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97 Cards in this Set
- Front
- Back
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Pharmacology
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the study of drugs
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Pharmacotherapeutics
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the treatment of pathological conditions thru the use of drugs
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Pharmacodynamics
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the study of biochemical and physiologic interactions of drugs
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Pharmacokinetics
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the study of drug distribution rates on various body compartments
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Absorption
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the rate @ which a drug leaves its sit of admistration.
BIOAVAILABILITY |
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Factors of Absorption
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Route
food/fluids status of absorptive surface rate of blood flow to small intestine stomach acidity gastrointestinal mobility |
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First Pass Routes
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Oral
Rectal Hepatic Artery Portal Vein |
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Non First Pass Routes
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IV
IM Sub Q Transderman Sublingual Buccal Intraoccular |
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Distribution
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The transport of a drug by the bloodstream to the site of action
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Distribution of a drug occurs to what areas first
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Vascular Areas:
Liver Kidneys Heart Brain |
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Which organ is most responsible for metabolism / biotransformation of drugs?
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LIVER
also: kidneys, lungs, plasma, intestinal mucosa |
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Diseases that can alter biotransfermation of drugs
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Renal Failure
Conjestive heart failure Liver Failure |
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Conditions that can alter the biotransformation of drugs
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Starvation
Obstructive Jaundice Genetic Disorders |
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Excretion
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The elimination of drugs from the body
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Idiosyncrascy
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An unusual individual reaction to a food or drug
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Side effect
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an effect (whether therapeutic or adverse) that is secondary to the one intended
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Iatrogenic effect
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The unintentional harmful effect of medical intervention or advice
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Extrapyramidal Effect
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Physical symptoms that are associated with impoper dosing or unusual reactions to anti-psychotic drugs:
tremor, slurred speech, dystonia, anxiety, paranoia |
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Therapeutic Effect
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A consequence of medical treatment of any kind that is deemed to be disirable and beneficial
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Peak & Trough
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Serun samples collected to determine the level of a drug in the blood.
Peak - collected 1/2 hr after the dose is give IV or 1 hr after it is given IM. Trough - collected 1/2 hr before next dose |
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Loading Dose/Maintenance Dose
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Loading dose is an initial higher dose that may be given at the beginning of a course of treatment before dropping down to a lower maintenance dose.
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Teratogenicity
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The capability of producing fetal malformaiton
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Tolerance
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Decreased response following a long term administration of drugs
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Tachyphylaxis
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quickly developing toleranc brought on by rapid and repeated administration of drugs
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Duration
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The amount of time the drug concentration is sufficient to work
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Peak
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increased drug concentration at site of action
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Onset
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The time it takes for a drug to elicit a therapeutic response
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Half-Life
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The time it takes for one half of the original amount of a drug to be removed. After about 5 half lives, most drugs are considered 97% removed.
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Enterohepatic Circulation
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Fat soluble drugs that are in bile and are reabsobed, returned to liver and again excreted into bile. Long half-lives.
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Biliary excretion
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When drugs are excreted by the intestine (feces)
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Primary organ responsible for excretion
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Kidneys
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FDA Drug Categories
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A- studies indicate no risk to fetus
B- studies indicate no risk to animal fetus C- adverse effects reported in animal fetus D- possible fetal risk in humans X-fetal abnormalities reported. Should not be used in pregnant women. |
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Categories of Controlled Substances
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C1- No medical use (heroine)
C2- Accepted use, high abuse (demerol) C3 - less abuse than C2 (Codeine, nonOpioids) C4-less abuse than C3 (benzos) C5 - Cough suppressants, etc |
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Passive Transport
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Diffusion
Hydrostatic Pressure Osmosis |
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Characteristics that inhibit the passage through blood/brain barrier
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- large molecular size
- highly charged molecules - low lipid solubility |
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Mediated Transport (Active)
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ATP - against the concentration gradient
Sodium Potassium Pump |
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Mediated Transport (Passive)
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Facilitated Diffusion- down the concentration gradient
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Could cause alteration in Blood-Brain Barrier
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Hypertension, Inflammation
Radiation, Pressure Infection, Ischemia Trauma |
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Types of Tissue
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Epithelial- Simple, Stratisfied
Connective - Cartilage/bone, loose/dense, elastin/regular, adipose/vascular Muscle - smooth, cardiac, skeletal Neural- neurons, synapses, neurotransmitters |
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Toxicity
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The degree to which a substance can damage an organism
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Malnourished patients, burn patients and others with low albumin are at risk for...
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drug toxicity.
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Acid/Base regulation plays a major roll in what three bodily processes?
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- delivery of oxygen to the cells.
-cellular use of oxygen w/the subsequent production of ATP. -hormonal regulation of metabolism. |
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Labs reflecting fluid status:
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Hemoglobin & Hematocrit
BUN Creatinine |
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3 primary proteins that bind and carry drugs:
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Albumin
Alpha 1 Acid glycoprotein Corticosteiroid-binding globulin |
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Drug classes that can alter the biotransformation of drugs
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Certain antibiotics
(-azoles, -myocins) Some sedatives (barbituates) |
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Edema
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a problem of fluid distribution that results in fluid accumulation.
