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Drug? Any chemical that affects living tissue
Medicine? Chemical produce to produce therapeutic effect
3 drug names 1-chemical 2-non-proprietary/genetic 3-proprietary/trade
Pharmacodynamics What drug does to body
Pharmacokinetics What body does to drug
Affinity Ability of drug to bind at receptor
Efficacy Ability to generate stimulus => effect
Potency Concentration at which drug produce effect
Full agonist Produce max effect response/equal to max response of tissue.
Partial agonist Max response less than max redone if tissue
Agonist Mimic effect of endogenous chem. Both efficacy and affinity
Antagonist Inhibit effect of endogenous chem sub. Affinity no efficacy
Full agonist Full efficacy at receptor
Partial agonist Only partial efficacy relative to full agonist
Competitive reversible antagonist Compete with agonist at receptor. Will bind, but not activate receptor.
Competitive irreversible antagonist Permanently bind to receptor
Non competitive antagonist Bind to allosteric (non agonist) site on receptor to prevent activation of receptor
Structure of cell plasma membrane Phosphate lipid bi-layer -heads(outer) are hydrophilic -tails(inter) are hydrophobic
Homeostasis Tendency towards relative suitable equilibrium. Maintaining a constant -internal- environment with balance of physiological variables despite -internal- conditions.
pH? Figure expressing acidity or alkalinity. 1-lower pH=> more acidic(readily gives H+ ions) 2-higher pH=> more basic(really accepts H+ ions)
Negative Feedback Response to reduce stimulus and restore homeostasis
Bioavailability Portion of drug that reaches systemic circulation intact.
Enzymic metabolism of drug Phase 1 (catabolic/functionalism) Phase 2 (synthetic/conjunction)
4 phases of pharmacokinetics 1-absorption 2-distribution 3-metabolism 4-excretion
Adverse drug event Injury resulting from medical intervention related to a drug. -not necessarily due to drug-
Adverse drug reaction Any response to a drug which is noxious, unintended, and which occurs at doses normally (and appropriately) used in man fit the prophylaxis diagnosis or therapy of a disease
Type A (augmented) ADR -common. -typically predictable from known pharmacology of drug and related dose. -usually mild with higher morbidity and low mortality. -about to reproduce in animal study.
Type B (bizarre) ADR -uncommon. -unpredictable. -not related to known pharmacology of drug. -high mortality and high morbidity -e.g.allergy, hypersensitivity
Type C (chronic) ADR -uncommon. -related to cumulative dose.
Type D(delay) ADR -uncommon. -usually dose related. -occurs or becomes apparent some time after the use of drug.
ADR Risk factors Age, gender, concurrent diseases, genetic factors, history of prior drug use, Chemical characteristics, route of admin, dose, duration and frequency.
5 Rights Drug, dose, route, time, patient
Mutagenic Physical or chemical agent rhesus cause genetic material (DNA) to undergo a detectable and heritable structural change. All mutagens are teratogens, but not all teratogens are mutagens.
Carcinogen Any agent that by either direct or indirect action cause a normal call to become a neoplastic cell
Teratogen A substance that causes transient or permanent physical or functional disorder in the foetus without causing toxicity to the mother.
ABSORPTION- Altered pharmacokinetics elderly ~+ gastric pH. ~ altered gastric emptying and intestinal blood flow. ~ decrease in first pass metabolism in liver
DISTRIBUTION- Altered pharmacokinetics elderly +Altered body composition (+fat store). ~ -in total body water. ~ -plasma albumin ~ -blood flow and cardiac output
METABOLISM -Altered pharmacokinetics elderly ~ -hepatic blood flow ~ -in oxidative metabolism(P450 system)
EXCRETION -Altered pharmacokinetics elderly decrease globular filtration rate and renal function
Neurotransmitters of ANS ACh (acetylcholine) and NA (noradrenaline)
Receptors of ANS ACh(-Muscarinic,-nicotinic) NA(-ALPHA, BETA)
SNS Pre ganglionic receptor Nicotinic
SNS post ganglionic receptors ALPHA..BETA
PNS pre ganglionic receptor Nicotinic
PNS post ganglionic receptor Muscarinic
Somatic efferent system receptor Nicotinic
Alpha adrenoceptors Noradrenaline> adrenaline> isoprenaline (excitatory response)
BETA adrenoceptors Isoprenaline> adrenaline> Noradrenaline (Inhibitory response, except in heart)
Organophosphate poisoning symptoms 1.Stim of Muscarinic receptors(SLUDGE) 2.Stim of Nicotinic receptors(NMTWTF) 3.CNS effects(anxiety, lethargic, psychosis, coma, seizure)
SLUDGE Organophosphate poisoning Muscarinic symptoms... S-alivation L-acrimation U-rination D-efecation G-I cramping E-misis
Acetylcholinesterase Enzyme that breaks down acetylcholine.
