N5334 Final
1.Prescribing basics: Prescribing is regulated by state BON
2.Proper RX: Providers name and address, Telephone DEA
Pt name/DOB/Addres
Name of Drug, strength, SIG(directions) with indication/Route and frequency, Quantity and signature.
3.Drug Schedules: Most addictive to least: 1: Heroin,LSD, MJ
2: hydrocodone, cocaine, Methamphetamine, methadone, oxycodone, meperidine, fentanyl, adderall, ritalin
3: codeine, ketamine, testosterone
4: xanax, valium, soma, ambient, tramadol 5: antidiarrheal, antitussives, lomotil, lyrica
4.Pharmicodyamics: The effects of drug on the body. Receptors are large mole- cules usually proteins, that interact and mediate the action of drugs
5.agonist: produce receptor stimulation and a conformational change every time they bind. Do not need all available receptors to produce a maximum response
6.Partial agonist: drugs that have properties in b/w those of full agonist and antagonist. They bind to receptors but when they occupy the receptor sites, they stimulate only some of the receptors.
7.antagonist: drugs with affinity for a receptor but with no intrinsic
activity. Affinity allows the antagonist to bind to receptors, but lack of
intrinsic activity prevents the bound antagonist from causing receptor
activation. The block action of drugs (ex. Narcan)
8.Bioavailabity: % of administered dosage of the drug that survives the
first pass through the liver and reaches the blood stream
9.half life: Time required for the amount of a drug in the body to decline by 50%, drugs with shorter half lives must be administer frequently. 4.5-5.5 times the half life to get steady state and to be limited from the body
10.what the body does to the drug: absorption, distribution, metabolism,
excre- tion
11.Distribution: movement of absorbed drug in bodily fluids throughout
the body to target tissue. Properties affecting: lipid/water solubility, PH
affects ionization of drug, protein binding, size of molecule (smaller molecules are more able to diffuse)
Tissue: fat, bone, blood/brain barrier (only lipid soluble will pass), placental barrier (many drugs can pass) .Protein binding: unbound drug is free which is active, crosses membrane. Low plasma proteins result in more free drug. Competition: when 2 highly bound drugs are given it increases the level of both drugs
13.Metabolism: take place in the liver mostly. Chemical change of a drug structure to:
Enhance excretion, inactivate the drug, increase therapeutic
action, active a prodrug (inactive until metabolized in the body
into the active compound, ex: levodopa), increase or decrease
toxicity
14.CYP450: enzymes constitutes the most important of the phase I metabolizing enzymes (account for about 75% of drug metabolism in the liver)
Phase 2: conjugation reaction occur leading to large increases in hydrophilicity of the substrates rendering them more readily excretable
15.Substrate: an agent that is metabolized by an enzyme into a metabolite and product and eventually excreted
16.Inhibitors: compete with other drugs for a particular enzyme affecting the metabolism (decreased) of the substrate and decreases the excretion of the substrate and increasing the circulating drug
17.inducer: competes with other drugs for a particular enzyme affecting metabo- lism of the substrate (increases) decreasing the efficacy of the drug
18.excretion: renal: passive glomerular filtration, active tubular secretion, tubular reabsorption, gi tract, lung, sweat and salivary, mammary
19.genomics: study of the complete set of genetic information present
in a cell, an organism, or species
20.pharmacogenetics: the study of the influence of hereditary factors on the response of individual organisms to drugs, and the study of variations of DNA and RNA characteristics as related to drug response
21.Pharmacogenetics tests: Mentioned on drug labels can be classified as "test required," "test recommended," and "information only." Currently, four drugs are required to have pharmacogenetics testing performed before they are prescribed: cetuximab, trastuzumab, maraviroc and dasatinib
wafarin, carbamazepine, valproic acid and abacavir are recommended to tests prior to initial dosing