Ch. 7 Pharmacological Principles Flashcards by Ali S

pharmacokinetics:

what the body does to drugs
-absorption
-distribution
-metabolism
-excretion

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pharmacodynamics:

what the drug does to the body
-target sites for drug actions include receptors, ion channels, enzymes, and carrier proteins

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method and rate at which drugs leave the site of administration:
a. absorption b. distribution c. metabolism d. excretion

a. absorption

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for oral medications, absorption normally occurs in ________ and then in the _____

small intestine and then in the liver

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occurs after the drug leaves the systemic circulation and enters the interstitium and cells:
a. absorption b. distribution c. metabolism d. excretion

b. distribution

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drugs are redistributed in organs according to their ____ and ____ content

fat and protein content

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True or False: most psychotropic drugs are lipophilic and highly protein bound

True

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True or False: only the bound portion of the drug is active

False, only the unbound (free) portion is active
-those w/ low protein (albumin) levels may experience toxicity

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process by which the drug becomes chemically altered in the body:
a. absorption b. distribution c. metabolism d. excretion

c. metabolism

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First-pass metabolism= process in which drug is metabolized by:
a. blood brain barrier b. cytochrome P450 enzymes c. kidneys d. adrenal glands

b. cytochrome P450 enzymes
-in the liver and intestines prior to systemic circulation

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process by which the drug is removed from the body:
a. absorption b. distribution c. metabolism d. excretion

d. excretion

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Half-life (T1/2)= time needed to clear _____% of the drug from the plamsa

50%
-determines dosing interval and length of time to reach stead state

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steady state: dose at which amount of drug _____ between doses is approximately equal to dose ______

-eliminated
-administered

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True or False: drugs are usually administered one every half-life to achieve a steady state

True

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How many half-lives does it take to achieve steady state or to completely eliminate the drug

5 half-lives

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Enzyme inducers (increase or decrease?) the serum level of other drugs that are substrates of that enzyme- and cause ______ levels

-decrease
-cause subtherapeutic levels

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Enzyme inhibitors (increase or decrease?) the serum level of other drugs that are substrates of that enzyme- and cause ______ levels

-increase
-cause toxic levels

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Approx. 10% of Caucasians are poor metabolizers of the P450 ____ enzyme

2D6

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Approx. 20% of Asians may have reduced activity of the P450 ____ enzyme

2C19

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Which of these medications is considered an inducer of cytochrome P450?
a. Buproprion b. Clomipramine
c. SSRIs d. Carbamazepine

d. Carbamazepine
-the other meds listed are inhibitors
-more inhibitors include: Cimetidine, Clarithromycin, Fluoroquinolones, Grapefruit/ grapefruit juice, Ketoconazole

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Which of these medications is an inhibitor of cytochrome P450?
a. Hypericum (St. John’s Wort) b. Phenytoin c. Nefazodone d. Phenobarbital

c. Nefazodone
-the other meds are inducers
-tobacco is also an inducer

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liver disease may result in (toxic or subtherapeutic?) drug levels

toxic

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True or False: drugs that reduce renal clearance (NSAIDs) may increase serum concentrations of drugs that are excreted by the kidneys (lithium)

True

True or False: older adults tend to have less body fat and more protein

False, they are more likely to have more body fat and less protein, making them more like to develop toxicity d/t accumulation and erratic blood levels of drug

drug binds to receptors and activates a biological response: a. agonist b. antagonist c. partial agonist d. inverse agonist

a. agonist

drug causes the opposite effect of agonist; binds to same receptor: a. agonist b. antagonist c. partial agonist d. inverse agonist

d. inverse agonist

drug does not fully activate the receptors: a. agonist b. antagonist c. partial agonist d. inverse agonist

c. partial agonist

drug binds to the receptor but does not activate a biological response: a. agonist b. antagonist c. partial agonist d. inverse agonist

b. antagonist

True or False: NTs or drugs may be excitatory or inhibitory depending on the type of ion channel they gate

True

Excitatory response (depolarization) involves the opening of ____ and _____ channels, so these ions can go into the cell

sodium and calcium

Inhibitory response (repolarization) involves the opening of ____ channels so _____ goes into the cell and ____ leaves or both

