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Pharmacology > Week 2:over the counter/problematic drugs > Flashcards

Week 2:over the counter/problematic drugs Flashcards

1
Q

Pregnancy: Pharmacokinetics

A
  1. 1st trimester is the period of greatest danger for drug-induced developmental defects
  2. Drugs cross the placenta by diffusion
  3. Last Trimester the greatest percentage of drugs are absorbed by the fetus
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2
Q

Category A for pregnancy

A

Studies indicate no risk to the human fetus

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3
Q

Category B for pregnancy

A

Studies indicate no risk to animal fetus, information for human fetus not available

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4
Q

Category C for pregnancy

A

Adverse effects reported in animal fetus but no information in humans

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5
Q

Category D for pregnancy

A

Possible fetal risk in humans reported; however consideration of potential benefit versus risk may in selected cases warrant use of the drugs in pregnant women

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6
Q

Category X for pregnancy

A

Fetal abnormalities reported and positive evidence of fetal risk in humans available from animal or human studies or both

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7
Q

Drug therapy effects and Lifespan Considerations:

A

Pregnancy

Breastfeeding

Children

Older Adults

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8
Q

Classification of younger than 38 w

A

Premature or pre term infant

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9
Q

classification of a younger than one month

A

Neonate or newborn

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10
Q

Classification of 1 month to 1 year old

A

Infant

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11
Q

Classification of 1 year to 12 years old

A

Child

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12
Q

Considerations for Children: Absoprtion

A

Gastric Ph less acidic and slow gastric emptying

Liver immaturely reduces first pass elimination

Intramuscular absorption faster and irregular

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13
Q

Considerations for Children: Metabolism

A

Liver is immature it doesn’t produce enough microsomal enzymes

Older children may have increased metabolism requiring a higher does than infants

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14
Q

Considerations of Children: Excretion

A

Kidney immaturity affects glomerular filtration rate and tubular secretion

Decreased perfusion rate of the kidneys may reduce excretion of drugs

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15
Q

Factors Affecting Drug Dosages for Children

A
  1. Skin in thin and permeable
  2. Stomach lacks acid to kill bacteria
  3. Lungs have weak mucus barrier
  4. Body temp are less regulated and dehydration occurs easily
  5. Liver and Kidneys are immature, impairing drug metabolism and excretion
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16
Q

Children Considerations: Distribution

A

The younger the reason the greater the percentage of total body water

Greater body water means fat content is lower

Protein binding is decreased

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17
Q

Dosage Calculation for Children

A

Body weight dosage calculations

  • use milligrams per kilogram of body weight
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18
Q

The Older Adult

A

Over 65

Use of OTC

Increased Chronic Illness

Polypharmcy

Increased risk of adverse drug reactions

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19
Q

Cardiovascular System in Older Adults

A

Decreased cardiac output = decreased absorption and distribution

Decreased blood flow = decreased absorption and distribution

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20
Q

GI in Older Adults

A

Increased PH (alkaline gastric secretions) = altered absorption

Decreased peristalsis = delayed gastric emptying

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21
Q

Liver in Older Adults

A

Decreased enzyme production = decreased metabolism

Decreased blood flow = Decreased metabolism

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22
Q

Kidneys In Older Adults

A

Decreased Function = decreased excretion

Decreased globular filtration rate = decreased excretion

Decreased blood flow = decreased excretion

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23
Q

The older adults: Absoprtion

A

Gastric Ph less acidic and slowed gastric emptying

Reduced blood flow to GI tract and reduced absorptive surface area due to flattened intestinal villi

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24
Q

The Older Adults: Distribution

A

Decreased proteins by liver, decreasing protein binding of drugs and increased circulation of free drugs
= Faster distribution

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25
Q

The Older Adult: Metabolism

A

Aging liver produces fewer microsomal enzymes

Blood flow to liver is reduced

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26
Q

The Older Adult: Excretion

A

Decreased glomular filtration rate

Decreased number of intact nephrons

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27
Q

Drugs to avoid if older adults have Bladder Flow Obstruction

A

Antihistamines

Antidepressants

Decongestants

Anticholinergics

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28
Q

Drugs to avoid if older adults have Chronic Constipation

A

Calcium Channel Blockers

Antidepressants

Anticholinergics

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29
Q

Drugs to avoid if older adults have Chronic Obstructive Pulmonary Disease

A

Sedatives

Narcotics

B-Blockers

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30
Q

Drugs to avoid if older adults have Clotting Disorders

A

NSAIDS

Aspirin

Anti platelet drugs

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31
Q

Drugs to avoid if older adults have Depression

A

Anti hypertensives

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32
Q

Drugs to avoid if older adults have Heart Failure and Hypertension

A

Sodium

Decongestants

Amphetamines

OTC cold products

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33
Q

Drugs to avoid if older adults have Insomina

A

Decongestants

Bronchodilators

MAO Inhibitors

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34
Q

Drugs to avoid if older adults have Parkinson’s Disease

A

Antipsychotics

Phenothiazines

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35
Q

Drugs to avoid if older adults have Syncope

A

Sedatives

Hypnotics

Narcotics

CNS depressants

Muscle Relaxants

Anti hypertensives

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36
Q

What does the Health Protection Branch do?

