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56 Cards in this Set
- Front
- Back
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what is Pharmacokinetics
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the study of what the body does to drugs (absorption, distribution, metabolism, and excretion)
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what is Pharmacodynamics
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study of what drugs do in the body, target sites for drug actions, include receptors, ion channels, enzymes, and carrier proteins
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Absorption
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method and rate at which drugs leave the site of administration
with oral meds, usually absorbed in the small intestine and then ultimately metabolized in the liver |
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distribution
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occurs after the drug leaves the systemic circulation and enters the interstitium and cells
drugs are redistributed in organs according to fat and protein content of the organ most psychotropic meds are lipophilic and highly protein bound. Only the unbound free portion of the drug is active, therefore a person with a low protein can get toxic |
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Metabolism
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process by which the drug becomes chemically alerted in the body
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First pass metabolism
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process by which the drug is metabolized by P450 enzymes in the intestines and liver before going to they systemic circulation
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elimination
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process the drug is removed from the body
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half-life
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time needed to clear 50% of the drug from plasma
also determines the dosing interval and length of time to reach a steady state |
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steady state
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point at which the amount of drug eliminated between doses is approximately equal to the dose administered
drugs are usually administered once every half life to achieve steady stte it takes about 5 half lives to achieve steady state and that many to eliminate the drug too |
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what can P450 enzymes do?
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can induce or inhibit the metabolism of certain drugs and changing their concentration
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what are 6 common P450 enzyme inducers
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Tegretol
antifungals Rifampin Dilantin phenobarbital trileptal or topamax |
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what are 6 common enzyme P450 enzyme inhibitors
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tagament
erythromycin biaxin fluroquinolones prozac paxil |
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what do enzyme inducers do?
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can decrease the serum level of other drugs that are substrates of that enzyme
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what can enzyme inhibitors do?
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can increase the serum level of the other drugs that are substrates of that enzyme causing toxic levels
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what can liver disease do to drug levels
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liver disease will affect liver enzymes and first pass metabolism resulting in a possible toxic plasma drug level
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What can kidney disease do or NSAIDS to drug levels
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may increase serum concentrations of the drugs that are excreted by the kidneys (lithium)
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what is the agonist effect
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bind to receptors and activate biological response
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inverse agonist effect
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cause the opposite effect of agonists, do not bind to receptors
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partial agonist
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do not fully activate the receptors
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antagonist effect
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bind to the receptors but do not activate a biological response
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Another site for drug action are the ion channels, which exist for many ions such as sodium, potassium, chloride, and calcium and can be open at some times and closed at other times. Neurotransmittors or drugs may be excitatory or inhibitory depending on the type of ion channlel they gate
what is the excitatory response what is the inhibitory response |
depolarization; involves the opening of sodium and calcium channels with these ions going into cells.
repolarization; involves the opening of chloride channels with chloride going into the cell, potassium leaving or both |
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How do enzymes work for a site of drug action?
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Are important for drug metabolism and play an important role in the chemical alteration of the drug, some drugs will inhibit the action of a particular enzyme, thus increasing the availability of the neurotransmitter. (like MAOIs)
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how do the carrier protein or reuptake pumps work for drug action site
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they transport neurotransmitters out of the synapse and back into the presynaptic neuron to be recycled or reused. Some drugs will inhibit re-uptake such pumps such as SSRI's and increase the synaptic availability of the neurotransmitter
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what does potency mean
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the relative dose required to achieve a certain effect
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Describe schedule 1 drugs
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nonmedicinal substances
high abuse potential reseach only not legal in prescription heroin, marijuana |
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describe schedule 2 drugs
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medicinal drugs in current use
high potential for abuse and dependency written prescription allowed no telephone orders allowed no refills allowed on prescription examples- morphine, codeine, fentanyl, methadone, Dilaudid, Oxycontin |
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Schedule 3 drugs
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medicinal with less abuse potential than Schedule II drugs
telephone orders only if followed by a prescription prescription MUST be renewed every 6 months refills limited to five examples include- appetite supressants, butalbital, testosterone |
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Schedule 4 drugs
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Medicinal with less abuse potential than schedule 3
Darvon, Talwin, Benzodiazapines, Provigil, Ambien, Phenobarbital, Darvocet, Lunesta, Restoril |
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Schedule 5 drugs
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Lowest abuse potential
handled like non-controlled drugs similarly imodium, buprenex, robitussin with codine, phenergen with codine |
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Preg A
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Controlled studies show no risk
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Preg B
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no evidence of risk to humans
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Preg C
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Risk can't be ruled out
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Preg D
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Positive risk in pregnancy
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Preg X
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contraindicated in pregancy
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What are the 2 common risks of using psychiatric medications in pregnancy BENZO
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floppy baby syndrome, cleft palate
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Pregnancy risk with tegretol
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neural tube defects
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Pregnancy risk with Lithium
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Epstein anomaly
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Pregnancy risk with depakote
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neural tube defects, spina bifida
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what 8 classes or medications can cause depression
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betablockers
steroids interferon accutane retrovirals neoplastic drugs benzos progesterone |
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what 4 drugs or classes can cause mania
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steroids
antidepressants isoniazid antabuse |
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What 8 drugs can cause a false positive for amphetamines
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stimulants
wellbutrin prozac trazadone rantidine serzone nasal decongestants pseudoephedrine |
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what med might pop as a positive for alcohol
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valium
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what might pop positive for benzo's
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zoloft
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what might pop positive for cocaine (3)
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NSAIDS
antibiotics most amoxicillian |
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what 4 pop positive for morphine or heroin
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quinolones
rifampin codine poppy seeds |
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what pops positive for methadone
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nyquil
destromethorphan |
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what medications are typical antipsychotics10
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haldol
loxitane (loxiapine) Mellaril (thioridazine) Moban (molindone) Navane (thiothixene) Prolixin Serentil Stelazine Thorazine Trilifon (perphenazine) |
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what are the 7 second generation antipsychotics
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abilify
clozaril geodon invega risperdal seroquel zyprexa |
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name 10 mood stablaizers
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Depakene
depakote Equetro (carbamazepine ER) Eskalith, Lithobid, Lithonate, Lithotabs (lithium Carbonate) Keppra Laminctal Neurontin Tegretol Topamax Triliptal |
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what are the 9 Tricyclics
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Anafranil- clomipramine
asendin- amoxapine elavil- amitryptyline norpramin- desipramine pamelor- nortriptyline Sinequan- doxepin surmontil- trimipramine tofranil- imiprimine vivactil-protriptyline |
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what are the 7 SSRI's
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Celexa
Lexapro Luvox Paxil Prozac Zoloft (pexeva) |
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what are the 3 MAOI's (one is a patch)
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EMSAM (selegiline transdermal)
Nardil Parnate |
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What are the "other" agents that are antidepressants
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Cymbalta
Desyrel Effexor Remeron Serzone Wellbutrin |
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What 9 agents are used to treat anxiety
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ativan
klonopin librium serax tranzene xanax buspar inderal (propranolol) tenormin (atenolol |
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what are the 6 stimulants
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adderall
focalin dexedrine ritalin concerta vyvanse (stratera?) |
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What are 3 non-stimulants to treat ADHD
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Norpramine, Effexor, Wellbutrin
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