-opening of chloride channels -chloride goes into cell -potassium leaves cell

reuptake pumps:

transport NTs out of synapse and back into the presynaptic neuron to be recycled/reused

SSRIs inhibit ____, which increases the synaptic availability of the NT

reuptake pumps

relative dose required to achieve certain affects is: a. therapeutic index b. potency c. tolerance d. efficacy

b. potency

relative measure of the toxicity or safety of a drug; ratio of the median toxic dose to the median effective dose: a. therapeutic index b. potency c. tolerance d. efficacy

a. therapeutic index

the process of becoming less responsive to a particular drug over time: a. therapeutic index b. potency c. tolerance d. efficacy

c. tolerance

True or False: drugs with a high therapeutic index have a high margin of safety

True -toxic dose and therapeutic dose are far apart -high margin of safety

Divalproex is an example of which: high or low therapeutic index

high (50-125mcg/ml)

Lithium is an example of which: high or low therpeutic index

low (0.5-1.2 mEQ/L) pg. 114

tachyphylaxis:

acute decrease in the therapeutic response

Which schedule drugs are used for research purpose only: a. Schedule I b. Schedule II c. Schedule III d. Schedule IV

a. Schedule I -not legally available by prescription/high abuse potential -examples: marijuana (depending on state) and heroin

Which schedule drugs are written prescription only, high abuse potential, no refills allowed on prescription, no telephone orders allowed: a. Schedule I b. Schedule II c. Schedule III d. Schedule IV

b. Schedule II -examples include: morphine, codeine, fentanyl, methadone, hydromorphone, oxycodone, hydrocodone, amphetamine salts, methylphenidate

Which schedule drugs have less abuse potential but still greater abuse potential than other drugs, prescription must be renewed q 6 months and refill limit of 5: a. Schedule I b. Schedule II c. Schedule III d. Schedule IV

c. Schedule III -examples: appetite suppressants, butalbital, testosterone, buprenorphine/naloxone

Benzodiazepines are an example of which schedule drugs: a. Schedule I b. Schedule V c. Schedule III d. Schedule IV

d. Schedule IV -other examples: modafinil, phenobarbital, zolpidem, eszopiclone, temazepam, armodafinil

Which schedule drugs have the lowest abuse potential: a. Schedule I b. Schedule V c. Schedule III d. Schedule IV

b. Schedule V -examples: buprenorphine, Robitussin w/ codeine, promethazine w/ codeine, Lomotil

risks of not taking psychotropics during pregnancy include: a. recurrence of psych symptoms b. premature labor c. teratogenic effects d. discontinuation symptoms

a. recurrence of symptoms -along w/: poor bonding and maternal self-care -the others are examples of risks of taking psychotropics during pregnancy, along w/: issues w/ appetite, transient agitation or sedation

teratogenic risks associated w/ benzodiazepines (2):

floppy baby syndrome, cleft palate

teratogenic risk associated w/ carbamazepine:

neural tube defects

teratogenic risk associated w/ lithium:

Epstein anomaly

teratogenic risks associated w/ divalproex sodium include (4):

-neural tube defects (specifically spina bifida) -atrial septal defect -cleft palate -possible long-term developmental deficits

which medication has the potential to induce mania? a. beta blockers b. disulfiram (Antabuse) c. benzodiazepines d. progesterone e. some retroviral drugs

b. disulfiram -the other medications listed may induce depression, not mania -other meds that may induce mania include isoniazid (INH), antidepressants in persons w/ bipolar and steroids (also can induce depression)

True or False: Isotretinoin (Accutane) may induce depression

True

True or False: Bupropion (Wellbutrin) may cause a false positive for amphetamines

True, other meds that may also cause false positive for this include: -stimulants -Prozac -Trazodone -Ranitidine -Nefazodone -Nasal decongestants -Pseudoephedrine

Zoloft may cause a false positive for which drugs?: a. cocaine b. benzodiazepines c. amphetamines d. heroin

b. benzodiazepines

True or False: Amoxicillin and most antibiotics can cause a false positive for amphetamines

False, amoxicillin, most antibiotics and NSAIDs can cause a false positive for cocaine

True or False: Valium can cause a false positive for alcohol

True