Lecture 7: Pharmacology and DOA

Question 1

What is a a narrow therapeutic range

Answer 1

Drugs that are monitored tend to have a narrow “therapeutic range” – the quantity required to be effective is not far removed from the quantity that causes significant side effects and/or signs of toxicity.

Question 2

What is the goal of Therapeutic Drug Management?

Answer 2

enables the assessment of the efficacy and safety of a particular medication in a variety of clinical settings.

The goal of this process is to individualize therapeutic regimens for optimal patient benefit.

Question 3

Define Pharmacokinetics and Pharamacodynamics

Answer 3

Pharmacokinetics influences the decided route of administration for a specific medication, the amount and frequency of each dose and its dosing intervals.

Pharmacodynamics is the study of how a medicine acts on a living organism.
This includes the pharmacological response and its duration and magnitude observed, relative to the medicines concentration at an active site in the organism

Question 4

What are the 4 main concepts of pharmacokinetics and what do they mean

Answer 4

Study of the time coursefollowing administration of a drug is characterized by individualized patterns of absorption, distribution, metabolism, and elimination.

Absorption is defined as the crossing of drugs through various sites (intestines, muscle, etc) into the circulatory system.

The drug distribution phase is the time required for the drug to penetrate and equilibrate with its site of action and other extravascular tissues

Metabolism and elimination determine the duration of the drug’s pharmacologic activity and are the result of biotransformations that take place primarily within the liver and are followed by excretion by the kidneys.

Question 5

What is the therapeutic range? Diagram

Answer 5

The therapeutic range of a drug is the dosage range or blood plasma or serum concentration usually expected to achieve the desired therapeutic effect with no side effect.

Lecture Slide for diagram

Question 6

Where does Pharmacokinetic and pharmacodynamic variability arise?

Answer 6

Stage one: Prescribed drug regime

Pharmacokinetic variability:
Compliance, Dosing errors, Tissue and fluid volume and mass, drug interactions

Stage 2: Drug at the site of action or blood conc

Pharmacodynamic Variability:
Drug receptor status, genetic factors, Drug interactions, tolerance

Stage 3: Clinical or drug effects

Question 7

What are the two levels used for monitoring drug therapeutic agents and when should they be collected?

Answer 7

To adequately evaluate the appropriate dosage levels of many drugs, the collection and testing of specimens for trough and peak levels is necessary.

Trough level is the lowest concentration in the patient’s bloodstream, therefore, the specimen should be collected just prior to administration of the drug.

Peak level is the highest concentration of a drug in the patient’s bloodstream.

Question 8

Prostaglandin Description:
What is it?
Where are they, how are they made?
What do they do?

Answer 8

Hormones that are acidic lipids which can be enzymatically produced by mostmammalian celltypes in response to mechanical, chemical or immunological stimuli.

Prostaglandins are produced in nearly all cells and are part of the body’s way of dealing with injury and illness.

Are made at sites of tissue damage or infection, where they causeinflammation, pain and fever as part of the healing process.

When a blood vessel is injured, a prostaglandin called thromboxane stimulates the formation of a blood clot to try to heal the damage.

Cyclooxygenase makes prostaglandin through chemical reaction

Question 9

Paracetamol is termed as what?

Answer 9

an antipyretic used as an analgesic for mild to moderate pain

Question 10

How does paracetamol and prostaglandin interact?

Answer 10

Analgesic and antipyretic affects of paracetamol are probably due to its ability to inhibit prostaglandin synthesis.

Question 11

Typical effect of paracetamol overdose?

Answer 11

analgesic nephropathy, liver damage (in alcoholic liver patients)

Question 12

What is Salicylate and purpose

Answer 12

Are analgesic, anti-rheumatic and anti-inflammatory drug

Salicylates is essential in the proper use and control of treatment in arthritic conditions and has anti-coagulant effect.

Question 13

Mechanism of action for salicylate: _______ action of what enzyme leading to….

Answer 13

inhibit the activity of the enzyme now called cyclooxygenase (COX) which leads to the formation of prostaglandins (PGs) that cause inflammation, swelling, pain and fever.

Question 14

6 classes of Drug of abuse

Answer 14

Central nervous system depressants
Central nervous system stimulants
Opiates
Cannabinols
Hallucinogens
Inhalants

Question 15

Central Nervous System Depressants:
Used for?
Example

Answer 15

are used to treat insomnia (trouble sleeping), anxiety, panic attacks, and seizures, relieve anxiety and tension before surgery.

Examples of central nervous system depressants are benzodiazepines, barbiturates, and certain sleep medicines.

Question 16

Central Nervous System Stimulants:
Used for?
Examples?

Answer 16

used for attention deficit disorder, narcolepsy or excessive sleepiness include methylphenidate, atomoxetine, modafinil, armodafinil and the amphetamines.

loosely defined group of drugs that tend to increase behavioural alertness, agitation, or excitation

Question 17

Opoids:
What are they?
Examples?
Used for?

Answer 17

are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells.

Opioids can be made from the poppy plant — for example, morphine (Kadian, Ms Contin, others) — or synthesized in a laboratory — for example, fentanyl (Actiq, Duragesic, others).

When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure

Question 18

Cannabinols:
What are the 3 forms?

Answer 18

Marijuana: the most common and least powerful form of cannabis, this is the dried leaf and flower (buds) of the plant. It is mostly green in appearance although some strains have orange, silver and purple fibres

Hashish: Dried blocks of cannabis resin, which can range in colour from gold to nearly black. This produces a more intense high than marijuana

Hash oil: This is a thick oily liquid extracted from hashish and is the most powerful form of cannabis.

Question 19

Halluciongens:
What are they?
Two examples?
Purpose

Answer 19

are a class of drugs that cause hallucinations—profound distortions in a person’s perceptions of reality.

classic hallucinogens (such as LSD) and
dissociative drugs (such as PCP).

work at least partially by temporarily disrupting communication between neurotransmitter systems throughout the brain and spinal cord that regulate mood, sensory perception, sleep, hunger, body temperature, sexual behavior, and muscle control.

Question 20

Inhalants:
What are they?
Three types?

Answer 20

volatile substances that produce chemical vapors that can be inhaled to induce a psychoactive, or mind-altering, effect.

Volatile solvents are liquids that vaporize at room temperature. They are found in a multitude of inexpensive, easily available products used for common household and industrial purposes.

Aerosols are sprays that contain propellants and solvents. They include spray paints, deodorant and hair sprays, vegetable oil sprays for cooking, and fabric protector sprays.

Gases include medical anesthetics as well as gases used in household or commercial products.