3: Pharmacokinetics Flashcards

1
Q

Three ways to minimize med errors

A
  1. Use computerized orders instead of hand written
  2. Use a bar-code system
  3. Have a senior pharmacist accompany physicians on rounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Most common means for drugs to reach their targets

A

Simple diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Three ways drugs cross the cell membrane and what theyre most commonly used for

A
  1. Facilitated diffusion via channels -> drug elim
  2. Active transport -> drug elim
  3. Direct penetration -> reaching target tissues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Example of a polar drug

A

Quaternary ammonium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

If pH is lower, what does that mean for a compound in that solution?

A

Its more likely to have an H attached

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Only way weak acids and bases can cross a membrane

A

In their unionized form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Values for both S (salt factor) and F (bioavailability)

A

Less than 1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does Vd become large and “apparent”?

A

When there is a lot of drug in the body, but not in the plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Examples of non-Microsomal enzymes in phase I of biotransformation

A

Esterases, alcohol dehydrogenases, oxidative deaminases, decarboxylases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Inducers vs inhibitors for cytochrome P450 enzymes

A

Inducers: increase enzyme levels -> speed up metabolism of other drugs
Inhibitors: inhibit the enzyme -> slow metabolism of the drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of inducers and inhibitors of cytochrome P450

A

Inducers: phenobarbital, carbamazepine, ethanol, cigarette smoke
Inhibitors: erythromycin, ketoconazole, metronidazole, grapefruit juice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which specific cytochrome P450 is inhibited by grapefruit juice?

A

P450 CYP3A4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does first pass metabolism do?

A

Greatly decreases bioavailability of orally administered drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Excretion rate

A

Mass eliminated per unit time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clearance

A

Plasma volume from which all solute is removed per unit time (a flow rate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tachyphylaxis

A

Rapid tolerance to a drug

17
Q

Idiosyncrasy

A

An unusual response to a drug due to inherited alteration, often an enzyme defect

18
Q

Why are adverse drug reactions more likely in elderly

A
  1. Drug accumulation due to declining renal function
  2. Greater severity of illness
  3. Use of drugs with low therapeutic index
  4. Poor compliance
  5. Presence of multiple pathologies
  6. Inadequate supervision
19
Q

Three possibilities in a drug-drug interaction

A
  1. Intensification of effects
  2. Reduction of effects
  3. Creation of a unique response
20
Q

Common adverse drug effects

A

Constipation, skin rash, diarrhea, dizziness, drowsiness, dry mouth, HA, insomnia

21
Q

What can food impact in terms of drugs?

A
  1. Absorption
  2. Metabolism (ex: grapefruit juice)
  3. Drug toxicity
  4. Drug action
  5. Timing of drug admin
22
Q

Examples of drugs that can lead to liver failure

A
  1. Lipid lowering drugs
  2. Antiseizure drugs
  3. Drugs for Tb
  4. Antiretroviral drugs
  5. Oral hypoglycemics
  6. Anti fungal drugs
  7. Immunosuppressants
  8. Acetaminophen
23
Q

Common heart condition caused by 100+ drugs

A

QT prolongation

24
Q

Three characteristics for calling something a teratogen

A
  1. Characteristic malformations
  2. Acts during a specific window of vulnerability
  3. Incidence increases with dose and duration of exposure
25
Q

Drugs among the greatest carcinogenic potential

A

Cancer chemotherapeutics (ex: diethylstilbestrol)

26
Q

Physiological changes during pregnancy that can affect drugs

A
  1. Decreased bowel tone = increased time for drug absorption
  2. Increased hepatic metabolism
  3. Increased RBF (Doubles)
27
Q

What order of kinetics is the most typical form for drug elimination

A

First order

28
Q

If S and F are not provided in clearance calculations, what can you assume they are?

A

1

29
Q

Loading dose

A

Dose needed to rapidly achieve therapeutic drug concentrations for drugs with a very long half life