255 pathopharm

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255 pathopharm
2013-08-29 20:00:21
255 pathopharm

255 pathopharm
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  1. orphan drugs =
    • drugs that show promise but no one wants to work on drug
    • there are incentives given to provide finacial incentives
  2. orphan drug act of 1983 =
    provided financial incentives for drug companies to adopt and develop these drugs
  3. Legend drugs are
    prescription drugs
  4. OTC
    • deemed safe when used as directed
    • some OTC were grandfathered in prior to current testing
  5. big thing about alternative therapy drugs is
    • they are not tested by FDA
    • interactions may occur
  6. problems with OTC
    • may mask S&S of underlying issues
    • drug interactions
    • can be taken in greater than recommended dose
  7. generic name is always
    lower case
  8. Brand names are always
    Upper case
  9. who is last person in link of medication admin
  10. enteral meds =
    • oral medications
    • NG
    • G tube
  11. buccal med route
  12. sublingual med admin route
    under tongue
  13. parenteral med route =
    • IV
    • IM
    • Intrdermal
    • subcutaneous
  14. slowest to fastest enteral med admin
    • XR, XL = extended release
    • enteric coated tablet
    • tablet
    • capsule
    • liquid
  15. enteric coated tablet given when
    when passes up through stomach to be absorbed in small intestine
  16. ODT tablet  =
    orally disintegrating tablets
  17. In regards to drug absorption rate which is most important
    blood flow
  18. asthma inhaler is example of what type of drug route admin
  19. pharmacokinetics =
    how the body acts on the drug

    what the body does to drug
  20. pharmacodynamics
    how the drug effects the body
  21. pharmacokinetics involves the processes of
    • absorption
    • distribution
    • metabolism (biotransformation)
    • excretion
  22. what do you need to absorb a drug
    absorption of drug
  23. major organ of drug metabolism =
  24. major organ of drug excretion =
  25. absorption =
    moving drug from site of admin to blood
  26. what types of drugs are more likely to enter cell
    • small particles
    • non ionized
    • lipophilic
  27. enteral meds affected by
    • food and drugs in stomach - especially fatty foods
    • acidity of stomach
    • blood flow to GI tract
  28. antiacids shouldnt be taken within
    2 hours of other meds
  29. ileus =
    intestinal blockage
  30. First Pass Effect =
    liver metabolizes part of the drug before it reaches the target tissue
  31. high first pass effect
    • drug doesn't reach tissue in large quantities
    • may need higher dose
    • cannot be given by oral admin if first pass effect is too large
  32. IM works faster in who compared to
    men VS women due to more vascular muscles in men than women
  33. what will increase absorption of drug
    • anything that increases blood flow
    • temp increase
  34. PR route of drug admin =
    • perirectal
    • rectal
  35. food and smoking does what to sublingual and buccal meds
    slows absorption
  36. Distribution =
    • drug transport throughout body
    • movement of the drug to the body's tissue
  37. intratheccal =
    into spinal column
  38. benzodiazepines are stored where
    in adipose tissue
  39. bound drug =
    drug in the blood stream bound to a protein
  40. low protein levels can cause
    increase for drug toxicity due to less bound drug
  41. protein binding increases what
    the length of drug action because as level of drug in blood stream goes down more drug is unbound from protein
  42. increased risk of toxicity related to protein binding is
    elderly and low albumin levels
  43. cytochrome P450 =
    enzyme system in the liver that is responsible for most of the metabolism of drugs
  44. liver disfunction can lead to
    • accumulation of drugs
    • increased risk for drug toxicity
  45. what do you test for liver function
    • AST
    • ALT
    • if it is elevated = increased risk for toxicity and liver is not function as it should
  46. if pt has elevated AST and ALT tests what process of drug interaction
    • metabolism
    • increases risk for drug toxicity
  47. autoinduction =
    drug speeds up liver metabolism
  48. prodrug =
    drug has to be metabolised before you get to the active ingredient in drug
  49. BUN and Creatinine =
    kidney function
  50. what is test that is most important to determine kidney function
  51. elevated BUN and creatinine can show
    decreased kidney function
  52. therapeutic drug monitoring =
    monitoring plasma levle sof drugs with low safety margin
  53. minimum effective concentration  =
    amount of drug required to produce a therapeutic effect
  54. therapeutic range =
    range of plasma concentration of drug that produces a therapeutic effect
  55. INR shows what
    the level of anticoagulation in blood
  56. high INR =
    blood is more anticoagulated
  57. toxic concentration =
    plasma concentration of drug that leads to toxic effects
  58. pharmokinetic processes give you what
    • onset
    • peak action
    • excretion
  59. half-life is
    time it takes for 1/2 of drug to be eliminated from body
  60. higher half life =
    longer it takes to eliminate and longer onset of action
  61. half life is affected by what
    absorption, distribution, metabolism, and excretion
  62. half life assists in
    • determination of dosing schedules
    • longer half life = give drug less often
  63. maintenance dose =
    dose required to keep the drug in the therapeutic range
  64. loading dose =
    a higher dose that usually is used for treatment. used for drugs that take longer to reach min effective concentration

