Advanced Pharmacology Flashcards
cost-effectiveness analysis
cost per unit of survival time
cost-benefit analysis
cost to achieve therapeutic objective
cost-minimization analysis
total cost in dollars
cost-unity analysis
cost per quality-adjusted life year
primary cost of therapy
cost of the drug itself
secondary costs of therapy
med administration, lab monitoring, follow-up care, re-treatment/rescue therapy
MedWatch 4 goals
- increase awareness of drug and device induced disease
- clarify what should(nt) be reported
- to report adverse events and product problems
- to provide regular feedback to health care members abut safety issues with medical products
Adverse Drug reaction: Inherent effect
excessive degree or desired effect, unintended side effect
Adverse Drug reaction: Allergy
classic manifestations of immunologic response
Adverse Drug reaction: Local irritant
Hypersensitivity reaction
Drug interaction: Addition
a response elicited by combining drugs thats equal to the combined responses of the individual drugs
1+1=2
Drug interaction: Synergism
The response elicited by combined drugs is greater than the combined responses of the individual drugs
1+1=3
Drug interaction: Potentiation
A drug which has no effect and enhances the effect of the 2nd drug
0+1=2
Drug interaction: Antafonism
The drug inhibits the effect of another drug, usually antagonism has no inherent activity
0+1=0
1+1=0
Type I hypersensitivity reaction
IgE medicated allergic reaction
Type II hypersensitivity reaction
Cytotoxic reactions
Type III hypersensitivity reaction
Immune complex reactions
Type IV hypersensitivity reaction
Cell-mediated reactions
Type D- Teratogenic drug reactions
delayed, becomes apparent after use of drug
Thalidomide (Caontergan)
used as CNS depressant, causes severe birth defects
Teratogen pre-implantation (first 2 weeks)
affected cells die or undifferentiated
Teratogen effects on embryonic period (3-8 weeks)
most critical to avoid drug exposure
Teratogen effects on fetal period (9 weeks-term)
organ structure grow, can cause intrauterine growth retardation
what other factors affect teratology?
- maternal-fetal genotype(maternal absorption)
- dose-response relationships(route of administration, amount of med given)
- specificity of agent (maternal metabolism and placental transfer)
- drug interactions
Teratology
the scientific study of congenital abnormalities and abnormal formations.
FDA pregnancy category A
controlled studies, no risk to fetus in first trimester
FDA pregnancy category B
animal studies= no risk, no pregnant studies
OR animal studies = risk but controlled pregnant studies =no risk
FDA pregnancy category C
animal studies=risk, no pregnant studies
OR no studies available
FDA pregnancy category D
pregnant risk but may be prescribed if benefit outweighs risk
FDA pregnancy category X
absolute pregnancy risk, risk outweigh benefit
predictors of non-adherence
low literacy, homelessness, depression, psychiatric disease, lack of insight to disease etc
KISS principle (keep it simple stupid)
S=simplify regimen I= Impart knowledge M= modify patient beliefs and human behavior P= provide communication and trust L= leave the bias E= evaluate adherence
contingency contracting
an agreement between a patient and provider for behavioral goals and reinforces and rewards that the patient will receive contingent upon achieving goals
