Patho Exam 1 Study Guide PDF

Module 0-1 (15-20 questions) Pharmacology Foundations ○ Drug: any chemical that can affect the living process ○ Pharmacology: study of drugs and their interactions w/ living systems ○ Clinical pharmacology: study of drugs in humans ○ Therapeutics: use of drugs to diagn...

Module 0-1 (15-20 questions) Pharmacology Foundations ○ Drug: any chemical that can affect the living process ○ Pharmacology: study of drugs and their interactions w/ living systems ○ Clinical pharmacology: study of drugs in humans ○ Therapeutics: use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy ○ Properties of Ideal Drug: Effective, Selective, Safety ○ No such thing as an Ideal Drug! ○ Therapeutic Objective: to provide maximum benefit with minimum harm Pathophysiology Foundations ○ Pathophysiology: study of what happens when normal anatomy goes wrong ○ Health: absence of disease ○ Disease (How they are classified?): a state in which a bodily function is no longer functioning properly ○ Homeostasis: equilibrium ○ Negative Feedback: works to maintain deficit in the system, works to resist change ○ Positive Feedback: moves body away from homeostasis Medication Safety ○ Patient Rights: Right Patient, Right Drug, Right Dose, Right Time, Right Route, Right Implication, Right Documentation ○ Adverse, Near-miss, Sentinel, Error of commission, Error of omission, Error of execution, Comorbidity/Polypharmacy Drug Classification ○ A way to organize drugs into categories, grouped together as a pharmacologic class ○ Ex: NSAIDS, Analgesics, Antibiotics Drug Interactions ○ How do drugs interact with each other? Be aware of this and be proactive. Do research to prevent this. Adverse Drug Reactions vs. Medication Errors ○ Adverse Drug Reactions: a result of an injury as a result of a med error and can occur even when everything is done correctly ○ Medication Errors: preventable events that can lead to pt harm Individual Variation in Drug Responses ○ Physiological: age, gender, weight ○ Pathological: kidneys, liver, etc. ○ Genetics: alters the metabolism of drugs Module 2 (15-20 questions) Pharmacokinetics ○ Process of drug movement to achieve drug action ○ Absorption, distribution, metabolism, excretion Pharmacodynamics ○ Study of the way drugs affect the body ○ The primary effect is desirable; the secondary effect may or may not be desirable Protein-binding ○ Drugs are distributed in the plasma ○ Bound drugs are inactive; FREE Drugs are active Agonists ○ Mimics the actions of the body Antagonists ○ Blocks receptor activation First-pass effect ○ The process by which the drug passes to the liver first, concentration is significantly reduced before it reaches the system circulation Drug Tolerance ○ Decreased responsiveness over the course of therapy Phases of Pharmacokinetics ○ Absorption: movement of drug from its site of administration into the blood ○ Distribution: drug becomes available to body fluids and body tissue ○ Metabolism: biotransformation of the drug ○ Excretion: elimination of the drug ○ Elimination: excretion and metabolism Therapeutic index ○ a window that measures the margin of safety of a drug Half-life ○ The time it takes for one-half of the drug to concentration to be eliminated Peak and trough ○ Peak: highest plasma concentration of drug ○ Trough: lowest plasma concentration of drug Kidney and liver impact in metabolism and excretion - labs to monitor ○ Hepatotoxic drugs: toxic to liver drug becomes toxic to the liver once metabolized ○ Ex: watch for signs of liver injury, urine, and jaundice, Creatinine labs Prevention and management of drug interactions  ○ Prevent this by asking your pt all the drugs they take and being specific ○ Drug-Drug, Drug-Food, Drug Herb Module 3 (20-25 questions) Pain ○ Whatever the patient says it is, existing whenever they say it does Pathophysiology of Pain ○ Sensory/discriminative: consists of sensory receptors, neural pathways, and parts of the brain involved in sensory perception such as vision, hearing, touch, and smell ○ Motivational/affective: unpleasant sensations that cause/motivate a