Chap. 5 - pharmacological principles

Question 1

Pharmacology

Answer 1

Study of what drugs do and how they do it

Question 2

Pharmacokinetics (includes 4 mechanisms)

Answer 2

Study of what the body does to drugs; includes absorption, distribution, metabolism, and excretion

Question 3

Pharmacodynamics

Answer 3

Study of what drugs do to the body; target sites for drug actions include receptors, ion channels, enzymes, and carrier proteins.

Question 4

Absorption

Answer 4

Method and rate at which drugs leave the site of administration

Question 5

Oral meds - where are they typically absorbed and metabolized?

Answer 5

Absorbed in the small intestine

Metabolized in the liver

Question 6

Distribution

Answer 6

Occurs after the drug leaves the systemic circulation and enters the interstitium and cells

Question 7

Most psychotropics are lipophilic and protein bound. A patient with low protein (albumin) may become _____ from an increased amount of free drug.

Answer 7

Toxic

Question 8

Drugs are redistributed in organs according to the _____ and _____ content of the organ.

Answer 8

Fat and protein

Question 9

Metabolism

Answer 9

Process by which the drug becomes chemically altered in the body.

Question 10

First-pass metabolism

Answer 10

Process by which the drug is metabolized by P450 enzymes in the intestines and liver before going to the systemic circulation

Question 11

Elimination

Answer 11

Process by which the drug is removed from the body

Question 12

Half-life (T1/2)

Answer 12

Time needed to clear 50% of the drug from the plasma

Question 13

Half-life determines _____ _____

Answer 13

Dosing interval

Question 14

Steady state

Answer 14

Point at which the amount of drug eliminated between doses is approximately equal to the dose administered

Question 15

It takes approximately _____ half-lives to achieve a steady state and _____ half-lives to completely eliminate a drug

Answer 15

Five

Five

Question 16

Drugs are usually administered _____ per half life to achieve steady state

Answer 16

Once

Question 17

Tegretol, antifungals, rifampin, dilantin, phenobarbital, trileptal, and topamax are common enzyme inducers or inhibitors?

Answer 17

Inducers

Question 18

Tagamet, erythromycin, biaxin, fluoroquinolones, prozac, and paxil are common enzyme inducers or inhibitors?

Answer 18

Inhibitors

Question 19

Inducers will _____ the serum level of a substrate drug, causing _____ levels

Answer 19

Decrease

Subtherapeutic

Question 20

Inhibitors will _____ the serum level of a substrate drug, causing _____ levels

Answer 20

Increase

Toxic

Question 21

Liver disease affects first-pass metabolism, causing _____ plasma drug levels

Answer 21

Toxic

Question 22

Kidney disease may _____ levels of renally excreted drugs

Answer 22

Increase

Question 23

A common drug class that reduces renal clearance is _____

Answer 23

NSAIDS

Question 24

A common renally excreted psych drug is _____

Answer 24

Lithium

Question 25

A client taking lithium and Ibuprofen regularly and may find that their lithium level is now _____

Answer 25

Toxic

Question 26

Because the elderly typically have _____ fat and _____ protein, they are _____ likely to become toxic on psychotropics

Answer 26

Increased fat Decreased protein More likely to become toxic

Question 27

Low protein levels lead to _____ with psychotropics

Answer 27

Toxicity

Question 28

High fat leads to _____ with psychotropics

Answer 28

Toxicity

Question 29

Agonism, inverse agonism, partial agonism, and antagonism are four types of _____

Answer 29

Pharmacodynamics

Question 30

Agonism

Answer 30

Binding to a receptor site to activate a biological response

Question 31

Antagonism

Answer 31

Binding to a receptor site to NOT cause activation of a biological response

Question 32

Inverse agonism

Answer 32

Do not bind and do not activate a biological response (the opposite of agonism)

Question 33

Partial agonism

Answer 33

Do not fully activate the receptors

Question 34

Excitatory response at an ion channel: channels will _____, allowing _____ and _____ ions to _____ the cell

Answer 34

Channels will open, allowing sodium and calcium to enter the cell

Question 35

An excitatory response is known as depolarization or repolarization?

Answer 35

Depolarization

Question 36

Inhibitory response at an ion channel: channels will _____, allowing _____ ions to _____ the cell and _____ ions to _____ the cell.

Answer 36

Channels will open Chloride enters Potassium leaves

Question 37

An inhibitory response is known as depolarization or repolarization?

Answer 37

Repolarization

Question 38

Some drugs will inhibit enzymes, increasing the availability of neurotransmitter. Name this class of drugs.

Answer 38

MAOIs

Question 39

Drugs like SSRIs and NDRIs act on...

Answer 39

Reuptake pumps

Question 40

Potency

Answer 40

Relative dose required to achieve certain effects

Question 41

Therapeutic index

Answer 41

Relative measure of toxicity or safety of a drug

Question 42

A drug with a high (think wide) therapeutic index is relatively _____

Answer 42

Safe. Think DPK (high therapeutic index) vs Li+ (low therapeutic index).

Question 43

A drug with a low (think narrow) therapeutic index is more or less prone to toxicity?

Answer 43

More.

Question 44

Tolerance

Answer 44

Process of becoming less responsive to a particular drug over time