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43 Cards in this Set
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Drug
any substance that, when taken into the body changes one or more of the body's functions |
pharmacology
science of drugs, includes study of drug origin, ingredients,uses and actions |
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toxicology
study of poisons and undesired drug reactions |
pharmocodynamics
study of drug actions on the body and is the basis for TX with a particular drug |
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pharacokinetics
study of drug movement through the body over a period of time absorbtion, duration of action, distribution, meatbolism, biotransformation, elimination |
drug standards and testing
1 - toxicity 2 - therapeutic index 3 - pharacokinetics |
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assay - chemical testing of drug
bioassay - testing on living organisms |
Drug nomenclature
chemical name generic name trade name USP/NF (official) name |
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Drug Preparations
topical - ointments and lotions oral - aqueous, spirits, elixers solid - capsule, tablet, lozenger, pill parenteral - ampule, vial, prefill syrin inhalants - nebulizer suppositories |
absorbtion or drug dependent upon
pt circulatory status drug solubility body's PH drug concentration |
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ET administraion of drugs only in peds
LEANO lidocaine, epi, atropine, narcan, O2 |
pharmacodynamics
onset of drug action ↓ or ↑ actions at targeted receptors done by binding to it's receptor |
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Mechanism of action
drug = key receptor = lock (both required) |
agonist - enables drug effect
antagonist - inhibits or counteracts affinity - mutual attraction efficacy - power to produce desired affect |
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agonist
has both affinity and efficacy antagonist has affinity but no efficacy (narcan) |
additive
added to another for increased effect antagonistic inhibits or counteracts |
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commulative
tendency to accumulate or pile up depressant reduce activity of target |
habituation
for of habit (pshyco dependent) idiosyncracy individual behavior that is characteristic |
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potentiation
greater additive affect physiologic action normal action of drug |
synergism
co-related action (work together) untoward reaction unexpected reactions |
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addsorbants
attract molecules to its surface (sorbitol charcoal) |
CNS & PNS
PNS divided in somatic and autonomic autonomic divides into sypathetic and parasympathetic |
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alpha and beta receptors
alpha1 - constrictor beta1 - increase heart contractility beta2 - bronchodilation of lungs |
primary neurotransmitters
actycholine norepinephine epinephrine |
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parasympathetic - SLUDGE effect
salivation lacrimation urination defication gastric motility (increased) emesis |
ALPHA receptors
work on smooth muscle (arteries, veins, pupils) reactive to sympathomimetic drugs |
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BETA1 receptors
↑HR ↑contractions ↑conduction at AV junction ↑myocardial O2 demand |
BETA2
vasodialtion, bronchodialation |
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inotrope
makes heart beat harder - increases contractility |
chronotrope
makes heart beat faster |
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dromotrope
increases conduction speed |
-mimetic....increases
-lytic ......decreases |
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drug sources
plants - digitalis animals - insulin minerals - iron sythesis - sulfonamides |
food and drug act (pure food act) 1906
established united states pharmacopia (USP) and National Formulary (NF) |
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federal food, drug, and cosmetic act of 1938
"caution federal law prohibits deispensing without prescription" |
harrison narcotic act of 1914
established federal control over the import, manufacture, and sale of opium, cocoa plants |
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controlled substances act of 1970
schedules 1, 2, 3, 4 |
schedule 1 narcotic
high abuse/no medical use may lead to severe dependence HEROIN LSD |
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schedule 2 narcotic
high potential for abuse and dependence accepted medical use OPIUM MORPHINE |
schedule 3 narcotic
moderate potential for abuse accepted medical use may lead to low dependence high pshycological dependence DRUGS WITH LIMITED QUANTITIES OF OPIUM OR CODEINE |
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schedule 4 narcotic
low potential for abuse accepted medical uses may have limited phyical or psychological dependence VALIUM |
↑↑↑↑↑
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second messenger
chemical that participates in complex cascading reactions that eventually causes a drugs desired effects |
down-regulation - target receptors are stimulated and often destroyed
up-regulation - stimulated receptors causes additional receptors to form |
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agonist-antagonist
binds to a receptor and stimulates some if its effects but blocks others |
Lidocaine
blocks sodium channels |
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verapamil, nefedipine
blocks calcium channels |
