Unit 1-5 Flashcards
Receptors
Usually the drug forms chemical bonds with specific sites
Pharmacodynamics
The study of the interactions between drugs and their receptors and the series of events that result in a pharmacologic response
Agonists
Drugs that interact with a receptor to stimulate a response
Antagonists
Drugs that attach to a receptor but do not stimulate a response
Partial Agonists
Drugs that interact with a receptor to stimulate a response but inhibit other responses
Enteral Route
Drug is administered directly into the gastrointestinal (GI) tract by the oral, rectal, or nasogastric route.
Parenteral Route
Bypasses the GI tract with the use of subcutaneous (subcut), intramuscular (IM), or intravenous (IV) injection.
Percutaneous Route
Involves drugs being absorbed through the skin and mucous membranes.
*Methods of the percutaneous route include inhalation, sublingual (under the tongue), and topical (on the skin) administration.
Pharmacokinetics
The study of the mathematical relationships among the ADME features of individual medicines over time
LADME
Liberation, Absorption, Distribution, Metabolism, and Excretion
Absorption
Process whereby a drug is transferred from its site of entry into the body to the circulating fluids of the body (i.e., blood and lymph) for distribution around the body
Distribution
Refers to the ways in which a drug is transported throughout the body by the circulating body fluids to the sites of action or to the receptors that the drug affect
Drug Distribution
Refers to the transport of the drug throughout the entire body by the blood and lymphatic systems and the transport from the circulating fluids into and out of the fluids that bathe the receptor site
Unbound
Free; portion of a drug is able to diffuse into tissues, interact with receptors, and produce physiologic effects; it is also only this portion that can be metabolized and excreted
Drug blood level
When a drug is circulating in the blood, a blood sample may be drawn and assayed to determine the amount of drug present
Metabolism
Process whereby the body inactivates drugs. The enzyme systems of the liver are the primary sites for the metabolism of drug
Excretion
The elimination of drug metabolites and, in some cases, of the active drug itself from the body
Half-life
Amount of time required for 50% of the drug to be eliminated from the body
Onsite of Action
When the concentration of a drug at the site of action is sufficient to start a physiologic (pharmacologic) response
Peak Action
Drug reaches the highest concentrations on the target receptor sites, thereby inducing the maximal pharmacologic response for the dose given
Duration of Action
How long the drug has a pharmacologic effect
Desired Action
Expected response
Side effects/adverse effects
all drugs have the potential to affect more than one body system simultaneously, thereby producing responses
Serious Adverse Effects
Can lead to toxicity
Idiosyncratic Reaction
when something unusual or abnormal happens when a drug is first administere
Allergic Reactions
also known as hypersensitivity reactions, occur in about 6% to 10% of patients who are taking medications. Allergic reactions occur among patients who have previously been exposed to a drug and whose immune systems have developed antibodies to the drug
Urticaria
Severe itching
Hives
Irregular shaped patches on the skin
Anaphylactic Reaction
Patient has a severe, life-threatening reaction that causes respiratory distress and cardiovascular collapse
Enzyme Inducers
Common drugs that bind to enzymes and increase the metabolism of other drugs
*phenobarbital, carbamazepine, rifampin, and phenytoin
Additive effect
Two drugs with similar actions are taken for an increased effect.
*hydrocodone + acetaminophen = added analgesic effect
Synergistic effect
The combined effect of two drugs is greater than the sum of the effect of each drug given together
ex: aspirin + codeine = much greater analgesic effect
Antagonistic effect
One drug interferes with the action of another.
ex: tetracycline + antacid = decreased absorption of the tetracycline
Displacement
The displacement of the first drug from protein-binding sites (i.e., bound drugs are inactive) by a second drug increases the activity of the first drug because more unbound drug is available.
ex: warfarin + valproic acid = increased anticoagulant effect
Interference
The first drug inhibits the metabolism or excretion of the second drug, thereby causing increased activity of the second drug.
ex: probenecid + ampicillin = prolonged antibacterial activity of ampicillin because probenecid blocks the renal excretion of ampicillin
Incompatibility
The first drug is chemically incompatible with the second drug, thereby causing deterioration when the drugs are mixed in the same syringe or solution or are administered together at the same site. Signs include haziness, formation of a precipitate, or a change in the color of the solution when the drugs are mixed
Pharmacology
study of drugs and their actions on living organisms.
Therapeutic methods
Drug Therapy
Diet Therapy
Physiotherapy
Psychological Therapy
Therapies
Diseases that cause illness may be treated in several different ways
Drug Therapy
Treatment with drugs
Diet Therapy
Treatment with diet
Physiotherapy
Treatment with natural physical forces (e.g., water, light, heat)
Psychological therapy
The identification of stressors and methods that can be used to reduce or eliminate stress
Drugs
chemical substances that have an effect on living organisms
Biological Agents
large, complex proteins manufactured in a living system such as a microorganism, or within plant or animal cells
Chemical Name
most meaningful to the chemist. By means of the chemical name, the chemist understands the exact chemical constitution of the drug and the exact placement of its atoms or molecular groupings.
generic name or common name
The generic name is simpler than the chemical name. It may be used in any country and by any manufacturer. The first letter of the generic name is not capitalized
United States Adopted Names Council
Provides generic names
-organization sponsored by the United States Pharmacopeial Convention, the American Medical Association, and the American Pharmacists Association
Official Name
virtually always the generic name in the United States, is the name under which the drug is listed by the US Food and Drug Administration (FDA)
trademark or brand name
followed by the symbol ®. This symbol indicates that the name is registered and that the use of the name is restricted to the owner of the drug, which is usually the manufacturer
Prescription drugs
require an order by a health professional who is licensed to prescribe drugs
Nonprescription drugs, or over-the-counter (OTC) drugs
sold without a prescription in a pharmacy or in the health section of department or grocery stores.
