exam 1 review

• Oral tablets- must be disintegrated into smaller particles
• Liquid drugs- more readily available for GI absorption
• Enteric-coated drugs- have coating to delay onset of effects and cannot be crushed
• Most drugs are absorbed through mucosal lining of small intestines before entering bloodstream
• Lipid soluble drugs- easily pass across mucous membrane
• First-pass - drugs that are metabolized into an inactive form and excreted; reduces amount of drug available for pharmacological effect (only PO)
• Protein binding- many drugs bind with plasma proteins (albumin, lipoproteins, AGP)
• Two highly bound drugs together= competition for binding sites, more free drug in circulation, and toxicity
• Low protein plasma levels= less available binding sites and more free drug in circulation
• Metabolism- body chemically changes drugs into a form that can be excreted. Normally happens in liver
• Half-life- time it takes for the amount of drug in the body to be reduced by half
• Therapeutic index- relationship between therapeutic dose of a drug and the toxic dose
• Narrow therapeutic index- close relationship between therapeutic dose and toxic dose; require close monitoring
• Agonist- drugs that activate receptors and produced desired response
• Partial agonist- elicit moderate activity when binding to receptors; prevent receptor activation by other drugs
• Antagonist- prevent receptor activation and block a response
• Nonselective drugs- affect multiple receptor sites
• Nonspecific drugs- affect multiple receptor sites
• Side effects- secondary effects of drug therapy (always occur)
• Adverse drug reactions- unintentional, unexpected reactions to drug therapy at normal doses
• Drug toxicity- drug levels exceed therapeutic range
• Bioavailability- percentage of drug available for activity
• Liver function tests- ALT and AST
• Kidney function tests- BUN and Creatinine
• Anemia- hgb and hematocrit
• Pediatric considerations: immature GI tract, immature BBB, low hepatic flow, bilirubin, unpredictable gastric emptying, varying weights and body comps in adolescence. Overall higher absorption and higher chance of toxicity
• Older adult considerations: Decreased surface area in small intestine, slow gastric emptying, low gastric blood flow, low gastric acidity, low albumin, decreased hepatic metabolism, decreased first-pass metabolism. Overall lower absorption and decreased metabolism
• Cannabis use disorder: Impairs short term memory, ability to focus, balance, and coordination. Increased heart rate, hallucinations, panic attacks, anxiety, and psychosis. Chronic cough.
• Opioid use disorder: sense of euphoria and tranquility from flooded reward system. Causes drowsiness, confusion, constipation, respiratory distress, decreased heart rate. Coma/ death when taken with alcohol.
• Opioids- oxycodone, hydrocodone, morphine, methadone, fentanyl
• Naloxone- competitively attaches to opioid receptors in CNS, blocking activation of opioid.
• Methadone- Blocks sense of euphoria from opioids, preventing withdrawal
• Buprenorphine- binds to various opioid receptors in the brain. Provides some euphoria and decreases withdrawal sx and cravings
• Cough/ cold products- contain psychoactive ingredients. DXM and promethazine-codeine.
• Heroin- euphoria, warm flushing, dry mouth, wakefulness and drowsiness, decreared resp rate and HR
• MDMA- decreased inhibition, increased sensory perception, confusion, depression, tension and clenching
• Methamphetamine- decreased appetite, irregular HR, increased resp, BP, temp, and HR
• Cocaine- narrowed blood vessels, enlarged pupils, increased temp, HR, and BP. Euphoria, increased energy and alertness
• Ketamine- dreamlike state, hallucinations, sedation, loss of memory, increased BP, slow breathing, death
• Psilocybin- hallucinations, muscle relaxation, N/V, drowsiness