Pathophysiology Week 1

What are agonist drugs?

They are drugs that bind to the receptor and initiate change in the cell function.

What is a drug?

A drug is a substance that alters physiological functions in the body.

What are examples of drugs?

Concerta, ibuprofen, adderall

What is pharmacology?

Pharmacology is the study of drugs

What is the role of pharmacology for the PT?

What is the study of pathophysiology?

It is the study and function of diseases in the body

What is pharmacology?

It is the study of drugs

What is pharmacokinectics?

Pharmacokinetics is the study of how the body absorbs, distributes, and eliminates from compounds called drugs.

What does a PT need to know about pharmacokinectics?

We need to understand the administration route selection, optimize the drugs to reach the intended target tissue, and recognize the effects if drug metabolism is altered.

Iontophoresis

Electrical current applied to drive medications into the skin

Nanotechnology

Using small particles to enhance drug movement across membranes in the body

Bioavailability

Extent to which a drug reaches the systemic circulation or the percentage of drug administered that reaches the bloodstream.

Phonophoresis

Ultrasound waves to drive medications through the dermis and into deeper tissues.

True or False. Drugs need to travel to get to work?

True

Passive diffusion

Pass right through

Active transport

To make ATP, you need ADP-PiF

Facilitated diffusion

En

Endocytosis

The micro is being engulfed

What causes different drug reactions in different people

Genetics, disease, drug interactions, age, diet, sex, environment

Enteral (enter-all)

GI tract, entering the intestine

Hydrophilic

Water soluble

Parenteral (para meaning beyond) GI tract

Entering beyond the GI tract

Parenteral (injection)

Inhalation

Inhalation

Albuterol

Injection

Insulin

Topical

Aquaphor (ointment, aunt Eileen)

Transdermal

Finley wants to throw up in the car 6 times as a child, she took a transdermal medicine. For example, motion sickness medication

Enteral

How is oral, an enteral route administration absorbed?

First it is absorbed in the alimentary canal. Second taken to be metabolized in the liver. Third transporte metabolite (metabolize = breaking down) to target tissue.

In order for oral to take place?

Must have a high degree of lipid solubility to survive the GI tract, may irritate the GI due to acid degradation

Sublingual and Buccal

No first pass inactivation, faster acting.

Sublingual and buccal

Absorbed through oral mucosa into venous system —> venous system transport in blood to heart

Rectal

Drugs often absorbed poorly, use to an unconscious patient or if vomiting, used most often to treat local conditions

Parenteral route administration

Inhalation, injection, topical, and transdermal

Inhalation

System or local action, risk of infection

What are examples of an injection?

Intravenous (IV), adminster meds quickly

Intra-arterial another part of injection

Dangerous, reserved for chemotherapeutics or radiopaque liquids

Subcutaneous

Local treatment, small dosage delivered just under skin, slower prolonged release

Intrathecal

Injection to space (subarchnoid space, intrathecal space, tendon shealth)

Topical

Applied to skin and mucosa, little absorption into systemic circulation

Topical

Applied to skin and mucosa, little absorption into systemic circulation

Transdermal

Drugs applied directly to the surface of the skin with the intent of absorption, drive the metabolic enzymes into the dermis

PT role in Intrathecal Baclofen Pump

Delivers anti spasticity medication directly to the intrathecal sac, reducing the dosage required and bathing the spinal cord in the medication.

Direct route

Avoids blood brain barrier degradation

Pts are directly involved in most ITB pump placement trials

Long term PT implications-monitoring for needed dosage changes

PT Modalities for Transdermal Delivery

Iontophoresis, Phonophoresis

Iontophoresis (eye on toe phoresis)

Electrical current applied to medications into the skin.

Phonophoresis (phono phoresis)

Controlled-release preparations

Permit slower and prolonged absorption from the GI tract

Controlled release preparations

Resulting in fewer doses/day, level plasma drug levels during the day and sustain plasma drug levels throughout the night. Example: beta blocks, calcium channel blockers, narcotic, levodopa

Implanted Drug Delivery systems

Container places on skin or lower abdomen with a programmable schedule to release daily medication changes, often remote controlled

Targeting Drug Delivery

Monoclonal Antibodies —> target specific antigens on tumor cells, carry drugs to specific cells only and reduce side effects and focus drug effects

Mono (1) clonal (multiple) antibodies —> fighting against

Target specific antigens on tumor cells, carry drugs to specific cells only and reduce side effects