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43 Cards in this Set

  • Front
  • Back
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
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
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
assay - chemical testing of drug

bioassay - testing on living organisms
Drug nomenclature

chemical name
generic name
trade name
USP/NF (official) name
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
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
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
agonist
has both affinity and efficacy

antagonist
has affinity but no efficacy (narcan)
additive
added to another for increased effect

antagonistic
inhibits or counteracts
commulative
tendency to accumulate or pile up

depressant
reduce activity of target
habituation
for of habit (pshyco dependent)

idiosyncracy
individual behavior that is characteristic
potentiation
greater additive affect

physiologic action
normal action of drug
synergism
co-related action (work together)

untoward reaction
unexpected reactions
addsorbants
attract molecules to its surface
(sorbitol charcoal)
CNS & PNS

PNS divided in somatic and autonomic

autonomic divides into sypathetic and parasympathetic
alpha and beta receptors
alpha1 - constrictor
beta1 - increase heart contractility
beta2 - bronchodilation of lungs
primary neurotransmitters
actycholine
norepinephine
epinephrine
parasympathetic - SLUDGE effect
salivation
lacrimation
urination
defication
gastric motility (increased)
emesis
ALPHA receptors
work on smooth muscle (arteries, veins, pupils)
reactive to sympathomimetic drugs
BETA1 receptors
↑HR
↑contractions
↑conduction at AV junction
↑myocardial O2 demand
BETA2
vasodialtion, bronchodialation
inotrope

makes heart beat harder - increases contractility
chronotrope

makes heart beat faster
dromotrope

increases conduction speed
-mimetic....increases
-lytic ......decreases
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)
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
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
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
schedule 4 narcotic

low potential for abuse
accepted medical uses
may have limited phyical or psychological dependence

VALIUM
↑↑↑↑↑
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
agonist-antagonist

binds to a receptor and stimulates some if its effects but blocks others
Lidocaine

blocks sodium channels
verapamil, nefedipine

blocks calcium channels
bretylium
potency
absolute amount of drug required to produce an effect
threshold (minimal) dose

least amount of drug to produce a desired effect
-phyllic (loving)

-phobic (fear of)
blood brain barrier
small uncharged particles will pas
(O2, CO2)
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
shirley act of 1912
prohibited fraudulent therapeutic claims
black box warnings
issued by FDA when problem arises with serious concerns (IE Death)
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
PPG

pregnant, pediatric, geriatric
teratrogenic drugs

medications that may defrom or kill the fetus
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
Analgesia - absence of pain
Anesthesia - absence of all sensation
opiod agonists
-similarity to natural pain reducing peptides called endorphins

- Prototype - morphine
Non-opioid analgesics

fever fighting properties

-salicylates
-NSAIDS (ibuprofen)
-paraaminophenol derivates (aceaminophen)
opiod antagonists

prototype - narcan
competitively binds with opiod receptors
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
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
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
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
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
neuroleptic

antipsychotic - literally, affecting the nerves
Antipshycotics
phenothiazines (thorazine)
butyrophenones (haldol)
atypicals - clozaril, risperdal, geodon, zyprexa
Antidepressant Meds

TCA's
SSRI's
MAOI's
lithium widely used in the treatment of bipolar disorder has a very low therapeutic index
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
3 hormones in brain
norepinephrine
dopamine
serotonin
narcotic analgesic
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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