Ch. 1-4

Question 1

3 Most Important Properties of an Ideal Drug

Answer 1

1. effectiveness: most important
2. safety: no harmful effects
3. selectivity: drug elicits only the response for which it is given

Question 2

5 Rights

Answer 2

1. drug
2. patient
3. dose
4. time
5. route

Question 3

Pre-admin Assessment

Answer 3

• collection of baseline data to evaluate therapeutic and adverse effects
• identify high–risk patients
• assess of patient’s capacity for self-care

Question 4

Application of Pharm in Patient Care

Answer 4

• pre-admin assessment
  2. dosage and admin
  3. evaluating and promoting therapeutic effects
  4. minimizing adverse effects
  5. minimizing adverse interactions
  6. making PRN decisions
  7. manage toxicity

Question 5

P-glycoprotein

Answer 5

• transports a wide variety of drugs out of cells

Question 6

Passage of Drugs Across Membranes

Answer 6

• to directly penetrate, must be lipophilic
• polar molecules: uneven distribution of a charge; no net charge
• ions: molecules that have a net electrical charge
• Quats: contain at least one atom of nitrogen and carry a positive charge at all times
• pH-dependent ionization: acid is proton DONOR (ionize in basic media); base is a proton ACCEPTOR (ionize in acidic media)

Question 7

Ion Trapping

Answer 7

• acidic drugs accumulate on alkaine side

- basic drugs accumulate on acidic side

Question 8

Absorption

Answer 8

• rate= how soon effects will begin
• amount= how intense the effects will be
• rate of diffusion, surface area, blood flow, lipid solubility, and pH partitioning

Question 9

First Pass Effect

Answer 9

• metabolism of a drug and its passage from liver into circulation
• ex. oral route- could be extensively metabolized by liver before reaching the systemic circulation
• ex. IV bypasses liver, preventing first-pass effect and more drug reaches circulation

Question 10

Distribution

Answer 10

• blood flow to tissues
• exiting the vascular system
• entering cells

Question 11

Blood Flow to Tissues

Answer 11

• blood flow determine rate of delivery
• abscesses and tumors: low regional blood flow affects therapy, pus-filled pockets rather than internal blood vessels, solid tumors have a limited blood supply

Question 12

Exiting Vascular System

Answer 12

• typical capillary beds: drugs pass between capillary cells rather than through

Question 13

BBB

Answer 13

• tight junctions

- lipid soluble or have a transport system can cross BBB

Question 14

Placental Drug Transfer

Answer 14

• membranes do NOT constitute an absolute barrier

- birth defects: mental retardation, gross malformations, low birth weight

Question 15

Protein Binding

Answer 15

• can form reversible bonds with proteins

- albumin is most abundant; large molecule always remains in blood stream

Question 16

Entering Cells

Answer 16

• binding with receptors on external surface of cell membrane
• do not need to cross the membrane to act

Question 17

Hepatic Drug-Metabolizing Enzymes

Answer 17

• most that takes place in liver, also known as P450 system

- does not always result in a smaller molecule

Question 18

Therapeutic Consequences of Drug Metabolism

Answer 18

• accelerated renal drug excretion
• drug inactivation
• increased therapeutic action
• activation of prodrugs
• increased or decreased toxicity

Question 19

Enterohepatic Recirculation

Answer 19

• repeating cycle in which drug is transported

- limited to drugs that have undergone glucronidation

Question 20

Renal Routed of Drug Excretion

Answer 20

• glomerular filtratoin, passive tubular reabsorption, active tubular secretion
• factors that modify renal drug excretion: pH-dependent ionization, competition for active tubular transport, and age

Question 21

Time Course of Drug Response

Answer 21

• Plasma drug levels: minimum effective concentration and toxic concentration (therapeutic range)
• single-dose time course: duration of effects is determined by the combination of metabolism and excretion; for drug levels to min. effective dose, therapeutic response will be maintained
• drug half-life: time required for the amount of drug in the body to decrease by 50%, percentage vs. amount, determine the dosing interval
• drug levels produced with repeated doses: plateau drug levels are achieved, time to plateau, techniques for reducing fluncuations in drug levels, loading doses vs maintenance doses, and decline from plateau