Chapter 15 Flashcards
Define the term pharmacology
study of drugs
define the term drug
Any substance that can produce biological changes in the body, whether those changes are therapeutic or damaging.
if therapeutic it can be terms medication.
they can be very addicitive and cause abuse potential.
Who can prescribe a prescription (Rx) drug?
licensed physician dentist- limited to which kinds optometrist- eye medication physician assistants- limited nurse practitioners- limited psychiatrist- limited
What are OTC drugs?
over the counter or medications that do note require a Px.
- self-precribed
Who determined if a drug must be prescribed by a doctor or can be purchased as an OTC drug?
FDA
what are supplements?
products that are not sold as therapeutic drugs
-FDA does not regulate diatary supplements and medicinal herbs
Define the US drug schedule chart- used to categorize dependency
schedule 1- highest potential for abuse - eg LSD/heroin
schedule 2- high potential for abuse- morphine,
schedule 3- moderate potential for abuse- codeine, T3
schedule 4- lower potential for abuse- Valium, Xanax
Schedule 5- lowest potential for abuse- OTC cough medicine with codeine
Drugs have 3 categories of names. What are they using an example.
chemical, generic and trade name: ie:
chemical name: N-Acetyl-para-aminophenol
generic: acetaminiphone-
trade name: Tylenol
What are the two terms given to describe the two processes in which how a drug is utalized in the body?
- pharmacokinetics- how drug moves in the body (metabolized, transported, excreted)
- pharmacodynamics- how drug changes the body.
how are administration routes, dosages nd dosing schedules determined?
by how the drug moves thorugh the body and the target location effectiveness.
what can affect a drug response in the body?
tolerance, placebo effect, and other body variables as well as dosage and potency.
drug metabolism varies in individuals. Define some variant facotrs
age, gender, DMI, and genetic makeup.
what factors must you consider when determine an administration method of a drug?
speed and degree of absorption- to determine time and onset + intensity
Define the term side effect
a nearly unavoidable secondary drug effect produced at therapeutic doses.
what is drug toxicity?
excessive dosing that causes adverse effects
define the following terms:
- allergic reaction
- idiosyncratic effects
- iatrogenic
- physical dependence
- carcinogenic effect
- teratogenic effect
- immune responses
- uncommon responses to a drug secondary to a genetic predisposition.
- medication error
- occurs when body adapts to repeated use of a substance and thus becomes addicted to the drug
- cancer-causing
- drug-induced birth defects.
When drugs react with eachother there are 3 outcomes. What are they?
- effect is intensified-
- reduced effect- this is why it is important for some drugs to be taken with food, and others on empty stomach
- new effect- ie. MAO inhibitors and food rich in tyramine can raise BP to critical
The heart is assisted by pressure gradients in the vascular system, which are dependant on what factors?
diameter and length of blood vessels
and resistance to blood flow.
it is regulated by a feedback system that involves the (autonomic neuvous system) ANS and teh RAS (renin-angitensin system) and kidneys
What does the ANS, RAS and kidneys do on the circulatory system?
ANS - controls heart
RNS- controls constriction of arterioles and veins. \
kidney: regulate blood volume
What does angiotensin 2- do on the body
its the chemical that causes the muscles surrounding the blood vessels to contract, which increases BP.
if this were to be blocked, it would help regulate BP and also blood volume
Define Angiotensin-converting enzyme inhibitor
called ACE inhibitor.
inhibits the RAS from producing angiotensin 2. > controls BP
AE: chronic cough,
eg: lisinopril and enalapril
Define Angitensin receptor blockers
called ARBs
-block angiotensin 2 from binding to the angiotensin receptors
AE: none, its used if ACE inhibitors has AE
EG: losatan nd candesartan
What do beta blockers do?
decrease heart rate and contractile force, which decreses the cardiac O2 demand. this reduced BP and promotes dilation of blood vessels.
When are Beta blockers usually pxed?
in angina pectoris, heart failure HTN helpful in some dysrhythmias, migraines, glaucoma, benign tremor, nd anxiety
it acts as a cardioprotective agent following MI or intervention for CAD.
EG: antenolol, metoprolol.
What do Ca+ channel blockers do?
clock calcium channels in the heart and blood vessels. This reduces cardiac muscle contraction, which results in lower cardiac output. > vasodilation.
tx: HTN, some anginas, and some arrhythmias
EG: diltiazem and verapamil
Define Anti-arrhythmic Agents (3) kinds
- potassium channel blockers- prolong the recovery of the heart between beats/repolrization. Tx: A fib. EGg: amiodarone, sotalol
- sodium channel blockers- slows electrical impulse. does not interfere with pacemaker therapy. eg: flecainide.
- Cardiac glycosides - used to tx refractory A fib and arterial flutter, after beta blockers and Ca+ have failed. EG: digoxin.
define the term vasodilator
class of drugs that relaxes smooth muscles within the vessel walls. Act on arteries and/or viens depending on pharmodynamics.
define organic nitrates in terms of vasodilator rx.
affects both types of blood vessels, but at normal therapeutic doses the venous dilation predominates and reduces reload venous resistance
tx: angina pectoris but can comabine with other agents to tx congestive heart failure.
