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Questions and Answers
What does the term 'first pass metabolism' refer to?
What does the term 'first pass metabolism' refer to?
Injections bypass the liver during initial drug metabolism.
Injections bypass the liver during initial drug metabolism.
True
What does TI stand for in the context of drug efficacy?
What does TI stand for in the context of drug efficacy?
Therapeutic Index
An inactive drug that is activated by the liver is called a _____ drug.
An inactive drug that is activated by the liver is called a _____ drug.
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Match the following drug actions with their definitions:
Match the following drug actions with their definitions:
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Which of the following describes a drug's therapeutic index (TI)?
Which of the following describes a drug's therapeutic index (TI)?
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Injections do not undergo first pass metabolism.
Injections do not undergo first pass metabolism.
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What is the main organ responsible for drug metabolism?
What is the main organ responsible for drug metabolism?
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An inactive drug that is activated by the liver is known as a _____ drug.
An inactive drug that is activated by the liver is known as a _____ drug.
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Match the following routes of drug administration with their characteristics:
Match the following routes of drug administration with their characteristics:
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What is the purpose of inactive ingredients in a drug formulation?
What is the purpose of inactive ingredients in a drug formulation?
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Drugs that are metabolized by the liver are always absorbed into the bloodstream before passing through the liver.
Drugs that are metabolized by the liver are always absorbed into the bloodstream before passing through the liver.
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Drugs administered via injection have ______ first pass metabolism.
Drugs administered via injection have ______ first pass metabolism.
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Study Notes
Principles of Pharmacology and Pharmacokinetics
- This field deals with the principles of drugs and their action within the body.
- It also covers the process of drug movement within the body.
Drug Receptors
- Detailed study of drug receptors is a key aspect of pharmacology.
Principles of CNS Pharmacology
- This section focuses on the CNS and the effects of drugs on the nervous system.
Pharmacology in Physical Therapist Practice
- Physical therapists utilize their knowledge of medications for patient and client management.
- Prescriptions and non-prescription medications influence health, function, movement, and disability.
- Administering and storing medications is well within the scope of a physical therapist's practice when addressing patient outcomes.
- Patient care is optimized via medication therapy, and health and disease prevention are promoted.
- Goals like pain reduction, inflammation reduction, integumentary repair and protection, airway clearance, circulation, and metabolism facilitation, and functional movement are common goals in the use of medications.
Pharmacy vs Pharmacology
- Pharmacy is the art and profession of preparing, preserving, compounding, and dispensing medical drugs.
- Pharmacists are trained in how drugs function, their usage, and potential side effects.
- Clinical pharmacy involves optimizng medication therapy, promoting health, and preventing disease.
- Pharmacology is a branch of medicine and biology focused on the study of drug action and its impact.
- Pharmacotherapeutics is a subset of pharmacology, focusing specifically on the use of drugs to prevent, treat, or diagnose diseases.
Pharmacotherapeutics
- This area of study within pharmacology concerns how drugs are absorbed, distributed, metabolized, and eliminated (ADME) within the body.
- It also examines the effects of drugs on target tissues within the body.
- Drug action, including how it affects the body, is often quantitative.
Drug Names
- Chemical names, like 2-(4-isobutylphenyl)propanoic acid, describe the molecule's structure exactly.
- Generic names, like ibuprofen, are shorter, standardized versions used in prescriptions.
- Brand names, like Motrin or Advil, are names used by specific companies to market the drug.
Important considerations regarding drug names
- Medication errors due to sound-alike names, such as with Celebrex (NSAID), Celexa (antidepressant), Cerebyx (antiseizure), and Clarinex (antihistamine), are common and serious.
Generic Drugs
- Generic drugs contain the same active ingredients as brand-name medications and must meet pharmacokinetic/bioequivalent parameters.
- Generic and brand-name drugs are considered bioequivalent when the same dosage produces similar concentrations within the body, which is critical for efficacy.
- Cost reduction is a significant benefit of generic drugs in patient care.
Generics vs Brand Drugs (Important Considerations)
- Not all generic drugs are equivalent to brand drugs.
- Differences in inactive ingredients can affect drug absorption resulting in differing patient responses.
Drug development and FDA approval
- This process typically involves several phases of testing with increasing numbers of human subjects to assess safety and efficacy.
