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General Concepts in Pharmacotherapy
General Concepts in Pharmacotherapy
General Concepts in Pharmacotherapy
PHARMACOTHERAPY
To define Pharmacotherapy
To enlist and describe briefly on various concepts
in pharmacotherapy
To summarize the topic
PHARMACOTHERAPY: DEFINITION
PHARMACOTHERAPY
Compliance
Essential
Medicines
Placebo Medicines
THE THERAPEUTIC SITUATION
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Age
Physiological differences between different age groups.
For eg: newborn has low GFR and tubular transport is
immature. Thus, the t 1/2 (half-life) of drugs excreted
by glomerular filtration and tubular secretion is
prolonged by 3-5 times.
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Age
After first year, higher metabolism rate than
adults
Elderly- renal function declines, cumulative
toxicity, slower absorption, drug-drug
interactions
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Body size:
Affects the concentration of drug reached at the site of action.
Dose of drug is calculated on the basis of body weight.
For extremely lean or obese , body surface area is considered
for accuracy
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Race/ ethnicity
For eg. blacks require higher and mongols require
lower concentrations of atropine and ephedrine to
dilate their pupil.
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PHARMACOGENETICS
Route of administration
speed and intensity of drug response
Different uses through different routes
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Environmental factors:
Time of administration, Exposure to insecticides,
carcinogens, tobacco smoke, type of diet
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Psychological factors
Drug efficacy influenced by patient’s beliefs,
attitudes and expectations.
Specially for centrally acting drugs.
Placebo and nocebo effect.
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PLACEBO
Pathological state:
Various diseased states modify drug disposition
and responses
GI diseases, liver diseases, Kidney diseases
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Liver disease:
Alternative drugs that do not depend on hepatic
metabolism for elimination and/or have shorter
t½ should be preferred, e.g. oxazepam or
lorazepam in place of diazepam
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Drug combinations
Desirable: Synergistic or additive effect. Or
complementary. Eg. Antimicrobials
Non-desirable: Fatal, adverse reactions. For eg.
Drugs with narrow therapeutic margin, closely
related function, highly plasma protein bound drugs,
etc. 28
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Dosage