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Pharm > Pharmacological terms > Flashcards

Pharmacological terms Flashcards

1
Q

Why do massage therapists need to be familiar with pharmacology?

A

Medications can interfere with expected physiologic responses to massage therapy and hydrotherapy
• Particular medications may be a contraindication to massage or hydrotherapy
• Minor changes to the treatment plan may be necessary when working around certain drug delivery devices,routes

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2
Q

Pharmacology

A

the study of the action of chemicals on living organisms to produce biological effects

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3
Q

pharmacokinetics

A

“what the body does to the drug”

  • how the body absorbs, distributes, metabolizes, and eliminates the drug
  • how long the body takes to accomplish this process, and the drug levels the body is exposed to as a result of this process
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4
Q

pharmacodynamics

A

“what the drug does to the body”

  • does the drug mimic normal physiological processes or inhibit processes
  • this is defined in the “mechanism of action” of the drug
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5
Q

Pharmacology can be divided into:

A
  • pharmacokinetics “what the body does to the drug”
  • pharmacodynamics “what the drug does to the body”
  • pharmacy
  • toxicology
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6
Q

To provide safe and effective treatment, massage therapists should have:

A
  • a basic understanding of the actions and effects of commonly used drugs, and the ability to research the effects of other medications encountered
  • knowledge of how massage affects the body’s physiology and the ability to apply this knowledge to varying client presentations
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7
Q

Drugs are known by either:

A

Generic Name
- simplified term that reflects the official chemical name and structure of the drug
-Assigned by an international committee
- Same worldwide
- Example: Diazepam is the generic name for 7 chloro-1,3-dihydro-1-methyl-5-phenyl-2H-1,4-benziodiazepin-2-one (C16 H13 CIN2 O)
Brand Name
- when a drug is developed, researched, tested, and produced for sale by a drug manufacturing company, the formulation is assigned a brand name chosen by the company
-does not reflect function of chemistry of the drug
-widely differing drugs may have similar sounding trade names
- Example: Ibuprofen is the generic name and is known by several brand names including Advil, Motrin

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8
Q

Agonist:

A

a measure of how well a drug produces a response

effectiveness

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9
Q

Antagonist:

A

a drug is called antagonist when binding to a receptor is not associated with a response.

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10
Q

Affinity:

A

Ability of drug to bind to a receptor.

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11
Q

Efficacy:

A

a measure of how well a drug produces a response (effectiveness)

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12
Q

generic medications

A
  • companies are manufacturing generic drugs after a patent expires that typically sell at a cheaper price than the brand name version
  • they do meet official (FDA) requirements, but concerns about their effectiveness and tolerability do sometimes arise when compared to their brand name counterparts
  • also generic medications may not have the same degree of therapeutic effectiveness as the original version
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13
Q

DRUG CLASSIFICATION

A

Drugs can be broadly classified as:
- non-prescription drugs
- prescription drugs
- restricted and controlled drugs
Can also be classified by:
- therapeutic properties (describes effect drug has on body)
- Example: Antihypertensive drugs (to reduce blood pressure)
- action or effect on a specific body system (Describes body system drug effects)
-Example: Drugs that affect CNS, GI tract
- chemical structures (describe basic chemical or pharmacological properties of the drug is beta-blocker)
* Pay attention to these points when reading a drug profile

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14
Q

USES OR INDICATIONS

A
  • includes a list of diseases or disorders for which the drug is officially recommended by Health Canada
  • can be used for unofficial or experimental manner for conditions that drug has shown benefit for but not been approved for.
  • Contraindication: is a disease or disorder that the drug has a negative effect on and should not be prescribed to a client with that condition
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15
Q

Effects of medications can be grouped:

A
  • therapeutic effects
  • side effects or adverse effects
  • unpredictable effects
    effects are influenced by factors such as dosage, age, gender, lifestyle, pathologies
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16
Q

Therapeutic Effect

A

is the desired effect which is intended to help the user get better

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17
Q

Side Effect

A
  • are the undesirable reactions a drug can produce
  • can be due to the therapeutic effect (stronger effect?) or from additional actions a drug may have
  • can also be due to the interaction among 2 or more medications
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18
Q

Unpredictable Effect

A

can be either:
o allergic or hypersensitivity reactions
o idiosyncratic reactions

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19
Q

Allergic or Hypersensitivity Reactions

A

reactions can be mild (hives, joint pain, fever) or more severe (anaphylaxis)

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20
Q

Anaphylaxis:

A

medical emergency characterized by seriously decreased blood pressure and restricted airflow

