TDM/TOX – Chemistry – Flashcards

the study of how drugs interact with living organisms to produce a change in function and how the body affects the drugs.

if substances have medicinal properties, they are considered pharmaceuticals

the study of the body's effects on the drug.

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this includes the processes of absorption, distribution, metabolism, and excretion of drugs

the lowest drug concentration during a dosing interval when drug is given intermittently.

the trough concetration generally occurs immediately before administration of the next dose.

the highest serum drug concetration that occurs following a single dose or at steady state within a dosing interval.

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if the drug is given orally the peak is determined by the rate of absorption and the rate of elimination.

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Exact peak concentration can't be determined  w/o frequent serial blood sampling

trough blood concentration should not fall below the  MEC and the peak blood concentration should not rise higher than the MTC

drug is administered once every half-life.

during dosing regimens should achieve steady state in which  concentration is greater than MEC but less than MTC

If the patient is greater than MTC they're at risk for toxic effects

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If the concentration is less than MEC patient's at risk for the drug having no effect

mouth> stomach>small intestine>liver

the liver is the principal organ responsible for drug metabolism

drugs are generally converted to polar, water-soluble molecules by atering chemical structure of the drug through oxidation, reduction, or hydrolysis reactions

you absorb medicine much faster than you excrete it

drugs that are admisinstered through iv must be formulated in much lower doses since 100% of it directly enters into the bloodstrem and avoids the first pass metabolic effect

abnormal GI motility

disease of infections of the GI tracts

food: vitamin K can reduce the effects of the drug coumadin (coumadin is less able to inhibit clotting factors)

co-administered drugs can affect gastric absorption by altering pH

synegistic: a drug that enhances the therapeutic effect of another drug; may be beneficial or harmful

antaognistic: a drug that diminishes the action of another drug; may be beneficial or harmful

drugs enter systemic circulation, it undergoes simultaneous distribution to body tissues and elmination by clearing organs (liver and kidneys)

lipophillic drugs can cross the cellular membrane

water-soluble drugs can interact with drug receptors on the cell to elicit a biological response.

acidic drugs generally bind to albumin while basic drugs generally bind to globulins

renal pathway is a major excretion route for water soluble drugs or drug metabolites

excretion of a drug from the body can also occur through intestinal and pulmonary routes

a class of drugs used to treat heart conditions

some that requires TDM since they have a small therapeutic range

a class of drugs that is effective against a wide range of bacteria

both gram negative and gram positive

a glycopeptide antiobiotic that is effective against select gram positive bacteria.

because of poor absorption they are given through iv infusion

a slow acting barbituate that effectively controls several types of seizures.

absorption is oral and slow

reaches peak 10 hrs after dose

used to treat a variety of seizure disorders

also used as a short term prophylactic agent in brain injury to prevent loss of function use

primarily administered orally

used for treatment as an anticovulsant and mood- stabilization drug primarily in the treatment of epilepsy and bipolar disorder

also used to treat migrane headaches and schizophrenia

an orally administered drug used to treat manic- depressive illness ( bipolar disorder)

absorption is complete and rapid

discontinuing medicine after a patient feels better

forgetting to take medication regularly or follow the prescribed dosage

can result in the heightening of the disorder, significant toxicity, and/or treatment failure

detects patients undergoing changes in drug dispostion charateristcs.

establishes a basleline for therapeutic concentration:

a baseline drug concewntetation a twhich the patient responds os established and implemented

should the patient's response change the clinic can determine whether the patient has non- compliant or whether diesease state or other factors have altered the pharmocokentics

legal request will require a chain of custody

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proper specime and preservation is required. always follow the sop

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properly label and seal the containers.

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sign and date the appropriate chain of custody

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must be in custody of appropriate personnel at all times or in a locked container to avoid any legal objections

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analysis is run in duplicate alongside known controls

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legal toxicology results are NEVER given over the phone

the amount of chemical agent introduced to the body.

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for many medications, the right dose differentiates poison from remedy

any drug used i excess or for non-therapeutic reasons

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these drugs have high abue potential and users can become addicted

a severe physiological degree of drug dependence with a continuing involvement in drug use

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interference with critical enzyme actions ( ex. nerve agents inhibiting acetylcholinesterase)

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blockage of O2 usage and transport (ex. carbin monoxide poisining)

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intereferes with cell function

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hypersensitivity reactions

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drug interactions: synergistic, antagonisitic

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biological variables: these will vary according to the individuals age gender genetics and overall health factors

analysis of drugs, heavy metals and other chemical agents in tissues, blood or body fluids to support patient care

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process by which solutions containing alcohol are heated and the vapors collected and condensed back into the liquid

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means of concentrating ethanol

alcoholic bevarages

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solvents ( perfumes, varnish, mouthwash, antiseptic, cough medicine)

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antedote for methanol poisoning

rapidly absorbed from the GI tract

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approximately 20% is absorbed in the stomach

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80% absorbed in the small intestine

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from 90-98%; is oxidized to acetaldehyde by the enzyme alcohol dehydrogenase

muscular system- coordination is impaired

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circulatory system- blood vessels dialate causing increased loss of body heat

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respiratory system-small doses stimulate respiration

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nervous system- lowered social inhibitition at low doses followed by mental confusion and uncontrolled mood swings at higher levels

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digestive system- increase digestive secretions cause stomach irritation ( increased pH)

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endocrine- secretions of various hormones may be altered

during pregnancy can cause lead to miscarriages, infant deaths, and smaller, weaker new borns

birth defects include Fetal Alcohol Syndrome

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( in males leads to impotence and testerone levels)

clear the stomach

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withdrawl may cause delirium tremens: a condition associated with tremors, tachycardia, hypertension diaphoresis, hallucinations, delusions, disorientation, and possibly seizures

antabuse

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nutritous diet supplemented with vitamins

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behavior modification to teach avoidance and coping mechanisms

used as a common over the counter analgesic medication

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water-solube glcuronide metabolized by the cytochrome p450 enzyme in the liver

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poisoning caused if large amounts are taken

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renal damage occurs less frequently but by the same mechanism

toxicity is a consequence of cellular hypoxia

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most commonly encountered toxic gas

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CO binds to hemoglobin with an affinity 250 times greater than O2

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co may also directly inhibit extracellylar enzymes like cytochrome oxidase further disrupting cellular function

includes lead, mercury, and arsenic

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lead is toxic to multiple organ systems

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associated with;alterations in cellular and mitochondrial membranes diminshed neurotransmitter and heme synthesis and impeded nucleotide metabolism

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frequently found in house paint and used to be an additive in gasoline