Actions and Uses of Medicines (305) Flashcards
1
Q
What is the use of the BNF?
A
The BNF is the dispensing guide.
2
Q
Who produces the BNF?
A
The BNF is jointly produced by the British Medical Association and the Royal Pharmaceutical Society of Great Britain.
3
Q
How often is the BNF published?
A
The BNF is published twice yearly.
4
Q
What is the British Pharmaceutical Codex used for?
A
Contains the master formula of BPC products including their ingredients, actions, users and storage requirements.
5
Q
What does the British Pharmacopoeia contain?
A
Details standards of purity and strength for medical substances, products and dressings as well as products that are suitable for extemporaneous dispensing.
6
Q
What is the use of the European Pharmacopoeia?
A
The European Pharmacopoeia was created to permit the free circulation of drugs within the European community.
7
Q
What is the use of Martindale: the extra Pharmacopoeia?
A
Provides information on nomenclature, physical and pharmaceutical properties, adverse effects, actions and uses of drugs.
8
Q
How often is Martindale published?
A
Martindale is published every 3 years.
9
Q
What information is included in the Association of British Pharmaceutical Industry (APBI) Data Sheet Compendium?
A
Contains copies of the data sheets of all participating companies. Information is given on drug presentations, uses dosage, administration, contraindications, warnings and pharmaceutical precautions.
10
Q
How often is the Association of British Pharmaceutical Industry (ABPI) Data Sheet Compendium published?
A
The Association of British Pharmaceutical Industry (ABPI) Data Sheet Compendium is published annually.
11
Q
What is the use of the Monthly Index of Medical Specialties (MIMS)?
A
Can be used as a reference and a prescribing guide. It lists proprietary preparations that can be prescribed or recommended.
12
Q
How often is the Monthly Index of Medical Specialties (MIMS) published?
A
The Monthly Index of Medical Specialties (MIMS) is published monthly.
13
Q
What is the Patient Information Leaflet Compendium used for?
A
It includes copies of patient information leaflets found in proprietary medicine packs.
14
Q
How often is the Patient Information Leaflet Compendium produced?
A
The Patient Information Leaflet Compendium is produced annually.
15
Q
What is the use of the use of the Chemist and Druggists Guide to OTC Medicines?
A
Includes general advice in specific categories, including monographs detailing directions for use, cautions and costs as well as herbal and homeopathic products.
16
Q
What is another publication with similar information to the Chemist and Druggist Guide to OTC Medicines?
A
The OTC Directory contains similar information to the Chemist and Druggist Guide to OTC Medicines
17
Q
What is the use of Medicines, Ethics and Practice - a Guide for Pharmacists?
A
The Medicines, Ethics and Practice - a Guide for Pharmacists is a practical guide to the legal classification of medicinal products incorporating the ‘code of ethics’ and the ‘guide to good dispensing practice’
18
Q
How often is the Medicines, Ethics and Practice - a Guide for Pharmacists updated?
A
The Medicines, Ethics and Practice - a Guide for Pharmacists is updated twice yearly.
19
Q
How else can the BNF be accessed other than its book format?
A
Online or on the app.
20
Q
What is pharmacology?
A
Pharmacology is the study of actions and uses of medication, mechanisms and adverse effects.
21
Q
What is pharmacokinetics?
A
Pharmacokinetics is the branch of pharmacology concerned with the movement of drugs within the body and the way in which the body affects drugs with time. (absorption, distribution, metabolism, excretion)
22
Q
What is pharmacodynamics?
A
Pharmacodynamics is the branch of pharmacology concerned with the effect of drugs and the mechanism of their action.
ie how the drug affects the body.
23
Q
What is a receptor?
A
A receptor is a protein molecule with a tertiary structure with a complementary binding site to that of the molecules to which it binds. Once the receptor is attached, it activates it to have an affect on the cell.
24
Q
What is a agonist?
A
An agonist is a substance which initiates a physiological response when combined with a receptor.