A

Regulates the sale and use of foods, drugs, cosmetics and medical devices

Administers and enforces the Food and Drugs Act

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37
Q

Controlled Drugs and Substances Act

A

Passed in 1997 replacing the Narcotic Control Act of 1952 and changing parts 3 and 4 of the food and drugs act

Prohibits possession, possession for the purpose of illegal trading, importing and exporting

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38
Q

Controlled Drugs and Substances Act Schedule 1

A

Opium

Heroin

Morphine

Cocaine

Methamphetamine

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39
Q

Controlled Drugs and Substances Act Schedule 2

A

Cannabis related drugs

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40
Q

Controlled Drugs and Substances Act Schedule 3

A

Amphetamines

LSD

41
Q

Controlled Drugs and Substances Act Schedule 4

A

Barbiturates

Anabolic Steroids

42
Q

Controlled Drugs and Substances Act Schedule 5 and 6

A

Precursors required to produce controlled substances

43
Q

Controlled Drugs and Substances Act Schedules 7 and 8

A

Amounts of cannabis and cannabis resin required for charge and sentencing purposes

44
Q

What Schedule is the worst in the Controlled Drugs and Substances Act

A

Schedule 1

45
Q

New Drug Development

A

Investigational New Drug Application is needed to prove drug safety and efficacy

Submit drug name: chemical, generic and trade name

Informed consent is needed before procedures can be performed in a research study

46
Q

Health Canada Drug Approval Process

A

Preclinical Investigational drug studies

4 Clinical phases of drug studies

Priority review process

47
Q

Legal and Ethical Principals

A

Autonomy

Beneficence

Confidentiality

Justice

Non Maleficence

Veracity (Tell the truth)

48
Q

Ethnic Cultural Influences

A

Drug Polymorphism

Adherence to Therapy

Environmental Considerations

Genetic Factors

Varying Responses to specific drugs

Changing National Demographics

Influence of Ethnicity and Genetics

49
Q

Ethnic Cultural Assessment

A

Past uses of medicine

Use of over the counter drugs

Use of natural health products

Responsiveness to medical treatment

Religious practices and beliefs

Dietary Habits

50
Q

What is OTC?

A

Medicine that is legally available to the consumer without a prescription

51
Q

What is Complimentary Medicine

A

Used in conjunction with Western Medicine

52
Q

Criteria for OTC meds:

A

Indications for use: the consumer must be able to diagnose
Condition and monitor effectiveness

Safety Profile: The drug should have limited drug interaction info
Low Potential Misuse
Favourable Adverse Event Profile

Practicality: Easy to use and easy to monitor

53
Q

What is Iatrogenic Effects?

A

Unintentional effects caused by action of physician or health care provider

54
Q

What’s a Mineral?

A

An inorganic substance that is ingested and attaches to enzymes and other organic molecules

55
Q

Fat Soluble Vitamins

56
Q

Water Soluble Vitamins

57
Q

What’s a Vitamin?

A

An organic compound essential in small quantities for normal physiological and metabolic functions of the body

58
Q

Vit B1

A

Thiamin - yeast, liver, whole grain products, beans

59
Q

Vit B2

A

Riboflavin - meat, dairy products, eggs, nuts

60
Q

Most important B vitamins?

61
Q

Vit B3

A

Niacin- liver, turkey, tuna, peanuts, beans

62
Q

Vit B5

A

Pantothenic Acid

63
Q

Vit B 6

A

Pyroxidine - meat, organ meats, poultry, fish

64
Q

Indications for Vit D

A

Hypocalcaemia

Rickets

Hyperparathyroidism

65
Q

Indications for Vit K?

A

Hemorrhagic disease in newborn

66
Q

Indications for Vit B12

A

Long standing infection

Hepatic Disease

Alcoholism

Malignancy

67
Q

Indications for Vit B6

A

People taking oral contraceptives, isoniazid, hydralazine

68
Q

Indications for Vit B12

69
Q

Action of Vit D

A

Regulate and absorb Calcium. Help with parathyroid and calcitonin production

Calcification of normal bones

70
Q

What vitamin isn’t stored in the body

A

Vit K

intestional flora makes it

71
Q

What Vitamin is a coenzyme and can’t absorb on its own?

