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PHM1000 De More11
PHM1000 Pharmacy Technician - Chap 11: Factors Affecting Drug Activity; De More
| Question | Answer |
|---|---|
| Neonate | Life stage: Up to one month after birth |
| Infant | Life stage: between ages 1 month and 2 years |
| Child | Life stage: between ages 2 and 12 years |
| Adolescent | Life stage: between ages 13 and 19 years |
| Adult | Life stage: between 20 and 70 years |
| Elderly | Life stage: older than 70 years |
| neonates and infants | not able to eliminate drugs as efficiently as adults because organ systems not fully developed |
| children | can metabolize certain drugs more rapidly than adults (ex: clindamycin, theophylline) |
| adults | experience a gradual decrease in physiological function, which can also effect drug activity |
| elderly | tend to take more drugs that can affect drug action; more physiological changes such as gastric pH changes, cardiovascular changes that tend to slow distribution; decrease in liver metabolism; decline in kidney function can slow excretion of certain drugs |
| gender | differences in activity related to hormonal differences in men and women, as well as body composition (affecting drug distribution) |
| pregnancy | drug activity is affected, tends to reduce the rate of absorption |
| genetics | drug activity can be affected depending on genetic factors. ex: metabolizing may or may not occur based on certain genetic characteristics |
| body weight | can affect drug activity, Over or under weight individuals may experience issues related to distribution and absorption |
| psychological factors | can influence an individuals response to a drug (ex: placebo effect) |
| CNS effects | adverse drug reaction; result for CNS stimulation; agitation, delirium, hallucinations, disorientation |
| Hepatoxicity | adverse drug reaction; liver toxicities; hepatitis, hepatic necrosis, biliary tract inflammation. |
| adverse drug reactions/ adverse effect | unintended side effect of a medication that is negative or in some way injurious to a persons health |
| hypersensitivity | abnormal sensitivity generally resulting in an allergic reaction (ex: hives) |
| anaphylactic shock | potentially fatal hypersensitivity reaction to producing severe respiratory distress and cardiovascular collapse |
| gastrointestinal effects | adverse reactions such as anorexia, nausea, vomiting, constipation and diarrhea |
| nephrotoxity | adverse reaction; kidney failure |
| idiosyncrasy | unexpected reaction to a drug the first time it is given; thought to be related to genetic make up |
| hematological effects | adverse drug reaction; blood coagulation, bleeding, bone marrow disorders |
| drug dependence | adverse drug reaction; chronic use of narcotic analgesics, sedatives, anti-anxiety agents and amphetamines |
| teratogenicity | adverse drug reaction; can cause abnormal fetal development when given to pregnant women |
| carcinogenicity | adverse drug reaction; ability to cause cancer |
| additive effects | two drugs with similar pharmacological actions result in an effect equal to the sum of the individual effects. (drug-drug interaction) |
| synergism | occurs when two drugs with similar pharmacological actions produce greater effects then the sum of the individual effects. (drug-drug interaction) |
| potentation | occurs when one drug with no inherent activity of its own increases the activity or another drug that produces an effect |
| antidote | given to block the effects of a drug |
| displacement | a drug bound to a plasma protein is removed when another drug of greater binding potential binds to the same protein (aspirin + warfarin = increased anticoagulant effect)drug-drug interaction |
| inhibition | a drug blocks the activity of metabolic enzymes in the liver (drug-drug interaction) ex: cimetidine inhibits drug metabolism enzymes in the liver and can cause toxic effects when used with other drugs |
| induction | a drug causes more metabolic enzymes to be produced, thus increasing metabolic activity. Ex: phenytoin + oral contraceptives = decreased contraceptive effects. drug-drug interaction |
| urinary excretion | can be altered by raising urinary pH and decreasing renal reabsorption. sodium bicarbonate + phenobarbital = increased excretion of phenobarbital. drug-drug interaction |
| GI Binding | drug-drug interaction; drugs can bind to others and affect absorption (ex: antacids) |
| Gastric emptying | drug-drug interaction; certain drugs can affect gastric emptying and in turn, increase or decrease absorption rates |
| Gastric pH | drug-drug interaction; drugs that alter gastric pH can have varied effects on other drugs - amount absorbed, rate of dissolution, degradation and intestinal motility |
| intestinal metabolism | drug-drug interaction; drugs can cause GI flora to be killed and affect other drug therapies (oral antibiotics and contraceptives) |
| enzyme induction | drug-drug interaction; increased concentration of metabolizing enzymes in the liver and results in reduction of pharmacological effect. ex: chronic alcohol use |
| enzyme inhibition | drug-drug interaction; occurs when two drugs compete for binding sites on the same metabolizing enzyme. Increases the pharmacological effect of one of the drugs. Most common drug-drug interactions. ex: ketoconazole, erythromycin |