25
What is an antagonist?
An antagonist is a substance that **binds to a receptor** and **blocks** it so the agonist cannot bind, **blocking or dampening** the biological response.
26
What is a partial agonist?
In pharmacology, partial agonists are drugs that **bind to and activate a given receptor** but have only **partial efficacy** at the receptor relative to the full agonist.
27
What is competition?
Drugs or other molecules that compete for the **same receptor**.
28
What is the result of a non-competitive inhibiter binding?
No pharmacological effect.
29
What will happen if a competitive inhibiter binds?
Capable of **reversing or altering** an effect already achieved.
30
What is an enzyme?
An enzyme is a **biological catalyst** that **speeds up** the rate of reaction.
31
What are ion channels?
Ion channels are the ubiquitous **transmembrane proteins** that allow the **selective transport** of ions and solutes across the plasma membrane.
32
What are the four basic processes involved in pharmokinetics?
* absorption
* distribution
* metabolism
* excretion
33
What affects the pharmokinetics of a drug?
The **make up** of a drug affects where the drug is absorbed, where it is distributed to, where and how effectively it is metabolised and how rapidly it is excreted.
34
What drugs are not absorbed by the body?
Almost all drugs apart from those that are **administered intravenously** must be absorbed before they can have effect on the body.
35
What is bioavailability?
Bioavailability is the term used to refer to the **proportion of an administered drug** that has reached the circulation and is **able to have effect** on the body.
36
What drugs are said to have 100% bioavailability?
Drugs that are **administered intravenously** are said to have 100% bioavailability.
37
Where are drugs that are administered orally absorbed?
Drugs administered orally are absorbed from the **gastro-intestinal tract**.
38
Where are drugs metabolised?
Once absorbed in the gastro-intestinal tract, the drug is carried via the **hepatic portal vein** to the **liver** to be **metabolised**.
39
What is the first-pass effect?
The **removal** of the drug by the liver **before the drug has become available for use** is termed the 'first-pass effect'.
40
Give an example of a drug that may be totally inactivated by the first-pass effect.
**Glyceryl trinitrate** is completely inactivated by the first-pass effect.
41
What transport mechanisms exist to aid the transport across lipid membranes?
* passive diffusion
* facilitated diffusion
* active transport
* pinocytosis
42
What is pinocytosis?
The ingestion of liquid **into** a cell by the budding of small vesicles from the cell membrane.
43
What is passive diffusion?
Passive diffusion is the movement of molecules **down a concentration gradient** from an area of high concentration to an area of low concentration.
44
Is energy required for diffusion?
No energy is required for diffusion.
45
What is facilitated diffusion?
Facilitated diffusion is the movement of lipid **insoluble** molecules across the phospholipid bilayer by combining with a **carrier protein**.
46
Does facilitated diffusion require energy?
Facilitated diffusion does **not require energy**. It is a passive process. The molecules are just **too large/insoluble** to move across the membrane, they are still moving **down a concentration gradient** however.
47
What is active transport?
Active transport is the movement of molecules **against their concentration gradient** using **ATP** as a source of energy. The molecules move through **transmembrane proteins** which act as **pumps**.
48
What are some factors that will affect the absorption of the drug from the GI tract?
* gut motility
* gastric emptying
* surface area
* gut pH
* blood flow
* presence of food and fluid in the GI tract
* antacids
* drug competition
49
How does the presence of food in the gut affect the rate of drug absorption?
The presence of food can **both increase and decrease** the rate of absorption of a drug depending on both the drug and the meal consumed. Fats slow the rate of gastric emptying.
50
Which form of drug is absorbed quicker, liquid or solid?
Liquid drugs are absorbed quicker than solid drugs.
51
How does parenteral administration affect the rate of absorption of a drug?
* intravenously → straight into blood supply
* intradermal → diffuses slowly into local capillaries
* subcutaneous → a little faster than intradermal
* intramuscular → absorbed quickly due to rich blood supply
52
TRUE or FALSE
Drugs that are applied topically are absorbed less than those administered by either the oral or parenteral routes?
