Chapter 11 - Therapeutic Medications Flashcards
What is the study of the movement of drugs through the body to produce the desired effects?
Pharmacokinetics
What are the five steps of moving a drug through the body?
- Administration
- Absorption
- Distribution
- Metabolism
- Excretion
What two factors affect bioavailibilty?
- route of drug administration
- absorption
T/F: Drugs that inhibit or block effects are called agonists.
False, agonists facilitate or produce a change
T/F: Drugs that inhibit or block effects are called antagonists.
True
What is the absorption rate?
The amount of time that it takes the drug to move into the tissues and produce a therapeutic effect
What are the three enteral routes?
oral, sublingual, rectal
What are medications combined with to facilitate entry into the body?
Vehicles
T/F: Enteric-coated preparations are drugs that are covered in acid-resistant materials to protect it from the acid and peptin in the stomach for absorbtion in the intestines.
True
T/F: Sustained-release perparations are capsules or tablets that are filled with tiny spheres designed to disolve at variable rates.
True
How long after taking it (on average) does an oral medication enter the bloodstream?
30 min
Why are sublingual medications absorbed much faster?
Going through the mucosa avoids metabolism in the liver
When would you use the recal route of administration?
For people who can’t hold down food/liquid or unconscious people
What are the four invasive parenteral routes of drug administration?
- Intravenous
- intra-arterial
- intramuscular
- subcutaneous injection
What are the three noninvasive parenteral routes of drug administration?
- inhalation
- topical
- transdermal
What factors affect drug absorption (5)
- type of administration
- surface area
- blood flow in area
- type of cell membrane it has to cross
- solubility of drug (fat or water)
Where do most drugs exit the blood?
capillary beds
T/F: All drugs will eventually leave the blood stream and be excreted.
False, if they are too large (like if it had bound to albumin) they will remain in the blood
T/F: Some drugs do not need a receptor to be effective.
True
What is the original drug broken down into after biotranformation (drug metabolism)
metabolites
T/F: All drugs go through the first-pass effect in the liver
False, only oral
T/F: Not all drugs are metabolized.
True
T/F: Drugs that are highly lipid soluable are usually excreted by the kidneys.
False, usually the kidneys cannot excrete them so they are broken down into more water soluable compounds by the liver for excretion
T/F: Drug metabolism will not alter the effect of the drug.
False, can sometime inactivate or activate the drug
What are the 6 routes a drug can exit the body?
Sweat, bile, saliva, urine, breast milk, or exhaled by the lung
What are the two main types of drug excretion?
renal and hepatic
What are the two basic drug plasma levels?
- Minimum effective concentration (MEC)
- Toxic concentration
What is the therapeutic range of a drug?
The range between the MEC and the toxic concentration
T/F: The narrower the therapeutic range of a drug, the safer it is.
False, the wider the range the safer (more flexibility between effective concentration and overdose)
T/F: As long as the plasma levels remain above the MEC, the therapeutic response of a drug will continue.
True
T/F: Maximal efficacy is the dose at which the therpeutic response occurs and continues to increase in magnitude until a plateau is reached.
True
T/F: If an additional dose of medication is given, the maximal efficacy of the dose will double.
False, it will have no effect if a plateau is reached
T/F: A drug with a higher potency requires a smaller dosage to produce the same effects.
True
What factors influence drug interactions? (7)
- genetics
- age
-current illness or disease - quantity of drug ingested
- duration of drug therapy
- time between taking 2 drugs
- which drug is taken first
Which three types of drugs are responsible for 80% of adverse drug reactions?
NSAIDS, beta-lactam antibiotics, and sulfonamides
T/F: Drug dispensing is the term given to providing one dose of a medication to a person.
False, that’s administration of medication. Drug dispensing is more than one dose.
T/F: Physicians currently use “Physicians Desk Reference” to access the most current diagnostic and treatment information.
False, they use Epocrates
What common medications are used to treat sports related injuries? (8)
- analgesics & antipyretics
- NSAIDS
- corticosteriods
- anesthetics
- antiseptics
- tobical antibiotics
- antifungal agents
What is an antipyretic?
A drug used to prevent or reduce fever
What does acetaminophen do?
inhibits synthesis of prostaglandins in the CNS (but not in peripheral tissues) > analgesic and reduces fever
T/F: Acetaminophen also has inti-inflammtory and antiplatelet proporties.
