19. Pharmacology - Intro Flashcards
Characteristics of allopathic therapies
Treats symptoms Symptom care Suppresses symptoms Toxic Invasive Adverse effects/aggravations can be severe and permanent
Examples of allopathic therapies
Drugs Surgery X-rays Radiation Chemicals
Characteristics of natural therapies
Treats whole person Patient care Corrects vital force of body Non-toxic Non-invasive Aggravations/healing crisis (not life threatening)
Examples of natural therapies
Nutrition Herbs Essences Oils Physical therapies
What is suppression?
Disappearance of an illness without having healed it
What can suppression cause?
The disease to go deeper into the body
It can reappear in another form
Adverse effects
Reoccurrence
Examples of suppressive treatments
NSAIDs Steroids Analgesics Anti-hypertensive medication Chemo Radiation
Classifications of drugs
Anti-microbial Anti-inflammatory Analgesic Anti-convulsant Anti-cancer
Naming conventions for drugs
Proprietary/Brand/Trade name e.g. Anadin, Nurofen
Generic name e.g. paracetamol
Chemical name e.g. N-acetyl-para-aminophenol
What is indication?
Approved uses of disease for which the drug has been proved effective
What is contraindication?
Circumstances under which the drug shouldn’t be taken
Should aspirin be taken by asthmatics?
No
What is ‘adverse effects’?
Additional effect on the body even at the recommended dose e.g. drowsiness
If a patient is experiencing adverse effects from a drug, what should you do?
Refer back to GP
Classifications of adverse effects
Predictable
Unpredictable
What are predictable adverse effects?
Exaggerated physiological effect
Toxicity
What are unpredictable adverse effects?
Allergy
Idiosyncratic reaction
Adverse effects of statins
Reduced CoQ10 levels leading to: Muscle pain Liver dysfunction Renal failure Cataracts
What is CoQ10?
Powerful antioxidant found in mitochondria
More concentrated in cells that are more active
Examples of hypersensitivity adverse effects
Penicillin - nausea, vomiting, pruritus, hives
Local anaesthetics
What is an idiosyncratic reaction?
Reaction to a substance specific to the sufferer
What can cause an idiosyncratic reaction?
Enzymopathy
Disturbance in enzyme function
Example of idiosyncratic reaction
Excessive excitement in children after taking a sedative drug
Categories of drug interactions
Synergism
Antagonism
What is synergism?
Effect of drug increased
Examples of drug synergism
Painkiller combination
Some supplements e.g. fish oils and anti-coagulation medication
What is antagonism?
Effect of drug decreased
Examples of drug antagonism
Vitamin K counteracts anti-coagulants
What is an iatrogenic effect?
Induced by physician/practitioner
Why can some interactions between orthodox medications be fatal?
Some medications block liver/intestine enzyme pathways
Some affect liver detoxification
Facilitates an iatrogenic overdose
Why can grapefruit juice significantly alter drug levels in the body?
Inhibits enzyme CYP 3A4 in intestinal wall
Leads to excessive quantity of the drug
What does enzyme CYP 3A4 do?
Breaks down/metabolises hundreds of medications
Which drugs can be affected by grapefruit juice?
Statins
HRT/OCP
Anti-retrovirals
Calcium channel blockers
How long can the inhibition of CYP3A4 last?
Up to 24 hours
What impact does the lasting effects of grapefruit juice on CYP3A4 have?
Can’t separate grapefruit and drugs
Why can the consumption of alcohol significantly interact with drugs?
Alcohol can inhibit a drug’s metabolism by competing with the drug for the same set of metabolising enzymes
What can long-term alcohol ingestion have on drug interaction?
May activate drug metabolising enzymes, therefore decreasing the drug’s availability
Diminishes the drug’s effects
Can also transform some drugs into toxic chemicals that can damage the liver/other organs
What effects can alcohol have on sedative/narcotic drugs?
Magnify the inhibitory effects of the drugs in the brain
What effects can alcohol have on slow-releasing drugs?
Can force them to release faster - resulting in overdose
Can some herbs interact with drugs?
Yes
Example of St John’s Wort interacting with drugs
St John’s Wort reduces the effectiveness of anti-retroviral drugs for HIV
Examples of liquorice interacting with drugs
Digoxin - can increase adverse effects by lowering potassium levels
Interferes with ACE inhibitors and diuretics
Contraceptives - can elevate blood pressure and lower potassium
May effect breakdown of drugs in the liver
Examples of senna interacting with drugs
Can increase adverse effects of digoxin
Can cause diarrhoea if taken in high doses
Can increase the effect of warfarin
May cause dependence if taken long-term
What is pharmacokinetics?
How drugs are absorbed and moved around the body