TRUE!
53
What is the rate of absorption for drugs administered rectally?
**Rapid**, due to the vascularity of the mucosa.
54
What is the rate of absorption for drugs administered sublingually?
**Rapid**, due to the vascularity of the mucosa.
55
What is polypharmacy?
Polypharmacy is the **concurrent use of multiple medications** by a patient. Polypharmacy is most common in the elderly.
56
What is the plasma protein that some drugs bind to?
**Albumin** is the plasma protein that some drugs bind to.
57
If a drug is bound to albumin is it active or inactive?
If a drug is bound to albumin it is said to be inactive and cannot have pharmacological action.
58
Which drugs can fairly readily cross the blood-brain barrier into the CNS?
**Lipid soluble** drugs can cross the blood-brain barrier and enter the CNS.
59
Where are lipid soluble drugs stored?
Lipid soluble drugs are stored in **fat tissues**.
60
What does drug metabolism involve?
Drug metabolism involves **breaking a drug down** or **adding a chemical that makes it easier to pass** it into the urine or stool.
61
Where does drug metabolism take place?
Most drug metabolism occurs in the liver; but drug metabolism also occurs in the kidneys, intestinal mucosa, lungs, plasma and placenta.
62
What is drug tolerance?
Drug tolerance is when a drug is **repeatedly given** and metabolism becomes **more effective** and therefore a **larger dose** of the drug may be required in order to produce the **same effect**.
63
What are factors that affect a person's ability to metabolise drugs?
* genetic difference
* age
* disease processes
64
How does age affect a person's ability to metabolise drugs?
First-pass metabolism may be **reduced**, resulting in **increased bioavailability**. Delayed production and elimination of metabolites may **prolong drug action** so may need **reduced dose**.
65
What disease might affect drug metabolism?
**Liver disease** will affect drug metabolism.
66
Which organ excretes most drugs and metabolites?
The **kidneys** excrete most drugs and metabolites.
67
What factors affect the rate at which a drug is excreted by the kidneys?
* presence of kidney disease
* altered renal blood flow
* pH of urine
* concentration of the drug in plasma
* molecular weight of the drug
68
Drugs that are secreted into bile are excreted how?
Drugs that are secreted into bile will pass through the large intestine and be **excreted in the faeces**.
69
What is the half life of a drug?
The half life of a drug is the time it takes for the concentration of the drug in the blood to fall to **50%** of its original value.
70
Why is knowing the half life of a drug important?
Knowing the half life of a drug means **standard dose intervals** can be set up to maintain **stable plasma concentration** of a drug.
71
Why do the young have problems related to their ability to metabolise and excrete drugs?
The very young have problems related to their ability to metabolise and exrete drugs because their hepatic enzyme systems are not fully effective.
72
Why do the elderly have problems related to their ability to metabolise and excrete drugs?
In the elderly **metabolism is delayed in the liver** and their is a **decline in renal function** resulting in **delayed excretion** of the drug by the kidney, prolonging the drug action.
73
What factors might affect a persons response to a drug?
* age
* body weight
* pregnancy and lactation
* nurtitional status
* food-drug interactions
* disease processes
74
Why might someone's body weight affect their response to a drug?
The size of an individual will affect the **amount of drug that is distributed** and available to act.
75
How might a drug affect a developing foetus?
Some drugs can **cross the placenta** and affect the foetus. If the drug is **teratogenic** this may result in a **foetal malformation**.
76
TRUE or FALSE
Drugs can be transferred to an infant via the breast milk.
TRUE!
Drugs can be transferred to the suckling via the breast milk and have adverse reactions on the child.
77
How might inadequate dietary protein affect a patient's response to a drug?
Inadequate dietary protein may effect **enzyme activity** and **slow the metabolism** of drugs.
78
How might a reduction in plasma protein affect a patient's response to a drug?