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Causes of Edema
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-Loss of plasma proteins which causes loss of oncotic pressure or
-Increased capilary hydrostatic pressure or -Lymph obstruction |
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Dehydration
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indications both sodium and water loss
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Symptoms of dehydration
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thirst, dry skin, dry mucous membranes, high temp, weight loss, concentrated urine, tachycardia, weak pulse, postural hypotension
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OsmolALity
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the concentration of molecules per WEIGHT of WATER.
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OsmolARity
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the concentration of molecules per VOLUME of SOLUTION.
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Electrolyte Ranges
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Sodium 135-145 mEq/L
Potassium 3.5-5 mEq/L Calcium 8.5-12 mg/dl Phosphate 2.0-4.5 mg/dl Magnesium 1.5-2.4 mEq/L |
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Isotonic Fluid Imbalances
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Extracellular Fluid (ECF) loss or gain is accompanined by proportional changes in electrolytes.
Cells stay the same size |
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Hypertonic Fluid Imbalances
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Water loss or Solute gain.
Due to hypertonic saline IV diarrhea insufficient water intake diabetes Cells shrink |
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Hypotonic Fluid Imbalances
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Water gain or Solute loss
Due to: Vomiting, excessive sweating, diarrhea, diuretics, burns, renal failure Cells swell |
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Common IV Fluids
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Normal Saline (NS)
5% Dextrose in Water (D5W) 0.45 NS D5W NS D5W 0.45NS Lactated Ringers High Concentration Saline |
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Hypotonic Fluids
(ex: half NS) |
Total electrolyte content less than 250 mEq/L.
Used to replace cellular fluid bc it is hypotonic as compared to plasma. Can lead to intravascular fluid depletion, low bp, cellular edema |
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Hypertonic Fluids
(ex: Lactated Ringers w/ D5W, high concentration saline) |
Total electrolyte content more than 375 mEq/L
Contain D5W Draw water out of ICF to ECF, cause cells to shrink. Could lead to dehydration |
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Isotonic Fluids
(ex: NS, D5W) |
Total electrolyte content around 310 mEq/L.
Total osmolality close to that of ECF. 1L expands ECF by 1L, plasma by 0.25L 3L needed to replace 1L of blood loss |
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Goals for administering IV fluids
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-to provide water, electrolytes and nutrients to meet daily requirements
-to replace water and correct electrolyte deficits -to administer meds |
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pH
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the concentration of hydrogen ions in arterial blood.
-increase H ions, decrease pH. -decrease H ions, increase pH. |
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Base
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can accept hydrogen ion.
-negative charge |
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Acids
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donate a hydrogen ion.
-Positively charged |
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Normal pH
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7.35-7.45
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The body's ability to regulate acid/base balance is dependent upon
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-lungs
-kidneys -chemical buffer system |
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The most powerful buffer
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Protein - hemoglobin
(intracellular) |
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Most important renal buffering systems
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Phosphate Buffer System
and Ammonia/Ammonium Ion Buffer System (bothe extra and intracellular) |
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Most active buffer system,
Facilitates the conversion of hydrogen (strong acid) to carbonic acid (weak acid) and then eliminates via the lungs |
Bicarbonate/Carbonic Acid Buffering System
(extracellular) |
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Acidosis
pH decreases |
Respiratory: Hypoventilation causes retention of CO2 which leads to carbonic acid excess.
Metabolic: excess of fixed acids: Lactic acid from anaerobic metabolism, shock, cardiac arrest, excessive ingestion of acids |
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Alkalosis
pH Increases |
Respiratory: Hyperventiliation causes excessive CO2 exhalation which leads to too little carbonic acid. (Panic attacks, fever in infants)
Metabolic: excess of bases or deficit of acid. Vomiting, diarrhea, antacid overdose |
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With regard to acid/base regulation, the unconscious, sedated or head injured are at risk for
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CO2 accumulation
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-nol
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anti gout
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nitrate
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anti anginal
vaso dialator |
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-olol
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betblockers
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-kinase
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anti thrombolitic
thromolitic |
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lactone
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potassium sparing diuretics
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-mide
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lupe diuretics
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-tidine
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anti ulcerant
H2 receptor antagonist preventative treatment |
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-mol
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bronchodilators
beta 2 adrenergic for DOB |
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-pium
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beta 2 adrenergic for DOB
relaxes bronchi |
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-ide
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oral hypoglycemics
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-rin
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anticoagulant
anti HPN affects the blood vessels of the heart |
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pine
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Ca channel blocker
anti HPN affects the blood vessels of the heart |
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-cillin
-micin |
antibiotics
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-vastatin
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antihyperlipidemia
antihypercholesterolimia |
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-nium
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neuromuscular blocking agent
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-caine
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local analgesics
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-aluminum
-magnesium -hydroxide |
antacids
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-prazole
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proton pump inhibitors
w/evidence of ulcer scars |
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-vir
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antiviral
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-zepam
-lam |
anti anxiety
major tranquilizer |
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-pril
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ACE I inhibitor
affects the kidney |
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-sartan
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ACE II antagonist
affects the kidney |
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-dol
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non opioid analgesic
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-done
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opioid analgesic
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-sone
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corticosteiroid anti-inflammatory
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-mine
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antihistamine
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