Pharmacology Flashcards
what are the 2 simple principles of absorption
1 - acidic drugs require an acidic environment
e.g. phenytoin, aspirin
2 - basic drugs require a basic environment
e.g. diazepam, morphine
what binds to acidic drugs
albumin (basic)
what binds to basic drugs
alpha-1 acid glycoprotein (acidic)
what can affect distribution in the elderly
IMPORTANT
they have low albumin but higher A-1 AG
increased fat = increases the Vd and half life of lipophilic drugs e.g. diazepam
decreased body water = lower Vd of hydrophilic drugs e.g. lithium
what does Vd mean
volume of distribution
how is hepatic metabolism affect in the elderly
Reduced liver function due to decreased liver size, blood flow, and disease
- first pass metabolism reduced (e.g. propranolol)
how is renal metabolism affect in the elderly
Lower GFR (decreased: size, tubular secretion, renal blood flow)
what is the general principles of pharmacodynamics
lower doses achieve same effect in the elderly
BUT
some effects are decreases (e.g. beta blockers and HR)
what are the 5 reasons adverse drug reactions happen as a result of
1 - Drug-drug interactions
2 - Drug-disease interactions
3 - Drug-food interactions
4 - Drug side effects
5 - Drug toxicity
what are examples of common herbs and alternative therapies
Vitamin C - Grapefruit Juice
OA - Glucosamine
what can NSAIDs exacerbate
CHF
what drugs do potassium rich foods interact with
- i.e. bananas, oranges, green leafy veg
ACEIs, ARBs, K-sparing diuretics
what drugs do vitamin E and F rich foods interact with
- i.e. apples, chickpeas, spinach, nuts, kiwi broccoli
Warfarin
These foods alter pH, what drugs does this interact with
- chicken, turkey, milk, soy, cheese, yogurt
antibiotics
thyroid meds
digoxin
diuretics
These foods affect cytochrome P450, what drugs does this interact with
- Grapefruit, Apple, Orange, & Cranberry
Statin
antihistamines