A reduction in plasma protein may mean that there is an **excess of drug** available for activity.
79
What will enhance the absorption of iron sulphate?
**Vitamin C** enhances the absorption of iron sulphate.
80
What reduces the absorption of tetracycline?
**Dairy produce** will reduce the absorption of tetracycline.
81
How do hepatic diseases (hepatitis, cirrhosis, liver failure) affect a patient's response to a drug?
Hepatic diseases will **reduce metabolism** of drugs and lead to a **gradual accumulation** of drugs and may lead to **toxicity**.
82
How do circulatory diseases affect a patient's response to a drug?
Circulatory diseases, i.e heart failure, will **reduce distribution and transport** of drugs.
83
How do mental and emotional factors affect a patient's response to a drug?
Mental and emotional factors may affect a **patient's ability to comply** with a drug regime.
84
What factors may affect the absorption of a drug?
* mobility
* gastric emptying
* blood supply
* drug form
* pH
* presence of food/drink
85
What factors may affect the distribution of a drug within the body?
* blood flow
* concentration gradient
* blood-brain barrier
* drug form
* body weight
86
What factors affect drug metabolism within the body?
* age
* liver function
* diet
* genetics
87
What factors affect excretion of a drug?
* kidney function
* blood flow (through the kidneys)
* pH of urine
* age
88
What is pharmacodynamics?
Pharmacodynamics is the way that a drug affects the body
89
Where might you find a receptor for a drug?
* on the **surface** of the cell membrane
* **within** the cell
90
TRUE or FALSE
Some drugs will combine with more than one receptor.
TRUE!
Some drugs do combine with more than one receptor.
91
Give an example of a drug that acts as an agonist.
**Morphine**.
Morphine is an opiod agonist, it binds to receptors in the central nervous system to depress the appreciation of pain.
92
What is an agonist to a receptor?
A drug that is an agonist has an **affinity for a receptor** and once bound will cause a **specific response**.
93
What is an antagonist action at a receptor site?
A drug that binds to a receptor and does **not cause a response** is an antagonist, or **receptor blocker**.
94
Give an example of a competitive antagonist.
**Naloxone** is a competitive antagonist and works by **competing with morphine** for receptor sites in the central nervous system and **reverses the effects of an excessive dose** of morphine.
95
Which drugs work by blocking ion channels that allow movement of ions in and out of the cell?
**Nifedipine**, **verapamil** and **lidocaine** block ion channels.
96
What are examples of drugs that interact with enzymes?
aspirin, methotrexate, ACE inhibitors such as enalapril.
97
What is the action of Verapamil?
Verapamil **slows** down the movement of **calcium** through the **muscle cells found in the heart and walls of the blood vessels**.
Blocks calcium channels on the muscle cells. Calcium causes muscles to contract. Verapamil makes them **relax**. Verapamil treats **high blood pressure** and **angina**.
98
What conditions is Verapamil used to treat?
Verapamil is used to treat **high blood pressure** and **angina**.
99
What is Nifedipine used to treat?
Nifedipine is used to treat **high blood pressure** and **angina**.
100
What is the mechanism of action of Nifedipine?
Nifedipine **blocks calcium ion channels** in the **heart muscle and artery walls**. Muscles need calcium to contract; Nifedipine causes them to **relax**.
101
What is Lidocaine used for?
**Lidocaine** is a local anaesthetic used to manage pain.
102
What is the mechanism of action of Lidocaine?
Pain is caused by stimulation at pain receptors at the end of the nerves. Stimulation causes **sodium** to enter the nerve ending. Electrical signals build up. Lidocaine **blocks the pathway of the pain signals** along the nerves. **Stops sodium ions entering the nerve** ending preventing an electrical signal.
103
Where does most metabolism occur?
Most metabolism occurs in the **liver**.
104
What will metabolic processes convert a drug into?
Metabolic processes will convert a drug into a more **water soluble** compound in order for it to be **excreted**.
105
To which group do most of the enzymes responsible for metabolism belong?
