Lecture 4 Flashcards
What is drug TOXICITY?
drugs ability to poison the body by EXCESSIVE dosing
can result in apoptosis or necrosis of cells
can develop toxics side effects
What are ADVERSE effects in drug reactions?
a harmful or abnormal result of any substance
UNINTENDED and occurs at doses used in humans for prophylaxis, diagnosis, or therapy
Are Product monographs a good source of information for adverse reactions of drugs?
YES!
What are the levels of severity of adverse drug reactions?
- mild –> GI tract probs, minor, headaches, fatigure, muscle aches
- moderate –> like mild but symptoms are distinctly annoying, disstressing and tolerable, drug not usually discontinued just re-evaluate dose, frequency, and timing
- severe –> LIFE THREATENING, usually STOP using drug and MUST be treated. Doctors must sometimes continue giving high risk drugs
What are “idiosyncratic reactions”?
unique, strange, unpredictable
ex: Anaphylaxis
What is a “drug interaction”?
When a drug interferes in a negative way with another…
- drug
-food/nurtients
-drinks
-herbs
-medical condition
NOT ALL NEGATIVE!!
What is a drug-drug interaction in pharmacodynamics?
- when drug changes how tissues respond or do not respond to another drug
What is a drug-drug interaction in pharmacokinetics?
alters a drugs ADME which changes concentration of active drug within body
What can drug interactions lead to?
- additive effects –> beneficial or cause side effects
- lessened effects –> drug failure
- no effect —> no change
What are 3 types of drug-drug interactions that involve prescription or OTC drugs?
- Duplication
- Opposition
- Alteration
What is duplication?
when 2 drugs with the same effect are taken, side effects can be INTENSIFIED
likely to occur when people…
- see several doctors
- more than one pharmacy
ex: someone drinks “neocitrin” and then take “tylenol” to help cold but really you took double dose of tylenol (acetominophen)
What is Opposition?
Two drugs with opposing actions interact, REDUCING their effectiveness
ex: NSAIDs cause body to retain salt, diruretics help rid body of excess salt and fluid so both them together
What is Alteration?
affects ADME
- when one drug may alter how the body absorbs, distributes, metabolizes, or excretes another drug
ex: acid-blocking drugs raise pH of stomach and decrease absorption of drug
Can some drugs affect the rate at which the kidneys excrete another drug?
YES!!!
ex: large doses of vitamin C increases the urine’s acidity and thus may change the rate of excretion and activity of drugs
What are some Drug-nutrient interactions (x10)?
- Bisphosphonates
- used for osetoarthritis
- ANY food causes reduction in absorption and effectiveness
- take on empty stomach, cannot eat for 1/2hr after - Anticoagulants
- cannot take these with foods high in VITAMIN K –> causes increased risk of clotting - Benzodiazepines, calcium channel blockers, cyclosporine, estrogen, and oral contraceptives, statins
- cannot take with GRAPEFRUIT JUICE –> intensifies effects of drugs - Digoxin
- cannot take with OATMEAL –> interfere with abosrption due to fibre - MAO inhibitors
- cannot take with foods high in TYRAMINE–> severe headache, fatal increase in BP
6.Tetracycline
- cannot take with CALCIUM or other METALS –> reduce absorption
- Lipitor/Zocor Statins
- cannot take with ANTIOXIDANTS –> reverse drug effect - Norvasc
- cannot take with foods high in SODIUM –> reduce effectiveness - Alcohol
- cannot take with almost EVERY MEDICATION - Pectin
- slow down absorption of acetaminophen
What are some drug-disease interactions?
drugs that are benefical to one disease can be harmful to others
- beta-blockers
- take for heart diseae
-worsen ASTHMA - cold medicaitons
- worsen GLAUCOMA - NSAIDs
- worsen ASTHMA - Nasal decongestants
- worsen HYPERTENSION
DO blood clots cause hypertension?
NO!
What is pharmacogenomics?
study of the factors that influence variations in drug responses
P450 profiles!
uses genetic information to choose drugs and doses for individual patients
what are drug/biological targets?
any component inside the body to which drugs or other agents bind
PROTEINS!
What are drug-herbal interactions?
- Dong Quai –> do NOT mix w/ WARFIN
- Echinacea –> no NOT mix w/ HEART meds
- Ephedra –> no NOT mix w/ HEART meds
4.Feverfew –> no NOT mix w/ MIGRAINE meds - Ginkgo –> do NOT mix w/ ANTI-COAGULANT meds
6.Garlic –> large amounts increase BLOOD THINNING - Ginseng –> do nNOT mix w/ high BP and Coumadin
- Hawthorn –> do NOT mix w/ DIGOXIN (heart med)
9.Kava –> do NOT take if probs with liver - Licorice –> do NOT use w/ DIURETICS or DIGOXiN
- St.John’s Wort –> do NOT take w/ other ANTI-DEPRESSANTS
- Valerian–> do NOT take with ALCOHOL or VALIUM (sedative)
What is a drug addiction?
can occur without being dependent on drugs
can be from…
- using drugs
- unable to stop
-neglecting social and work obligaitons due to drugs
CHRONIC DISEASE
lead to brain changes –> problems with self-control
What are known triggers for substance abuse?
- family history of addiction
- environment
- history of anxiety
-history of depression - history of other mental health conditions
What is physical dependence?
from long-term use of drugs
Absence will cause withdrawl symptoms -> unique for each drug (LONGER HALF LIFE = LESS withdraw l symptoms)
What are teratogenic effects?
substance or illness that can HARM THE FETUS
