Intro to Pharm (Iszard) Flashcards
Describe the six levels of pharmacology (Pyramid of Pharmacology)
- drug names and class (MOA vs. chemical)
- MOA
- Indications/uses
- Toxicities (common/severe and contraindications)
- Monitoring
- Drug Interactions
What are the three ways drugs can be named?
- Chemical (think organic chemistry)
- Generic Name (oxymorphone hydrochloride)
- Brand Name (OPANA)
Compare and Contrast pharmacokinetics vs. pharmacodynamics
Pharmacokinetics looks at the time that the drug is active in the body
Pharmacodynamics looks at the effect of the drug in the body
What is the therapeutic window?
ratio between minimum effective concentrations (MEC) and the minimum toxic concentration
Define therapeutic Equivalence
Must be pharmaceutically equivalent and expected to have the same therapeutic clinical effect and same safety profile
Define bioequivalence
similar rate and extent of absorption
80%-125% of reference product
What are “A” codes for therapeutic equivalence?
Drug products that are considered to be therapeutically equicalent to other pharmceutically equivalent products
What are “B” codes
Drugs that the FDA at this time is considered not to be therapeutically equivalent to other pharmaceutically equivalent products
What are schedule 1 drugs?
all non-research use is illegal under federal law
includes rohypnol, marijuana, LSD, PCP
What are schedule II drugs?
no telephone Rxs, no refills
includes opiods, cannabinoids, amphetamines, phenobarbitol
What are schedule III drugs?
New Rx written after 6 months or five refills, high potential for abuse
incldues: opiods, cannabinoids, amphetamines, phenobarbitol
What are schedule IV drugs?
Rx must be written after 6 months/5 refills, differes from III for illegal possesion
includes low risk for abuse/dependence; propoxyphene, phentermine, alprazolam
What are schedule V drugs?
Non-opiod Rx, Dispensed without Rx,
Drugs with lower potential for abuse, with limited quantities of narcotics; pregabalin-lyrica
Dosage Formula
D/H x Q=one dose
D= Doctor’s order (name and amount prescribed)
H=supply on hand
Q=form of medication
Example: 30mg/60mg x 1 tablet=0.5mg, therefore one dose will be one half of a tablet
Define pharmacotherapeutics
a field of study of appropriate use of medications to effectively treat or prevent disease and manage symptoms
Define pharmacogenomics
a field of study of genetic impact on drug metabolic of handling processes which can affect individual responses to drugs
Define pharmacoeconomics
a field of study utilizing scientific and economic methods to evaluate and compare value between therapies
Define pharmacoepidemiology
a field of study that applies epidemiological principles and methods to study the uses and effects of medications on large populations
beta blockers end with-
alpha blockers end with-
ACE inhibitors end with-
Ca Channel blockers end with-
Diuretic agents end with-
- olol
- sin
- pril
- pine
-ide
Development timeline of drugs
in Vitro studies
Animal testing
clinical testing
Marketing
1-2 years
2 years, with investigational new drug at year 4
4-5 years, with new drug application at year 8-9
approx. 20 years and then generic can be made
What are some errors/effects that can come between the physician prescribed dose and the pt administration of the drug?
medication errors and patient compliance
Major reason in past years for drug therapy
What are some errors/effects between the administered dose of a drug and the concentration of the drug at the action site?
- rate and extent of absorption
- body size and composition
- distribution in body fluids
- binding in plasma and tissues
- rate of metabolism and excretion
What are some errors/effects between the concentration of the drug at the action site and the drug’s effects?
- drug-receptor interaction
- functional state of targeted system
- selectivity of drug, propensity to produce unwanted effects
- placebo effects
- resistance
What are some issues with drug concentration at action site that are related to dose and effects?
- physiological variables
- pathological factors
- genetic factors
- interaction with other drugs
- development of tolerance and desensitization
Describe the dose-response relationship curve
- drug taken
- absorption (avg. 20min)
- distribution and onset of effect
- peak concentration reached
- interaction with receptors
- produces effects
- drug is biotransformed
- drug is inactivated
- drug is eliminated
Drugs with low TI
Drugs with high TI
Digoxin, lithium, warfarin
benzos
What is important to remember about potency?
the closer to zero, the more potent the drug
if two drugs are equally effective, give the least potent, since it will have fewer adverse effects
What is an additive effect of drug interactions?
ex: 2+3=5
ETOH and diphenhydramine together will cause more sedation than either separate
What is a synergistic/multple interaction of drug interactions?
3+3=9
Ex: EtOH and alprazolam together is a deadly combination of sedation while either separate are fine in moderation
What is an example of potentiation in drug interactions?
2+0=4
Ex: EtOH and CCl4 together will cause liver damage much rapidly than just EtOH alone. CCl4 forms a free radical in the presence of EtOH and accelerates liver damage
What is functional antagonism?
2 agonists interact with different receptors to produce opposite effects
ex: adrenergic drug/vasodilator
What is chemical antagonism?
drug counters effect of another resulting in decreased effect
Ex: CaNa2, EDTA and Pb/As
What is dispositional antagonism?
metabolism of a chemical is altered and the concentration and/or duration of the chemical are diminished
ex: ETOH/methanol/Ethylene glycol getting metabolized to formaldehyde by alc. dehydrogenase causing blindness and widened anion gap (death)
tx with etoh
What is receptor antagonism?
receptor configuration/specificty changes
ex. is opiates and nalaxone
What are non-deleterious drug side effects?
What are deleterious drug effects?
hair loss, itching, hair growth, benign swelling
pharmacological: adriamycin and anticancers (tissue damage)
Pathological: Isoniazid for TB causes hepatic damage
Genotoxic: thalidomide causes phocomelia
What are pharmaceutical alternatives?
same drug but different formulation or dosage strength
example: tetracycline hydrochloride vs. tetracycline phosphate complex
What are the FDA’s updated pregnancy guidelines?
the pregnancy subsection will provide info about dosing and risks to fetus and data collection on how pregnant women are affected by drug
info in drug labeling about the existence of any pregnancy registries has been recommended in the past but is now required.
What are the FDA’s new guidelines on lactation?
replaces “nursing mother’s” section and now includes drugs that should not be used during breastfeeding due to presence in milk or clinical effects on infant
What are the FDA’s new guidelines for males and females of reproductive potential?
relevant info on pregnancy testing or birth control before/during/after therapy and effects on fertility and miscarriage will be provided when available
Common abbreviations that i am unfamiliar with-not inclusive:
QOD:
AC:
PC:
OD:
OS:
OU:
AD:
AS:
AU:
GTT:
every other day
before meals (ante comida)
after meals (post comida)
right eye (oculus dextro)
left eye (oculus sinistre)
both eyes
right ear
left ear
both ears
drops
Practice writing/reading scripts and maths
do it..