| glomerular filtration | drug-drug interaction; changes in filtration rate, also changes rate of excretion. |
| renal secretion | drug-drug interaction; two basic or two acidic drugs may compete for the same transport system and cause one or both drugs to accumulate in the blood. ex: probenecid and penicillin. probenecid reduces penicillin secretion |
| urinary reabsorption | drug-drug interaction; influenced by urine pH and extent of ionization of drug. acidic drugs tend to be absorbed while alkaline drugs do not. basic drugs are excreted in urine. alkaline urine: acidic drugs not reabsorbed, excreted in urine(page 259) |
| Gastric pH | drug-drug interaction; drugs that alter gastric pH can have varied effects on other drugs - amount absorbed, rate of dissolution, degradation and intestinal motility |
| intestinal metabolism | drug-drug interaction; drugs can cause GI flora to be killed and affect other drug therapies (oral antibiotics and contraceptives) |
| enzyme induction | drug-drug interaction; increased concentration of metabolizing enzymes in the liver and results in reduction of pharmacological effect. ex: chronic alcohol use |
| enzyme inhibition | drug-drug interaction; occurs when two drugs compete for binding sites on the same metabolizing enzyme. Increases the pharmacological effect of one of the drugs. Most common drug-drug interactions. ex: ketoconazole, erythromycin |
| glomerular filtration | drug-drug interaction; changes in filtration rate, also changes rate of excretion. |
| renal secretion | drug-drug interaction; two basic or two acidic drugs may compete for the same transport system and cause one or both drugs to accumulate in the blood. ex: probenecid and penicillin. probenecid reduces penicillin secretion |
| urinary reabsorption | drug-drug interaction; influenced by urine pH and extent of ionization of drug. acidic drugs tend to be absorbed while alkaline drugs do not. basic drugs are excreted in urine. alkaline urine: acidic drugs not reabsorbed, excreted in urine(page 259) |
| food | drug-diet interaction;can alter absorption and distribution of some drugs depending on chemical reactions, amount of fat, calories, carbohydrates, proteins and time given (see pg 260-1) |
| dietary factors in metabolism | increased protein = increased metabolism; increased carbohydrates = decreased metabolism; increased fat = no effect; decreased calories = decreased metabolism |
| MAO Inhibitors | monamine oxidase inhinitors (such as some antidepressants and Parkinson's drug). Must exercise caution with certain drugs and foods that react to these. Foods containing tyramine (beer, wine etc) and amphetamines are some examples. |
| disease states | drug action can be altered when the normal functions of organs involved in ADME of a drug are changed by disease or other physiological changes |
| ADME | absorption, distribution, metabolism, and excretion |
| cirrhosis | liver disease (potentially fatal) that occurs after long term alcohol abuse. Affects liver metabolism and diminishes elimination rates of drugs |
| acute viral hepatitis | inflammatory condition of the liver caused by viruses; affects drug disposition; |
| first-pass effect | the fraction of lost drug during the process of absorption which is generally related to the liver and gut wall;concentration of a drug is greatly reduced before it reaches the systemic circulation. |
| circulatory disease states | cause diminished blood flow to organs, cabn affect metabolization of drugs in the liver and can have widespread effects on absorption and to a lesser effect elimination |
| renal disease states | reduced renal (kidney) function can effect elimination of certain drugs, plasma protein binding of acidic drugs is reduced in severe renal insufficiency; |
| thyroid disease states | affects aspects of absorption, excretion and metabolism of some drugs. EX: hypothyroidism increases bioavailability of some drug; hyperthyroidism decreases bioavailabilty of some drugs |
| obstructive jaundice | obstruction of the bile duct that causes hepatic waste product and bile to accumulate in the liver |
| drug disposition | general term for the absorption, distribution, metabolism, and excretion (ADME) of a drug that has been administered |
| foods containing tyramine | avoid while taking MAOIs; these include: beer, red wine, aged cheeses, yeast products, chicken livers, pickled herring |
| cruciferous vegetables | can stimulate the metabolism of a few drugs; i.e brussel sprouts, cabbage, broccoli, bok choy, turnips, alfalfa, arugala |
| vitamin k | inhibits the action of oral anticoagulants such as coumadin/warfarin sodium (patient eating spinach while on coumadin would not receive full therapeutic effect of the drug) |
| administration times | interations that alter drug absorption can be minimized by seperating administration of drug and food intake by about 2 hours |
| enzyme inducers | increase the hepatic enzyme activity that results in greater metabolism of drugs; examples include: phenobarbital, phenytoin, rifampin, carbamazepine; cigarrette smoking and chronic alcohol use also contribute |
Created by:
MrsAFlaherty
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