reaction/response ○ Cognitive/evaluative systems: person's attitude about pain ○ Afferent pathways ○ Efferent pathways ○ Nociception: perception of pain Pain Medications ○ OTC, NSAIDS, Nonopiod, Opioid analgesics, Combination drugs Pain Management ○ pharmacologic, nonpharmacologic, alternative & complementary therapies Headaches ○ Migraines: dilation and inflammation of intracranial blood vessels, throbbing head pain ○ Cluster: occurs in a series or cluster of attacks ○ Tension-type: headband distribution. Most common. Prostaglandins ○ Protective to the stomach and kidneys (coats the stomach lining and increases blood from the glomerulus) Types of Pain ○ Acute Somatic: arises from skin, joints, and muscles. Sharp/well-localized Visceral: pain in the internal organs and lining of body cavities. Radiates Referred: pain that is present in an area removed or distant from the point of origin ○ Neuropathic: can be acute but often becomes chronic. Amplification of pain w/o stimulation. Burning, shooting, shocklike, or tingling ○ Nociceptive Somatic: localized  Visceral: generalized ○ Chronic: may be persistent or intermittent. Usually lasts 3 to 6 months Types of Headaches Medications ○ Opioids (as a group): Endogenous opioid peptides: the body produces it = originates in the body ○ Oxycodone: Strong opioid agonists. Similar to morphine, it produces less analgesia and respiratory depression. Long-acting analgesic: Immediate-release/Controlled-release ○ Morphine: Strong opioid agonists and moderate to strong opioid agonists. Relief of pain without affecting other senses. No loss of consciousness. Monitor vital signs before giving Adverse effects: constipation, respiratory depression, urinary retention, emesis ○ Naloxone: Prototype of the pure opioid antagonists. Used to reverse opioid overdose. ○ Acetaminophen: Analgesic, antipyretic, no anti-inflammatory actions Inhibits prostaglandin synthesis in CNS ONLY Safe with pregnancy Adverse effects: very few at normal doses, hepatotoxic, treatment for overdose is acetylcysteine Interactions: alcohol, warfarin, vaccines ○ Lidocaine: Suppress pain by blocking sodium channels and blocking impulse conduction along axons. Local blunts pain in only a limited area. Most widely used local anesthetic, topical, and injectable applications ○ Propofol: Most widely used anesthetic - IV Unconsciousness develops within 60 seconds and lasts 3 to 5 minutes Adverse effects: respiratory depression, hypotension, risk for bacterial infection, risk for abuse ○ Codeine:  Moderate to strong agonist. Pain and cough suppression. 10% converts to morphine in the liver ○ Aspirin: Nonselective inhibitor of both cox 1 & cox 2 inhibits CNS & PNS Uses: analgesic, antipyretic, anti-inflammatory, suppression of platelet aggregation Adverse Affects: GI Bleeding, Reyes syndrome, tinnitus, sweating, headache, dizziness. DO NOT use pregnant Interactions: alcohol, anticoagulants, ibuprofen ○ Cox-inhibitors (as a group): Cyclooxygenase inhibitors (antagonists) COX-1 (good COX) protection against myocardial infarction and stroke COX-2 (bad COX) suppression inflammation and is more specific, so it doesn't affect the stomach as much Uses: suppress inflammation, relieve pain, fever MOA: inhibits COX, the enzyme that converts arachidonic acid into prostanoids Adverse effects occur due to inhibition of COX-1 (good COX) ○ Celecoxib: Second-gen COX-2 inhibitor. Because of cardiovascular risks, a last-choice drug for long-term management of pain Uses: arthritis, acute pain, dysmenorrhea Adverse effects: Dyspepsia, abdominal pain, renal impairment, cardiovascular impact. DO NO use pregnant Interactions: warfarin, furosemide, fluconazole increases ○ NSAIDS (as a group): First generation: inhibits COX-1 and COX-2, used to treat inflammatory disorders. Poses risk of serious harm to stomach (GI bleeding) Second generation: selective inhibitor = just suppresses COX 2. Lower risk for GI side effects ○ Ibuprofen: Inhibits COX-1 & COX-2 and is anti-inflammatory, antipyretic, and analgesic Low incidence of GI bleeding compared to aspirin DO NOT USE with kidney disease