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21
Q

Idiosyncratic Reactions

A

unexpected or highly unusual effects of medication, occurring in a small number of people

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22
Q

Effects of medications Clinical Relevance

A
  • a client’s chief complain may actually be a drug side effect
  • should monitor patient symptomatology and be alert for anything unusual, unexpected change, or atypical response to massage treatment
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23
Q

MECHANISM OF ACTION

A

drugs do not create new functions; they alter existing cellular activities

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24
Q

Drug mechanism of action occurs through one or a combination of the following

A
  • By Combining with Specific Cellular Receptors
  • By Chemically Altering Body Fluids
  • By Chemically Altering Cell Membranes
  • By Interacting with Extracellular Enzyme Systems
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25
Q

By Combining with Specific Cellular Receptors

A
  • drug must interact with the target cell and its specific receptor “Lock and Key”
  • by a drug binding to receptor, it can alter cellular activity/function in order to exert its effects
26
Q

By Chemically Altering Body Fluids

A

an example is taking an antacid to neutralize excess stomach acidity and reduce or prevent digestive discomfort

27
Q

By Chemically Altering Cell Membranes

A
  • can alter its electrical stability and alter a cells responsiveness to stimuli
  • will influence the cell’s permeability causing speeding up or slowing down of the movement of ions into and out of the cell
28
Q

By Interacting with Extracellular Enzyme Systems

A
  • Enzyme: protein molecules that facilitate or catalyze chemical reactions of all cells and by influencing enzyme behaviours, medications can have numerous types of impacts on tissue function
  • Example: NSAIDs alter pain by blocking the activity of enzyme in the inflammatory response
29
Q

Half-life —->

A

the time it takes for the body’s normal metabolic and elimination processes to reduce the blood concentration of the drug to one half (50%)

30
Q

the primary determinants of a drug’s half life

A

are metabolism and elimination

31
Q

ONSET OF ACTION

A
  • the time it takes before the user feels the effects of the drug
  • determining factor is typically how the drug was administered (IV versus orally)
32
Q

Clinical Relevance of ONSET OF ACTION

A

knowing the general onset of action of a drug can help practitioner determine optimal scheduling of massage therapy

33
Q

BIOAVAILABILITY

A
  • the amount of a drug that actually enters the systemic circulation and is available to produce its effects
  • key factor is how the drug is administered into the body
  • Example: 50mg of drug is taken orally and bioavailability is approximately 50%, if 50mg is administered directly via intravenous injection, it is 100% bioavailability
  • other factors affecting bioavailability is dosage and frequency, person’s age and general health
34
Q

route of administration influences the rate and completeness of absorption of the drug into the bloodstream
- this can affect:

A

o bioavailability
o onset of action
o intensity of action

35
Q

ORAL ADMINISTRATION

A
  • most popular route of introducing drugs into the body
  • medication is swallowed in prescribed dose and absorption occurs into the blood from the GI tract
  • depending on its form (solid or liquid) it can take between minutes and an hour before the drug is absorbed and distributed in the blood and exerts its effects
  • solids typically dissolve in the stomach and are to be absorbed in the intestines
  • liquid medications are generally absorbed into the circulation within 15 minutes and usually has a faster onset of action when compared to solid
36
Q

APPLICATION TO MUCOUS MEMBRANES

A

mucous membranes are highly vascularized with extensive networks of blood vessels that pose fewer restrictions to drug access
EXAMPLES:
o suppositories or enemas to rectum
o inhalations into respiratory tract
o sprays and drops applied to oral and respiratory tracts

37
Q

TOPICAL APPLICATIONS can be applied into:

A

o the eye
o the ear
o the skin

38
Q

Otic Administration

A
  • usually as drops

- are applied as close to body temperature as possible to avoid overstimulation of the auditory nerve

39
Q

Opthalmic Administration

A
  • drops or ointments must be kept as sterile as possible because eyes are very susceptible to infection
  • eye medications may be followed by periods of blurred vision
40
Q

Dermal Administration- used to treat local skin conditions such as:

A

o rashes, dry skin, infections and abrasions
 tend to contain antibiotics, antihistamines, corticosteroids, moisturizers and analgesics
 designed to absorb and act specifically on affected area

41
Q

Dermal Administration- used to treat relief of muscle and joint pain

A

 typically contain capsaicin, menthol, wintergreen, and oils that are quite volatile, and evaporate quickly
 they will all affect the local circulation and superficial nerves in ways to relieve pain and stiffness by increasing local blood flow that improves oxygen and nutrient delivery and removes metabolic waste from affected tissues

