membrane.
Can drugs become ionized in the body?
Yes, if they are a weak acid or weak bases but not H+. In low acidic environment weak acids ionize less (remain neutral)
Name the 4 factors that increase absorption?
- Increased lipid solubility
- Increase surface area
- Increase BF
- Increase dissolution
It is the absorption rate of a drug but there are factors that can alter the rate of disintegration.
What is the enteric-coating?
It is a waxy layer which protects the drug from gasteric acid and enzymes or protects the stomach from irritation from the drug. It is design so the drug will release in the intestine. It should not be crushed.
Can BF and exiting blood vessels impact the distribution of a drug?
Yes, the rate of drug delivery to the tissues and organs is influenced by BF. Antibotics can not reach the centre of an abscess which has not BF. Most capillary vessels are leaky, gaps between endothelial cells allow drugs to pass out except in the brain where they are tightly joined BBB
Can water soluble drugs pass through the placenta?
No, the drugs that cross over the placenta barrier are lipid soluble. Caution required during pregnancy.
It is th emetabolism / alteration of drugs. It mainly occurs in the liver cells (hepatocytes) that have a number of enzymes for this task.
How can drugs exit the body?
- Urine - This is the predominant pathway
- Breast milk
Name the 3 events in renal absorption?
- Glomerular Filtration - If the proteins are not too large and the pt is not in renal failure or low BP.
- Tubular Reabsorption - Passively reabsorb into the blood if they are lipid soluble. Water soluble drugs remain.
- Active Tubular Secretion - Some drugs can be pumped from the blood into the filtrate.
I am a response that is linked to the amount of drug in th eplasma to establish appropriate drug dosage scheduales. The amt of drug in the blood is related to how much the drug is at sight of action. What is my name?
What does MEC, TC, TI & TR stand for?
- MEC = Minimum effective concentration
- TC = Toxic concentration
- TI = Therapeutic Index
- TR = Therapeutic Range
I am involved in the absorption process. The shorter I am it increases the dosing frequency. What is my name?
What is the difference between ED & LD?
ED is effective dose and LD is lethal dose (50% of experimental animals are killed at this point)
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