Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nutritional > ADME > Flashcards

ADME Flashcards

1
Q

What is absorption?

A

Requires movement of medication from the GI tract to the general circulation

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

Is all drug necessarily absorbed? Why or Why not?

A

No because not all drug reaches the systemic circulation as an active drug

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

What is the difference between absorption and bioavailability?

A 
Absorption = transportation of the unmetabolized drug from the site of administration
Bioavailability = rate in extent to which the drug is absorbed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the rate-limiting step for most solid dose form drugs?

A

Disintegration and dissolution

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

FYI question: Define rate-limiting step

A

Step with the slowest rate that is slowing the whole process down

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

What is the rate-limiting step for liquid medications in solution?

A

Blood perfusion of the intestines

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

What 4 factors could affect the blood perfusion of the intestines?

A
  • Disease states
  • Edema
  • Surgery
  • Sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What 6 factors can alter medication absorption?

A
  • Presence of other drugs
  • Presence of food
  • Formulation of medication
  • Route of administration
  • Location of the distal tip of the enteral tube
  • Gastric emptying
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 approaches to enhance absorption?

A
  1. Use liquid medications to bypass the dissolution step
  2. Administer adequate fluids with liquid medications or pulverized tablets
  3. Administer additional free water to flush in conjunction w/ scheduled medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If tablets are used to bypass the dissolution step, what should be done before administration?

A

Should be pulverised

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

What is the benefit of administering fluids with liquid medications or pulverized tablets?

A

Expands stomach and enhances gastric emptying

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

What is 1 factor that could inhibit absorption?

A

Placement of distal tip of enteral tube (stomach vs. duodenum vs. jejunum)

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

Example: Itraconazole tablets require an acidic environment for dissolution, which enteral tube would be great choices for itraconazole tablets?

A

Orogastric, nasogastric and gastrostomy because it ends in an acidic environment

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

(T/F) - Itraconazole tablets in a post pyloric administration have a great absorption?

A

FALSE - It has poor absorption

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

For a post pyloric administration, which itraconazole formulation would be best to be given?

A

Liquid formulation - medication is already dissolved bypassing the rate dissolution step

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

Example: Ciprofloxacin (fluoroquinolone antibiotic) is absorbed mainly in the upper part of the intestinal tract. Will it be absorbed properly if administered by a jejunostomy tube?

A

NO - that’s below the upper part (duodenum) of the intestinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What 4 medications are best taken on an empty stomach?

A
  • Penicillins
  • Tetracyclines
  • Rifampin
  • Levothyroxine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Before a patient is administered a medication that is best taken on an empty stomach who is also on a tube-feed - how would one proceed?

A

Hold feeds 30-60 mins before medication administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

After a patient is administered a medication that is best taken on an empty stomach who is also on a tube feed - how would one proceed?

A

Hold feeds 30 mins after medication administration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If feeding schedule has been jeopardized, what should be done in order for the patient to receive 24-hour nutritional needs?

A

Re-adjust feeding schedule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some GI intolerances during tube feeding due to the formulation of some drugs?

A
  • N/V/D
  • Cramping
  • Increased gastric residuals
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

If GI intolerances occur, for example, why should the clinician review the medication profile?

A

To determine if a drug’s route of administration should be changed or change the drug to equivalent therapeutic drugs for less GI intolerance occurance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name 3 medications that delay gastric emptying or decrease GI motility

A
  • Anticholinergics
  • Aluminum-containing antacids
  • Narcotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Name 2 prokinetic drugs

A
  • Metoclopramide

- Erythromycin

25
Q

When will prokinetic drugs be appropriately used?

A

When medications decrease gastric transit time

26
Q

How can protein binding effect distribution?

A
  • Can increase half-life of the drug

- Could decrease hepatic metabolism

27
Q

How can solubility and tissue distribution effect distribution?

A
  • Hydrophilic substances are primarily distributed within the fluid compartments of the body
  • Lipophilic substances are primarily distributed within adipose tissue
28
Q

Which Cytochrome P-450 enzyme (CYP450) is involved in metabolizing most currently marketed drugs?

A

CYP3A4

29
Q

What are 3 other isozymes that are associated with drug metabolism?

