Intro Flashcards
Effects of pharm on PT practice
hinder therapy w side effects/effects
facilitate therapy by reducing pain or symptoms
contribute to safety with emergency meds like inhalers
chemical name
compound structure name
generic name
derived from chemical name, shorter
ex) acetaminophen
Trade/brand name
assigned to compound by company for marketing purposes
schedule 1 drug
drugs that have no approved medical use as well as a high potential for abuse
ex) heroin, LSD, MDMA
Schedule 2 drug
drugs with high potential for abuse and dependence but have an accepted medical use
ex) fentanyl, methamphetamine, oxycodone
Schedule 3 drugs
mod-low abuse potential compared to schedule 2 drugs
ex) steroids, testosterone, ketamine
Schedule 4 drugs
Low abuse potential compared to 3 and low risk of dependence
ex) diazepam, tramadol
Schedule 5 drugs
lowest abuse potential
low dose opioid in cough meds
Sources of drugs
Natural: plant, animal/marine, mineral, microorganisms
Chemical: semi or fully synthetic
biotechnological: monoclonal antibodies, recombinant proteins, gene therapy
What criteria do generic drugs need to satisfy to sub for a brand name?
generic has been tested to make sure its the same type/amount of active ingredient, sane pharmacokinetic profile, same admin route, same effects
if all are equal, then drugs are bioequivalent
off label prescribing
drs prescribe drugs for conditions they are not approved for based on their experience and observation
often for conditions where we don’t have a good treatment or FDA approved option
pharmacokinetics
what happens in your body when you take a medication
absorption/distribution/metabolism/excretion
movement of medicine
pharmacodynamics
how drug affects the body, the purpose of taking the medication
has cellular and systemic effects
mechanism of action
dose response/potency/therapeutic index
effects
side effects
toxicology
toxic effects of a medication in overdose or abnormal dose
What factors impact absorption of medication?
bioavailability of drug in systemic circulation determines absorption
stomach acidity, gastric emptying, SA, GI enzymes, dvlptal changes all impact
bioavailability depends on
route of administration
drugs ability to cross membranes passive/active/facilitated/other
distribution of a drug is affected by
tissue permeability, blood flow, plasma proteins, and subcellular components
eg drugs go to areas of higher blood flow first such as the live, kidneys, brain, lungs
drugs are stored in:
bone, adipose, muscle, organs
volume of distribution
amount of drug administered/concentration of drug in plasma
availability of the drug in the bloodstream
affected by distribution and it’s binding to blood proteins
drug excretion is through
kidneys: glomerular filtration and tubular secretion
excreted in urine mainly
can also be excreted through fecal matter like with fat soluble substances
Drug metabolism: significance of CYP enzyme
CYP enzyme is involved in drug metabolism, so drugs either increasing or decreasing its activity will have an impact on the metabolism of other drugs the patient is taking
could lead to toxic effects or reducing the intended effect
clearance rate of a drug
ability of organs/tissue to eliminate the drug
half life
time to reduce to 50% of the original drug amount in the body
factors impacting patient response to a drug
genetics
disease of liver/kidneys/etc
age
gender
drug interactions
environmental
exercise
how is absorption different in infants
less stomach acid decreases bioavilability
delayed gastric emptying increases time for drug to work
increased cutaneous perfusion
increased topical absorption
how is distribution different in infants
altered distribution due to different water, adipose, and albumin concentrations
how is drug metabolism different in infants
lower hepatic enzyme levels until 1
how does excretion differ in infants
decreased glomerular filtration/secretion
before 7 months drugs can have adverse effects due to lack of elimination from kidneys
How does absorption differ in the elderly?
increased stomach pH
delayed gastric emptying
How does distribution differ in the elderly?
lower water percentage, increased adipose %, decreased albumin
How does drug metabolism differ in the elderly?
decrease in hepatic biotransformation
How does excretion differ in the elderly?
decreased glomerular filtration/secretion
causes adverse drug rxns
potency of a drug
dose that produces a given response in a specific amplitude
dose required for response. depending on strength of medication
dose response curve
shows minimum therapeutic level as well as ceiling effect where response will not increase beyond
therapeutic window of a drug
minimum level to achieve desired response to maximum level before experiencing adverse effects
E50
median effective dose
50% of the population responds to the drug at this dose
T50
median toxic dose
50% of the group exhibits adverse effects at this dose
often lethality, animal studies
therapeutic index
TI = TD50/ED50
want number to be high so toxic dose is high and effective dose is low, safer to have larger difference in doses
