2. Pharmacokinetics, Pharmacodynamics, and Pharmacogenetics Flashcards

1
Q

process of drug movement through the body that is necessary to achieve drug action

A

pharmacokinetics

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2
Q

4 processes of pharmacokinetics

A
  • absorption
  • distribution
  • metabolism
  • excretion
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3
Q

movement of the drug into the bloodstream

A

absorption

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4
Q

purpose of enteric coated drugs (EC)

A

resist disintegration in the gastric contents of the stomach (wait until small intestine)

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5
Q

T/F: enteric coated (EC) drugs and extended release (ER) drugs should not be crushed

A

True

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6
Q

Which route is going to be absorbed the quickest?

A

IV (already in the bloodstream); IM and subcutaneous will both be quicker than oral (enteral)

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7
Q

Which version of transport will be absorbed quicker: active or passive?

A

Passive; does not require molecules or energy -> can diffuse across membranes

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8
Q

What types of molecules cannot diffuse across membranes (passive)?

A

water-soluble and ionized (positively or negatively charged)

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9
Q

What types of molecules can diffuse passively across membranes?

A

lipid-soluble and nonionized

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10
Q

oral drugs pass from intestinal lumen to the liver via the portal vein and undergo metabolism -> reduces amount of active drug

A

first pass effect

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11
Q

percentage of administered drug available for activity

A

bioavailability

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12
Q

Factors that alter bioavailability

A
  • drug form
  • route of administration
  • gastric mucosa and motility
  • administration w/ food and other drugs
  • changes in liver metabolism (liver dysfunction)
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13
Q

movement of drug from circulation to the body tissues

A

distribution

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14
Q

What occurs w/ drugs that are highly protein-bound?

A

less active drug available -> drug bound to protein is inactive

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15
Q

What is the effect of taking at least 2 meds that are both highly protein-bound?

A

both drugs will compete for protein binding -> higher free active drug -> may need smaller dose

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16
Q

What types of drugs are able to cross the blood brain barrier (BBB)

A

highly lipid soluble and of low molecular weight can cross by diffusion while other may cross via transport proteins

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17
Q

What is considered before giving drugs during pregnancy?

A

risk-to-benefit ratio

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18
Q

process by which the body chemically changes drugs into a form that can be excreted; aka biotransformation

A

metabolism

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19
Q

liver enzymes that covert drugs into metabolites

A

cytochrome P450 enzymes

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20
Q

time it takes for the amount of drug in the body to be reduced by half

A

half life

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21
Q

occurs when the amount of drug being administered is the same amount of the drug being eliminated

A

steady state (plateau drug level)

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22
Q

What is a loading dose?

A

a large initial dose of a drug w/ a long half life -> allows therapeutic effects to take place while reaching a steady state

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23
Q

elimination of drugs from the body

A

excretion

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24
Q

main route of drug excretion

A

kidneys

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25
Q

What must you be aware of when administering drugs?

A

renal lab values (will the drugs be excreted properly)

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26
Q

study of effects of drugs on the body

A

pharmacodynamics

27
Q

amount of drug needed to elicit a specific physiologic response

A

potency

28
Q

high vs low potency

A
  • high: produces significant therapeutic response w/ low concentration
  • low: produces minimal therapeutic response at low concentrations
29
Q

point at which increasing a drug’s dosage no longer increases desired therapeutic response

A

maximal efficacy

30
Q

describes relationship between therapeutic dose of a drug (ED50) and the toxic dose of a drug (TD50); difference between the 2 points

A

therapeutic index (TI)

31
Q

dose of drug that produces a therapeutic response in 50% of the population

A

ED50

32
Q

dose of a drug that produces a toxic response in 50% of the population

A

TD50

33
Q

What does it mean if a drug has a narrow (low) therapeutic index?

