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Pharm > Intro to Pharm > Flashcards

Intro to Pharm Flashcards

1
Q

Definition of Pharmacology

A

the study of drugs

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2
Q

Definition of pharmacy

A

drug preparation and dispensing

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3
Q

Why do therapists needs an understanding of pharmacology

A
  • physical therapy may be MORE effective when
    combined or coordinated with pharmacotherapy
  • PT may be more effective when timed around
    drugs
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4
Q

PTs should be able to suggest or advise…

A

physician about need for, or modification of, drug administration based on the patient’s performance in the therapy

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5
Q

Therapists are in the best position to do what?

A

to observe or note the side effects or drug
interactions

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6
Q

Pharmacokinetics

A
  • How the body acts on the drug
  • Absorption, metabolism, elimination
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7
Q

3 phases of drug metabolism

A

absorption, metabolism, elimination

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8
Q

absorption

A
  • route of administration
  • onset
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9
Q

metabolism

A
  • distribution and bioavailability
  • peak and duration
  • half life
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10
Q

elimination

A

duration

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11
Q

half-life

A

time it takes for blood level to decrease by half

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12
Q

oral administration

A
  • most common
  • cheap, easy to administer, convenient
  • 1st pass metabolism (liver), must be GI- compatible
  • potential for abuse
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13
Q

Parenteral

A

administered in a manner other than through the digestive tract

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14
Q

Parenteral - IV

A
  • into vascular compartment
  • Fast, little control, requires sterility
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15
Q

Parenteral - Intramuscular

A
  • absorption depends on blood supply, concentration and
    bioavailability of drug
  • Absorbs drug more slowly but is affected by exercise
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16
Q

Parenteral - Subcutaneous

A
  • similar to intramuscular, but typically slower absorption
  • not as affected by exercise
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17
Q

Transdermal

A

complex pharmacokinetics & inconsistent absorption

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18
Q

Inhaled

A

very rapid, may or may not remain local

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19
Q

Buccal/sublingual

A

faster than oral, but slower than IV or inhalation, does not require sterilization

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20
Q

What is pharmacodynamics?

A

how a drug affects the body

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21
Q

What is the clearance of drugs from the body highly dependent on?

A

liver and kidney function

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22
Q

Factors affecting pharmacokinetics

A
  • Age: older adults and children may metabolize and eliminate certain drugs more slowly
  • Liver and kidney dysfunction slow metabolism and elimination of some drugs (both more common in elderly)
  • Enzyme-induction in liver may affect drug activity and bioavailability (may develop tolerance)
  • Presence of certain chemicals increases or
    decreases elimination
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23
Q

What does vitamin C do?

A

acidifies urine, increasing exertion of weak bases (may drugs fall into the category of weak acids)

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24
Q

Therapeutic Dose

A
  • Blood level of a drug will increase with multiple doses until elimination = intake
  • Therapeutic dose achieved at 4-5 times the half life
  • Loading dose” allows for shorter time course
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25
Q

What do pharmacodynamics include?

A

indications, mechanism of action, side effects

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26
Q

Potency

A

the amount of drug necessary to achieve a given response (determines the size of the pill)

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27
Q

Efficacy

A

The effectiveness of a drug in producing the desired response when given at it’s maximal dose

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28
Q

Dose Response Curves

A
  • below threshold for response
  • Prescribe at E50
  • above threshold: no further response
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29
Q

review potency and efficacy charts on slide 19

A
30
Q

what is determined by the potency of the medication

A

drug “dose”
A more potent drug will require a lesser dose

31
Q

review frequency response curve

A
32
Q

Therapeutic Window

A
  • The difference between the effective dose (ED50) and a dose that is lethal (LD50)
  • The greater the window the better
33
Q

Drugs with a narrow therapeutic window

A

– digoxin
– Lithium salts
– phenobarbital

34
Q

Principles Governing Activity of Drugs

A
  • Dose-response Effect
  • Absorption
  • Distribution (pH differences, lipophilic properties)
  • Elimination
35
Q

Dose-response effect:

A

Effect proportional to dose administered

36
Q

absorption

A

acid/base properties

37
Q

distribution - lipophilic properties

A
  • Very important for crossing blood-brain
    barrier
  • Most neuro-active compounds are lipophilic
  • Ethanol
  • Lipophilic gets into the brain
38
Q

what do most drugs works through?

A

a known neurotransmitter and a known receptor

39
Q

what is a secondary effect of drugs?

