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Pharmacology and Nutrition > Basic Principles of Pharmacology > Flashcards

Basic Principles of Pharmacology Flashcards

1
Q

Drug =

A

Any substance that, when taken into a living organism, may modify one or more of its functions

Any substance that alters physiological function in an organism – this alteration can be beneficial or harmful = pharmacology vs toxicology

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2
Q

Clinical pharmacology =

A

the study of medications in humans and their cellular effect, safe and economic use in patients for beneficial or therapeutic effects; while minimizing side effects

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3
Q

Physical therapist patient and client management:

A

integrates an understanding of a patient’s or client’s prescription and nonprescription medication regimen with consideration of its impact on health, function, movement, and disability

within the physical therapist’s professional scope of practice to administer and store medication to facilitate outcomes of physical therapist patient and client management

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4
Q

Goals that may benefit from the concomitant use of medications include, but are not limited to:

A

> Reducing pain
Reducing inflammation
Promoting integumentary repair and/or protection
Facilitating airway clearance and/or ventilation and respiration
Facilitating adequate circulation and/or metabolism
Facilitating functional movement

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5
Q

Evolution of Pharmacology

A

1700s: naturally occurring chemicals used to relieve pain and treat disease = Home remedies handed down from one generation to the next

1800s: initiation of synthetic drugs and pharmaceutical research

Last 100+ years: Medical practitioners have expanded use of natural, semisynthetic, and synthetic chemical agents

> Diseases prevented, cured, and managed => improving the general health
Antibiotics and vaccines = significant impact on lifespan

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6
Q

Physicians are expected to know the drugs and mechanisms of action

Physical Therapists are expected to ____

A

have a fundamental knowledge of pharmacology

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7
Q

Important to know a patient’s list of medications: increasing Age = increasing # of meds

A

How do the drugs affect a patient

Drug interactions

Mechanisms of Action

Purpose or effects

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8
Q

Analgesics:

A

Peak effect=> Decrease pain => Optimal performance

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9
Q

Anti-Parkinson:

A

Peak effect=> Improve motor function => Optimal performance

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10
Q

Sedative:

A

Peak effect => Inability to actively participate => Suboptimal performance

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11
Q

adverse effect =

A

comorbidities
environment
genetics

rare
unexpected event
research sometimes misses

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12
Q

side effect =

A

expected

concurrence event

happens with medication

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13
Q

Pharmacotherapeutics:

A

the use of specific drugs to prevent, treat, or diagnose a disease

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14
Q

Pharmacokinetics:

A

study of how the body absorbs, distributes, and eliminates a drug

administration

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15
Q

Pharmacodynamics:

A

analysis of what the drug does to the body and mechanisms of action

cellular level

systemic and cellular effects

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16
Q

Toxicology:

A

Study of harmful effects of chemicals

Adverse effects, environmental toxins, and poisons

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17
Q

Pharmacy:

A

Preparation and dispensing of medications

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18
Q

Pharmacogenetics:

A

Study of genetic influence on drug response

Individual differences can alter pharmacokinetic and pharmacodynamics responses

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19
Q

Drug Nomenclature

A

Chemical Name: specific compound structure

Generic Name: shorter and often derived from chemical name

Trade/Brand Name: assigned to the compound by the pharmaceutical company
> Does not necessarily resemble the chemical name
> Several manufacturers may market the same compound
> Controlled by copyright or patent

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20
Q

Trade/Brand Names:

A

Celebrex, Cerebyx, and Celexa: Analgesic, Anti-seizure, and Antidepressant

Similarity in Trade Names in particular is a potential source of confusion with large implications

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21
Q

Substitution of Generic Drugs for Brand-Name Drugs

A

Generic brand typically less expensive => may reduce overall healthcare costs

Decreased therapeutic benefit from generic drugs may increase health care costs due to decreased effectiveness = genetic differences

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22
Q

Bioequivalence =

A

the comparison of bioavailability between two drug formulations

Bioequivalent drugs = same safety and efficacy after administration

bioequivalence does not guarantee that a patient will have the same effect from the generic form as compared to the brand name

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23
Q

Bioavailability =

A

percentage of the medication that reaches the systemic circulation

If the generic form is ‘bioequivalent’ to brand name drugs => it should be as safe and effective, same type and amount of the active ingredients, same administration route, same pharmacokinetic and pharmacodynamic profile

Genetic differences: ability to absorb and metabolize different drugs

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24
Q

Food and Drug Administration: FDA

A

Responsible for developing and approving new drugs and monitoring the use of existing drugs

Primary concerns of the FDA

Is a drug effective?
Is a drug safe?

