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27 Cards in this Set
- Front
- Back
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Pharmacokinetics... |
How the body affects the drug. |
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Pharmacodynamics... |
How the drug affects the body... |
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What is a drug? |
A substance used in the... - diagnosis, treatment or prevention of a disease. - or as a component of a medication. |
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Why is 'small' advantageous? |
Quicker access into the body. Reach target (chemically sensitive site) sooner. Longer to excrete. |
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What is an agonist? |
Activates receptors and elicits a response... - Drug - Hormone - Neurotransmitter - Signaling molecule |
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What is an antagonist? |
Prevent (block) effect of agonist... - Competitive. - Non-competitive. |
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What is affinity? |
How well the drug binds to the receptor... - Depends on the concentration of the drug. - Removal depends on how well it was bound in the first place. - If we know how much drug we need for the receptor site, we know what kind of dose we need. |
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Pharmacokinetics; 4 Stages? |
1. Absorption 2. Distribution 3. Metabolism 4. Excretion |
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Routes of administration? |
- Oral (po) - Inhaled (inh) - Topical (top) - Sub lingual (s/l) - Rectal (pr) - Parenteral (bypassing digestive system ((injection))) |
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What is the half life? |
The time it takes for the drug in the body to drop to half the original. |
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Where does drug metabolism occur? |
Liver |
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Where does drug excretion occur? |
Kidneys |
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Opiates - Class effect (CNS system) |
- Analgesia - Euphoria (mew receptors) - Respiratory depression (commonest cause of death) - Cough suppression - Pin point pupils (mew & k receptors) - Nausea and vomiting (SE) |
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Opiates - Class effect (elsewhere) |
- Constipation (GI system) - Bronchospasm - Hypotension - Local itchiness |
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What is drug tolerance? |
Receptor desensitisation, therefore increasing dose to get same pharmacological effect. |
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What is dependence? |
Physical, physiological dependence on drug - withdrawal symptoms. - Signs of aggression - Irritability - Diarrhoea - Weight loss Symptoms can last for weeks. |
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WHO Pain relief ladder |
Non-opioid - Paracetamol Adjuvant - NSAIDs (ibruprofen, diclofenac) Opioid (mild) - Codeine - Dihydrocodeine - Tramadol Opioid (mod-severe) - Morphine |
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What is a TTO? |
TTO = To Take Out It is the supply of medication in addition to what the patient already possesses at home that the patient is issued with upon discharge from hospital. |
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What does a GP need from a discharge letter? |
Relevant information regarding new medication; dose, time, administration. Reason for starting patient on TTO medication. Whether the hospital prescribed prophylaxes should be continued. |
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Where do you obtain a reliable drug history if the patient is confused? |
- Patient's partner/carer - Patient's own medicines - GP surgery - GP referral letter - Previous discharge prescriptions - Care home records - Community pharmacy |
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Salbutamol
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-B2-receptor agonist. -Bronchodilation; Relaxes uterine and smooth muscle. -Used for asthma. -Decrease in calcium-mediated contraction in bronchioles. -Increases cAMP which activates protein kinase which inhibits myosin light chain kinase (the mediator of contraction). |
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Atenolol
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- B1 antagonist - Reduces BP in hypertensive patients by decreasing cardiac output. - Block of the action of endogenous and exogenous agonists on B1-receptors. - Used in hypertension and angina. - Can cause bronchoconstriction in asthma. |
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Ibuprofen
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NSAID - Reduces inflammation - Analgesic for inflammatory pain - Antipyretic (reduces raised temperature) - Reversible inhibition of COX-1, weak inhibition of COX-2. - GI disturbances. |
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Aspirin
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- Reduces inflammation. - Analgesic for inflammatory pain. - Antipyretic (reduces raised temperature). - Inhibits platelet aggregation. - Irreversible acetylation of cyclo-oxygenases; weakly COX-1 selective. |
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Aspirin Special Points
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- Can cause increased effect of warfarin resulting in bleeding. - Should not be used for gout because it reduces urate excretion and interferes with the action of uricosuric agents. |
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Paracetamol
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- Analgesic and antipyretic (i.e. reduces raised temperature). - Has little anti-inflammatory action. - Inhibition of COX-1, COX-2 and also the recently identified COX-3 which occurs predominantly in the CNS. - Mild to moderate pain, especially headache. |
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Methotrexate
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- Cytotoxic in the larger doses used to treat cancer. - First choice for RA. - Also used in psoriasis, ankylosing spondylitis, polymyositis and vasculitis. - MTX is also an anti-cancer agent. - GI disturbances, liver toxicity, bone marrow depression. |