A

the therapeutic dose and toxic doses are close together -> require close monitoring for pt safety

34
Q

highest plasma concentration of a drug at a specific time; indicates rate of absorption; usually 30-60 minutes by IV

A

peak drug level

35
Q

lowest plasma drug concentration; drug level drawn right before next dose without regard to administration

A

trough drug level

36
Q

What determines the activity of most drugs?

A

ability of the drug to bind to a specific receptor; more active the better the drug fits at the receptor site

37
Q

drugs that activate receptors and produce a desired response

A

agonists

38
Q

drugs that prevent receptor activation and blocks a response

A

antagonists

39
Q

T/F: antagonists only decrease cellular action

A

False; may increase or decrease cellular action depending on the action of the chemical messenger that is blocked

40
Q

drugs that affect multiple receptor sites

A

non-specific drugs

41
Q

drugs that affect multiple receptors types

A

non-selective drugs

42
Q

7 mechanism of drug actions

A
  • stimulation
  • depression
  • irritation
  • replacement
  • cytotoxic action
  • antimicrobial action
  • modification of immune status
43
Q

unintentional, unexpected reactions to drug therapy that occur at normal dosage; may be mild to life-threatening

A

adverse drug reactions (ADRs)

44
Q

secondary effects to drug therapy

A

side effects

45
Q

T/F: all drugs have side effects

A

True

46
Q

Most common side effects found in drugs?

A

N/V/D

47
Q

occurs when drug levels exceed a therapeutic range; may be due to overdose or drug accumulation

A

drug toxicity

48
Q

refers to study of genetic factors that influence an individual’s response to a specific drug

A

pharmacogenetics

49
Q

decreased responsiveness to a drug over the course of therapy; individual will require higher dosage of drug to achieve same therapeutic response

A

Drug tolerance

50
Q

acute, rapid decrease in response to a drug; may occur after first dose or several doses

A

tachyphylaxis

51
Q

drug response not attributed to the chemical properties of the drug; can be positive or negative; psychological origin but physiologic response

A

placebo effect

52
Q

changes that occur in the absorption, distribution, metabolism, and excretion of one or more drugs (ex. taking enzyme inducers and enzyme inhibitors together)

A

pharmacokinetic interactions

53
Q

interactions that result in additive, synergistic, or antagonistic drug effects

A

pharmacodynamic interactions

54
Q

when 2 drugs are administered together and the response is equal to the effects of the 2 drugs together (2+2=4)

A

additive effect

55
Q

when 2 drugs are given together, the clinical effects of the 2 drugs is greater than their separate effects (2+2>4)

A

synergistic effect

56
Q

when 2 drugs are administered together and one drug reduces or blocks the effects of the other (2+2<4)

A

antagonistic effect

57
Q

Name 4 things drugs can interact with?

A
  • other drugs
  • nutrients: foods increase/decrease or delay body’s response to drugs (grapefruit and CYP450 enzyme)
  • labs: cephalosporin can alter urine glucose/ketone tests
  • photosensitivity: skin reaction from sunlight (usually UVA); causes photosensitive and photoallergic reactions
58
Q

List 4 receptor families

A
  • cell membrane-embedded enzymes
  • ligand-gated ion channels
  • G protein-coupled receptors
  • transcription factors
59
Q

drug binds to domain on cell surface -> activates enzyme inside cell which causes response (fast acting)

A

cell membrane-embedded enzymes

60
Q

channel crosses the cell membrane -> when it opens, ions flow in and out -> mainly affects Na and Ca (fast acting)

A

ligand-gated ion channels

61
Q

drug activates receptor -> receptor activates G protein -> binds w/ GTP -> activates the effect (fast acting)

A

G protein-coupled receptors

62
Q

found in the cell nucleus on DNA -> activation regulates protein synthesis (prolonged)

A

transcription factors

63
Q

drugs that increase drug metabolism -> promote drug elimination and decrease plasma concentration (decreased action)

A

enzyme inducers

64
Q

drugs that decrease drug metabolism -> increase plasma concentration and potential toxicity

A

enzyme inhibitors