False
What does aspirin do?
analgesic, anti-inflammatory, antipyretic
T/F: Acetaminophen can be used as a substitute for aspirin to decrease GI stress and ulcer develpoment.
True
T/F: You cannot overdose on acetominophen because it is processed quickly by the liver.
False, too much can lead to liver damage and death
What is Reye syndrome?
swelling of liver and brain - recurrent vomiting that occurs a week after the onset and can result in a full recovery or a coma (possibility of death)
T/F: If aspirin is used in a child younger than 18, it can result in Reye syndrome
True
What is the main mechanism of an NSAID?
inhibits prostaglandins and other related compounds by inhibiting COX
What does a prostaglandin do?
regulate cell function - at an injury promotes blood flow, tissue permeability, and facilitaites histamine and bradykinin
T/F: Inhibition of COX-1 result in anti-inflamatory effects?
false, thats COX-2
T/F: Inhibition of COX-1 can result in adverse GI effects?
True
Which COX is responsible for the inflammation?
COX-2
T/F: NSAIDs do not normally create dependance
True
T/F: NSAIDs have anti-pyretic properties and antiplatelet effects.
True
T/F: Alcohol should never be taken with NSAIDs because it increases the risk of GI irritation and stomach ulcers.
True
T/F: NSAIDs are effective for relief of severe pain which is why they are so widely used.
false, not effective
T/F: Prescription strength NSAIDs can only be precribed by a lincenced practitioner.
True
What are corticosteroids?
steriod hormones that are naturally produced in the adrenal cortex but can be produced synthetically.
T/F: Corticosteroids are powerful drugs that affect almost the entire body.
True
How do corticosteroids block inflammation?
by inhibiting chemical mediators
T/F: Corticosteriods have a more specific scope of reducing inflammation compared to NSAIDs.
False, corticosteriods have more ways to reduce inflammation than NSAIDs
T/F: Chronic use of corticosteriods can weaken the immune system and make a person mor susceptible to infection
True
What are some possible adverse reactions to corticosteroids?
- itching
- burning
- dry skin
- fluid retention
Rare: change in appetite, abnormal hair growth, dizziness, restlessness, GI distress, menstrual irregularities, optic pain.
What are corticosteriods indicated for?
skin disorders
nasal inflammation
rheumatic disorders
skin infections
Corticosteriods should not be used by whom?
individuals with
HIV /AIDS, heart disease, hypertension, diabetes, gastritis, peptic ulcers, lupus, or other infections.
T/F: Corticosteriods are banned by the NCAA and USOC with the exception of topical applications.
False, not banned for NCAA
T/F: The USOC will allow inhaled, local, or intra-articular injections with written permission.
True
What does pruritus mean?
Itchiness
How do anesthetics work?
Inhibit the sensory nerve receptors in the skin.
For what conditions are infiltrative anesthetics commonly used?
turf toes or hip pointers
What are topical anesthetics called when they are used for relieving pain in a musculoskeletal injury?
counterirritants
Give two examples of counterirritants
Icy Hot, Solarcaine
T/F: Methyl salicylate is safe for people who are allergic to aspirin.
False, body may absorb the salicylate.
How do muscle relaxors works?
Inhibit affferent messages that travel form the muscles to the brian
T/F: Because muscle relaxors work on the CNS, they can cause overally CNS depression (drowsiness, dizziness, sedation).
True
T/F: Muscle relaxors are not banned by the NCAA or USOC
True
What are the two basic types of bacteria that antibiotics fight against?
Streptococcus and Staphylococcus
What is the difference betweeen antiseptics and disinfectants?
Antiseptics are used on living tissue (isopropyl alcohol, iodine) and disinfectants are used on non-living tissue.
In humans, what are the two types of fungal cells?
molds or yeasts
Tinea coporis, tinea pedis, and tinea cruris are caused by molds or yeasts?
molds
What are the performance benefits of caffeine
CNS stimulant that increases alertness and feelings of well-being. Stimulates the secretion of adrenaline
candidiasis and moniliasis are caused by molds or yeasts?
yeasts
T/F: Caffeine is considered by the NCAA and the IOC to be a restricted/controlled drug.
True
What are the performance benefits of tobacco?
low-level CNS stimulant, nicotine is a stimulant that is highly addictive
T/F: In low doses, nicotine stimulates the autonomic ganglia and large doses depress
True
What are the adverse conditions associated with oral tobacco
halitosis, permanantly discoloured teeth, oral abrasions, peridontal disease, tooth loss and leukoplakia.