42
Q

Dermal Administration- used for systemic administration of drugs

A

 typically involves “transdermal” meaning that the drug is formulated in a special gel-like matrix and is able to pass through the skin barrier and enter the systemic circulation
 Examples: nicotine and hormone replacement therapy
 Therapists should be aware that transdermal patches is typically used to maintain a controlled medication level in the blood and implications of wiping it off or disengaging a patch can be more serious

43
Q

PARENTERAL ADMINISTRATION

A
  • this is typically referring to injections and can be used for a variety of reasons:
    o when oral administration would be ineffective (insulin would be destroyed in the stomach)
    o during an emergency (anaphylaxis)
    o continuous, steady supply of a drug
    o vaccines
    o an injection specifically into a tissue (intra-articular injection)
  • muscles commonly used for intramuscular injections are deltoids, glutes, and the quadriceps
44
Q

IMPLANTED CATHETERS AND DRUG PUMPS

A

Implanted Catheters
- is surgically fitted so it is mostly lying beneath the skin
Drug Pumps
- used to deliver medications into the bloodstream via an intravenous line or an implanted catheter

45
Q

CLINICAL RELEVANCE of HOW DRUGS ARE ADMINISTERED

A
  • knowing the route of administration can help to minimize any chances of medication-related adverse reactions
  • those on anti-inflammatories may not be able to give accurate feedback about depth of treatment
  • treatment around implanted catheters and drug pumps should be monitored by all involved in patient’s care
46
Q

once drugs are administered, they are subjected to certain physiological processes that can modify their capacity to affect their target cells:

A

o dissolving and dissociating
o metabolism
o distribution
o elimination

47
Q

during manufacturing of certain medications, several inactive substances called _________ are included in the preparations

A

excipients

48
Q

excipients serve 2 main functions:

A

o to help the preparation maintain its stability while being stored
o to ensure that it can readily dissolve and dissociate in the GI tract

49
Q

tablets and capsules that quickly dissolve and dissociate are more rapidly absorbed therefore increasing

A

the drug’s bioavailability and making the onset of action faster

50
Q

Dissolving and Dissociating: absorption of a drug into the blood is influenced by many factors:

A 
o chemical nature
o dosage
o form of administration
o size of its particles
o presence of any GI pathologies
51
Q

Metabolism

- after being absorbed

A

a drug is transported to the liver via portal circulation

52
Q

the most important organ of metabolism

A

the liver

53
Q

First pass effect: refers to

A

the effects of liver processes on a drug that has just entered the blood from the GI tract. Not all drugs are affected by liver enzymes…. If not, the drug is typically excreted or eliminated in its original form

54
Q

when a drug undergoes metabolic reactions, substances called _________are formed

A

metabolites

55
Q

metabolites are inactive and harmless but some can have

A

pharmacological effects and can either produce desired therapeutic effects or they may be responsible for undesired side effects

56
Q

Distribution - refers to

A

how a drug is transported from its site of absorption to its site of action, metabolism, and excretion

57
Q

the following circulatory factors can affect drug distribution

A

o rate of blood flow to various tissues
o how much drug is bound to plasma proteins
o mechanisms that control brain access

58
Q

rate of blood flow to various tissues

A

 organs that receive high volumes of blood (kidneys, liver, brain) will initially receive higher drug concentrations than do tissues like fat and muscles

59
Q

how much drug is bound to plasma proteins

A

 drugs are typically bound to plasma proteins to form drug-protein complexes
 each drug has a characteristic degree of binding, yet there is constant movement of drug molecules from the bloodstream into the intercellular spaces

60
Q

mechanisms that control brain access

A

 cells of the blood brain barrier identify substances that are potentially damaging and obstruct them from leaving the blood and enter the brain
 lipid soluble drugs cross the blood brain barrier much more easily than drugs with poor lipid solubility

61
Q

Elimination

A
  • the liver prepares drugs and other toxic substances for elimination
  • the metabolites are biochemically altered to make them harmless to body tissue and more readily eliminated
  • together metabolism and elimination are the primary determinants of a drug’s half-life
62
Q

Clinical Relevance of DRUG PROCESSING IN THE BODY

A
  • health and function of the liver and kidneys are extremely important for the normal removal of drugs and other toxic substances from the body
  • clients who are fasting or those with liver or kidney disease will often have a decrease in albumin therefore more free drug available for interaction with target cells
    o less absorption leads to lower bioavailability, slower onset of action, and questionable effectiveness

Pharm (4 decks)

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