Patho Pharm Exam 1: Pharmacology Principles

pharmacology

the study of drugs and their effects on the body

drug

any chemical that affects the physiologic processes of a living organism

chemical name

describes the drug's chemical composition and molecular structure

generic name (nonproprietary)

given by the US Adopted Names (USAN) Council

trade name (proprietary)

registered trademark name; use of the name restricted to the owner of the patent for the drug (manufacturer)

preclinical investigational drug study

all new drugs must undergo laboratory test w/ in vitro (cell or tissue) and animal students before human testing can begin

investigational new drug study

informed consent must be obtained and participants should be informed of potential hazards

phase 1 clinical phase of investigational drug study

small numbers of healthy subjects to determine optimal dosage and pharmacokinetics of drug

phase 2 clinical phase of investigational drug study

small numbers of those who have the disease that drug is designed to treat, therapeutic dosages are refined

phase 3 clinical phase of investigational drug study

large numbers of subjects who are followed by the medical researchers, identification of rare adverse effects within larger population, study is designed to incorporate a placebo

phase 4 clinical phase of investigational drug study

post-marketing studies conducted by pharmaceutical companies to further demonstrate therapeutic and adverse effects of a drug for a minimum of 2 years duration

black box warning

voluntary recall of a drug, necessary if a pattern of severe reactions to a drug occur in phase 4

class 1 drug recall

most serious, use of the drug presents a reasonable probability of adverse health effects or death

class 2 drug recall

less severe, use of drug may result in temporary or medically reversible health effects, risk of lasting adverse effects low

class 3 drug recall

least severe, use of the drug unlikely to result in a significant health problem

pharmacokinetics

what the body does to the drug

enteral, parenteral, and topical

absorption of pharmacokinetics includes

bioavailability

the extent of drug absorption; only IV drugs have 100%

first pass effect

decreases the bioavailability of the drug to less than 100%

enteral route of absorption

drug is absorbed into systemic circulation through oral or gastric mucosa or the small intestine; tablets

parenteral route of absorption

drug enters the body through injection

topical route of absorption

drug is applied directly to a localized area of the skin or mucous membrane; creams

distribution of pharmacokinetics

drug first delivered to areas with most extensive blood supply; begins to be eliminated by organs that metabolize/excrete drugs

non-bound plasma portein

in the distribution phase of pharmacokinetics, _____ are able to leave tissue; amount of albumin to hold the drug

metabolites

in distribution phase of pharmacokinetics, ___ bound to plasma protein are not able to leave vascular and enter tissue

metabolism of pharmacokinetics

change of the biochemistry into an inactive metabolite, soluble compound, potent active metabolite, less active metabolite

cytochrome P-450 enzymes

metabolism of pharmacokinetics; target lipophilic drugs that are difficult to eliminate; hydrophilic drugs more easily mobilized; influences drug-drug interactions

pharmacodynamics

study of what the drug does to the body

receptors, enzymes, and non-selective interactions

3 ways drugs exert their actions in pharmacodynamics

receptors of pharmacodynamics

reactive site on the surface or inside of a cell; drug binds and interacts with this to produce a response

enzymes of pharmacodynamics

substances that catalyze the biochemical reaction in a cell; drugs produce an effect by interacting

non-selective interactions of pharmacodynamics

drugs that do not interact with receptors of enzymes; target cell membranes and various cellular processes

inhibit Na, K, Cl reabsorption in loop of henle

loop diuretics

replaces lost potassium

potassium chloride

stabilizes myocardium in high K or Mg

calcium gluconate

raises serum pH by buffering H

sodium bicarbonate

Na imbalance affects brain cell volume

confusion or seizures

K imbalance disrupts cardiac conduction

irregular heartbeat

properly dose and prevent toxicity

in pharmacokinetics, half life is important to

onset of pharmacokinetics

time requires for drug to elicit a therapeutic effect

peak of pharmacokinetics

time required to reach maximum therapeutic effect

duration of pharmacokinetics

length of time that a drug creates a therapeutic effect

toxicity of pharmacokinetics

occurs when the peak blood level is too high; may result in damage to vital organs

low sodium causes water to enter brain cells; Na+ < 135; sodium loss or excess water

what happens in hyponatremia and why

high sodium pulls water out of brain cells; Na+ > 145; water loss or excess sodium intake

what happens in hypernatremia and why

impaired nerve and muscle signaling; K+ < 3.5; diuretics, GI loss, insulin/alkalosis shifts K into cells

what happens in hypokalemia and why

disrupts cardiac excitability; K+ > 5.0; renal failure, acidosis, cell lysis

what happens in hyperkalemia and why

increased neuromuscular excitability; Ca < 8.8; vit D/PTH deficiency, citrate in transfusions

what happens in hypocalcemia and why

decreases neuromuscular excitability; Ca > 10.5; bone resorption, malignancy, vit D/PTH excess

what happens in hypercalcemia and why

unstable nerve and cardiac function; Mg < 1.8; GI loss, poor nutrition, alcoholism

what happens in hypomagnesemia and why

depresses muscle and CNS function; Mg > 3.0; renal failure, excessive supplementation

what happens in hypermagnesemia and why

low phosphate impairs energy and oxygen delivery; PO4 < 2.5; alcoholism, malnutrition, DKA recovery

what happens in hypophosphatemia and why

high phosphate binds calcium and calcium drops; PO4 > 5.0; renal failure, tumor lysis, cell injury

what happens in hyperphosphatemia and why

accumulation of acid or loss of base; pH < 7.35 HCO3 < 22; DKA, diarrhea, renal failure

what happens in metabolic acidosis and why

loss of acid or accumulation of base; pH > 7.45 HCO3 > 28; vomiting, diuretics, overuse of antacids

what happens in metabolic alkalosis and why

CO2 retention from poor ventilation; pH < 7.35 PaCO2 > 45; COPD, sedation, hypoventilation

what happens in respiratory acidosis and why

CO2 loss from excessive ventilation; pH > 7.45 PaCO2 < 35; anxiety, fever, early sepsis

what happens in respiratory alkalosis and why

C5a

what complement component is the strongest chemotactic factor for neutrophils

C3b; C4a

____ is involved with classic opsonin and ____ gives a weaker anaphylatoxin

dendritic cells

which cell type bridges innate and adaptive immunity by presenting antigen to T cells

IgA

which immunoglobulin class predominates in mucosal secretions for the first line of defense

IgG; IgM

___ is predominant in serum; _____ is first in primary responses

neutrophils and macrophages

which leukocytes are recruited to "eat" invaders during innate immunity