Pharm Unit 3-5

Front 1

onset

Back 1

time required to cause a therapeutic response

Front 2

peak

Back 2

maximum concentration in the blood and at the active site.

Front 3

duration

Back 3

time btwn onset and when therapeutic response disappears

Front 4

absorption

Back 4

What factor (s) determine a drugs onset?

Front 5

distribution

Back 5

What factor (s) determine a drugs peak?

Front 6

metabolism
excretion

Back 6

What factor (s) determine a drugs duration?

Front 7

fever (+ aspirin)
injection (+ insulin)
pulmonary disease (+ anesthetics)

Back 7

Name the 3 examples of special cases of pathological states.

Front 8

Those specific to drug.
1. Blood abnormalities
2. Liver or kidney damage
3. Teratogenic effects
4. Dermatologic effects

Drug idiosyncracy
Drug allergy
1. local and systemic
2. Contrast with hypersensitivity

Back 8

Identify general kinds of adverse responses to single drugs.

Front 9

1. Blood abnormalities
2. Liver or kidney damage
3. Teratogenic effects
4. Dermatologic effects

Back 9

Name the "adverse responses" to those specific to a drug.

Front 10

Drug idiosyncracy

Back 10

Any abnormal or peculiar response to a drug generally thought to be a result of genetic deficiences that lead to abnormal metabolism of the drug in that individual. Person may respond to minute amounts of drug or may not respond at all to massive doses. *Cannot be predicted without prior experience.

Front 11

Drug allergy

Back 11

Reaction to a drug resulting from previous exposure (sensitization), perhaps inadvertant, i.e. meat ingestion, and development of an abnormal immunologic mechanism. Re-exposure in a sensitized individual results in tissue damage and histamine release. The histamine, in turn, is chiefly responsible for the symptoms of allergy that develop.

Front 12

Drug allergy

Back 12

1. May be local (hives, rash, skin irritation)--or systemic (low BP bronciole constriction) *Always ask patient of know allergies...still will happen i.e. cannot be predicted without prior "allergic" experience with drug.

2. Contrast with hypersensitivity

Front 13

local
allergies
prior

Back 13

1. May be ______ (hives, rash, skin irritation)--or systemic (low BP bronciole constriction) *Always ask patient of know ________...still will happen i.e. cannot be predicted without _______ "allergic" experience with drug.

2. Contrast with hypersensitivity

Front 14

sensitization
Re-exposure
responsible

Back 14

Reaction to a drug resulting from previous exposure (___________), perhaps inadvertant, i.e. meat ingestion, and development of an abnormal immunologic mechanism. ___________ in a sensitized individual results in tissue damage and histamine release. The histamine, in turn, is chiefly ___________ for the symptoms of allergy that develop.

Front 15

1. Increase in therapeutic or toxic response.
2. Decrease in therapeutic or toxic response - antagonism. May use interaction to advantage

Back 15

What are the consequences of drug interactions?

Front 16

toxic
potentiation
interaction
each
antagonistic

Back 16

1. Increase in therapeutic or _______ response.
a. additive
b. synergistic
c. ____________

2. Decrease in therapeutic or toxic response - antagonism. May use ___________to advantage.

-cut dosage of ____ drug when additive therapeutic effects
-especially useful if side effects are ___________
ex. one antihistamine make drowsy...other jittery.

Front 17

1. Alter pharmacodynamics
2. Alter pharmacokinetics

Back 17

What are the MECHANISMS of drug interactions?

Front 18

1. Alter pharmacodynamics

Back 18

Change how the drug affects the body.

- antagonists (both competitive and noncompetitive) alter drug binding to tissue receptor site.

-increase or decrease rate in two different portions pf a common pathway. Might increase or decrease the amount of a limiting factor that is available.

Front 19

2. Alter pharmacokinetics

Back 19

Alter absorption, distribution, metabolism, or excretion.

Front 20

absorption (altered)

Back 20

antacids

vasoconstrictors

physical incompatibilities (in an IV or syringe) changing drug solubility

Front 21

distribution (altered)

Back 21

competition for non-receptor binding sites (most notably PLASMA PROTEINS) affects drug distribution.

Front 22

plasma proteins
receptors
distribute

Back 22

Note that _______ ________ are NOT the active site where the drug acts. They are temporary "storage depots". Many, but not all, drugs bind reversibly to plasma proteins with different binding strengths. Drugs can only reach their _________ and have an effect when they are released from the plasma protein so they can continue to ________ to their active site.

Front 23

two
same
distibution
tighly
stronger
plasma proteins
both

Back 23

When ____ different drugs bind to plasma proteins in the ____ location each affects the __________ of the other drug. The effect depend upon which drug binds more ______ to the plasma protein. Often a patient is already taken one medication and a physician wishes to add a second medication to the regimen without removing the first medication. How they proceed is dictated by whether the _______ or weaker binding medication is in the system first. Because medications that bind to plasma proteins are often started with "priming" doses, the practioner must use caution with ______ medications when adding the second drug.

Front 24

medication
removing

Back 24

Often a patient is already taken one __________ and a physician wishes to add a second medication to the regimen without _________ the first medication.

Front 25

both

Back 25

Because medications that bind to plasma proteins are often started with "priming" doses, the practioner must use caution with ______ medications when adding the second drug.

Front 26

metabolism (alter)

Back 26

simulate "induce" or depress "bind to" liver enzymes.

binding to plasma proteins.

Front 27

metabolism

Back 27

may stimulate or depress __________ of the second drug.

Front 28

inducing

Back 28

Drugs simulate by "________" production of more enzymes especially in liver.

Front 29

Inhibit

Back 29

Drugs ________ by binding with enzymes.

Front 30

covalent

Back 30

Binding may be permanent (_________ binding is irreversible.)

Front 31

ionic

Back 31

Binding may be temporary (_______ binding is often reversible.)

Front 32

excretion

Back 32

diurectics

competition for plasma proteins.