What are the stages of the pharmacokinetic process any given drug?
- Administration
- Absorption
- Distribution
- Metabolism
- Excretion
What are the four main types of proteins that drugs will interact with? Provide an example for each.
- Receptors: beta 2 adrenoreceptors + salbutamol
- Ion channels: L calcium channels + dilitiazem
- Enzymes: angiotensin converting enzyme + ramipril
- Transporters (carriers): Na/K pump + digoxin
What does an antagonist do?
Drug binds to a receptor, without causing activation, but prevents the agonist (exogenous or endogenous) from binding
What relevance do medicines have to physiotherapy?
- Causing symptoms – dizziness, swollen ankles
- Controlling symptoms to enable treatment -pain, breathlessness
- Sedating – ability to comply with instructions
- Indicating underlying disease process - arthritis
- Effect observations – pulse, blood pressure
What relevance do medicines have to physiotherapy?
- Causing symptoms – dizziness, swollen ankles
- Controlling symptoms to enable treatment -pain, breathlessness
- Sedating – ability to comply with instructions
- Indicating underlying disease process - arthritis
- Effect observations – pulse, blood pressure
What resources can be used to find more information about medications?
- MimsOnline
- Therapeutic Guidelines
- NPS Medicinewise
- Australian Medicines Handbook
What is a partial agonist?
A drug that binds to a receptor causing a submaximal response
What is polypharmacy?
Five or more different medications, or more than 12 or more dose per day
What is hyperpolypharmacy?
Ten or more different medications
What adverse effects are associated with taking 5 or more medications?
- Mortality
- Falls
- Disability
- Fraility
What are the two main types of drug interactions?
- Pharmacokinetic
2. Pharmacodynamic
What is involved in a pharmacokinetic drug interaction?
Altered concentration
- Bioavailability: absorption or first-pass metabolism
- Clearance: metabolism or excretion of active drug
- Distribution: cell membrane transport to the site of action
What is involved in a pharmacodynamic drug interaction?
Altered effect
- Mechanism: molecular signal
- Mode: physiological effect
What pharmacokinetic and pharmacodynamic changes occur with ageing?
- Impaired renal function
- Changes in receptors and target organ response
What three medications combined are extremely dangerous to
- NSAIDs: Block prostaglandin production and reduce blood flow to the glomerulus
- Diuretics: reduced blood flow to the glomerulus
- ACE inhibitors or ARBs: reduced glomerular filtration rate via arteriole dilation
How does ibuprofen work, what are its interactions and its side effects?
- Inhibits prostaglandin synthesis
- Interacts with lithium, warfarin, ACE inhibitors/sartans/diuretics
- GI, bleeding, increased BP, fluid retention, headache
What drugs are used for heart failure?
- ACEI / A2RA
- Loop diuretic
- Beta-blocker
- Aldosterone antagonists
- Vasodilators: isosorbide dinitrate + hydralazin
- Digoxin
- Ivabradin
What drugs are used to treat angina?
- Beta blockers OR/and calcium channel blockers
- Nitrates
- Antiplatelet agents
- Statins
What drugs are used to treat MIs?
- Antiplatelets
- ACEI / A2RA
- Beta-blockers or CCB
- Aldosterone antagonists
Statins
What drugs are used to treat hypertension?
- Beta-blockers
- Alpha receptor antagonists
- Calcium channel blockers
- ACE Inhibitors
- Diuretics
What are the role of beta-blockers?
They block sympathetic stimulation of the heart.
What suffix is used for the naming of beta blockers?
“-olol”
What physiological effects do beta blockers cause?
They reduce systolic BP, HR, contractility and cardiac output, resulting in a decreased myocardial oxygen demand and increased threshold for ventricular fibrillation
What suffix is used for the naming of ACE inhibitors?
“-pril”
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Ageing26
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Exercise Prescription6
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Sleep and Ageing57
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Dementia, Delirium and Cognitive Decline18
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Foot and Ankle Dysfunction in the Ageing Population13
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Pharmacy33
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Osteoporosis45
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Falls58
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Osteoarthritis32
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Hip Pain in Older Adults20
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Community Participation and Health Usage9
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Week 2 revision6
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Week 1 revision9
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Week 3 revision10
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Week 4 and 5 revision11
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Tutorials20
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Incontinence70
