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