Drug Approval Pathways
- Expedited pathways (e.g., fast track, accelerated approval, priority review) allow faster approval for treatments addressing serious conditions or unmet medical needs.
Off-Label Prescribing
- Off-label prescribing occurs when a physician prescribes an FDA-approved drug to treat a condition different from the one for which it is approved.
- This practice can be used for diseases where this treatment has proven effective, even in the absence of FDA-approved trials.
Controlled Substances Act
- The CSA organizes drugs based on medical use, abuse potential, and dependence risks.
- Drugs are placed into schedules based on the above factors.
- Restrictions on refills and dispensing vary by schedule.
Drug Schedules (Examples)
- The table provides examples of drugs within each schedule.
Drug Dosages
- Ensuring the right dosage is crucial to ensure a beneficial effect, avoiding a toxic effect.
Dose-Response Curve
- The dose-response curve demonstrates how the effect of a drug corresponds to its dosage.
- The curve informs on effective dosage ranges for that given drug.
Potency and Efficacy
- Both potency and efficacy describe different aspects of drug activity.
- Potency focuses on the dosage needed to achieve a given response, while efficacy highlights the maximal effect that the drug can produce.
ED50, TD50, LD50
- ED50 is the effective dose for 50% of patients observed.
- TD50, or toxic dose for 50% of patients, shows the dosage causing adverse effects.
- LD50 is the lethal dose for 50% of patients, typically in animal testing.
Therapeutic Index
- A high therapeutic index suggests a safer drug (e.g. over-the-counter medications).
- TD50/ED50 ratio estimates a drug's safety margin.
Pharmacokinetics
- Pharmacokinetics refers to the movement of a drug in the body, encompassing absorption, distribution, metabolism, and excretion (ADME).
Drug Administration
- This section describes how a drug can be administered to the body. (Categorized as; Enteral, Parenteral, and Other Routes).
Oral Administration
- The most common drug administration method, drugs travel through the gastrointestinal (GI) tract.
First-Pass Effect
- The first-pass effect occurs when a drug is metabolized by the liver before it reaches the systemic circulation.
Sublingual and Buccal Administration
- Sublingual and buccal medications are dissolved in the mouth, often avoiding the first-pass effect of the liver.
Rectal Administration
- Rectal administration involves using suppositories and often yields poor absorption but useful in particular situations.
Parenteral Administration (Injections)
- The drug is introduced directly into the bloodstream or other tissues.
Routes of Parenteral Administration
- This section discusses several routes for parenteral drug administration (injections) e.g Intravenous, Intramuscular, Subcutaneous and others.
Other Routes of Administration
- Inhalational, and topical are alternative methods for administering drugs directly to target organs or tissues.
Other Techniques for Drug Delivery
- Controlled release drug formulations prolong drug activity.
Drug Distribution
- Drugs need to reach their target organs at suitable concentrations
- Distribution is primarily via blood flow and influenced by multiple factors.
Drug Permeability
- Lipid-soluble drugs can readily cross tissues and cellular membranes.
Blood Flow
- Drugs will more readily access tissues with higher blood flow.
Protein Binding
- The portion of the drug not bound to proteins is readily available to organs and tissues for action.
Drug Metabolism
- Drugs are metabolized in organs & tissue, ultimately breaking down inactive forms.
Drug Excretion
- The process of removing drugs and metabolites from the body, primarily via the kidneys and liver.
Drug Elimination Rates
- Drug elimination rates impact the dosage regimen chosen.
Drug Clearance
- A measure of the rate at which a drug is removed from the body.
Drug Half-Life
- Half-life is the time it takes for 50% of a drug to be eliminated from the body.
Drug Response
- Individual responses to drugs can vary due to genetic differences, disease status, age, gender, diet, and other factors including drug interactions and exercise.
Drug Tolerance
- The tolerance of a drug refers to a decrease in the effectiveness of the drug over time.
General Principles of CNS Pharmacology
- This section identifies key principles of pharmacologically treating the central nervous system,including considerations for neurotransmitter regulation.
Summary
- This document covers the wide-ranging topic of drug therapy, from fundamental properties and applications to comprehensive principles of action.
- Various methods of drug introduction and factors influencing drug effects are discussed in detail.
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Description
Explore the essential principles of pharmacology, including drug action, movement within the body, and the role of drug receptors. This quiz also highlights the significance of pharmacology in physical therapist practices, emphasizing the administration and impact of medications on patient outcomes.
