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32 Cards in this Set

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onset
time required to cause a therapeutic response
peak
maximum concentration in the blood and at the active site.
duration
time btwn onset and when therapeutic response disappears
absorption
What factor (s) determine a drugs onset?
distribution
What factor (s) determine a drugs peak?
metabolism
excretion
What factor (s) determine a drugs duration?
fever (+ aspirin)
injection (+ insulin)
pulmonary disease (+ anesthetics)
Name the 3 examples of special cases of pathological states.
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
Identify general kinds of adverse responses to single drugs.
1. Blood abnormalities
2. Liver or kidney damage
3. Teratogenic effects
4. Dermatologic effects
Name the "adverse responses" to those specific to a drug.
Drug idiosyncracy
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.
Drug allergy
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.
Drug allergy
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
local
allergies
prior
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
sensitization
Re-exposure
responsible
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.
1. Increase in therapeutic or toxic response.
2. Decrease in therapeutic or toxic response - antagonism. May use interaction to advantage
What are the consequences of drug interactions?
toxic
potentiation
interaction
each
antagonistic
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.
1. Alter pharmacodynamics
2. Alter pharmacokinetics
What are the MECHANISMS of drug interactions?
1. Alter pharmacodynamics
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.
2. Alter pharmacokinetics
Alter absorption, distribution, metabolism, or excretion.
absorption (altered)
antacids

vasoconstrictors

physical incompatibilities (in an IV or syringe) changing drug solubility
distribution (altered)
competition for non-receptor binding sites (most notably PLASMA PROTEINS) affects drug distribution.
plasma proteins
receptors
distribute
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.
two
same
distibution
tighly
stronger
plasma proteins
both
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.
medication
removing
Often a patient is already taken one __________ and a physician wishes to add a second medication to the regimen without _________ the first medication.
both
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.
metabolism (alter)
simulate "induce" or depress "bind to" liver enzymes.

binding to plasma proteins.
metabolism
may stimulate or depress __________ of the second drug.
inducing
Drugs simulate by "________" production of more enzymes especially in liver.
Inhibit
Drugs ________ by binding with enzymes.
covalent
Binding may be permanent (_________ binding is irreversible.)
ionic
Binding may be temporary (_______ binding is often reversible.)
excretion
diurectics

competition for plasma proteins.