Most of the enzymes responsible for metabolism belong to the **hepatic cytochrome P450 group**.
106
Where in the cell would you find the hepatic cytochrome P450 enzymes?
The hepatic cytochrome P450 enzymes are found in the **smooth endoplasmic reticulum** of the cell.
107
How many stages are there to metabolism?
**Two**. Phase one and two.
108
What are some of the different routes of drug administration?
* oral
* sublingual
* buccal
* rectal
* vaginal
* inhalation
* topical
* parenteral
109
What is the most commonly used route of drug administration?
Oral
110
When a drug is given orally, are its effects local or systemic?
Oral drugs can have a **systemic** or a **local** effect.
111
When a drug is given orally, where is it absorbed from?
The drug is absorbed from the **gatrointestinal tract** (GI tract).
112
Give an example of a drug that is given orally.
Paracetamol can be given orally.
113
When a drug is given rectally, what form is it in?
Drugs given rectally could be a **solid or a liquid**.
114
Do drugs given rectally have local or systemic effects?
Drugs given rectally can have **local or systemic** effects.
115
Give an example of a drug given rectally.
**Suppositories** are given rectally.
116
Give an example of a drug given via the submucosa.
**GTN spray** is given via the submucosa.
117
What form are drugs given vaginally in?
Drugs given vaginally can be pessaries or **creams**, **ointments** or **foams**.
118
Do drugs inserted vaginally have a local or systemic action?
Drugs inserted vaginally can have a **local or systemic** action.
119
Give an example of a drug given vaginally.
**Clotrimazole** is given vaginally.
120
How are drugs administered via the buccal route?
Drugs administered via the buccal route are placed **between the upper lip and the gum** and dissolve.
121
Do drugs given via the buccal route have a local or systemic action?
Drugs given via the buccal route can have a **local or a systemic** action.
122
Give an example of a drug given via the buccal route.
**Midazolam** is given via the buccal route.
123
Do drugs given via inhalation have local or systemic effects?
Drugs breathed in via inhalation can have **local or systemic** effects.
124
Which drug route of administration is primarily used to treat respiratory conditions?
**Inhalation** is used to treat respiratory conditions.
125
Give an example of a drug given via inhalation.
**Salbutamol inhalers** are given via inhalation.
126
Is the topical route of administration used for local or systemic effects?
The topical route of administration is primarily used to achieve a **local** effect.
127
Give an example of a drug given topically.
**Cetraban** cream is administered topically.
128
What are the different routes of parenteral administration?
* intravenous
* subcutaneous
* intramuscular
129
Where is the drug injected into in the intravenous route of administration?
Drugs are injected straight into the **systemic circulation**.
130
Where is the drug injected into in the subcutaneous injection method of drug administration?
In the subcutaneous injection method of drug administration, the drug is injected into the **subcutaneous layer of the skin**.
131
Give an example of a drug that is administered by subcutaneous injection.
**Insulin** is administered by subcutaneous injection.
132
Give an example of drugs commonly given via the intravenous route.
**Chemotherapy** drugs are often given intravenously.
133
Where are drugs given via intramuscular injection administered?
Drugs given via intramuscular injection are administered via an injection into the **muscle layers**.
134
If a drug given intramuscularly is formulated in an aqueous solution, will it produce a fast or slow onset of action?
If a drug given intramuscularly is forulated in an aqueous solution it will have a **fast** onset of action.
135
If a drug given intramuscularly is formulated in an oily vehicle, will it have a fast or slow onset of action?
If a drug given intramuscularly is formulated in an oily vehicle it will have a **slower** onset of action than an aqueous solution.
136
Give an example of a drug given intramuscularly.
**Haloperidol** is administered intramuscularly.
137
What are the advantages of giving a medication orally?
* a lot of medications are available orally
* often cheap
* easy route; non-invasive
138
What are the disadvantages of giving a drug orally?