    once loading dose given then you start maintenance dose
  65. dynamic equilibrum =
    • steady state
    • when the amount of drug absorbed equals the amount excreted the steady state is acheived
    • this is when drug stays in the therapeutic range
  66. pharmacodynamics
    what drug does to body
  67. medican effective dose =
    the dose required to produce a therapeutic effect in 50% of a group of patients
  68. potency =
    • strength of a drug at a certain concentration or dose
    • more potent drug = lower dose needed to achieve the effect
  69. efficacy =
    • greatest maximal response that can be produced from a particular drug
    • drug has higher efficacy if it causes a more significant therapeutic response
  70. agonist =
    causes the same activity that natural chemicals would cause at the site

    ie beta recpetor causes increased heart rate so a beta one agonist causes increased heart rate
  71. antagonist =
    • has opposite effect of agonist
    • causes the opposite response of natural chemicals or competes with other drugs for the same receptors
    • NARCAN is a narcotic antiagonist
  72. partial agonist =
    casues an agonist response but weaker

    ie partial agonist narcotic = decreases pain but not as much as agonist narcotic
  73. lock and key theory of drug interaction =
    drug locks onto receptor site and has agonist or antiagonist effect
  74. drug enzyme interaction =
    drugs can interfere with enzyme systems in the body to change function
  75. selective toxicity =
    when a drug attacks only foreign cells and not healthy cells
  76. factors influencing drug effects
    • weight
    • age
    • gender
    • physiological factors (dehydration)
    • pathological factors (kidney and liver dysfunction)
    • genetic
    • immunological
    • psychological (placebo effect)
    • environmental
    • drug tolerance
    • cumulative effect
  77. Pharmacogenomics =
    study of genetic factor influencing drugs effects on the body
  78. side effect vs adverse effect =
    adverse effect is worse/more serious than side effect
  79. idiosyncratic reactions =
    • adverse drug effect that produces an unusual and unexpected response
    • "can't be explained"
  80. black box warning
    warning on some drugs about serious adverse effect
  81. phototoxicity =
    skin absorbs excess ultraviolet radiation from sun or heat lamps
  82. hypersensitivity =
    increased immune response
  83. angioedema =
    swelling of dermis, periorbital area, can close airway
  84. steven johnsons syndrome =
    sever blistering of the skin with membrane involvement and fever
  85. stomatitis=
    inflammation of the mucous membranes
  86. superinfections
    when normal flora is killed and bad microbes are no longer suppressed
  87. blood dyscrasia
    decreased blood cell counts
  88. assessment of liver toxicity =
    elevated AST ALT, RUQ pain, jaundice
  89. kidney toxicity assessment
    • change in urine pattern
    • elevated BUN creatinine
  90. rhabdomyolysis=
    extensive muscle necrosis with release of enzymes from the muscles
  91. pathophysiology =
    the study of altered health
  92. etiology
    the cause of something
  93. risk factors
    things that increase your chances to acquire disease
  94. sign vs symptom
    • sign = objective
    • symptom = subjective
  95. syndrome =
    cluster of signs and symptoms
  96. complication
    adverse effect
  97. sequelae =
    impairment that follows or is caused by a disease
  98. pharmacology =
    study of drugs
  99. pharmacotherapeutics =
    the application of drug for the purpose of disease prevention and treatment of suffering
  100. therapeutic effect =
    positive effects of drugs
  101. Adverse effects
    negative effects of drugs
  102. Indication =
    why a drug is given
  103. protype =
    agent to which all other drugs in the classification are compared
  104. combination drugs
    • drugs with more that one active ingredient
    • ie aspirin, acetaminophen
  105. drugs have 3 names
    • chemical
    • generic
    • Brand
  106. a brand name drug is
    a drug produced by a specific company
  107. a generic drug is a drug that
    is produced by many different companies
  108. bioavailability of a drug =
    rate and extent of drug available to patient to effect the tissue
  109. when should a generic drug be given
    when it is available
  110. "dispense as written"means
    the pharmacy must fill brand name drug that DR write for
  111. theraputic index -
    difference between toxic level and minimum effective concentration level

    tested by peak and trough
  112. Pure food and drug act of 1906 =
    • required proper labeling
    • drug label reflected the contents
  113. Federal Food, Drug and Cosmetic Act of 1938 = `
    prevented the sale of drugs that had not been thoroughly tested for safety prior to marketing
  114. Durham-Humphrey Amendment 1951=
    designated prescription and OTC drugs
  115. Kefauver-HArris Act 1962
    MAnufacturers had to prove drugs were effective and safe
  116. Pregnancy categories
    • A-D and X
    • no demonstrate risk- adverse reactions/abnormalities in fetus
  117. teratogenic effects of drug
    how a drug effects a fetus
  118. Preg category A =
    no demonstrated risk
  119. Preg. Category B =
    animal studies = no risk no sifficient evidence in human studies
  120. preg cateegory C
    animal studies show risk but no human, use may be acceptable despite potential risk
  121. Preg. Catergory D =
    evidence of potential risk but benefit may outweigh risk
  122. Controlled Substances Act of 1970 =
    define drug abuse and classified drugs according to abuse potential defined control of distribution, storage, dispensing and use imposes restriction and penalties for failure to comply
  123. Schedule 1
  124. lower schedule number =
    the more likely abuse potential