SNS pre ganglionic neurotransmitter AHc
SNS post ganglionic neurotransmitter NA ACh
PNS pre/post ganglionic neurotransmitter ACh
Nicotinic receptors Autonomic junction Adrenal medulla
Adrenal medulla Innovated by ACh directly to provided sympathetic response
Alpha-1 Alpha 1 receptors - smooth muscle contraction
Beta-1 increase speed, force of contraction and conductivity of heart
Beta-2 smooth muscle relaxation - bronchodilator
Things that affect a patient's response to drugs? age weight environment genetics
What are the Pregnancy drug levels? A- No fetal harm B- Animals were good, never tested on human C- Drugs should be given if benefits outweigh risk D- Human fetal risk, but benefits could be wanted X- Animals and human fetal risk, no benefit
Pharmacokinetic process 1. Absorption. 2.Distribution. 3.Metabolism. 4.Excretion.
Alpha-2 Presynaptic "inhibitory feedback"
Nicotinic symptoms for Organophosphate poisoning. M-Muscle cramps. T-Tachycardia. W-Weakness . T-Twitching. F_Fasciculations. Max The Weary Toad Farted
who regulates Drugs in AUS Therapeutic Goods Administration
What is Therapeutic Goods? product for use in humans; 1.prevent, diagnose, cure a disease ailment or injury. 2.influencing, inhibiting or modifying a physiological process. 3.testing the susceptibility to disease or ailment. 4.influencing controlling or preventing conception. 5.testing pregnancy includes 1.ingredient or components in the manufacture of therapeutic goods. 2.thing used to replace or modify part of anatomy
Registered drugs/meds -most OTC meds. -ALL prescribed meds are registered. Complimentary meds must be registered if: 1.contain ingredient or componant that is subjct to condtns of a schedual. 2.contain an ingredient that has been identified as being unsuitable for use in listed medications
when is a therapeutic good unacceptable for registration 1.states something that the goods have ingredients/compnts that they dont 2.name is the same as another therapeutic good supplied in australia 3.label of good doesnt declare presence of active therapeutic ingredient.
Sheduling of drugs toxicity is one of the factors considered, the decision to include a substance in a particular Schedule also takes into account criteria such as the purpose of use, potential for abuse, safety in use and the need for the substance
Drug Scheduling 1- Unscheduled 2-Pharmacy medicine 3-Pharmacist only medication 4-Prescription only Medication 5-caution 6-poison 7-dangerous poison 8-Controlled drug 9-Prohibited substance
Drug Labeling must contain NAME, MANUFACTURER+one or more of following:1-signal words(warn of potential hazard) 2-cautionary statement(concise general precaution) 3-safety directions(for safe use) 4-warning statement(advise about specific hazard to avoid) 5-first aid instruction(advice if poisoned) 6-Dangerous goods classification symbols 7-name quantity proportion strength of constituents 8-directions for use
Schedule 2 drugs pharmacy only meds. mostly cough and cold preparations, some antihistamines, some anti-inflammatory drugs and mild analgesics
Schedule 3 Drugs Pharmacist only Medicine--\available to public from a pharmacist, medical, dental or veterinary practitioner. some metered-dose bronchodilatators, some topical corticosteroids, low-strength analgesics, emergency contraception and adrenaline injections
Schedule 4 Drugs Prescription only Medication--\only under prescription from a medical, dental and veterinary practitioner. antibiotics, antidepressants, hormones including insulin and hormonal contraceptives, vaccines, cardiovascular and central nervous system drugs. All new drugs are scheduled S4 drugs.\ require: Records of administration and supply, records of transfers between different storage locations, and records of destruction and disposal.
Schedule 8 Drugs CONTROLLED DRUG--\ possession without authority is illegal. Prescriptions are valid for only 3 months.\\opioids (morphine, fentanyl, methadone, codeine only) and central nervous stimulants such as dexamphetamine. Require; Records of administration and supply, records of transfers between different storage locations, and records of destruction and disposal. + readily sorted by substnce, show true balance of subs and name of prsn carrying out transaction
Advertising Regualtion direct to consumer permitted in unscheduled, sched 2, and sched 3 only not permited for sched 4 and sched 8
Pharmaceutical Benefits Scheme (PBS) provide affordable access to necessary medicines. Government covers a large proportion of the cost. Pt.pay the co-payment
Harm minimisation –the National Strategy ‘refers to policies and programs designed to reduce and prevent harm associated with both licit and illicit drugs’. \ ‘Harm minimisation includes prevention of uptake of harmful use of licit and illicit substances. It aims to improve health, >>> social and economic outcomes for both the community and the individual and encompasses a wide range of approaches including abstinence-orientated strategies’
Harm minimisation Objectives and Strategies Objectives: –identify harms to the individual and society –implement strategies to minimise these harms Strategies: –demand reduction –supply reduction –harm reduction
Created by: Gt_cockatoo