DD French interactions and toxicity Flashcards
What are the FDA drug use categories for pregnancy?
A, B, C, D, X
Define pregnancy drug category A.
No risk
Define pregnancy drug category B.
No evidence of risk
Define pregnancy drug category C.
Risk cannot be ruled out
Define pregnancy drug category D.
Positive evidence of risk but may be used in life threatening circumstances.
Define pregnancy drug category X.
Contraindicated for any reason
What do pharmacodynamic interactions do.
May enhance or antagonize a drug?s action without changing its plasma concentration.
What do the elderly, the acutely ill, those with renal/hepatic disease, and those with multiple prescribing physicians have in common?
They are all at high risk for drug-drug interactions
T or F: Increasing GI motility decreases the absorption of a drug.
FALSE
T or F: Decreasing blood flow lengthens the plasma concentration of a drug.
TRUE
T or F: Release of drug from plasma proteins decreases the plasma concentration of a drug.
TRUE
T or F: Competition for active kidney tubule excretion decreases plasma concentration of a drug.
FALSE
Define indirect pharmadynamic effect.
The pharmacologic effect of one drug indirectly affects the second drug.
What is the single most important determinant of poisoning outcomes?
Good supportive care
What are the two general ways to decrease toxicity?
Decrease absorption and enhance elimination
How can you limit absorption?
Emesis, activated charcoal, gastric lavage, whole bowel irrigation, cathartics
Contraindications for emetic use.
Lack of gag reflex, swallow corrosive agent, ingestion of CNS stimulant, ingestion of petroleum distillate, pregnancy cat C drug
T or F: Gastric lavage gets rid of approx 90% of toxin.
False. Only 30%
T or F: Activated charcoal can reduce eliminations half lives of drugs given IV.
True. Back diffusion of drug from blood with ion-trapping
What is an osmotic cathartic?
Decreases time of toxin in GI tract as on osmotic laxative (sorbitol)
What drug should be given with activated charcoal?
Sorbitol
T or F: Methanol and ethylene glycol are toxic on their own.
False. They are not toxic until they are metabolized (formic acid and oxalic acid, respectively). They damage the retinas and kidneys, respectively.
T or F: Methanol and ethylene glycol cause metabolic acidosis.
TRUE
How do you prevent toxic metabolite production with methanol and ethylene glycol? (3 ways)
1.) Hemodalysis 2.) Ethanol 3.) Fomepizole
Which phase of metabolism primarily processes methanol and ethylene glycol.
Phase II
Which phase of metabolism primarily processes methanol and ethylene glycol.
Phase II (conjugations)
T or F: Phase II metabolism of acetaminophen produces toxic metabolites.
False. Phase I produces toxic metabolites that are then detoxified by Phase II reactions.
T or F: Hemodialysis is most effect for toxins with a large Vd.
False. Small Vd
T or F: Hemodialysis is most effect for toxins with a high protein binding capacity.
FALSE
T or F: Hemoperfusion and hemodialysis are the same thing.
FALSE
T or F: Forced diuresis is not good for patients with poor pulmonary function.
True. Puts them in danger of fluid overload.
How do heavy metals affect body function.
They can interact with essential molecules, inhibit enzymes, alter membrane structures (esp. neurons)
