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PHARMACOLOGY

Back to the Basics

QuestionAnswer
Changes in Absorption in Elderly Increase of Gastric pH, decrease in absorptive surface area, decreased GI motility, delayed gastric emptying, decreased splanchnic blood flow
Changes in Distribution in Elderly Increased % of body fat & lean body mass. Decreased total body water, reduced concentration of serum albumin, decreased cardiac output
Changes in Metabolism in Elderly Rate of hepatic drug tens to decrease due to reduced hepatic blood flow, reduced liver mass, and decreased activity of some hepatic enzymes
Changes in Excretion in Elderly Decreased renal blood flow, decreased GFR, decreased tubular secretion, decreased number of nephrons
If the drug contained is absorbed at the same rate and to the same extent bioavailability
Infants and young children are more susceptible to drugs because..... immature organs
Parenteral Administrations IV, IM, SubQ, Intra/transdermal, lotions, eye/ear drops, inhalants
Antagonist Drug that binds to a receptor and blocks or inhibits their responses
Agonist Drug that binds to receptor and initiates or promotes the same response as the substance
Generic Name often classified with suffix of pharmacological class, easier to say and remember, only one (nonproprietary name)
Brand Name Manufacturers chosen name, how they are marketed, may have many (proprietary/trade name)
Analgesic Drugs that relieve pain without sedation
Addiction A condition of compulsive physiological need for use of habiting forming substances
Withdrawal Symptoms that occur after stopping an addicting substance, includes cravings for the substance
Dependency Physical and behavioral need to continue a drug, discontinuing leads to an abstinence syndrome
Immunocompromised Impaired or weakened immune system
Percutaneous medications medications introduced into the body through skin or muscous membranes (lotions, ointments, creams, inhalation, topical), or any med going through skin
Enteral medications Medications introduced into the body through GI tract (PO)
Parenteral medications Medications introduced directly into circulatory system (SubQ, IM, IV)
Subtherapeutic level inadequate therapeutic effect
Supratherapeutic level Excessive therapeutic effect
Tolerance state where medication loses effectiveness, higher doses are needed
Half-life The amount of time required to eliminate one half of the amount of a drug in the body
Narrow therapeutic index Drug relatively unsafe.
Antipyretic Drugs that lower body temperature
Adrenergic Drugs that stimulate the SNS either by direct activation or promoting release of receptor-activating catecholamines
Pharmacokinetics study of drug movement through the body
Routes of Administration enteral, parenteral, topical
IV Absorption Barriers bypassed
IV Absorption Rate Immediate
IV Advantages rapid onset, control, can administer large volumes of fluid, can administer irritants
IV Disadvantages irreversible, expensive, inconvenient, difficult, risk of fluid overload, infection, and clots, drug must be water soluble
IM & SubQ Absorption Barriers Through capillary Wall
IM & SubQ Absorption Rate Rapid with water-soluble drugs, slow with others
IM & SubQ Advantages Permits use of poorly soluble drugs and depot preparations
IM & SubQ Disadvantages can cause discomfort, inconvenient, potential for injury
PO absorption barriers epithelial lining of GI tract
PO absorption rate Slow, variable
PO Advantages easy, convenient, ideal for self-medication, potentially reversible
PO Disadvantages varies, inactivation of some drugs by gastric acid and digestive enzymes, possible nausea and vomiting from irritation, patient must be conscious and cooperative
Absorption movement of drug from site of administration into blood
Factors effecting absorption Rate of dissolution, surface area, drug flow, lipid solubility, pH
Distribution drug movement from the blood to the interstitial space of tissues and into cells
Metabolism biotransformation and is defined as the chemical alteration of a drug structure
Excretion process of drug removal from the body
Sustained Release capsules filled with tiny spheres that contain actual drug
Enteric Coated absorbed in small intestine, not in stomach to prevent GI upset and protect drug from gastric acid
Body Composition the same dose cannot be given to a smaller person as a bigger person
Therapeutic Index The measurement of drug safety. The drug level should fall in between the range.
Controlled Substance Act Goals/Impact reduce chances of drugs from legitimate sources being diverted to abusers, keep track of controlled substances, regulate drugs in categories of 1-5, place restrictions on prescriptions of schedule 2-5, schedule 2-4 must have a label stating it is against the law to transfer
Schedule 2 Drugs Highest potential for abuse, includes, codeine, fentanyl, hydrocodone, methadone, morphine, oxycodone, amphetamines, cocaine, barbiturates
Schedule 1 drugs have no medical use and includes meth, heroin
Schedule 3 Drugs cannabinoids, stimulants, barbiturates, anabolic steroids
Schedule 4 Drugs phentermine (stimulant), alprazolam (benzos)
Schedule 5 Drugs pregabalin, diphenoxylate plus atropine (voids)
Idiosyncratic Effect Uncommon
paradoxical effect opposite effect than intended
Iatrogenic Disease results from medical treatment
Physical Dependence body adapted to drug
Carcinogenic Effect ability of drugs and environmental chemicals to cause cancer
teratogenic Effect gross malformation
Hepatotoxic organ specific
Toxicity Adverse drug reaction caused by excessive dosing, and may occur even with normal dosing
Allergic Reaction immune response that intensity is based on the degree of sensitization of the immune system
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