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• Charachteristics of Drugs o Effectiveness**** most important o Safety o Selectivity
• Side effect o nearly unavoidable secondary drug effect produced at therapeutic doses *generally predictable (An effect that we know is going to happen )
• Adverse reaction o Any noxious , unintended, and undesired effect that occurs at normal drug doeses o More intense than side effect (mild to severe
• Med error Overdose, wrong drug, wrong route; the cause of this is due to human factors, communication mistakes and name confusion. Major cause of morbidity (sickness) and mortality (death).
• Allergic reaction: o Immune response o *must be prior sensitization of the immune system first, so the reexposure can trigger the allergic response o *based on DEGREE of immune system sensitization (not drug dose) o Itchy, swelling rash, fever)- minor o Anaphylaxis- maj
• Dependent o Psychologic: Intense subjective need o Physical: state in which abstinence syndrome will occur
• Tolerance Results from regular drug use. A state in which a particular dose elicits a smaller response than it did with initial use.
• Potency o The AMOUNT of drug needed to produce effect
• o Chemical name (the chemical properties it consists of)
o Generic name equivalent to brand name counterpart/cheaper/basically a copy of the brand name but names differently) (i.e. acetaminophen)
o Trade name (propriety or brand name/identifies it as the exclusive property of a particular company/simply a shortened version. Multiple trade names for a single drug=confusing) (Tylenol example- everyone knows this name)
• Parenteral o absorbed through IV, straight into circulatory, FAST
• Enteral o goes through GI, slower
• (Intrinsic activity) ability for drug to activate following binding
• Affinity The attraction to a receptor site
• Agonist o Activates receptor o Has affinity and intrinsic factor o (mimics)
• Antagonist o Blocker o Prevents receptor activation by endogenous regulatory molecules and drugs o Has affinity but NO intrinsic factor (can bind to receptors but does NOT activate)
• Receptor o Any functional macromolecule in a cell to which a drug binds to produce its effects
Pharmacokinetics how MUCH of dose to site of action (body impact on drugs)
o Absorption  (into bloodstream)  Movement of drug from site of administration into blood  (important determinants of drug response, dosage size, and route)
o Distribution The movement of drugs throughout the body into cells/tissues; poor blood flow or a solid mass can affect distribution.
o Metabolism o Metabolism
o Elimination Excretion of the drug. Kidney disease can decrease this action.
• Beta lactam o The ring attached to the antibiotic (penicillins and cephalasporins are in this category- also bacteriocidal which weaken the cell wall and kill the virus (PROTECTS THE ANTIBIOTIC)
• Beta-lactamase : Breaks down the beta lactam ring that is around the antibiotic making it not work
Narrow therapeutic index (range): A small range where one will see therapeutic effects. It is very easy to reach toxic concentrations or minimum effective concentrations. Monitoring frequently is very important. (ex: Dilantin has a very narrow therapeutic range)
• Glucocorticoid Cortisol is the most important glucocorticoid. Highly effective in relieving pain for short term use for inflammation. They increase the availability of glucose.
• B2 agonist Activate beta₂ receptors (primarily selective to the lungs and used for asthma).
• Bronchoconstriction: The constriction of the airway and the lungs due to tightening of surrounding smooth muscle. (cholinergic effect)
o Surfactant  Pulls water back in makes fecal matter SOFT  Non drug of choice with people with bad peristalsis
o Osmotic  Nonabsorbed salts  FAST  Dehydration risk  Pull in water and electrolytes
o Bulk forming  Like fiber  Creates bulk by stretching lumen and creates peristalsis  DRINK WATER
o Stimulant  Usually with Opioids*  Stimulating peristalsis  A day or so Senokot-s
• Neuroleptic malignant syndrome DEFINISTION o Initiation or increase in antipsychotics; drugs cause an inability to regulate body temperature/autonomic function; elevated CPK levels (muscle breakdown and acidosis) [What can happen when you start someone on antipsychotics or increase their dose]*
• Neuroleptic malignant syndrome S/S o s/s include high fever, muscle cramps “lead pipe rigidity”, tachycardia, tachypnea, fluctuating BP, delirium
o Acute attack Beta 2 agonist (albuterol)
o Maintenance Glucocorticoid (Prednisone)
In between drug... allergy o Leukotrienes (signgulair)
o Exercise induced asthma - Cromolyn
• Why is “fat soluble” important o It crosses the BBB and any part of the body more effectively (GETS ACROSS ANY PART OF BODY EASIER)
• Purpose general anesthetics o Unconsciousness o Lack of response to painful stimuli o Skeletal muscle relax o Amnesia [ULSA]
What are the side effects of anticholinergics?  Dry mouth, chronic thirst, blurred vision, dry eyes, sedation, urinary retention, constipation
 Bacteriostatic - slows growth
v Bacteriocidal kills
What is included in a complete drug history?:  Do you drink?  Do you take any OTC meds?  Do you take any herbal meds?  Do you take any street drugs?  Do you take any prescription drugs? Do you know the exact dosage?  Are you pregnant?  Do you smoke?