A

CYP1A2
CYP2C9
CYP2D6

30
Q

What types of nutrition could induce CYP1A2?

A
  • Broccoli
  • Brussel-sprouts
  • Charcoal-broiled meats
31
Q

(T/F) - Metabolism could decrease bioavailability and effectiveness of some drugs

A

TRUE

32
Q

(T/F) - Metabolism will not lead toxicity of other drugs

A

FALSE - metabolism MAY lead toxicity

33
Q

What nutrition factor could inhibit CYP3A4 and CYP1A2? Hint: it’s a juice

A

Grapefruit juice

34
Q

What nutrition factor could inhibit CYP2C9? Hint: it’s a juice

A

Cranberry juice

35
Q

Cranberry juice and warfarin interact with each other, which will be affected and what will happen?

A

Warfarin - could increase INR and bleeding

36
Q

What are two common pathways for a drug to be excreted?

A
  • Urinary (renal)

- Gastrointestinal (bile)

37
Q

Which pathway eliminates the majority of hydrophilic drugs and metabolites?

A

Urinary (renal)

38
Q

(T/F) - Alterations in renal function have profound effects on drug clearance

A

TRUE

39
Q

Which elimination pathway is mediated by protein transporters?

A

Gastrointestinal (bile)

40
Q

Name 4 common classes of drugs or drug names that go through the enterohepatic cycling

A
  • Macrolides
  • Nafcillin
  • Ceftriaxone
  • Doxycycline
41
Q

What are 5 types of enteral incompatibilities? Hint: They start with 5 P’s

A
  • Physical
  • Pharmaceuticals
  • Physiologic
  • Pharmacologic
  • Pharmacokinetic
42
Q

What are 3 examples of physical incompatability?

A
  1. Chemical instability that occurs when two susceptible substances are mixed together
  2. Results in a physical change between two substances
  3. Formation of precipitate
43
Q

Name some examples of precipitation

A
  • Curdling
  • Flocculation (flaking)
  • Altered enteral formulation consistency
  • Viscosity
44
Q

Name some examples of viscosity

A
  • Coagulation
  • Thickening
  • Gelling
  • Thinning
45
Q

What 3 things will be affected by pharmaceutical incompatibility?

A
  • Efficacy
  • Potency
  • Tolerance
46
Q

What 4 specialized dosage forms cannot be administered in a feeding tube administration?

A
  • Enteric coated
  • Extended release
  • Sustained release
  • Sublingual (different from ODT)
47
Q

How would physiologic incompatibility be defined as?

A

Result of nonpharmacologic action incurred by the medication or the suspending medium

48
Q

Physiologic incompatibility will occur most likely with:

A
  • High osmolality liquid medications

- Sorbitol containing medications

49
Q

High osmolality liquid and sorbitol containing medications have several side effects? What are they? Hint: GI effects

A
  • N/D
  • Cramping
  • Bloating
  • Increased gastric residuals
50
Q

How would pharmacologic incompatibility be defined as?

A

Results when a medication alters tolerance of the EN or PN regimen because of its mechanism of action

51
Q

What agents is an example of a greater than expected pharmacologic effect of medication?

A

Prokinetics

52
Q

What agents is an example of leading to unintended side effects of medication?

A

Narcotic analgesics

53
Q

How would pharmacokinetic incompatibility be defined as?

A

EN or PN regiment alters the bioavailability, absorption, distribution, metabolism, and/or eliminate of a medication

54
Q

(T/F) - Medication that alters nutrient function falls under pharmacokinetic incompatibility

A

TRUE

55
Q

What are common medications that could cause pharmacokinetic incompatibility?

A
  • Phenytoin
  • Warfarin
  • Ciprofloxacin
  • Levothyroxine (given on empty stomach)
56
Q

What 4 types of immediate release dosage forms can be administered in an enteral tube feeding?

A
  • Oral tablets
  • Hard or soft gelatin capsules
  • Liquid formulations
57
Q

Would an appropriate diluent be administered with the immediate release dosage forms in an enteral tube feeding?

A

Yes

58
Q

(T/F) - Feeding tube must be flushed with water before AND after each medication is administered

A

TRUE

59
Q

Will the immediate release medications be given separately or together in an enteral tube feeding?

A

Separately; it depends also

Nutritional (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions