Unit 6 Pharmacology

Front 1

Pharmacology

Back 1

The study of drugs and their uses

Front 2

Controlled Substances

Back 2

Drug with the potential for abuse

Front 3

Generic Drug

Back 3

Chemical name of drug, ibuprofen

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Brand Name

Back 4

Name given by manufacture ex. Advil

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FDA

Back 5

US Food & Drug Administration - the gov't agency responsible for the safety and drugs in the US.
* control of products inserts, warnings.

Front 6

DEA

Back 6

US Drug Enforcement Agency regulates manufacturing and dispensing of controlled substances.

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USP

Back 7

United States Pharmacopeia guide which gives information on the preparation of medications in the US

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USP 797

Back 8

Regulates nuclear medicine preparations

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Pharmacodynamics

Back 9

The actions of drugs on the body

Front 10

Pharmacokinetics

Back 10

How the body processes a drug

Front 11

Pharmacognosy

Back 11

The origins of drugs

Front 12

Pharmacotherapeutics

Back 12

The effects of drugs on the body

Front 13

Toxicology

Back 13

The toxic effects of drugs on the body

Front 14

Pharmacognosy

Back 14

The origins of the drugs

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Pharmacodynamics

Back 15

The action of drugs on the body

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4 Categories
Depression (1)

Back 16

Lessening of a body function

Front 17

Stimulation (2)

Back 17

Increase a body function

Front 18

Irritant (3)

Back 18

Produces a inflammation on skin or mucous membranes

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Demulcent

Back 19

Soothes a body part

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How the body processes drugs

Back 20

4 Categories

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Absorption (1)

Back 21

Directly related to route or administration
* Enterally (via the GI tract)

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Parentally

Back 22

intradermal, subcutaneous (SC), intramuscular (IM), intravenous (IV) intrathecal

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Percutaneously

Back 23

through the skin & mucous membrane) inhalation, sublingually, transdermally, tropically

* Also affected by pH, food in stomach, length of contact (tropical) & drug concentration

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(2) Distribution

Back 24

Drug travels through blood vessels to its site of action

Front 25

Factors that affect Distribution

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Protein binding - drug molecule binds to plasma proteins. Decreases amount of free drug available to tissues.

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Fat solubility

Back 26

Fat soluble molecules cross membranes more readily than fat-insoluble molecules.

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(3) Metabolism

Back 27

Series of reactions that convert a drug into a water soluble compound for excretion from the body
* Without Metabolism, the drug would have a permanent effect on the body
* Primary site for drug metabolism is the liver
* Drug half life = time for the body to metabolize half of the drug.
* Individuals with impaired liver function may have different rate of metabolism.

Front 28

(4) Excretion

Back 28

Through respiration, perspiration, urination, or defecation.
* Commonest route is through the kidneys
* Individuals with impaired kidney function may experience delayed exertion.

Front 29

Pharmacognosy

Back 29

The study of the origin of a drug

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Early drugs came from

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Plants ( nicotine, morphine, digitalis)
Minerals (NaCl)
Animals (insulin, vaccines, hgh)

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New drugs are produced in the laboratory and are

Back 31

synthetic.

Front 32

Pharmacotherapeutics

Back 32

The effects of the drug on the body.
*Different from the action of the drug. The action of the drug is how and where it acts on the body. The effect is the sum of the biological, physical and psychological changes that occur because of the drug.

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Pharmacotherapeutics

Back 33

5 effects

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(1) Curative

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drug produces a cure

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(2) Palliative

Back 35

Drug decreases or relieves symptoms but does not produce a cure.

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(3) Preventative

Back 36

Drug Prevents disease

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(4) Diagnostic

Back 37

Drug given to diagnose such as nuclear medicine

Front 38

(5) Substitutive

Back 38

Drug replaces a substance that is deficit such as thyroid hormone`

Front 39

Toxicology

Back 39

The toxic effects of a drug
All drugs have a toxic level
Side Effect = An additional mild effectnoted when the drug is administrated, apart from the desired effect.
Adverse reaction - A problem more severe than a side effect

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Allergic Reactions

Back 40

May be mild to severe
Anaphylaxis - severe allergic reaction, potentially fatal!
hives, bronchospasm, high blood pressure, loss of consciousness, cardiac arrhythmia's & arrest

Front 41

The six rights of drug administration

Back 41

Right Patient
Right Time
Right Drug
Right Dose
Right route of administration
Right Documentation