• Effect grapefruit Juice with drugs? With CYP450 o It can inhibit intestinal metabolism thereby increasing absorption which increases the drug blood level
• Purpose clinical drug testing DETERMINE EFFECTIVENESS
PRotein binding  EX: If there is a drug taken that is 50% protein bound and another drug taken that is 95% protein bound, the 95% protein bound drug will take up all the albumin sites leaving the 50% protein bound as free drug floating in the blood.
 Mucomyst reverses the effects of tylenol
 Narcan used to reverse respiratory depression (because of opioids)
 Protamine reverses the anticoagulating effects of heprin
 Vitamin K reverses the anticoagulating effects of Coumadin
 Fever (which nsaids) NSAIDS, ASA, Tylenol
 Pain NSAIDS, ASA, Tylenol
 Inflammation NSAIDS, ASA
• MAOI – what food to avoid  Yeast, cheese, wine, *processed meats and stuff
• HypOkalemia o Muscle weakness o Muscle cramps o Diminished refelexes o **digoxin risk
• HypERkalemia o Dysrthythmias o Palpitations o Diarrhea o Weakness/fatigue o Nausea/vomiting
• Hypoglycemia o Diaphoresis o Confusion o palpitations o Jittery o hunger
• Hyperglycemia o Dry o Irritable o Lethargic o Tachycardia o Thirst o hypotension
 Losartan ARB, does not affect heart rate
 Nipelipine CCB
 Metoprolol selective beta blocker, affects heart rate decreases it
 Captopil ACE
 Propanolol non selective beta blocker, decrease HR
• CO (cardiac output): The amount of blood pumped out of the ventricles at any given time. SVxHR=CO
• Afterload The force that the ventricles have to overcome to eject blood out of the heart (left side)
• Preload The amount of tension applied to the heart muscle prior to contraction (heart is stretching and filling up) (right side)
• Stroke volume The volume of blood that is ejected out of a ventricle during a single contraction
• Baroreceptors Located in the carotid sinus and aortic arch that monitors changes in blood pressure and send this information to the brain
• B1 receptors are selective for: o Heart- increase heart rate, increase conductivity, constrict arterioles o Kidney- release renin, increase blood pressure
• B2 receptors o Lungs- vasodilation o Arterioles- vasodilation o Uterus- relaxed muscle o Liver- gluconeogenesis (conversion of glycogen to glucose) o Skeletal muscle- gluconeogenesis (conversion of glycogen to glucose)
o Benefits (Estrogen) - helps with osteoporosis - menopause, - polycystic ovarian disease - growth in breasts, acne - thickens vaginal epithelium - helps with proliferation of uterun epithelium (period) - stimulates uterun blood flow - hormone replacement theory
o Risks - increase breast cancer - possible cardiovascular problems for MI and stroke - uteran cancer - ovarian cancer - nausea
• How do OC’s work? o Prevent/inhibit ovulation, thicken cervical mucus and thin the endometrial lining
• What is an “antabuse reaction”? why would you have this? o Given in treatment to those that are dedicated to stop drinking alcohol. If any type of alcohol is ingested, the client will become violently ill o LASTS FOR TWO WEEKS….
Teratogenesis? What is it/when significant?  Consuming a substance that will cause abnormalities to an unborn child. This is significant when a female is pregnant in first trimester (ex: fetal alcohol syndrome)
Created by: emixlizzie