25
Q

FDA: Drug Approval Process

A

> Preclinical
Clinical
Post Marketing Surveillance

26
Q

Preclinical =>

A

Animal Testing => 1-2 years

Determine drug effect and safety, pharmacokinetics and pharmacodynamics

Preclinical phase successful = drug sponsor files an Investigational New Drug (IND) application with the FDA

27
Q

Clinical =>

A

Human Testing => Phase 1: ~1 year, Phase 2: 2 years, Phase 3: 3 years

Phase 1: relatively small numbers of healthy volunteers (10-100) to determine effect, safety, and pharmacokinetics

Phase 2: relatively small numbers (50-500) to determine drug’s effectiveness and dosage in treating a specific disease

Phase 3: larger number of subjects (100s-1000s) to determine drug’s safety and effectiveness

28
Q

Phase 1-3 successful =

A

drug sponsor files a New Drug Application (NDA)

If approved, drug is released to the general market

29
Q

Post Marketing Surveillance:

A

Phase 4: drug monitored for rare adverse events post NDA

Required with most new drug released to the general public

Continued monitoring for safety and effectiveness particularly by drug prescribers

Rare adverse effects: 1 in 10,000 may not be detected in phase 1-3

30
Q

Drug Development and Approval

A

Extremely expensive in the US

Animal trial through post market surveillance can take up to 10 years

Expedited Review of process = FDA fast track review, priority review, and accelerated approval

31
Q

Expedited Review of process

A

Drugs designed to treat serious and life-threatening conditions = Covid-19, HIV

Drugs that show substantial benefits over existing treatment

Can become available before clinical testing is complete = phase 3

32
Q

Orphan Drugs

A

Drugs used to treat rare diseases in the US => fewer than 200,000 people

Research and development difficult due to small population in need of orphan drugs

Additional funding from federal budget is made available for these drugs

33
Q

Off-Label Prescribing

A

Use of a drug to treat a condition other than the condition that the drug was originally approved to treat

FDA approves drugs based on the NDA

Clinical observation and post market surveillance may lead to determining that a drug is effective in treating a condition it was not originally approved to treat

Gabapentin = anti-seizure drug: now used to treat chronic pain

34
Q

Off-label prescribing is legal:

A

FDA does not have authority to question a physician’s clinical judgement

35
Q

Classification of prescription and OTC:

A

FDA jurisdiction

36
Q

Pharmacotherapeutics:

A

prescription and over-the-counter meds

37
Q

OTC:

A

typically used to treat minor problems to increase comfort while the condition resolves

Deemed safe without direct medical supervision, small chance of toxic effect when dosage recommendations are followed

Pt education = use of OTC medication & potential side effects well within DPT scope of practice

38
Q

Many prescription drugs have transitioned to OTC drugs via FDA approval process

A

Benefits: increased availability, decreased insurance cost

Concerns: self care and appropriate use, serious interactions with prescription meds

Patient education: benefits and concerns of OTC meds

39
Q

1970: federal legislation =>

A

The Comprehensive Drug Abuse Prevention and Control Act

placed drugs in specific categories (schedules) based on potential for abuse:
> narcotics
> depressants
> stimulants
> hallucinogens
> anabolic steroids

40
Q

Schedule 1:

A

highest potential for abuse, typically not used as medical treatment in the US

Heroin, LSD, hallucinogens

41
Q

Schedule 2:

A

high potential for abuse, approved for specific therapeutic purposes

Opioids

42
Q

Schedule 3:

A

lower abuse potential than 1 and 2, possibility of mild to moderate physical dependence, strong psychologic dependence, or both

Codeine, anabolic steroids, barbituates

43
Q

Schedule 4:

A

lower abuse potential than 3, limited possibility of physical and psychological dependence, or both

Antianxiety drugs, depressants, stimulants

44
Q

Schedule 5:

A

Lowest relative abuse potential

Low dose opioids found in cough meds, antidiarrheal meds

45
Q

Dose and Response

A

Drug reaches a target tissue and interacts via receptors = dependent upon bioavailability

Function of the cell altered => physiology changed to restore normal function and/or prevent a disease process

46
Q

Drug dose:

A

Large enough to allow an adequate concentration to reach the target cells creating a beneficial change

Small enough to avoid toxicological effects

47
Q

Dose-Response Curves

A

Describes critical characteristics of a drug

Provides information about the range in which a dose is effective in eliciting a therapeutic response

Identifies the peak response expected from a drug

48
Q

Threshold dosage =

A

therapeutic response achieved

49
Q

Continued increase in dose =

A

increase in therapeutic response until the response plateaus

50
Q

Ceiling effect or maximal effect =

A

plateau in drug response, maximum therapeutic response

Increase in dosage after reaching the ceiling effect will not produce increase in response

51
Q

Toxic Dose ->

A

toxicity

52
Q

Potency =

A

amount of drug required to produce desired therapeutic response

53
Q

Drug potency:

A

dose that produces a given response

Greater potency requires a lower dose to produce the same response

Potency is NOT the same as maximal effect = it is not an indication of a drugs overall therapeutic benefits

54
Q

Quantal Dose-Response Curve

A

Dose-Response curves typically represent large populations of people

Relationships between the drug and response from large groups represented on quantal dose-response curves

Dose is represented on the X axis

Percentage of population that exhibits a specific response on the Y axis

Often called ‘Beneficial Effect’ = desirable response

55
Q

Median Effective Dose (ED50):

A

dose at which 50% of a patient population experience a biological response

56
Q

Median toxic dose (TD50 ):

A

dose at which 50% of a patient population exhibits adverse effect

57
Q

Lethal dose (LD50 ):

A

dose that causes death in 50% of animals

58
Q

Therapeutic Index (TI)

A

Used to indicate drug safety

Large TI = much larger dose to elicit a toxic response

TI = TD50/ED50

toxic/effective

59
Q

Prescription drugs tend to have a lower TI than OTC

A

Acetaminophen: 27
Valium: 3
Chemotherapeutics: 1

Pharmacology and Nutrition (5 decks)

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