Medical Issues Ch. 4 Flashcards by James Miller

what is a drug

a chemical that interacts with and affects living organism to produce a biological response

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who regulates drugs

FDA

DEA

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drug nomenclature and classifications

identified by
-chemical name
-generic name
-brand name
classifications
-prescription drugs
-over-the-counter drugs
-controlled substances

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Prescription drug

prescribed by Doctor, NP, or PA

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OTC products

no prescription necessary

FDA must approve ingredients and label information

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Controlled Substances

-schedules

high risk for abuse
schedule 1: high potential for abuse
-marijuana, LSD
schedule 2
-cocaine, riddalin
schedule 3
-anabolic steroids, prescription pain killers
schedule 4
-xalium
schedule 5
-codein

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routes of administration

enteral
-alimentary canal
-digestive system
parenteral
-pathway other than the alimentary canal or digestive system
-usually allows drug to be delivered directly to the tissue sight

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enteral and parenteral types

enteral
-oral
-rectal
parenteral
-inhalation
-intravenous
-intramuscular
-transdermal
-sublingual

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oral

most common
slow release preparation
(+) 
-easy
-convenienti
-nexpensive
(-)
-variability in absorption
-gastric irritation
-may take longer to produce therapeutic effects

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rectal

(+)
-quick acting and doesn't interfere with digestive system
-good for those with nausea and vomiting
(-)
-can't control absorption rate

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inhalation

(+)
-quick delivery of medication for quick relief of symptoms
(-)
-not as convenient

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injection types

-(+) and (-)

types
-intravenous
-intramuscular
-intraarticular
-subcutaneous tissue
(+)
-no barriers
-rapid onset
(-)
-cost and risk of infection
-discomfort
-inconvenient

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sublingual

-pros and cons

(+)
-absorbed rapidly
(-)
-uncomfortable
-expensive

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topical

types
pros and cons

types
-creams
-gels
-lotions
-patches
-drops
-sprays
(+)
-effective locally
(-)
-only effective locally

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primary vs. secondary effect

primary
-desired therapeutic effect of the drug
secondary
-everything else (side effects)

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pharmacokinetics

how the body acts on and processes a drug

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4 distinct processes of pharmacokinetics

absorption
distribution
metabolism
elimination

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absorption

for a drug to produce a therapeutic effect, it must be absorbed into the blood stream and distributed through the circulation

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2 types of drug solubility

hydrophilic
-water soluble
lypophilic
-fat soluble

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types of movement across cell membranes

passive diffusion
active transport
facilitated diffusion

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passive diffusion

most common mechanism of transport across membranes
lypophilic drugs will diffuse more quickly
movement of drug molecules across membranes based on concentration
move to equilibrium

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active transport

requires a protein to move the drug across a membrane
protein and drug bind
selective diffusion

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facilitated diffusion

active transport + passive diffusion
selective process
protein involvement
high conc. –> low conc.

oral absorption

pathway
effect of absorption rate
take with…

stomach –> small intestine –> circulatory system
the quicker the drug dissolves, the quicker it can be absorbed
take with a full glass of water

extended release drugs

enteric coating | -prevents dissolving in the stomach and takes it to the stomach

effects of exercise on absorption

decreases effects of oral drugs blood flow diverted medication should be taken at least 30 minutes prior to exercise

sublingual and buccal (cheek) absorption

dissolve directly in the mouth rapid absorption --> rapid therapeutic effect nitroglycerin

rectal absorption

drug dissolves in the rectum | absorbed into the hemerrhoidal veins

injection (intravenous, intramuscular, subcutaneous) absorption

very fast

topical absorption

slow absorption

inhalation absorption

rapid absorption (<5 minutes)

distribution factors

solubility | target tissue and blood-flow

distribution onset of action

the time it takes for drug molecules to reach their site of action in sufficient quantities to produce a therapeutic effect

duration of action

the period of time when concentration levels are sufficient enough to produce a therapeutic effect

effects of exercise on distribution

increase in blood flow may increase distribution rate dependent on site of action

metabolism

drugs inactivated | droken down into water-soluble metabolites for excretion

metabolism - primary site - secondary

``` primary -liver secondary -kidneys -GI tract ```

metabolism and exercise

exercise can decrease the clearance of some drugs due to blood being diverted away from the GI, kidneys, and liver to the skeletal muscles however -drug's effects are usually longer than exercise session therefore effect on metabolism is negligible

elimination

the process by which a drug leaves the body

elimination - primary site - secondary

``` primary -kidneys secondary -intestines -sweat -lugns ```

elimination and exercise

can decrease the rate of renal excretion

elimination can also be influenced by...

the drug's half-life

bioavailability | -factors

amount of the drug actually available to target tissue factors -rate at which a drug dissolves in the GI tract -amount and rate of drug absorbed -formulation (capsule, tablet, injection)

half-life

the time required for the body to eliminate 1/2 of a dosage of a drug by the regular physical processes

half-life and water- and fat-soluble drugs

water -move through faster fat -stay in system longer

half-life steady state

some drugs will be taken on a consistent basis ongoing process of drug absorption and removal amount going in = amount going out 5-6 half-lives of a medication to reach steady state

pharmacodynamics

how a drug acts on the body

receptor theory

for a drug to work, it must bind to a receptor receptor may be within a cell or on a cell membrane lock and key

agonist drug

a drug that interacts with a receptor to produce a pharmacological response

antagonist drug

a drug that binds with a receptor but does not produce a pharmacological response or prevents a response -may be blocking other chemicals from attaching to receptors

drug dosing - based on - increased dose =

``` based on -potency of the drug -patient's age -patient's condition increased dose = increased receptors -until steady state is reached ```

drug interactions

occur when one drug alters the effect of another drug may change how the body handles one or both drugs may change the way the drug acts on the body

additive interactions

agonistic two of the same type of drug taken together effects of the drug "add together"

inhibitory effects

antagonistic | can occur between two unrelated drugs

adverse drug reactions

range from side effects to hypersensitivity

side effects

common effects with use of certain medications

hypersensitivity

allergic reactions | may be local or anaphylactic shock