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& the certified athletic trainer
Pharmacology & the certified athletic trainer
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ATC and Drugs Study findings Health advisor Watch dog for abuse
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Terms Drug vs Medicine Pharmacology Dosing Potency Pharmacokinetics
Pharmacodynamics Dosing Standard Pediatric Loading Potency
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Pharmacology Pharmacotherapeutics Toxicology Pharmacokinetics
Pharmacodynamics Drug Absorption / Distribution Drug Metabolism / Excretion Cellular Effects Systemic Effects
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Routes of Administration
Enteral vs Parenteral Systemic Effects Oral (Ingestion) – liquid, tablets, capsules Pros and Cons Enteric coated pills Sustained release tablets/capsules Injection (Parenteral) – subcutaneous, intravenous, intramuscular Other – intranasal, inhalation, sublingual, buccal, rectal, transdermal
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Routes of Administration
Local Effects Topical – applied to the skin to treat skin conditions Otic Opthalmic
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Pharmacokinetics Refers to movement of drugs across body membranes to reach the target organ 4 phases (ADME) Absorption Distribution Metabolism Elimination
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Pharmacokinetics (phase 1)
Absorption from GI tract to bloodstream – ingestion All other methods go directly into blood Some drug binds to blood protein, some free floating Bioavailability – amount of drug available to use following digestion Exercise’s effect on Absorption Rate of dissolution Surface Area Lipid solubility
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Pharmacokinetics (phase 2)
Distribution – movement from circulation into tissues Delivered to target areas Exercise increases distribution Affected by poor circulation How does a drug exert it’s effect? Lipid solubility of drug Receptor Physical or Chemical means
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Drug Actions Activation (Stimulation) – increase the rate of functional activity Inactivation (Depression) – decrease the rate of functional activity Blocking – prevents an action or response Inhibition – changes cell functioning Substitutive (Replacement) – substitute an equivalent substance to restore optimal condition Curative – destruction or prevention of growth Irritation – abnormal excitation of function
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Drugs in the Body Example Site of action (Target organ) - Neuron
Synapses – space between axon and dendrites In central and peripheral nervous system Dendrite – receive impulse from adjacent neuron Cell body – processes incoming information; formulate action potential Axon – transmits action potential Neurotransmitter – protein chemical messenger that carries an AP across synapse
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Site of Action Effects on Synapses – either excitatory or inhibitory
Receptors – protein molecules on a cell membrane that can interact with drugs
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Dendrite Axon Neurotransmitter
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Dendrite Axon
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Dendrite Axon Drug binds to presynaptic receptor
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Dendrite Axon Drug binds to postsynaptic receptor
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Dendrite Axon Drug mimics neurotransmitter
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Dendrite Axon Drug destroys enzyme that should destroy neurotransmitter
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Agonist +
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Agonist -
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Antagonist
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Factors Affecting Drug Actions
Age – infants and elderly more sensitive Gender – affects women differently Hormones, % body fat, less H2O Mindset – Dosage – Potency – Purity – Tolerance –
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Pharmacokinetics Metabolism (phase 3) – clearing of drugs from the body Liver “First pass effect” Makes drug inactivative Exercise slows metabolism Liver illness slows metabolism – causes a buildup of unmetabolized drug Excretion (phase 4) – removal of drug from the body Exercise slows excretion Kidney illness slows excretion
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Example of Pharmacokinetic Process (Aspirin)
Orally administered Absorbed in Stomach and SI 80-90% binds to protein, so 10-20% exits blood and has therapeutic effect Compared with 20-50% binding w/ Tylenol Metabolism begins in blood and ends in liver – changes to salicylic acid Excreted by kidney
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Pharmacokinectic Terms
Half-life Duration of Action MEC Toxic Concentration Therapeutic Range Maximal Efficacy
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Drug Interactions Definition Depends on many factors…..
2 Types of Interactions Pharmacokinetic Interactions Pharmacodynamic Interactions Additive Effect 2+2=4 Synergistic Effect 2+3=5 Antagonistic Effect 2+2=1
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Drug Interactions (con’t)
Alcohol and Foods Preventive Methods Label Computerized record keeping Adverse Drug Reactions (ADR) Allergies Negative side effects Minor or severe Local or systemic Seek Tx and requires discontinuation of drug
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Guidelines for ATC’s Read label for appropriate dosage
Consider possible interactions Recognize adverse reactions and act quickly IV and those absorbed thru thin most mucus membrane take effect quicker than oral administration Drug effects are maximal at peak concentration level, but ADME can all be affected by a variety of factors Be aware of all meds an athlete is taking
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