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35 Cards in this Set

  • Front
  • Back
Definition of a drug
any chemical agent that affects a physiologic process
Routes of administration
ENTERAL (using GI Tract)
- Oral (PO)
- Sublingual (SL)
- Rectal (PR)

PARENTERAL (NOT using GI tract)
- Intravenous (IV)
- Intramuscular (IM)
- Subcutaneous (SC)
- Topical
- Transdermal
- Inhalation
Most important organ for drug excretion
Most common site for drug metabolism
LIVER. (may also occur in kidneys, lungs, GI tract)

- Will convert an active form --> inactive form to allow its elimination.

- Will convert a "pro-drug" to its active form.
Definition of pharmacokinetics
the rate at which a drug is absorbed and eliminated.
First Order Kinetics
Drug is eliminated at a rate proportional to its concentration.

** most common rate of elimination**
Considerations for dosing
Goal = therapeutic dose that avoids side effects and toxicity.

- It takes 4-5 half-lives to achieve a steady-state situation of a drug concentration in first-order kinetics.

Onset = amount of time it takes a drug to start working.

Duration = length of time a drug is therapeutic.
EC 50
"effective concentration" - concentration of drug which induces a therapeutic effect in 50% of subjects to which it is administered.
LD 50
"lethal dose" -
concentration of a drug that is lethal in 50% of the subjects to which it is administered.
Therapeutic index
LD 50 / EC 50
Margin of Safety
Margin between therapeutic and lethal doses of a drug.
drugs which alter the physiology of a cell by binding to its receptors.

response usually dependent on the percentage of receptors bound.
inhibits or blocks response caused by an agonist.

Competitive antagonist = competes with agonist for receptors.

Noncompetitive antagonist = binds to another site than the agonist, but causes a conformational change that prevents the agonist from binding.
= decreased response to a drug; must increase dose to acheive same effect.

- metabolic (increased rate)
- cellular (decreased # receptors)
- behavioral
- patient needs drug to "function normally"
- cessation of drug will cause withdrawl symptoms
- may be physical or psychological
Drug interaction equations
Additive response: 1+1=2
Synergist response: 1+1=3
Potentiation response: 1+0=2
Antagonism response: 1+1=0
NSAID v Acetaminophen
NSAID = analgesic, antipyretic, anti-inflammatory,

Acetaminophen = analgesic, antipyretic, NO EFFECT ON INFLAMMATION.
"Non-steroidal anti-inflammatory drugs."

- most widely prescribed class of medication in the US

- works by inhibiting cyclo-oxygenase activity in prostoglandin cascade.
COX-2 Inhibitors
(Celebrex, Vioxx, Bextra)
- Minimal GI side effects
- no platelet effects
- too much (too long/dose too high) leads to heart attacks.
NSAID side effects
- Gastric ulcers/distress (MOST COMMON)
- Platelet inhibition/bleeding
- Renal failure
- Hepatic dysfunction
- Hypertension
- peripheral edema
- tinnitus
- asthma exacerbations
- Extra risk for elderly, children, pregnant women.
COX/NSAID Safety (2 points)
1. Coxibs and nonselective NSAIDS are associated with increased hypertension and peripheral edema.

2. Coxibs provide better safety to GI tract than non-selective NSAIDs.
- but they're not any stronger.
- (?) destabilize vascular endothelium
- platelet effects
Actions of Narcotics
Narcotics mimic the effects of endogenous opioids: endorphin, enkephalin, dynorfins.

1. Pain relief
2. Euphoria
3. Anti-tussive
4. Decrease intestinal motility
Narcotic Side Effects
- Respiratory Depression
- Constipation
- Sedation
- Nausea/vomiting
- Confusion
- Hypotension
- Addiction/abuse
- Cholestasis (gall bladder attack)
Mechanism of Sedatives/Hypnotics
Enhances GABA's inhibitory action
- (GABA allows Cl- to enter, hyperpolarizing cell, making it harder to depolarize.)
Sedative/Hypnotic Side Effects
- Drowsiness
- Confusion
- Dysarthria (slow speech)
- Ataxia
- Memory loss (short term)
- Paradoxical stimulation
- Respiratory depression
- Behavioral disinhibition
- Addiction/abuse potential
3 Principles of Homepathy
1. Law of Similars: Substance may have opposite effects on health in different people.

2. Principle of Minimum Dose: By diluting a substance, its curative properties are enhanced and its side effects minimized.

3. Prescribing for the individual should take into account condition AND patient's temperament, personality, and emotional/psychological respose.
6 Basic Philosophies of Naturopathy
1. Body has an ability to heal itself.
2. Treat the whole person.
3. Do no harm.
4. Treat cause, not symptoms.
5. Prevention is best cure.
6. Physician as teacher.
- Naturally occuring nitrogen compound (3 amino acid)
- Primarily located in skeletal muscle
- Provides phosphate group to ADP to make ATP

- Loading dose is expensive for the amount of drug that is just excreted.
- Naturally synthesized in liver (2 grams daily); stored in liver as creatine phosphate.

- May be helpful in exercises that require short or repeated bouts of energy expenditure.
- No utility in long-distance events.
- Increased muscle mass and strength
- Delays fatigue
Creatine Side Effects
- Weight gain from water retention.
- Muscle cramps.

- Renal injury from prolonged use in dehydrated state.
= hormone produced by adrenals which is a precursor to estrogen and testosterone.

- anabolic steroid-like effect.
- Studies have shown oral andro does not increase seurm testosterone levels or enhance musculoskeletal adaptations.
- Notable increase in estradiol levels.
Androstenedione Side Effects
- Impotence
- Testicular Atrophy
- Elevated cholesterol levels (increased risk of CAD)
- Acne
- Prostatic hypertrophy
Glucosamine/Chondroitin Sulfate
- Promotes "joint health."
- Basic building blocks for joint cap cartilage
- mild antiinflammatory effect

- expensive, often not covered by insurance
- takes 3 months to see an effect
- wide variability in dosing and availability from mfg to mfg.
Glucosamine/Chondroitin Sulfate Side Effects
- Insulin resistance
- dyspepsia
- nausea/vomiting
- edema
- anorexia
- headache
- tachycardia
- Common supplement in weight reduction and energy pills
- medically used as treatment for asthma
- Similar to ingredients in OTC cold/sinus medication
Ephedra Side Effects
- Increases heart rate
- Constricts blood vessels
- Increases blood pressure
- Decreases ability of body to dissipate heat
- Banned in many sports organizations
- First supplement banned by FDA in recent era