Basics Flashcards
PharmacoDynaMics
Drugs to Man
PharmacoKineTics
Katawan to Tableta
Inhibits Vitamin K clotting factors synthesis 10, 9, 7, 2 (1972)
Antidote: Acute - FFP, Chronic - Vitamin K
Warfarin
Monitor PT/INR
Activates anti-thrombin III
Antidote: Protamine Sulfate
Heparin
Monitor aPTT
Safest site at the buttocks for IM drug administration
Superolateral
Superomedial - may result to gluteus medius gait
Inferomedial - Sciatica
Rectal route with first-pass effect
Superior Rectal Vein: drains to IMV which then drains to Portal v.
Middle rectal v. - IIV to IVC
Inferior rectal v. - IPV to IIV to IVC
Drugs with zero-order elimination kinetics?
WHAT PET Warfarin Heparin Aspirin Tolbutamide Phenytoin Ethanol Theophyline
Creatinine Clearance formula
((140-age) x weight in kg) / (72 x serum Crea in mg/dL)
Drug metabolism
Phase I reactions
HORDe of Phase I Hydration Oxidation Reduction Deamination
Phase II reactions
Glucuronidation Acetylation Conjugation Sulfation Methylation
Cytochrome P450 inducers
ETHel Booba takes PHEN-Phen and RIFuses GReasy CARB Shakes Ethanol Barbiturates Phenytoin Rifampicin Griseofulvin Carbamazepine St. John's Wort / Smoking
Cytochrome P450 inhibitors
Inhibitors Stop Cyber Kids from Eating GRApefruit QV Isoniazid Sulfonamides Cimetidine Ketoconazole Erythromycin Grapefruit juice Ritonavir Amiodarone Quinidine Valproic acid
FDA Drug categories
Classes:
A - safe to pregnant women and animals
B - no studies in pregnant women, unsafe in pregnant animals
C - no studies in pregnant women, no studies in pregnant animals (Benefits outweigh risks)
D - unsafe in pregnant women, unsafe in pregnant animals (for drugs needed in life-threatening conditions)
X - contraindicated in women who are or may become pregnant (Risks outweigh benefits)
Warfarin AE on pregnant women
1st tri chondrodysplasia
2nd tri CNS malformations
3rd tri bleeding diatheses
New drug application
Phases:
I - eval of pharmacoKineTics in normal human volunteers 25-50
II - eval of drugs in moderate no. Of patients with target dse (single blind or double blind)
III - many patients and many clinicians 1000-5000 (double blind), compare with older therapy, discover toxicities
IV - postmarketing surveillance