Front 42

Contrast Media
X-Ray & CT

Back 42

Negative and Positive agents
Negative agents decrease organ density
CO2 and air
Positive agents increase density
Barium sulfate, Iodine

Front 43

High Z value molecule attenuates x-rays and delineates structures

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Large molecules attenuates X-rays
Radiopaque
Iodine injected intravenously
Barium given orally or rectally
Not a Dye!!!! Colorless and dose not change color

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Contrast Media
Barium Sulfate

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Oral Administration: Upper GI Series
Delineates organs in upper GI tract
May be administered as part of a PET/CT scan.
Rectal administration: Lower GI Series
Not absorbed through GI tract

Front 45

Iodine

Back 45

Injected Intravenously
Can produce adverse reactions in in patients

Front 46

Iodinated Contrast Media
Characteristics

Back 46

Ionic monomer or dimer
Non-ionic monomer or dimer
Hyperosmolar compared to blood plasma
Human blood: 300mOsm/kg
Ionic contrast media: minimum 1000 mOsm/kg
Non-ionic contrast media: minimum 600 mOsm/kg : easier for people to take

Front 47

Iodinated Contrast Media

Back 47

Complex pharmacodynamics and pharmacpokinetics

Front 48

Osmolality

Back 48

Injection causes H20 to move from blood cells to plasma (osmosis) causes vasodilation, change in blood volume.
*Contrast media moves from plasma to extracellular tissue ( washes out of blood)
*Blood moves into area and reserves osmotic pressure, H20 moves back into blood, causes vasoconstriction.

Front 49

Iodinated Contrast Media

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Ionization: Central Nervous System sensitive to ionic changes which alter the electrical activity of the body.
Can cause seizures and cardiac arrest.

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Molecular Toxicity

Back 50

Reaction of contrast media with blood
Triggers histamine release and activation of complement
Causes increased thrombin time, increased coagulation time.

Front 51

Iodinated Contrast Media
Adverse Reactions

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Severe Reactions in 1/14,000 patients
Fatal Reactions in 1/40,000 patients
Risk Factors: asthma, previous reaction to contrast media, cardiac disease, kidney disease, diabetes and age of 70 years
Requires informed consent prior to administration

Front 52

Iodinated Contrast Media

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Overall: Warmth, flushing, metallic taste.
Cutaneous: Uticaria, itching, angioedema
GI: Nausea, vomiting
CNS: headaches, dizziness, seizures

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Respiratory Mild:

Back 53

Sneezing, wheezing, coughing, rhinorrhea.
Moderate: Mild dyspnea, mild pulmonary edema, mild bronchospasm
Severe: Severe dyspnea, cyanosis, respiratory arrest
Cardiovascular: Mild : tachycardia
Moderate: hypotension, bradycardia
SEVERE: dysrhythmia, cardiac arrest

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Renal

Back 54

Contrast causes alteration in glomerular filtration rate and produces diuresis
Can lead to acute renal failure
Risk factors: Prior renal disease, diabetes and over age 70.
Check serum BUN and creatinine levels prior contrast

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Contrast for MRI
Iodine does not provide contrast for MRI procedures

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Paramagnetic contrast medium =
Alters magnetic properties of tissues
Substance with many unpaired electrons

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Gadolinium

Back 56

Molecule with unpaired electrons (gad)
Highly toxic, so chelated with DTPA in contrast media.
Not associated with the type or quantity of adverse reactions seen with iodinated media

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Contrast for MRI
FDA black box warning on gadolinium-based contrast agents.

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Nephrogenic systemic fibrosis (NSF)
Patients with renal insufficiency
Fibrosis of skin and connective tissue
Highly debilitating and can cause death
Unknown cause = no treatment

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MRA (Magnetic Resonance Angiography)

Back 58

Off Label use of gad-based media at up to 5 times the recommended dose for MRI procedures.

Front 59

Gadolinium

Back 59

Molecule with unpaired electrons (gad)
Highly toxic, so chelated with DTPA in contrast media.
Not associated with the type or quantity of adverse reactions seen with iodinated media

Front 60

Contrast for MRI
FDA black box warning on gadolinium-based contrast agents.

Back 60

Nephrogenic systemic fibrosis (NSF)
Patients with renal insufficiency
Fibrosis of skin and connective tissue
Highly debilitating and can cause death
Unknown cause = no treatment

Front 61

MRA (Magnetic Resonance Angiography)

Back 61

Off Label use of gad-based media at up to 5 times the recommended dose for MRI procedures.