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PT9111 - Test 4 > Lecture 53 - Pharmacology > Flashcards

Lecture 53 - Pharmacology Flashcards

1
Q

Drug

A

A substance used in prevention, diagnosis, treatment or cure of a disease

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2
Q

Pharmacology

A

Study of drugs

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3
Q

Pharmacotherapeutics

A

Deliberate therapeutic application of drugs which can be divided into pharmacodynamics and pharmacokinetics

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4
Q

Pharmacodynamics

A

What the drug does to the body

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5
Q

Pharmacokinetics

A

What the body does to the drug

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6
Q

In order for drugs to be effective drugs have to (4)

A

1) Enter the body and cross barriers to entry (pass through skin, gut or other membranes)
2) Be distributed by the blood to the site of action (determines concentration of drug at site of action)
3) Be biotransformed (enzymes increase/decrease drug action)
4) Be excreted (remove drug/metabolite from body)

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7
Q

Drugs have to cross barrier to enter, how they pass is through (2)

A

1) Active diffusion using a carrier mediated transport
2) Passive diffusion through a cell membrane/pore

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8
Q

What are 5 pharmaceutical strategies to improve absorption and distribution

A
  1. Multilayer tablets (enteric coated)
  2. Sustained release capsules (resin)
  3. Depot injections (oily, viscous, particle size)
  4. Skin patches (nicotine, nitroglycerin)
  5. Pro-drugs (morphine -> codeine)
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9
Q

Explain the metabolism of drugs by the body

A

Drug molecules are processed by enzymes intended to convert natural compounds which will change their actions (increase or decrease), mainly occurs in the liver

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10
Q

Excretion

A

Removal of drugs from the body through urine, bile, sweat saliva, expired air and breast milk (kidney is responsible for the bulk of excretion)

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11
Q

What happens when excretion is inhibited

A

Drugs and waste accumulate which results in toxic affects

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12
Q

What are the 3 excretion parameters

A
  1. Rate of elimination
  2. Half-life
  3. Steady-state concentration
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13
Q

Rate of elimination

A

Volume of drug cleared per unit of time

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14
Q

Half-life

A

Time required to reduce the plasma concentration to one half its initial value

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15
Q

Steady State Concentration

A

The concentration point at which amount of drug administered = the amount of drug being cleared

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16
Q

Explain the Concentration-Time relationship of drug efficacy

A

Blood concentration of the drug goes up and the drug starts to get broken up at its peak and then the slope as it goes down represents the decreased drug concentration as it is excreted. The drugs must reach minimum concentration threshold to have an effect and must not pass the maximum concentration threshold or else adverse effects occur.

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17
Q

Explain the steady state diagram

A

This is when multiple doses are given over time. At first dose doesnt reach minimum threshold concentration and needs more doses to give it that push to pass concentration. The drug will then be in a constant phase of being in between the minimum and maximum efficacy concentration of the drug which causes a steady-state. This is where want drugs to be at when they are administered. Why we ask patients to take medications at the same time each day.

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18
Q

What are 3 types of pain management

A
  1. Non-opioid analgesics
  2. Opioid analgesics
  3. Adjuvant medications
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19
Q

Describe the analgesic ladder

A
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20
Q

Acetaminophen dose, mechanism of action, onset of effect, duration and adverse effects

A
21
Q

Non-prescription vs prescription names for NSAIDS

A
22
Q

NSAID’s role, dose, response, onset, duration, and mechanism of action

A
23
Q

NSAIDS adverse effects and ways to prevent these effects

A
24
Q

How do NSADS cause hypertension (chronic use) and nephrotoxicity (high dosage)

A
25
Q

What are 2 practical points for physiotherapists in regards to drug use (non-opioid analgesics)

A
  1. Non-opioid analgesics decrease mild-moderate musculoskeletal pain which increases participation in rehab
  2. NSAID’s decrease inflammation that could result from aerobic activities
26
Q

What are 2 effects of NSAIDS/non-opioid analgesics that could interfere with rehab and their possible therapy solutions

A

Problems:
1. HEMORRHAGE INTO MUSCLES AND JOINTS AS A RESULT OF AEROBIC ACTIVITES THAT MAY PRESENT AS MUSCLE AND JOINT SORNESS
2. Nephropathy can lead to electrolyte imbalances and hypertension

Solutions:
1. Check BP prior to and during and after aerobic activities
2. Differentiate delayed onset muscle soreness from arthropathy/myopathy due to hemorrhage

27
Q

Name some opioid products (9)

A
28
Q

Opioid relative potency chart

A
29
Q

What is special about morphine

A

That is where we move to step 2/3 on the pain ladder, so anything above morphine is milder (step 1)

30
Q

Whats the difference between this list

A

IR = immediate release
Contin (ER/ES): Continuous release (long-acting)

31
Q

Difference between short acting and long acting oral opioids

A
32
Q

List 6 opioid combo products

A
33
Q

What are some common and less common adverse effects of opioids

A
34
Q

Tolerance

A

Higher dose required for chronic use (disease progression is a factor)

35
Q

Physical dependence

A

Biologic phenomenon that occurs when you become dependent on a drug and this is why tapering of medications is important

36
Q

Psychological dependence (addiction)

A

Pattern of drug use characterized by craving for drugs, but is rare when treating true pain disorders

37
Q

Alpha Agonists

A

Neuropathic pain

38
Q

Anesthetics

A

Loss of sensation (temporary)

39
Q

Anticonvulsants

A

Neuropathic pain

40
Q

Antidepressants

A

Neuropathic pain

41
Q

Antihistamine

A

Nausea, pruritus

42
Q

Benzodiazepines

A

Pain with anxiety

43
Q

Bisphosphonates

A

Bone pain (cancer)

44
Q

Corticosteroids

A

Bone pain (cancer)

45
Q

Muscle relaxants

A

Spasticity

46
Q

NSAIDs/COX-II Inhibitors

A

Anti-inflammatory

47
Q

Opioid analgesics [increase/decrease] pain levels and allow increased participation in rehab

A

decrease

48
Q

What are effects of opioids that interfere with rehab and their possible therapeutic solutions

A

Effects:
1. Sedation, mental slowing, and drowsiness can affect patient interventions
2. Respiratory depression can lead to hypoxia and hypercapnia and blunt exercise response

Solutions:
1. Target interventions at peak levels for maximum analgesic benefit
2. Monitor for shortness of breath, respiratory rate

PT9111 - Test 4 (14 decks)

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