* not applicable if pt has trouble with swallowing
* prone to misuse
* affected by food/drink intake
139
What are the advantages of giving a drug sublingually?
* good blood supply, quick acting
* avoids first-pass effect
140
What are the disadvantages of giving a drug sublingually?
* difficult with facial injury
* taste may deter people
141
What are the advantages of giving drugs via the buccal route?
* good blood supply
* quick acting
* avoids first-pass effect
142
What are the disadvantages of giving a drug via the buccal route?
* difficult with facial injury
* taste may deter people
143
What are the advantages of giving a drug via the rectal route?
* good blood supply, quick acting
* can be used for unconscious patients
* local acting
144
What are the disadvantages of administering a drug via the rectal route?
* patient may not be comfortable or decline
* invasive
* difficult
* uncomfortable
145
What are the advantages of giving a drug vaginally?
* good blood supply, quick acting
* local acting
146
What are the disadvantages of giving a drug vaginally?
* patient may not be comfortable/decline
* invasive
* pregnant, can't use applicator
* may cause irritation
* may affect contraception
147
What are the advantages of taking a drug via inhalation?
* large surface area in the lungs, quick absorption
* local acting
148
What are the disadvantages of a drug being taken by inhalation?
* may require some training and coordination
* expensive
149
What are the advantages of applying a drug topically?
* easy application
* local
* reduced side effects
150
What are the disadvantages of applying a drug topically?
* slow absorption
* flammable
* irritation
151
What are the advantages of taking a drug via the parenteral route?
* get the drug to where it needs to go
* 100% bioavailability
* good for emergency situations
152
What are the disadvantages of the parenteral route?
* difficult to find a vein (IV) in the elderly
* people don't like needles
* expensive
* need to be administered by trained staff
153
What is an adverse drug reaction?
An adverse drug reaction is a response to a drug that is **noxious** (harmful) and **unintended** and occurs at doses normally used in man for prophylaxis, diagnosis or therapy of disease or for the restoration, correction or modification of physiological function.
154
What are the two different classifications of adverse drug reactions?
Type **A** and type **B** reactions.
155
What is a type A adverse drug reaction?
These types of reactions are **dose dependent** and **predictable** based on the pharmacology of the drug (eg bleeding with anticoagulants).
156
What is a type B adverse drug reaction?
Type B adverse drug reactions are reactions known as **idiosyncratic reactions**, they are bizarre and **cannot be predicted** from the known pharmacology of the drug.
157
What are the most important risk factors for adverse drug reactions?
**Extremes of age** and the **number of drugs taken** are the most important risk factors for adverse drug reactions.
158
What may explain the problem with adverse drug reactions in the elderly?
A **prescribing cascade** may explain part of the problem of adverse drug reactions in old age. This occurs when an adverse drug reaction is **misinterpreted as a new medical condition**. A new drug is then prescribed and the patient is **at risk of developing more adverse reactions** relating to this unecessary treatment.
159
Where would you record a suspected adverse drug reaction?
Adverse drug reactions should be recorded on the **yellow cards** at the back of the BNF.
160
What information needs to be recorded on the adverse drug reaction yellow cards in the back of the BNF?
* patient details
* suspected drug
* suspected reaction(s)
* drug history
* additional relevant information
* reporter details
161
For a side effect to be considered 'very common' how many people need to have reported it to have occured?
For a side effect to be 'very common' it will occur in **more than 1 in 10 people**.
162
What is the difference between an adverse drug reaction and a side effect of a drug?
An adverse drug reaction is **any undesirable drug effect**. A side effect is an adverse reaction that is **predictable** in response to that drug.
163
What is a toxic effect of a drug?
A toxic effect occurs when **too much drug has accumulated** in the patient. It can be due to a **high dose** of the drug being given, **chronic build-up** of the drug or an **increased sensitivity**.
164
What factors can cause a toxic drug effect?
* high dose of the drug being administered
* chronic build up
* increased sensitivity
165
What is a drug allergy?