A

Vit B12

Required for Nucleoprotein

Maintenance of normal erythropoisesis

*Absorption needs intrinsic factor or gastric intrinsic factor. Intrinsic factor is a glycoprotein produced by the partial cells of the stomach. Vit B12 is then absorbed by the small intestine.

72
Q

3 Main Minerals

A

Calcium

Magnesium

Phosphorus

73
Q

4 Types of Substance Abuse Dependance:

A

Physical Dependance

Psychological Dependance

Habituation

Addiction

74
Q

Commonly Abused Substances

A

Opioids

Depressants

Alcohol

Nicotine

Stimulants

75
Q

Opioids

A

Also known as narcotics

Used because they cause euphoria

76
Q

Natural Opiates

A

Heroin

Opium

77
Q

What are natural opiates?

A

Codeine

Morphine

78
Q

Opiate Mechanism of Action

A

Block receptors in the CNS and block pain perception

There are 3 main types of receptors where opioids bind

79
Q

Areas Opiods affect outside of the CNS?

A

Skin

GI

Genitourinary

80
Q

Indications of Opioids?

A

Relieve pain

Reduce cough

Relieve diarrhea

Induce anaesthesia

81
Q

3 ways heroin can be taken?

A

Injected

Sniffed

Smoked

82
Q

Opioid Drug Withdrawal duration and signs

A

Peak period: 1-3 days

Duration: 5-7 days

Signs: drug seeking, elevated blood pressure, diarrhea, lacrimation , mydriasis, rhinorrhea, diaphoreisis, muscle cramps, vomiting, anxiety

83
Q

Drugs for Opioid Withdrawal

A

Opioid antagonist

Patient should be free from Opiods for 1 week before using meds

These drugs block Opiod receptors so that the euphoria isn’t produced

Cloned one substitutions and methadone

84
Q

2 Types of Amphetamine Stimulants

A
  1. Methamphetamine:
    Comes in pill, powder or crystallized (meth) forms
    Smoking it is more powerful
  2. MDA
85
Q

Cocaine Mechanism of Action

A

Work by releasing biogenic amines from its storage site in nerve terminals

Primary biogenic amine released is norepinephrine.

Main effect on CVS

86
Q

Withdrawal of Cocaine Signs and Symptoms

A

Peak: 1-3 days

Social withdrawal, psychomotor retardation, suicidal thoughts, depression, paranoid

Death may occur during intoxication or withdrawal

87
Q

Depressant Withdrawal Peak Period

A

Short-Acting Drugs: 2-4 days

Long -Acting Drugs: 4-7 days

88
Q

Depressant Withdrawal Duration

A

Short-Acting Drugs: 4-7 days

Long-Acting Drugs: 7-12 days

89
Q

What are Depressants?

A

Relieve anxiety, irritability and tension

Benzodiazepine:
“Date rape drug”

Used to enhance a heroin high or to ease the coming down of a Occitan high

Produces disinhibition and amnesia when used with Alcohol

90
Q

Signs and Symptoms of Depressant Withdrawal

A

Muscular weakness, delirium, convulsions, tremors, anxiety, depression, suicidal thoughts etc.

91
Q

What do you take if you overdose on Depressants?

A

Flumazenil

92
Q

Alcohol/Ethanol (ETOH)

A

CNS Depression

Respiratory Stimulation or depression

Diuretic effects

Vasodilation, producing warm flushed skin

93
Q

Chronic Alcoholism Problems

A

Vitamin Def especially Vitamin B

Seizures

Cirrhosis

Polyneuritis

Wernicke’s Encephalopathy

Korsakoff’s Psychosis

Nicotinic Acid Deficiency Encephalopathy

94
Q

Fetal Alcohol Syndrome Signs and Symptoms

A

Craniofacial Abnormalities

CNS Dysfunction

Pre and postnatal growth retardation

95
Q

Mild Alcohol Withdrawal S & S

A

Insomnia

Tremors

Agitation

Temp greater than 37.7

Pulse greater than 110 beats

96
Q

Moderate Withdrawal Alcohol S&S

A

Temperate 37.7 to 38.3

Tremors, insomnia, agitation

Pulse 110 to 140 BPM

97
Q

Drugs to help with Alcohol withdrawal symptoms

A

Diazepam (Valium)

Lorazepam (Ativan)

98
Q

What’s the drug for helping aid smoking cessation?

A

Bupropion (Zyban)

Pharmacology (6 decks)

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