Wk 1- QUM/PD/PK Flashcards
Quality Use Medicines principles- NMP
- Judiciously- only when needed
- Appropriately- the right medicine for condition and person
- Safely- misuse minimised
- Efficaciously- medicine delivers benefits
Regulations between states are the same T/F
FALSE. Must practice in accordance to the state you’re in, all different. overrides everything
2 main legislations/organisations that asses and monitor medicines
- TGA: approve drugs, monitor drugs
- SUSMP (poisons standard): scheduling of drugs
Scheduling list
S1- not in use
S2- pharmacy medicine
S3- OTC pharmacist only medicine
S4- prescription only medicine
S5- caution
S6- poison
S7- dangerous poison
S8- controlled drug
S9- prohibited
S10- no sale, supply or use. Very dangerous
+unscheduled- supermakets
Podiatrists with ESM are able to
- administer
- Obtain
- Possess
- Prescribe
- Sell
- Supply
- Use
S2, 3, 4 (podiatrist) and 8 (surgeon) medicines (Medicines and posions act- medicines regulation)
What do u need for prescribing rights
- Endorsement from the board
- Authority from state drugs and poisons legislation (medicines and poisons regulation 2021
drug classes that a podiatrist can prescribe
- antihistamines/sympathomimetics
- analegesics
- anaesthetics (general/local)
- antidotes
- antibacterials
- antiinfectives
- antifungals
- corticosteroids
- psychotrpoic
- rhuematological
pbs and non pbs medicine
non pbs - not subsidised
roles of TGA
- approve products with therapeutic claims
2.pre market evaluation of new drugs - post market monitoring
- licensing of australian manufactors
- veriying overseas manufacturing
what acts/regulation is important for podiatrists
medicines and poisons act 2019
medicines and poisons regulation 2021
Pharmacodynamics is
What the drug does to the body
Pharmacokinetics is
What the body does to the drug
ADME
Absorption
Distribution
Metabolism
Excretion
Factors that impact drug absorption (6)
- Water or lipid solubility (unionised drugs typically lipid)
- Concentration
- Surface area
- Vascularity of surface
- Contact time with surface
- Route of administration
How does a drug stay unionised
- pH is the same as environment
Acidic drug in acidic environment
What route has the lowest bioavailability
Oral, FPM
Outcomes of metabolism can be
Active drug into active metabolite or inactive
metabolite or toxic metabolic OR
PRO drug into active drug
low drug distribution means
retained within vasculature, acidic drug
high drug distribution means
lipid soluble and distributed to tissues, basic drug
Phase 1 metabolism
Adding a function group tp make the drug more water soluble (hydrophilic), which is more likely to be excreted by kidneys
Reactions in phase 1 metabolism
- Oxidation (CYP450 enzyme)
- Reduction
- Hydrolysis
Phase 2 metabolism
Occurs in the liver, conjugation with endogenous compounds to make it further hydrophilic
difference between CYP450 enzyme inducer/inhibitor
inhibitor- decreased drug metabolism and increases potential for toxicity
inducer- increases metabolism of drugs and reduce therapeutic concentration
Routes for excretion
Main: kidneys, urine
Others: feces, expiration, sweat, breast milk
Excretion is dependent on
- Rate of metabolism of drug
- Rate of production of urine
- PH of urine
Half life means, things that can effect half life
Time it takes for drug to reach half concentration
- renal impairment
- age
- pregnancy
Populations with reduced excretion
Renal impairment
Age >50
Population with increased excretion and why
Pregnant women have increased clearance, increased dose required
metabolism enzyme inducing occurs
larger drug distribution
increased renal clearance
Types of drug actions
- Stimulation
- Depression
- Irritation
- Replacement
- Cytotoxic action
difference between an acid and base
an acid has a proton to give, a base can accept a proton
pKa is pH where the drug is 50% unionised /ionised
administrating the drug in a similar environment will not ionise it
factors that affect absorption from the GI tract
- pH of GI contents
- surface area
- contact time
- blood flow
- plasma protein binding
- active transport mechanism
- formulation
what is first pass metabolism
reduced bioavailability of oral drugs after being metabolised by the liver and drug concentration is reduced.
enterohepatic shunting
drug is excreted by liver into bile then into small intestines and reabsorbed by heaptic portal circulation to liver into circulation
define bioavailability
rate and extent of absorption of drugs reaching the blood by any route
drug distribution means
moves from blood to other tissue that have no drug (high to low concentration)
agonist
binds to receptor and causes same action
antagonist
binds to and blocks receptor preventing a response
partial agonist
binds to and activates a lower response than a full agonist
non competitive antagonist
binds to different area to rececptor and blocks response
efficacy means
ability of drug and receptor to produce resposne
ED 50
dose that produces a specific effect in 50% of population administered
EC 50
half maximimal effective concentration
