#5 Flashcards
Can drug effects vary person to person?
Absolutely! at a given dose, highly variable concentrations reached in plasma of different people. At a given dose, the plasma live might be sub-therapeutic in some people, yet enough to cause side effects in others.
What factors influence drug effects? (8)
- Body weight and composition
- Age (pediatric or geriatric patients)
- Sex of patient (dose adjustment with women)
- Pregnancy and lactation (Alteration in liver function, transfer to breast milk)
- Environmental factors (temp, altitude, sunlight, diet)
- Physiological factors (pH, circadian rhythms)
- Pathological conditions (disturbances in blood and circulation)
- Genetic factors
_________ is responsible for the metabolism of 60% of all drugs.
CYP3A4
*Grapefruit juice reduces the expression of CYP3A4!
True or false, bacteria in the gut can have significant effect on pharmacokinetics of a drug.
True! can also really vary in different people
______ is decreased responsiveness to drug upon repeated or continuous administration.
Tolerance
_______ is when the effective drug concentration is diminished.
Pharmacokinetic tolerance
_______ is when the response is diminished.
Pharmacodynamic tolerance
_________ is a rapid loss of response after drug administration.
Tachyphylaxis
What is sensitization?
Effect of drug is physiologically compounded? (documented in a few CNS drugs)
What are Idiosyncratic Reactions?
Effects that occur rarely and unpredictably in a small amount of the population/
*Ex: Procaine toxticicty due to low serum cholinesterase levels
______% of all adverse drug effects are due to drug allergies.
10
What are pseudo-allergies?
Mimic effects of allergy downstream (Aspirin, ibuprofen, opioids, anesthetics)
What is carcinogenesis?
some drugs can cause cancer
What are the 5 categories of drugs regarding use on pregnant women?
A) Studies failed to show risk in 1st trimester, no evidence of problem later.
B) Same as A, but Showed risk in animal studies OR human studies lacking, but animal studies failed to show risk.
C) No adequate human studies and animal studies are either lacking or have adverse effect on fetus (benefits MAY warrant use during pregnancy)
D) Positive evidence of fetal risk, but benefits MAY warrant use.
X) Studies in humans or animals have shown fetal abnormalities, or there is positive evidence of human fetal risk or both. The potential risk of the drug to the fetus clearly outweighs the potential benefit.
Examples of Type A drug?
sodium fluoride
Levothyroxine