The body sees the drug as an antigen and an **immune response** is started against the drug. It can be an **immediate** or a **delayed response**.
166
What is the therapeutic index of a drug?
The therapeutic index is the difference between the drug having a **therapeutic action** and the drug becoming **toxic**.
167
Give examples of drugs with a narrow therapeutic index.
* lithium
* anticonvulsants - phenytoin
* cardiac glycosides - digoxin
* cytotoxics
* immunosuppressants - cyclosporine
168
What are two main types of interaction that can take place when taking a medication?
* drug-drug
* drug-food
169
What is the drug-drug interaction between atorvastatin and clarithromycin?
plasma concentration of atorvastatin is increased.
Inhibits CYP4503AH, causes increased plasma concentration.
170
What is the drug-drug interaction between atorvastatin and diltiazem?
Increases concentration of atorvastatin.
Inhibits CYP4503AH
171
What is the role of CYP4503AH?
**Oxidises drugs and toxins** so that they can be removed from the body.
172
What is the drug-drug interaction between warfarin and allopurinol?
May enhance the anticoagulant effect of warfarin.
May inhibit the metabolism of warfarin.
173
What is the drug-drug interaction of warfarin with ibuprofen?
Anticoagulant effect is increased.
NSAIDs may potentiate the hypoprothrombinemic effect of bleeding risk.
174
What is the drug-food interaction of grapefruit juice with atorvastatin?
Possibly increases the plasma concentration of atorvastatin, increasing atorvastatins side effects.
175
What is the drug-food interaction of grapefruit juice and amlodipine?
Possibly increase plasma concentration of amlodipine.
Leads to unpredictable increase in blood pressure lowering effect of amlodipine.
176
What is the drug-food interaction of alcohol with warfarin?
Anticoagulant control may be affected.
177
How might alcohol reduce the absorption of a drug?
Alcohol can **slow down the digestive processes** and therefore **reduce the absorption** of the drug.
178
What is the result of alcohol competing for metabolic processes in the liver?
Alcohol can **compete for metabolic processes** in the liver and therefore **increase drug levels** within the blood stream because **the alcohol has been metabolised and not the drug**.
179
What happens if alcohol activates liver enzymes?
Alcohol can **activate liver enzymes reducing drug levels in chronic alcohol use**. The liver enzymes break down the drug **quicker than normal** which reduces the drug level.
180
What happens if alcohol is taken in conjunction with sedatives?
Alcohol is a sedative and so are some drugs. This then leads to **enhanced sedative effects** with some drugs and this increases drowsiness.
181
What are the six main categories of disease cause?
* infectious
* congenital
* mental illness
* organic
* metabolic
* deficiency disease
182
What is a congenital disease?
A congenital disease is when an individual is **born** with a specific defect in structure or functioning. These can be either **inherited or non-inherited**.
183
What is an organic disease?
An organic disease refers to an **anatomical change** in a tissue or an organ.
184
What are examples of some congenital disorders?
* sickle-cell anaemia (inherited)
* down syndrome (non-inherited)
* spina bifida (non-inherited)
* haemaphilia (inherited)
185
Give an example of an organic disease.
Cancer (benign vs malignant)
186
What is a metabolic disease defined as?
A metabolic disease includes **hormonal disorders** caused by either a **deficiency** or an **excess** of a specific hormone.
187
Give examples of metabolic disorders.
* diabetes
* hyperthyroidism
* hypothyroidism
* gigantism
188
What is a deficiency disease defined as?
A deficiency disease is any disease associated with a **lack of any essential nutrients**.
189
What disease results from a lack of vitamin A?
**Night-blindness** is the result of a lack of vitamin A.
190
What disease results from a lack of vitamin B?
**Beri-beri** results from a lack of vitamin B (thiamine).
191
What disease results from a lack of vitamin B12?
**Pernicious anaemia** is the result of a lack of vitamin B12.
192
What disease results from a lack of vitamin C?