Illegal Drugs
sometimes referred to as recreational drugs, are drugs or chemical substances used for nontherapeutic purposes
Reference Product
existing approved biologic product
Biosimilar
biologic product that is close in structure and function to an existing approved biologic product
The United States Pharmacopeial Convention
nongovernment organization that promotes public health by establishing state-of-the-art standards to ensure the quality of medicines and other healthcare technologies
Food, Drug, and Cosmetic Act of 1938
Requires that new drugs be safe, as well as pure (but did not require proof of efficacy). Enforcement by FDA.
Durham-Humphrey Amendment (1951) to the Food, Drug, and Cosmetic Act
Gives the FDA the power to determine which products may be sold with and without a prescription.
United States Pharmacopeia (USP)/National Formulary (NF)
primary purpose of this volume is to provide standards for the identity, quality, strength, and purity of substances used in the practice of healthcare
Kefauver-Harris Amendment (1962) to the Food, Drug, and Cosmetic Act
Requires proof of efficacy as well as safety for medicines released since 1938; establishes guidelines for reporting of information about adverse reactions, clinical testing, and advertising of new drugs.
Comprehensive Drug Abuse Prevention and Control Act (1970)
(Controlled Substances Act, 1970)
Outlines strict controls in the manufacture, distribution, and prescribing of habit-forming drugs; establishes drug schedules and programs to prevent and treat drug addiction. Established the Drug Enforcement Administration (DEA).
Dietary Supplement Health and Education Act (1994) (DSHEA Act–1994)
Under this act, almost all herbal medicines, vitamins, minerals, amino acids, and chemicals used for health are reclassified as dietary supplements, a food category
Schedules
five classifications of controlled substances
Schedule I
not available for other than highly controlled research purposes because of their very high potential for abuse and addiction
Schedule II
high potential for abuse and addiction, but are available by prescription only, in limited quantities, usually with no more than a 7- to 30-day supply. The prescription cannot be refilled; a new prescription must be issued for continued use
Schedule III, IV, V
lower potential for abuse and addiction and may be ordered by prescription with a maximum supply of 30 days of medicine. If so written by the prescriber, the prescription may be refilled up to five times but outdates at 6 months
The Comprehensive Drug Abuse Prevention and Control Act
commonly referred to as the Controlled Substances Act, is designed to improve the administration and regulation of the manufacturing, distribution, and dispensing of drugs that require tighter control by the government because of their higher incidence of abuse and potential for addiction.
Schedule I Drugs
Examples: lysergic acid diethylamide (LSD), peyote, heroin, hashish
Schedule II Drugs
Examples: amphetamines, morphine, hydrocodone/acetaminophen (Vicodin), hydrocodone/acetaminophen (Lortab), hydrocodone/acetaminophen (Norco), methadone, oxycodone/aspirin (Percodan), methylphenidate (Ritalin), amphetamine/dextroamphetamine (Adderall
Schedule III Drugs
Examples: aspirin/codeine (Empirin with codeine), aspirin/butalbital/caffeine (Fiorinal), acetaminophen/codeine (Tylenol with codeine)
Schedule IV Drugs
Examples: phenobarbital, chlordiazepoxide, diazepam, flurazepam, temazepam
Schedule V Drugs
Example: atropine/diphenoxylate (Lomotil, Virtussin AC)
The US Drug Enforcement Administration (DEA)
organized to enforce the Controlled Substances Act, to gather intelligence, to train its officers, and to conduct research in the area of dangerous drugs and drug abuse.
Violation of or failure to comply with the Controlled Substances Act
punishable by fine, imprisonment, or both and by the possible loss of professional licensing
fast tracking
To expedite the development and approval of drugs for the treatment of life-threatening illnesses
parallel tracking
mechanism to make INDs available to patients with life-threatening illnesses
health orphans
no companies were willing to “adopt” the diseases to complete extensive research to develop products for treatment
Gender-specific medicine
a developing science that studies differences in the normal function of men and women and addresses how people of each gender perceive and experience disease
Placebo effect
patient’s positive expectations about treatment and the care received can positively affect the outcome of therapy
Nocebo effect
negative expectations about therapy and the care received
Placebo
drug dosage form (e.g., tablet, capsule) that has no pharmacologic activity because the dosage form has no active ingredients
Tolerance
occurs when a person begins to require a higher dosage of a medication to produce the same effects that a lower dosage once provided.
Drug dependence
also known as addiction or habituation, occurs when a person is unable to control a desire for ingestion of drugs
Drug accumulation
may result in drug toxicity. An example of drug accumulation is the excessive ingestion of alcoholic beverages
Carcinogenicity
ability of a drug to induce living cells to mutate and become cancerous
Passive Diffusion
Hydrolysis
the process that uses water to initiate a chemical reaction. Infants cannot metabolize palmitic acid from chloramphenicol palmitate (an antibiotic), thereby preventing the absorption of the chloramphenicol
Protein binding
reduced in preterm infants because of decreased plasma protein concentrations, lower binding capacity of protein, and decreased affinity of proteins for drug binding
Drug Metabolism
Metabolites
which are the products of metabolism—and, in some cases, the active drug itself—are eventually excreted from the bod
Therapeutic drug monitering
the measurement of a drug’s concentration in biologic fluids to correlate the dosage administered and the level of medicine in the body with the pharmacologic response
Polypharmacy
Teratogens
Genetics
Genome
Polymorphism
Pharmacogenetics
Intestinal transit
refers to the speed at which the intestine moves foods, secretions, and other ingested matter along, and this rate varies with age