bretylium
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potency
absolute amount of drug required to produce an effect |
threshold (minimal) dose
least amount of drug to produce a desired effect |
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-phyllic (loving)
-phobic (fear of) |
blood brain barrier
small uncharged particles will pas (O2, CO2) |
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contraindications
a predictable harmful event will occur if drug is given in this situation |
idosyncrasy
opposite of what you would expect to see....tend to happen in kids and geriatrics alot |
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shirley act of 1912
prohibited fraudulent therapeutic claims |
black box warnings
issued by FDA when problem arises with serious concerns (IE Death) |
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oncotic pressure
pulling power of proteins moving water back into the intravascular space |
IV - fast and most dangerous
IM - depends on perfusion quality SQ - depends on perfusion quality ORAL - slow, unpredictable, little prehospital use |
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PPG
pregnant, pediatric, geriatric |
teratrogenic drugs
medications that may defrom or kill the fetus |
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Pediatric drug concerns
decrease in oral absorption thinner skin decrease plasma protein concentration increase extracellular fluid neonate altered metabolic rates - faster |
Bernius card - must reference the fact that you are using bernius card in documentation
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Analgesia - absence of pain
Anesthesia - absence of all sensation |
opiod agonists
-similarity to natural pain reducing peptides called endorphins - Prototype - morphine |
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Non-opioid analgesics
fever fighting properties -salicylates -NSAIDS (ibuprofen) -paraaminophenol derivates (aceaminophen) |
opiod antagonists
prototype - narcan competitively binds with opiod receptors |
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adjunct medications
may only have limited or no analgesic properties but when combined with analgesic they prolong or intensify its effect |
opioid agonists-antagonists
does both pentazocine (talwin) is prototype |
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anesthetic
medication that induces a loss of sensation to touch or pain |
neuroleptanesthesia
anesthesia that combines decreased sensation of pain with amnesia while the patient remains concious |
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benzodiazepines antagonist
flumazenil (romazicon) |
the goal of siezure management is to balance eliminating the seizures against the side effects of the medications used to treat them
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Seizures
dilantin and tegretol inhibit the influx of sodium into the cell, thus decreasing the cells ability to depolarize and propagate seizures |
seizures
valporic acid and ethosuximide act with tthe calcium channels in the hypothalmus, where absence seizure typically begin |
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Antiseizure meds
benzodiazepines - valium, ativan barbituates - phenobarbitol, dilantin, cerebyx succinimides - zarontin, depakote |
extrapyramidal symptoms - common side effects of antipsychotic meds, including muscle tremors and parkinsonism-like effects
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neuroleptic
antipsychotic - literally, affecting the nerves |
Antipshycotics
phenothiazines (thorazine) butyrophenones (haldol) atypicals - clozaril, risperdal, geodon, zyprexa |
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Antidepressant Meds
TCA's SSRI's MAOI's |
lithium widely used in the treatment of bipolar disorder has a very low therapeutic index
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Drugs
bind to a receptor change formation of a process chemically combine alter a normal pathway |
polarization (resting)
depolarization (stimulation) sodium in repolarization (resting) NA pumped out |
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3 hormones in brain
norepinephrine dopamine serotonin |
narcotic analgesic
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1. There is an increased sodium permeability through opening of sodium gates.
2. Amount of sodium entering cell is several 100x the amount of potassium leaving causing the inside of the cell to become positively charged relative to the outside. 3. Voltage change goes from -70mV to +30mV (or +35mV). Threshold is reached about -55mV. 4. By the time that +35mV is reached, there is a definite decrease in sodium permeability. No more sodium gets in. The membrane is now depolarized. 5. Repolarization begins in response to this high sodium concentration. Potassium gates open. 6. Potassium begins to move outside the cell, which has a much lower concentration of potassium ion than inside. It is also more negative than inside and attracts the positive potassium ions. The mV count begins to recede toward 0mV towards a negative reading. 7. Enough potassium ions move out to restore the RMP of -70mV. BUT, during this brief period, even MORE potassium ions move out, causing the membrane to hyperpolarize; that is, become even more negative than the RMP. 8. Now, in order to truly restore the -70mV, the sodium pump "kicks in" to move the excess sodium ions out of the cell and bring the potassium back in. (Three sodium ions go out of the cell, two potassium ions enter.) |
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