PharmacoDynamics – what the Drug does to the body
o Receptor interaction
o Dose response phenomenon
o Mechanisms of therapeutic and toxic action
PharmacoKinetics – what the Katawan does to the drug (ADME)
o Absorption – first pass effect on the liver
o Distribution
o Metabolism –...
PharmacoDynamics – what the Drug CYP450 Inhibitors
does to the body Inhibitors Stop Cyber Kids from Eating GRApefruit QV
o Receptor interaction Isoniazid
o Dose response phenomenon Sulfonamides
o Mechanisms of therapeutic and Cimetidine – H2 inhibitor
toxic action Ketoconazole – antifungal
PharmacoKinetics – what the Katawan Erythromycin – macrolides
does to the drug (ADME) Grapefruit juice or “suha” (BQ)
o Absorption – first pass effect on Ritonavir (acute ingestion)
the liver Amiodarone – antiarrhythmic
o Distribution Quinidine – antimalarial; antiarrhythmic
o Metabolism – drug is transformed Valproic acid – DOC for bipolar
into less toxic form
o Elimination Side Notes for Grapefruit Juice (BQ daw e)
Side Notes: BQ. Dagdag lang ni Bea
Oral drugs undergo first pass effect DO NOT consume grapefruit with:
Rectal drug (e.g. suppository) – also Felodipine (Plendil)
undergo first pass effect (partial first pass Nifedipine (Procardia)
effect); thru superior rectal vein to the liver Amlodipine (Norvasc)
ALL that goes thru the GIT undergo 1st Verapamil (Calan)
pass metabolism (rectum is part of GIT) Carbamazepine (Tegetrol)
Buspirone (Buspar)
CYTOCHROME P450 (BQ, no specific Lovastatin (Mevacor)
question given, just understand the MOA) Illustration below:
Enzyme inhibitor
Enzyme inducer CYP3A4, isozyme of CYP450
Enzyme Inhibitor Enzyme Inducer
Grapefruit juice (also metabolized in the liver)
D2 E (x) D2 E Inhibitor
absorption of drugs mentioned above
D1 D1
CYP450 Inducers (Isa lang tandaan mo, pag
wala dito edi nasa kabilang classification) Drugs build up to a dangerous level
Ethel Booba Phen-phen and Refuses Greasy Carb Shakes (increased drug potency)
Ethanol (chronic)
R
Barbiturates (antiseizure)
Phenytoin (antiseizure) Guidelines for
Rifampicin (alam mo na ‘to) Medication
Griseofulvin (antifungal) Administration
Carbamazepine (trigeminal neuralgia, bipolar)
St. John’s Wort (herbal drug for depression)
SAFETY ISSUES
FROM THE LECTURES OF DR. BAYLON 12.15.2018
, BQ Side notes:
gtts/min. computation SMX + TMP = Cotrimoxazole (a bactericidal)
Amount of infusion x gtt factor Drug Interactions
60 60 Additive 1+1 = 2 (Metro + Amox)
Synergism 1+1 = 3 (Ampi + Genta)
15 = macroset Potentiation 1+0 = 2 (Amox + Cluvanic Acid =
60 = microset Co-amoxiclab)
Antagonism 1+1 = 0 (Cipro & Doxy)
dosage computation Antibiotic Resistance (lam na dis; complete dosage
as px by MD)
Apply cross multiplication:
Cell Wall Synthesis Inhibitors
Dose on hand x Desired dose Natural Penicillin - Pen V, Pen G
Quantity on hand Desired quantity (x) V – oral, “sa ViVig”, primary prophy.
G – parenteral, secondary prophy
Dose on hand (x) = Desired dose (Quantity on hand)
Dose on hand Dose on hand Side notes:
RHD
Desired quantity = D x Q Benzathine & Penicillin are Pen G, IM, buttocks
S (gluteus minimus), q 21 days
Antistaphylococcal Penicillin (Isoxazolyl
Child’s Dosage = Penicillin)
Surface area of child (m2) = N adult dose Methicillin, Nafcillin, Oxacillin,
1.7 m2 Cloxacillin, Dicloxacillin
Side notes:
1 cc = 15 gtts/min MRSA give Vancomycin
4-5 cc = 1 tsp If not relieved, VRSA give Linezolid
15 cc = 1 tbsp
30 cc = 1 fl. oz. Extended Spectrum Penicillin
500 cc = 1pint (Aminopenicillin)
1000 cc = 1 quart Ampicillin, Amoxicillin
4000 cc = 1 gallon Antipseudomonal Penicillin
Carboxypenicillin – Carbenicillin,
ANTI-INFECTIVES/ANTIBIOTICS Ticarcillin
Confer selective toxicity (only target Ureidopenicillin, Mezlocillin,
pathogenic organisms) Azlocillin
Side notes:
Bactericidal – Kills Penicillin A/E: Steven Johnsons Syndrome
Vancomycin
Fluroquinolones (…xacin)
Penicillins
Aminoglycosides
Metronizadole
Bacteriostatic – Inhibits growth; needs host
defense mechanism to eradicate infxn Penicillin S/E: Redness
(ECSTaTiC)
Erythromycin Cephalosporins
Clindamycin 1st Gen. Cefazolin (Commonly used
SMX antibiotics post-op), Cephalexin,
TMP Cefadroxil
Tetracycline 2nd Gen. Cefuroxime, Cefoxitin,
Chloramphenicol Cefotetan
FROM THE LECTURES OF DR. BAYLON 12.15.2018
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