Pharmacokinetics
The drug's effect on the body is called?
Pharmacokinetics
What drug has a narrow therapeutic window, and medications such as NSAIDs, Doxepin, and TCAs increase the risk of bleeding?
Warfarin
The name of genetic differences at drug receptor sites that can alter a drug's efficacy and toxicity?
Polymorphisms- poor metabolizers and ultra-fast metabolizers
What is the name of the first antipsychotic drug that is an antihistamine and an anti-cholinergic drug?
Chlorpheniramine
If you are breastfeeding, when is it the best time to take medications?
After breastfeeding.
Define ED50
Does required to produce a therapeutic effect in 1/2 the population
What is the term for drugs that act on the liver to increase rates of drug metabolism?
Inducers
Define pharmacokinetics
What the drug does to the body.
Name two anticholinergic antiparkinson drugs
Benztropine - anti tremor
Trihexphenidyl - adjunct treatment + EPSE
Why might you need to increase a child's levothyroxine dose?
Increased metabolism
The term for the amount of drug in the body to decrease 50%?
1/2 life
What 4 medications on the BEERs list should the elderly avoid?
Diphenhydramine/Benadryl
NSAIDs
Oxybutynin/Ditropan
Define bioavailability
The ability of a dry to reach systemic circulation
Name 3 alpha 2-blocker drugs that are used in psychopharmacology
Clonidine ADHD and opioid withdrawal
Guanabenz
Guanfacine
If an elderly patient has a low albumin level and is given a drug that has a high affinity for albumin what would the effect be?
Increase drug level, possibly toxic
What is the rapid hepatic elimination of a drug without achieving a therapeutic effect called?
First pass?
What are drugs called that mimic the body's regulatory molecules?
Agonists
How would you describe the genetic predisposition effect on drugs?
Idiosyncratic effects of drugs
List seven anticholinergic psychiatric drugs
Amitriptyline (Elavil) TCA depression
Chlordiazepoxide-amitriptyline depression/GAD IV
Amitriptyline - clomipramine TCA panic attack
Doxepin GAD depression sleep
Impramine TCA sleep
Perphenazine (schizophrenia)- amitriptyline Typical antipsychotic and TCA
Tripramine TCA
Name seven drugs not to be used in PG.
Ciprofloxacin
Doxycycline
Atorvastatin
Risperidone
Paliperidone
Lithium
Benzos
You can take Olanzapine, Risperidone, and quetiapine
What are ADME body changes seen in the elderly when taking medications?
Absorption-20-25% decreased
Describe a drug inhibitor
Drugs that decrease the metabolism of other drugs by inhibiting hepatic enzymes
Name 7 main drug actions on the body.
1. Stimulating action
2. Depressing action
3. Blocking/antagonizing action
4. stabilizing action
5. Exchanging replacing substances
6. Direct beneficial chemical reaction
7. Direct harmful chemical reaction
Name nine anticholinergic peripheral side effects
Dry mouth, constipation, urinary retention, bowel obstruction, dilated pupils, blurred vision, increased heart rate, decreased sweating
At what weight is a child given an adult dose?
88-100
What term best describes the minimum effective concentration and toxic concentration?
Therapeutic range of plasma drug levels
Name 3 descriptors of pharmacodynamics.
1. Affinity
2. Potency
3. Efficacy
Name 5 SE of the central nervous system anticholinergic SE
Impaired concentration, confusion, attention deficit, memory impairment, and increase in schizophrenia symptoms
What term is associated with a need for increased amounts of a substance overtime to get the same effect
Tolerance
How would you manage anticholinergic side effects?
Decrease the dose of the AC drug
Change to a different drug such as
AP Risperdone, Olanzapine
Treat with physostigmine (PSN alkaloid that reverses cholinesterase inhibitors and Benzos
Name two conditions that are contraindicated with antipsychotics.
Narrow-angle glaucoma and prostate hypertrophy. Bethanechol, can be used for BPH
Avoid typical AP, TCAs, lithium, benzodiazepines, carbamazepine, topiramate, SSRIs give the most ocular problems. SNRI and typical AP
What is the mnemonic for anticholinergic delirium/ toxicity/poisoning?
Red as a beet
Dry as a bone
Blind as a bat, dilated
Mad as a hatter, hallucinations, delirium
Hot as a hare
Full as a flask
Treatment is physostigmine, Benzos
What is the mnemonic of symptoms of cholinergic toxicity?
D iaphoresis
U rination
M iosis
B radycardia, bronchospasm, bronchial secretions
E emesis
L acrimation
L osse stools
Treatment atropine followed by pralidoxime
What causes anticholinergic toxicity?
AH
TCA
Sleep aides
Cold preparations
scopolamine, tainted illicit drugs with scopolamine
Overdose
What can cause cholinergic toxicity?
INCECTICIDES
Mushrooms