6: Pharmacology Flashcards

1
Q

Pharmacokinetics: body’s action on the drug - ADME

(Absorption, distribution, metabolism, excretion)

Pharmacodynamics: drug’s action on the body

A
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2
Q

A patient’s ___ has an effect on the concentration of drugs they are administered.

A

age

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3
Q

Different drugs can ___ to change their metabolism.

A

interact

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4
Q

The ___ of the environment a drug is in affects its absorption.

A

pH

acidic drugs require an acidic environment for absorption

basic “” for “”

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5
Q

The route of delivery of a drug is important when talking about older patients.

Why?

A

Difficulty swallowing

Nasogastric or PEG tubes - tablets need to be suitable for them

Delirious patients won’t tolerate tablets, injections etc.

Pre-op patients may be nil-by-mouth

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6
Q

? how much of this we need to know

A
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7
Q

Name an example of an acidic drug.

A

Aspirin

Penicillin

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8
Q

Name an example of a basic drug.

A

TCAs

Opioids

Benzos

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9
Q

revise volume of distribution

high vd means more drug is stored in fatty tissue

dangerous when cachexic - fat broken down, drug released into circulation

A
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10
Q

Older patients have greater ___ stores than younger patients.

A

fat stores

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11
Q

high Vd means drug is lipophilic and most is absorbed into fat

low Vd means drugis hydrophilic and tends to be absorbed by the plasma

A
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12
Q

biological half life is the time taken for the activity of a drug to half

t1/2 = 0.693 (or ln2) x Vd all over clearance

lipophilic drugs have a large Vd so therefore their t1/2 is greater

A
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13
Q

older patients have a lower clearance and less body water (i.e plasma), so combined with a high Vd they take ages to clear lipophilic drugs

A
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14
Q

older people have reduced liver and kidney function so excretion is impaired

A
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15
Q

serum creatinine dependent on muscle mass, so not reliable for measuring renal function - use eGFR instead obviously

A
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16
Q

therapeutic index = toxic dose / effective dose

narrow therapeutic index (i.e <2) is bad

drug dose required to produce an effect decreases as you age, so therapeutic index narrows as you age

A
17
Q

Opioids - think constipation

Steroids - think osteoporosis

Calcium supplements and T3 need to be taken at morning/night - interact with one another

A
18
Q

Avoid long-term NSAIDs, risk of peptic ulcers, renal impairment, gammy other drugs

Opioids and benzos (e.g lorazepam) increase risk of falls

4 Cs and C. diff

A
19
Q

ask about OTC medication and herbal remedies

A
20
Q

go over drug side effects

A
21
Q

stopp-start tool

A
22
Q
A