EG: nitroglycering and isosorbide.
define diuretics
encourages kidneys to decrease blood volume by increasing urinary output which in turn lowers BP.
tx: heart failure,
AE: loss of potassium,
EX: furosemide and HCTZ
define potassium-sparing DIU
specificallty aldosterone antagonists but also DIU. it inhibits the affects of potassium excretion caused by aldosterone.
tx: HTN or heart failue, and ascites in those with liver failure and hyperaldosteronism d.t adrenal tumors.
eg: spironolactone and triamterene
What does aldosterone do to the body?
its a hormone produced by the adrenal cortex, which increases the reabsorption of sodium and water by the kidneys and thus increases blood volume. it can also increase the excretion of potassium.
what do anticoagulants do?
block substances that promote clotting. They are used to tx pathologic clot formation (eg: heparin) and prevent recurrences once an individual is stablilzed after and embolic (eg warfarin)
define the rx: enoxaparin and dibigatran
- prevents clotting post-opertively in hig-risk individuals who have undergone hip or knee replacement surgery
- direct thrombin inhibitor used to prevent stroke in those with A. Fib.
How does anti-platelet drugs work?
inhibit platelet formation at the site of vascular damage. these prevent the developmentn of platelet thrombi and are most commonly used to prevent stoke and MI.
EX: clopidogral bisulfate
How doe thrombolytics work?
class drugs are used to break down clots once the have formed.
used in emergency situation such as acute MI, stroke and pulmonary embolism or acute arterial thrombosis.
EG: tPAs, such as alteplase.
How do statins work?>
inhibit choelsterol production in the liver. Side effects include ^ LFT, and myalgias,
EG: atrovastatin, rosuvastatin and simvastatin
how do nicotinic acid work? (vit B3)
most potent therapy available to increase HDL cholesterol levels and may have additional vascular benefits
EG: niacin
how do bile-acid binding resins work?
bind to bile, in the intestine and eliminte it from the body through feces.
ex: colestipol and cholestyramine
How do ezetimibe works?
inhibits abosorption of cholesterol in the intestine
how do fibrates work?
used to decrease Trig levels and have been shown to assits in increasing HDL levels
eg: gemfibrozil and fenofibrate.
what are antacids?
alkaline compounds that neutralize stomach acid and are often the first line of defense in controlling increased acid.
this helps in reducing GERD, gastritis, and other causes of dyspepsia.
common eg: Alka-Seltzer and Mylanta
How do PPIs work>?
antisecretory agents that enhance the mucosal lining of the digestive tract by clocking the enzyme in the stomach wall that produces acid.
eg: omeprazole and pantoprazole.
How do histamine2-receptor antagonists work? (H2 antagonist)
reduce amount of acid in stomach like PPI
txs ulcers, gastritis and reflux in OTC.
eg: famotidine and ranitidine
What do laxatives do?
Rx used to increase movement of fecal matter through colon.
psyllium husk and methycellulose are bulking agents used to rain more water in the stool
stool softenier, (Eg docusate) allow wter and fat to be incorportated into the stool to move easily
lubricants and hydrating agents help to move stool through colon.
stimulants like bisacodyl alter water and electrolyte secretion and stimulate peristalic action.
How do antidiarrheal agents work?
employed to decrease amount of liquid in colon and slow production of feces.
opioids activate intestinal opioid receptors casing constipation
exg: loperamide.
What can be used in the tx of IBD depending on the severity of the disease?
sulfasalazine and one of its metabolites 5-ASA or mesalamine. These are DMARDS
and are thought to have anti-inflammatory effects that provides topical relief.
glucocorticoids can help reduce inflammation by surpressing the immune system
What does Bismuth do?
used to help fight H. Pylori.
also used as both an antiacid and antidiarrheal agent
HOW DO CYTOPROTECTIVE drugs work?
by coating the gastric mucosa at site of ulceration by forming an adherent complex with proteins.
eg: sucralfate and misoprostol
how do prokinetic drugs work?
suppress vomiting and increase gastrointestinal motility.
helpful with GERD, and chemotherapy-induced nausea and vomiting.
eg: metoclopramid and prochlorperazine
How do anticholinergics work>
selectively block the binding of acetylcholine to its receptors. This prevents involentary muscle contraction.
tx: gastritis, GI spasms, diverticulitis and ulcerative colitits
Eg: most commonly used anticholinergic for GI issues is hyoscyamine
how do antineoplastics and other anti-viral drugs used on the GI sxs?
used for tx of chronic, viral hepatitis, via a sustained virological response.
- Hep B tx’ed with interferon alfa-2b, and now lamivudine
- Hep C- tx’ed with interferon and ribavirin. in addition to protease inhibitors,
How does ursodeoxycholic acid ( a secondary bile acid) affect the body when used as a pharmaceutical agents?
reduces cholesterol absorption and helps dissolve gallstones.
- bot commonly used, instead people are tx’ed with cholecystotos.
how do drugs work on the tx of endocrine disorders?
most endo disoders are caused by insufficient or over production of hormones. Tx is supplementing hormones or supressing them.
There are 3 classes of steroid hormones produced by the adrenal cortex system. What are they?
- / Glucocorticoids- influence carbohydrate metabolism. eg: prednisone
- mineralcorticoids- influence salt and water balance- eg fludrocortisone
- androgens- development of sex characteristics
