pharmacology
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| Drug? | Any chemical that affects living tissue |
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| Medicine? | Chemical produce to produce therapeutic effect |
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| 3 drug names | 1-chemical 2-non-proprietary/genetic 3-proprietary/trade |
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| Pharmacodynamics | What drug does to body |
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| Pharmacokinetics | What body does to drug |
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| Affinity | Ability of drug to bind at receptor |
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| Efficacy | Ability to generate stimulus => effect |
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| Potency | Concentration at which drug produce effect |
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| Full agonist | Produce max effect response/equal to max response of tissue. |
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| Partial agonist | Max response less than max redone if tissue |
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| Agonist | Mimic effect of endogenous chem. Both efficacy and affinity |
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| Antagonist | Inhibit effect of endogenous chem sub. Affinity no efficacy |
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| Full agonist | Full efficacy at receptor |
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| Partial agonist | Only partial efficacy relative to full agonist |
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| Competitive reversible antagonist | Compete with agonist at receptor. Will bind, but not activate receptor. |
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| Competitive irreversible antagonist | Permanently bind to receptor |
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| Non competitive antagonist | Bind to allosteric (non agonist) site on receptor to prevent activation of receptor |
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| Structure of cell plasma membrane | Phosphate lipid bi-layer -heads(outer) are hydrophilic -tails(inter) are hydrophobic |
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| Homeostasis | Tendency towards relative suitable equilibrium. Maintaining a constant -internal- environment with balance of physiological variables despite -internal- conditions. |
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| pH? | Figure expressing acidity or alkalinity. 1-lower pH=> more acidic(readily gives H+ ions) 2-higher pH=> more basic(really accepts H+ ions) |
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| Negative Feedback | Response to reduce stimulus and restore homeostasis |
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| Bioavailability | Portion of drug that reaches systemic circulation intact. |
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| Enzymic metabolism of drug | Phase 1 (catabolic/functionalism) Phase 2 (synthetic/conjunction) |
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| 4 phases of pharmacokinetics | 1-absorption 2-distribution 3-metabolism 4-excretion |
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| Adverse drug event | Injury resulting from medical intervention related to a drug. -not necessarily due to drug- |
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| 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 |
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| 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. |
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| Type B (bizarre) ADR | -uncommon. -unpredictable. -not related to known pharmacology of drug. -high mortality and high morbidity -e.g.allergy, hypersensitivity |
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| Type C (chronic) ADR | -uncommon. -related to cumulative dose. |
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| Type D(delay) ADR | -uncommon. -usually dose related. -occurs or becomes apparent some time after the use of drug. |
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| ADR Risk factors | Age, gender, concurrent diseases, genetic factors, history of prior drug use, Chemical characteristics, route of admin, dose, duration and frequency. |
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| 5 Rights | Drug, dose, route, time, patient |
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| 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. |
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| Carcinogen | Any agent that by either direct or indirect action cause a normal call to become a neoplastic cell |
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| Teratogen | A substance that causes transient or permanent physical or functional disorder in the foetus without causing toxicity to the mother. |
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| ABSORPTION- Altered pharmacokinetics elderly | ~+ gastric pH. ~ altered gastric emptying and intestinal blood flow. ~ decrease in first pass metabolism in liver |
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| DISTRIBUTION- Altered pharmacokinetics elderly | +Altered body composition (+fat store). ~ -in total body water. ~ -plasma albumin ~ -blood flow and cardiac output |
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| METABOLISM -Altered pharmacokinetics elderly | ~ -hepatic blood flow ~ -in oxidative metabolism(P450 system) |
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| EXCRETION -Altered pharmacokinetics elderly | decrease globular filtration rate and renal function |
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| Neurotransmitters of ANS | ACh (acetylcholine) and NA (noradrenaline) |
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| Receptors of ANS | ACh(-Muscarinic,-nicotinic) NA(-ALPHA, BETA) |
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| SNS Pre ganglionic receptor | Nicotinic |
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| SNS post ganglionic receptors | ALPHA..BETA |
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| PNS pre ganglionic receptor | Nicotinic |
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| PNS post ganglionic receptor | Muscarinic |
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| Somatic efferent system receptor | Nicotinic |
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| Alpha adrenoceptors | Noradrenaline> adrenaline> isoprenaline (excitatory response) |
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| BETA adrenoceptors | Isoprenaline> adrenaline> Noradrenaline (Inhibitory response, except in heart) |
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| Organophosphate poisoning symptoms | 1.Stim of Muscarinic receptors(SLUDGE) 2.Stim of Nicotinic receptors(NMTWTF) 3.CNS effects(anxiety, lethargic, psychosis, coma, seizure) |
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| SLUDGE Organophosphate poisoning | Muscarinic symptoms... S-alivation L-acrimation U-rination D-efecation G-I cramping E-misis |
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| Acetylcholinesterase | Enzyme that breaks down acetylcholine. |
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| SNS pre ganglionic neurotransmitter | AHc |
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| SNS post ganglionic neurotransmitter | NA ACh |
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| PNS pre/post ganglionic neurotransmitter | ACh |
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| Nicotinic receptors | Autonomic junction Adrenal medulla |
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| Adrenal medulla | Innovated by ACh directly to provided sympathetic response |
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| Alpha-1 | Alpha 1 receptors - smooth muscle contraction |
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| Beta-1 | increase speed, force of contraction and conductivity of heart |
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| Beta-2 | smooth muscle relaxation - bronchodilator |
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| Things that affect a patient's response to drugs? | age weight environment genetics |
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| 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 |
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| Pharmacokinetic process | 1. Absorption. 2.Distribution. 3.Metabolism. 4.Excretion. |
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| Alpha-2 | Presynaptic "inhibitory feedback" |
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| Nicotinic symptoms for Organophosphate poisoning. | M-Muscle cramps. T-Tachycardia. W-Weakness . T-Twitching. F_Fasciculations. Max The Weary Toad Farted |
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| who regulates Drugs in AUS | Therapeutic Goods Administration |
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| 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
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| 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
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| 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. |
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| 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 |
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| 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 |
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| 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
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| Schedule 2 drugs | pharmacy only meds. mostly cough and cold preparations, some antihistamines, some anti-inflammatory drugs and mild analgesics |
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| 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 |
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| 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.
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| 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
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| Advertising Regualtion | direct to consumer permitted in unscheduled, sched 2, and sched 3 only not permited for sched 4 and sched 8 |
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| Pharmaceutical Benefits Scheme (PBS) | provide affordable access to necessary medicines. Government covers a large proportion of the cost. Pt.pay the co-payment |
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| 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’
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| 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 |
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