Patho Exam 1 Study Guide PDF
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Summary
This study guide, titled "Patho Exam 1 Study Guide," provides an outline for module 0-1 and module 2 and module 3. It details pharmacology foundations, pathophysiology foundations and medication safety. It also outlines drug classifications and interactions as well as individual variations in drug responses. The guide covers pain and headaches, making it helpful for medical or health-related students.
Full Transcript
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