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Pharmacology Ch 8
Pharmacology
| Question | Answer |
|---|---|
| Body Surface Area | Dosage adjustments made to account for size are often based on body surface area, which accounts for fat vs. lean, instead of just body weight. |
| Age - Individual Drug Response | Infants: organ immaturity Elderly: organ degeneration - increased severity of illness, multiple pathologies, multiple drugs |
| Kidney Disease - Individual Drug Response | Can decrease drug excretion -> rising drug levels. To prevent toxicity, reduce dosage. |
| Liver Disease - Individual Drug Response | Can decrease drug metabolism -> rising drug levels. To prevent toxicity, reduce dosage. |
| Acid-Base Imbalance - Individual Drug Response | pH changes that alter absorption, distribution, metabolism, & excretion of drugs. |
| Altered Electrolyte Status - Individual Drug Response | Rare for electrolyte changes to have a significant impact on drug responses. |
| Tolerance - Individual Drug Response | Decreased responsiveness to a drug as a result of repeated administration - requires higher doses. |
| 3 Types of Drug Tolerance | 1) Pharmacodynamic tolerance 2) Metabolic tolerance 3) Tachyphylaxis |
| Pharmacodynamic Tolerance | MEC of drug is abnormally high - assoc/w long-term administration of drugs such as morphine or heroin |
| Metabolic (Pharmacokinetic) Tolerance | Drug can increase synthesis of hepatic drug metabolizing enzymes - does not affect MEC |
| Tachyphylaxis | Reduction in drug responsiveness brought on by repeated dosing over a short time. |
| Placebo Effect | Any response a patient has to a placebo is based solely on his or her psychologic reaction to the idea of taking a medication & not to any direct physiologic or biochemical action of the placebo itself |
| Placebo | A preparation that is devoid of intrinsic pharmacologic activity. The presence of a placebo response does not imply that a patient's original pathology was "all in the head". |
| Bioavailability | Ability of the drug to reach the systemic circulation from admin site. Primarily with oral preparations. |
| Causes of Variability in Absorption | Tablet disintegration time, enteric coatings, sustained-release formulations, changes in gastric pH, diarrhea, constipation, food in the stomach, gastric emptying |
| Genetic Variations | Major cause = alterations in genes that code for drug-metabolizing enzymes & drug targets |
| Pharmacogenomics | The study of how genes affect individual drug responses |
| Altered Drug Targets | Genetic variations alter the structure of drug receptors |
| Gender Variations | Alcohol metabolized more slowly by women Certain opiods are much more effective in women Quinidine causes greater QT-interval prolongation in women |
| Race Variations | Poor predictor of drug responses 1) Genetic variations 2) Psychosocial factors |
| Failure to take medication as prescribed | Issues include manual dexterity, visual acuity, intellectual capacity, psychological state, attitude towards drugs, ability to pay for meds |
| Drug Itneractions | One drug alters the effects of another |
| Diet | Starvation reduces the protein binding of drugs, which increases levels of free drugs |
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