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Pharm1-final 1
Principles and PEDs info from study guide
| Question | Answer |
|---|---|
| Object of drug therapy | to provide maximum benefit with minimum harm |
| Safest drugs | no such thing. the goal is to choose a drug that will do the most good with the least amount of harm. watch SE, other drug interactions, affordable, and pt drug reation |
| What are receptors? | any functional macromolecule in a cell to which a drug binds to produce its effect |
| What does a drug do to receptors? | Binds to them to either increase or decrease the rate of the physiologic activity normally controlled by that receptor |
| What do drugs do? | Mimic or block the action of the bodys own regulatory molecules. NO NEW FUNCTIONS |
| How does selectivity occur? | drugs act through specific receptors to get the desired effect. if a drugs is specific to a certain type of receptor, then limited responses are elicited |
| Simple occupancy theory | states that the intensity of the response to a drug is proportional to the number of receptors occupied by that drug and that a maximal response will occur when all available receptors have been occupied. |
| Modified occupancy theory | states the qualities of affinity (strength of attraction between drug and receptor:high affinity=very potent) & intrinsic activity (ability of a drug to activate a receptor after binding) causes intense responses & have high maximal efficacy & vise versa |
| Agonist | molecules that activate receptors and have both affinity and high intrincis activity |
| Antagonist | Blocks; prevents receptor activation; has affinity for the receptor but with no intrincis activity |
| Partial agonist | have only moderate intrinsic activity--max effect that a partialagonist can produce is lower that that of a full agonist |
| 4 primary receptor families | 1)Cell membrane embedded enzymes 2)ligand gated ion channels 3)G protein coupled receptor systems 4)Transcription factors |
| Receptorless drugs do no use receptors | the pharmacologic effects are the results of simple physical or chemical interations (antacids or TUMS) |
| Side effects are | a nearly unacoidable secondary drug effect produced at therapeutic doses |
| Masimum efficacy | the largest effect that a drug can produce |
| Pharmacodynamics | the study of biochemical and physiological effects of drugs and the molecular mechanisms by which those effects are produced-what drugs do to the body and how they do it |
| Pharmacokinetics | how it moves through the body; process that determines how much of the administered dose gets to its site of actionl the impact of the body on the drug |
| 4 phases of pharmacokinetics | 1)Absorption 2)Distribution 3)Metabolism 4)Excretion |
| Potency | Amount/dosage of drug we must give to elicit an effect, implies nothing about its maximal efficacy |
| ED50 | the dose that is required to produce a defined therapeutic response in 50% of the population; "standard" drug dose but dosaged may need to be "fine-tuned" for pts |
| Adverse drug reactions | defined as any noxious, uninteded and undesired effect that occurs at normal drug doses; occur in ALL drugs |
| Population: adverse drug reaction | Can occur in all patients, more common in elderly and infants |
| Adverse drug reactions ranges | Annoying to life-threatening |
| Ways to decrease adverse drug reactions | Educate about S&S, anticipate ADRs, monitor for toxicity, individualize therapy, pts treated for chronic disorders are especially prone to ADRs, know pts allergies, watch for herb/drug/food interactions |
| General properties of drugs | Drugs dont confer any new functions on the body, they only modify existing ones. Drugs exert multiple actions, not just 1 effect. Drug action results from a physicochemical interaction between the drug & a functionally important molecule in the body |
| Properties of an ideal drug | effectiveness, safety, selectivity, reversible action, predictability, ease of administration, freedom from drug interactions, low cost, chemical stability, possession of a simple generic name |
| Most important considerations in all drug, fluid, and electrolyte therapy for children: | The ability to concentrate urine and the ability to excrete |
| Difference in adults and infant excretion: | GFR in infants is 30-50% of that to an adults, so drugs excreted through the kidneys have a half-life approximately 50% longer in infants than adults |
| Newborns kidneys | concentrate urine to only one and one-half time the osmolality of plasma, instead of the 3-4 time in adults |
| Because of renal immaturity, doses must be decreased until what age? | 1year old |
| Full renal function develops by what age? | 6-12months |
| Drug dosage calculation for PEDs | surface area of child in m2 / 1.7 m2 ----BSA: relationship between height and weight |
| IV route for PEDs | Intraosseous; topically |
| Nomogram | Char used for estimatin BSA based on height and weight |
| Giving liquid meds to infants | Administer drug via syringe, nipple, or dropper; do not add to formulas or essential foods, crush chewable tabs and add to flavored syrup, jelly, or applesauce; blow small puff of air if <1month old to elicit swallow reflex |
| Eardrop administration < 3yrs old | pull pinna down and back |
| Eardrop administration > 3yrs old | pull pinna up and back |
| Ear drops administration: to avoid causing pain in tympanic membrane do this: | Warm drops before administration |
| IM sites for PEDs | vastus lateralis ( <3yrs old), Ventrogluteal (> that 3 & can tolerate lg vol.) Deltoid-small, but rapid absorption rate |
| Contraindicated drugs for PEDs | Aspirin & salicylates (toxicity, Reye's syndrome w/chickenpox or influenze), Glucocorticoids (growth suppression), tetracyclines (discoloration of teeth), sulfonamides (kernicterus), chloramphenicol (gray baby), fluroquinolones (tendon rupture) |
Created by:
Keller_KI
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