T/F: Leukoplakia is an oral disease categorized as leasions on the teeth, gums, and cheeks. It can lead to oral cancer.
True
T/F: Alcohol is the most abused drug in US and the number 1 choice of drug for intercollegiate athletes
True
T/F: Caffeine causes vasoconstriction in all areas of the body.
False, no vasoconstriction in renal afferent artery
What is the half-life of caffeine?
3.5 hours
What is the limit for caffeine defind by the NCAA and the IOC?
NCAA: >15 ug/mL
IOC: >12 ug/mL
What effects do alcohol have on the body?
Passes the blood-brain barrier and depresses the CNS
How much of alcohol is processed in the liver?
A) 100%
B) 90%
C) 80%
D) 70%
B) 90%, the rest is excreted in sweat, urine, and exhalation
Which two systems does marjuana affect and what are the effects?
CNS
- Impaired motor coordination
- Decreased short-term memory
- Difficulty concentrating
- Decline work performance
Cardiovascular system
- Tachycardia
- Changes in BP
T/F: Alcohol is banned in all NCAA sports.
False, only riflery
T/F: Marijuana results in reduction of maximal exercise performance and a premature acheivement of VO2max
True
How long can marijuana be detected in drug testing?
up to 2-4 weeks
What are the 5 types of diaretics and when are they used?
1) carbonic anhydrase inhibitors- glucoma (decreases production of aqeuous humor -> decreases intraocular pressure)
2) loop diaretics - emergencies -> edema associated with cirrhosis, heart failure, renal disease.
3) Osmotic diuretics - low urine production in renal failure, reduce cerebral edema & intraocular pressure before surgery
4) Potassium sparing - chronic heart failure and hypertension
5) Thiazides - long term treatment of hypertension, edema from chronic heart failure, hepatic cirrhosis, corticosteriod and estrogen therapy, renal dysfunction
What are anabolic-androgenic steriods commonly used for?
stimulate growth and accelerate weight gain
T/F: In people who don’t exercise anabolic steriods have no effect.
False, increases hunger and feelings of well-being, just no effect on muscle size or strength
What are some short-term side effects of steriods?
Rage, increase appetite, increased sex-drive, lowered tolerance to pain, acne, male pattern baldness, menstrual irregularites, deepening of voice, decreased breast development, facial and body hair growth, gynecomastia.
What are some long-term side effects of steriod use?
CVD, liver disease, testicular atrophy, impotence, decrease in sperm, enlarged clitoris, uterine atrophy, early closure of physis in children (stunted height).
What is hGH used for?
Muscle growth and strength, and muculoskeletal healing properties.
T/F: hGH is also used medically to improve childrens growth and prevent body wasting in conditions like AIDS.
True
T/F: Overdose of hGH can lead to acromegaly, but the therapeutic window is large for hGH so it is rare.
False, the therapeutic window for hGH is very small.
T/F: hGH is difficult to detect in drug testing.
True
What do amphetamines do?
powerful CNS stimulant
What does Ephedra do?
CNS stimulant that increases serum levels of norepinephrine- increases BP, HR, cardiac output, and peripheral vascular resistance.
T/F: Ephedra can be deadly in hot envrioments because it increases heat production and body temperature
true
T/F: Synthetic variants of ephedra are used to make ecstacy and methamphetamines.
True
What are the two types of blood doping?
Homologous transfusions & autologous transfusions
What is the advantage of doping with erythropoietin?
Increased RBC count means more oxygen uptake
T/F: Both darbepoetin and erythropoietin can be detected in drug testing now.
True
What is the main advantage of creatine?
Faster regeneration of ATP, elays muscle fatigue and soreness,
T/F: Creatine is banned by the NCAA but not the IOC
False, banned by neither
What are the three intentions of drug testing?
1) drug testing discovers the individuals that may be experiencing problems.
2) Testing is performed to screen participants for evidence of drug use/abuse
3) Drug testing protects individuals from injury or from causing injury to others.
What are some methods of drug testing?
urine, blood, human hair, radioimmunoassay
What are the two main disadvantages of urine testing?
sample easily tampered with, potential of humiliating experience for individual
What are three ways people have tried to circumvent urine testing?
1) masking agents
2) determination of drug half-life
3) substitution of urine
T/F The NCAA does two random visits per year to drug test D1 football and track and field athletes.
True
