Pharm Topic 4L Modifying Drug Effects And Dose

Front 1

How does totally body water % of body weight change with age.

Back 1

From infants to elderly, it decreases with age.

Front 2

How does the fraction of lipophilic drug in fatty tissue change with age

Back 2

From infant to elderly, it increases with age.

Front 3

How do liver metabolism and renal elimination of a drug change with age?

Back 3

Infants and elderly are both less than young adults.

Front 4

How will the [] over time of a drug differ between an infant and adult if given IV? Sub Q?

Back 4

For IV, adult will decrease [] in blood faster in a exponential fashion while the infant will be slower and linear.
For Sub Q, both adult and infant will have [] resembling a bell curve but the adults will occur quicker and with a lower peak and shorter overall duration.

Front 5

Dose adjustment for weight

Back 5

Does required = average does/70 kg x weight of individual.
Does not work for abnormally lean or obese people.

Front 6

Tolerance

Back 6

Decreased responsiveness acquired after prior or repeated exposures to a given drug or one closely related in pharmacologic activity.

Front 7

Tachyphylaxis

Back 7

Acute tolerance acquired during repeated administration of a drug in short intervals, possibly due to depletion of a stored pool of a mediator.

Front 8

Pharmacokinetic Tolerance

Back 8

When a drug reduces its own absorption or transfer across some barrier, or increases the rate of its own elimination. Could be produced by another drug as well.

Front 9

Pharmacodynamic or cellular tolerance

Back 9

Reduction in reactivity of the receptor or translation of binding to a biological response. Opposite of supersensitivity.

Front 10

Homologous vs Heterozygous Desensitization

Back 10

Homologous - Give a drug that works on receptor A, get tolerance. Give a drug that works on receptor B, no tolerance to drug B.

Heterzygous - Give a drug that works on receptor A but creates tolerance for Drug A and Drug B which works on a different receptor.

Front 11

What types of drugs are especially susceptible to tolerance.

Back 11

Drugs which effect the nervous system.

Front 12

Pathological variables in drug dosage

Back 12

Most pharmacokynetics data is derrived for healthy individuals yet drugs are usually given to unhealthy individuals, therefore diseases may effect the drug effect.
Ex. chnages in Body temp, hydration, ph.

Front 13

Idiosyncrasy

Back 13

A quantitative and qualitative abnormal drug response with genetic abnormality usually being the underlying mechanism.

Front 14

Succinylcholine

Back 14

Muscle relaxant used in surgery.
Genetic basis for idiosyncrasy: Defective plasma cholinesterase
Disease trait: persistent apnea and paralysis
Inheritance: Autosomal Autonomous

Front 15

Isoniazid

Back 15

Genetic basis for idiosyncrasy: Deficient acetyltransferase
Disease trait: Increased toxicity
Inheritance: Auto recessive

Front 16

Primaquine/antimalarial/sulfonamide/probenecid/chloramphenicol

Back 16

Genetic basis for indiosyncrasy: Deficient G-6PD in erythrocytes
Disease trait: Drug induced hemolytic anemia
Sex linked

Front 17

Summation

Back 17

When 2 drugs elicit the same overt response but by different mechanisms and yet their combination is the algebraic sum of their individual effects.

Front 18

Additive Effect

Back 18

When the combined effect of drugs which act via the same mech are equal to that predicted by simple addition.

Front 19

Synergism

Back 19

Joint effect of 2 drugs that is greater than the algerbraic sum of their individual effects.

Front 20

Antagonism

Back 20

The conjoint effect of 2 drugs is less than the sum of the effects of the drugs acting separately.

Front 21

Pharmacological Antagonism

Back 21

When one drug prevents the response of another by preventing it from combining with its receptor.

Front 22

Physiological Antagonism

Back 22

When two drugs acting at different sites couterbalance each other by producing opposite effects on the same phisiological function.

Front 23

Biochemical Antagonism

Back 23

When one drug indirectly decreases the amount of a second drug present at its site of action.

Front 24

Chemical antagonist

Back 24

The reaction between 2 drugs to create an inactive product.

Front 25

Tetracycline antibiotics

Back 25

Have drug interactions which deal with GI absorption.
If mixed with (Al 3+, Ca 2+ Mg 2+ ect (found in milk)) will cause reduced absorbtion of antibiotic due to formation of poorly soluable chelates.

Front 26

Digitalis

Back 26

Have drug interactions which deal with GI absorption.
If combined with propantheline or other anticholinergics, will reduce aborption due to reduced gut motility.

Front 27

Anticholinergics + Antichlinergics

Back 27

Enhanced anticholinergic effects. Can cause heat stroke, toxic psychosis, and adynamic ileus.

Front 28

CNS depressants + CNS depressants

Back 28

Enhanced CNS depression; drowsiness

Front 29

Neuromuscular blockers + Neuromuscular blockers

Back 29

Enhanced neuromuscular blockade, prolonged apnea.

Front 30

Beta-adrenoreceptor stimulating bronchodilator + non-selective Beta 2 adrenoreceptor blocker

Back 30

Bronchodilator effects antagonized.

Front 31

Oral anticoagulants + Barbituates

Back 31

Anticoagulent effects reduced via induction.

Front 32

Oral contraceptives + Barbiturates, Phenytoin, Rifampicin

Back 32

Contraceptive reliability reduced via induction.

Front 33

Phenytoin + Chloramphenicol/Disulfiram

Back 33

Increased serum phenytoin levels due to enzyme inhibition.

Front 34

Pharmaceutical or chemical equivalents

Back 34

Drug products that contain identical amounts of the same active ingredient.

Front 35

Bioequivalent drug products

Back 35

Pharmeceutical equivalents whose rate and extent of absorption seem to be the same.

Front 36

Bioavailability

Back 36

Rate and extent to which the active drug is absorbed from a drug product and becomes available at the site of drug action.

Front 37

Therapeutic equivalence

Back 37

2 or more pharmaceutically equivalent drugs produce the same efficacy and toxicity in the same individuals under the same dose.

Front 38

Problems with absorbtion, Distribution, biotransformation, and excretion in an infant.

Back 38

Absorbtion - Altered absorbtion
Distrib - Incomplete BBB, higher volume of distribution for water soluble drugs
Biotransformation - Lower rate of oxidative Rxs and glucuronidase conjugation
Excretion - Reduced excretion

Front 39

Problems with absorbtion, Distribution, biotransformation, and excretion in an elderly person

Back 39

Distribution - Higher volume of fat soluable drugs stored
Biotransformation - Reduced oxidative metab (no change in glucuronidation)
Excretion - Reduced capacity