A

change in neurotransmitter receptor activity

40
Q

are there “silver bullets?”

A

no
most neuro-active drugs have a general effect

41
Q

non-specificity of drugs:

A

many drugs are used to treat different disorders

42
Q

Valium

A

anti-seizure medication, anti-anxiety medication, anesthetic, sedative-hypnotic used for sleep, muscle relaxer, anti-spasticity drug

43
Q

Lock and Key Model

A

– The receptor functions like a lock:
* Only a particular molecule (an “agonist”) with a certain structure can “unlock” it –> receptor stimulation
* Other types of molecules can bind to the
receptor that don’t “unlock” it, but instead block
activation (“antagonist”)

44
Q

neurotransmitters and their receptors

A

Forms basis for most pharmacological
intervention

45
Q

Hormone Receptors

A

– Membrane receptors: Insulin R, alpha and b-adrenergic receptors
– Intracellular receptors: thyroid hormone and glucocorticoid receptors

46
Q

Common mechanisms in pharmacology

A
  • Molecular interaction agonist/antagonist (Neurotransmitter agonists/antagonists)
  • NT Reuptake/breakdown inhibitors
  • Inhibit/facilitate synaptic vesicle fusion
  • Inhibit/stimulate NT precursors
47
Q

Molecular interaction agonist/antagonists examples

A

– Clopidogrel: anticoagulant that antagonizes platelet activation
– Dexamthasone: agonist to glucocorticosteroid receptors

48
Q

Neurotransmitter agonist example

A

Bromocreptine (Parlodel): agonize Dopamine receptors

49
Q

Neurotransmitter antagonist example

A

Acetophenazine (Thorazine): antagonize Dopamine R’s in limbic system

50
Q

Drug that block re-uptake/breakdown of a NT example

A

Fluoxetine (Prozac): Serotonin specific re-uptake inhibitor

51
Q

Drugs that facilitates neurotransmitter release example

A

Amphetamine (Ritalin): increase NE release and prevents re-uptake

52
Q

excitatory post-synaptic potentials

A

– Decreased K+ or Cl- conductance
– Increased Na+ or Ca+2 conductance

53
Q

inhibitory post synaptic potentials

A

– Increased K+ or Cl- conductance
– Decreased Na+ or Ca+2conductance

54
Q

what is seizure disorder?

A
  • Hyper-excitable or irritable neurons in cortex causing spontaneous depolarizations
55
Q

what do drugs for seizure disorder focus on?

A
  • suppressing the excitability of cortical neurons that trigger the seizure
    – gamma-aminobutyric acid (GABA): inhibitory NT found throughout the brain
    – most drugs that suppress seizures work by enhancing the action of GABA
56
Q

Review slide 33

A
57
Q

Where are adverse drug reactions common?

A

hospital settings

58
Q

what do adverse drug reactions depend on?

A
  • a variety of factors
  • Genetics (polymorphisms), gender, age, health, etc
59
Q

what can side effects be compounded by?

A

conditions that limit liver/kidney function, such as Aging, heart failure, liver disease, kidney
failure

60
Q

what is polypharmacy?

A

Duplication of medication or over-medication
through the use of multiple drugs

61
Q

what causes polypharmacy to be more likely?

A
  • more comorbilities
  • going to multiple physicians
62
Q

can herbal or over the counter medicines interact with prescription medicines?

A

yes

63
Q

What are drugs classified by?

A

action, indication, restriction, effectiveness

64
Q

action

A

mechanism of drug action (CNS vs PNS, antagonist vs agonist)

65
Q

drug indication

A

by body system or disease process

66
Q

drug restriction

A

Schedule of controlled substances:
- Schedule I: most restricted
- Schedule V- least restricted

67
Q

drug effectiveness

A

“cure” versus manage symptoms
* Most drugs control symptoms rather than cure disease

68
Q

Pregnancy Category C

A

Animal studies suggest risk, but no trials in pregnant women. Use
only when benefit outweighs risk

69
Q

Controlled Schedule I

A

High potential for abuse. No acceptable medical use: heroin, LSD, marijuana. Research only.

70
Q

What are the issues in Physical Therapy?

A
  • sedation of patients
  • respiratory issues
  • cardiovascular issues
  • controlling pain, infection, blood glucose
  • improve patients outlook
71
Q

respiratory issues

A

open airway, get patient breathing independently again

72
Q

cardiovascular issues - gain control of

A

– hemostasis/coagulation
– heart rate, blood pressure & organ perfusion

Pharm (12 decks)

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