**Scurvy** results from a lack of vitamin C.
193
What disease results from a lack of vitamin D?
**Ricketts** results from a lack of vitamin D.
194
What are infectious diseases defined as?
An infectious disease occurs when the body is invaded by **pathogens** (microorganisms). This includes **bacteria**, **viruses**, **fungi** and **parasites**.
195
What type of microorganism causes Tuberculosis?
**Bacteria** cause Tuberculosis.
196
What type of microorganism causes Typhoid?
**Bacteria** cause Typhoid.
197
What type of microorganism causes Legionnaires disease?
**Bacteria** cause Legionnaires disease.
198
What type of microorganism causes Meningitis?
Meningitis can be caused by **bacteria** or **virus**.
199
What type of microorganism causes Chicken Pox?
A **virus** causes Chicken Pox.
| (Varicella zoster)
200
What type of microorganism causes Influenza?
A **virus** causes Influenza.
201
What type of microorganism causes Tinea pedis?
Tinea pedis (athletes foot) is caused by a **fungus**.
202
What type of microorganism causes Candida albicans?
Candida albicans (thrush) is caused by a **fungus**.
203
What type of microorganism causes Malaria?
A **parasite** causes malaria.
204
What type of microorganism causes Dengue fever?
Dengue fever is caused by a **parasite**.
205
What type of microorganism are lice?
Lice are **parasites**.
206
Give examples of mental health illnesses.
* Depression & anxiety ('mild' mental health disorders)
* Schizophrenia (sever mental health disorder)
207
What is the definition of 'good health'?
Good health is defined as being in a state of **complete physical, mental and social well-being**, not merely the absence of disease.
208
What is 'sub health' defined as?
Sub health is defined as the state of **not being completely well or ill**. The body continues to **function, but not to the best of its ability**. The patient may have certain conditions such as a headache or indigestion and will often self-medicate.
209
What are factors that lead to successful medicinal treatment of disorders?
* good patient counselling
* reduced stress/increased rest
* compliance
* completing the treatment / course of antibiotics
* seeking out medical advice
* prescribed apropriate medication
* length of course
* appropriate dose
* appropriate form
* availability of medication
* correct diagnosis
* good healthcare professional
* support from family
210
What are factors that lead to unsuccessful medicinal treatment of disorders?
* lacking support
* comorbidities
* social factors
* mental health
* immunosuppressants
* adverse drug reactions
* economic factors
* lack of compliance
* eg not finishing antibiotic course
* foul taste
* putting off visiting healthcare professional
* not having the appropriate drug
* form
* dose
* length of course
* treatment side effects
* rarity of disease / misdiagnosis
* lack of compliance
* poor counseling
211
Methotrexate is a drug that works on an enzyme.
True or false.
True!
Methotrexate works on an enzyme called **dihydrofolate reductase**.
212
What are 'medicinal' drugs?
Medicinal drugs are those taken for **therapeutic purposes**.
213
What are 'non-medicinal' drugs?
Non-medicinal drugs are not prescribed and are used for their effects, **not therapeutic**, can be recreational.
214
What are the targets for drug action (on a biological cell level)?
* receptors
* ion channels
* enzymes
* carrier molecules
215
Where does the process of absorption take the drug?
Absorption takes the drug from the **site of administration** into the **circulatory or lymphatic system**.
216
If gut motility is increased, is drug absorption INCREASED or DECREASED?
Increased gut motility means reduced time present in the gut, so an **increased rate of absorption**.
217
If gastric emptying is increased, will the rate of absorption be increased or decreased?
If gastric emptying is increased, this will **speed up the absorption rate**, if delayed it will slow the delivery of the drug to the intestine, therefore reducing the absorption rate.
218
How will an increase in gut pH affect the rate of absorption?
The pH of the GI tract **varies along its course**. The changing environment may have **different effects on different drugs**. Absorption of a drug may be dependent on specific pH.
219
How does a rich blood supply affect the rate of absorption?
A good supply results in **lots of absorption**.
220
