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343 Pharm Exam 1 > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

Once a drug is administered, what two phases occur?

A

Pharmacokinetic phase
Pharmacodynamic phase

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2
Q

What is a pharmacokinetic phase?

A

What the body does to the drug, describes movement of the drug through the body

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3
Q

What are the 4 steps in pharmacokinetic ?

A

Absorption
Distribution
Metabolism
Excretion

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4
Q

What does pharmacodynamic phase mean?

A

What the drug does to the body, involves receptor binding, postreceptor effects and chemical reactions

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5
Q

What does drug absorption mean?

A

The movement of the drug into the bloodstream after administration

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6
Q

What does dissolution mean?

A

Disintegrate the tablet or drug with a combination of liquid

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7
Q

What does excipients mean?

A

Items like honey, syrup that are used in a drug to help it dissolve more

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8
Q

There are some drugs like enteric coated that have resist disintegration in the gastric acid of the stomach

So instead, disintegration doesn’t happen until when?

A

It reaches a more alkaline environment like the small intestine

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9
Q

Most oral drugs enter the bloodstream after absorption across the mucosal lining of the small intestine.

What is this small intestine epithelial lining covered in? And what is its job?

A

Villi
Increased surface area for absorption

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10
Q

How does absorption occur in the muscosal lining of the small intestine? (3)

A

Passive transport
Active transport
Pinocytosis

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11
Q

passive transport happens in two processes name them and what they do?

A

Diffusion
- drugs move from high to low concentration

Facilitated diffusion
- carriers protein move from high to low

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12
Q

Does passive transport need energy?

A

No

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13
Q

What is active transport ?

A

Enzyme or protein move the drug against concentration gradient

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14
Q

Does active transport need energy for active absorption?

A

Yes

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15
Q

What is pinocytosis?

A

Process by which cells carry a drug across their membranes by engulfing the drug particles in a vesicle

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16
Q

What is first pass effect or first pass metabolism?

A

Where the liver metabolizes a drug into an inactive state and then are excreted out, reducing the effect

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17
Q

How is the absorption of oral drugs work?

A

Oral -> GI -> intestine -> liver

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18
Q

What is bioavailability mean?

A

Percentage of administered drug available for activity

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19
Q

What does distribution mean?

A

Movement of the drug from the circulation into the body tissue

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20
Q

What are some things drug distribution is influenced by?

A

Vascular permeability
Blood flow
PH
Cardiac output
Tissue perfusion

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21
Q

What does highly protein bound drugs mean?
Example?

A

Drugs that are more than 90% going to bind with a protein

Warfarin

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22
Q

What does weakly protein bound drugs mean?
Example?

A

Drugs less than 10% bound to a protein
Metformin

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23
Q

The portion of the drug that binds with the protein is inactive, meaning ?

A

It is not available to interact with tissue receptors, ultimately not being able to exert a pharmacologic effect

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24
Q

The portion of the drug that doesn’t bind with the protein is known as ?

A

Free drugs

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25
Q

Since free drugs are not bound to a protein, they do what?

A

Are able to exit the blood vessel, reach site of action and cause a pharmacologic response

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26
Q

What is a blood brain barrier ?

A

Blood vessels in the brain that are pressed together and protects the brain from forgein substances

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27
Q

What does metabolism mean?

A

Process by which the body chemically changes drugs into a form that can be excreted

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28
Q

What is the primary site of metabolism?

A

Liver

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29
Q

If it takes 5 mins for a drug to be absorbed how long should it take?

A

Really fast! 5mins probably !

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30
Q

What is the fastest and slowest form of drug to get in the body?

A

IV
Oral

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31
Q

We want to be careful with giving 2 protein bound together because?

A

They will compete for protein sites and potentially have too much active drug circulating ( toxic )

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32
Q

What can cross the blood brain barrier?

A

Lipid soluble drug

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33
Q

Is a placenta an absolute barrier to the passage of drugs?

A

No!!!

34
Q

Why do we have to be careful with pregnant mothers with medications?

A

Because most can cause over to the baby and affect the baby And mom!

35
Q

Which crosses the placenta and which doesn’t?

Lipid and protein?
Think of which gets into the brain?

A

Lipid do cross
Protein dont!

36
Q

If the mother is an opioid/tobbacco addicted, what will happen to the baby?

A

The baby will be born drug dependent and we need weaned off of it

37
Q

What is the system that helps metabolize the drug in the liver to help excrete it out?

A

P450 system

38
Q

What is a prodrug?

A

Nothing happens until it is metabolized ( it works opposite ! )

39
Q

What does half life mean for medication?

A

How much time does the body take to get rid of half of dose of medication

40
Q

Why is half life important?

Give an example
24-36hours
Once a day

A

It determines how much and how often you give the medication

41
Q

What does steady state mean?

A

When the amount of drug being administered is the same as the amount of drug being eliminated

Usually happens after the 4th round

42
Q

However sometimes patients can’t wait for steady state of a drug, take an example of a seizure patient, they have to wait 22 hours?!?

Instead we are going to do a ______
Which is?

A

Loading dose
A larger dose than needed

43
Q

A loading dose can help patients how?

A

To reach a steady state and still receive therapeutic effects

And when they do, they can go back to normal routine

44
Q

What are some things that can decrease metabolism?

A

Cardiovascular dysfunction
Renal insufficiency
Starvation
Obstructive jaundice
Slow acetylator
Ketoconazole therapy
( fungal infection )

45
Q

What are 4 things that help increase factors of metabolism?

A

Fast acetylator
Barbiturate yherapy
Rifampin therapy
Phenytoin therapy ( seizure )

46
Q

Where does the drug excrete from?(6)

A

Kidney
Liver
Lungs
Saliva
Sweat
Breast

47
Q

Why is it important to know where and if our patient has some disease like kidney disease the drug is being excreted?

A

Then there kidneys aren’t filtering there substances
Meaning that won’t be able to excrete it, it can be toxic
Cause kidney can’t filter it out

48
Q

Just because it is okay to give medication to someone is pregnant ( like a pregnant medication ) does it mean it’s okay to give it to them when breast feeding after baby is born?

A

NO!!! It passes to the baby and harms them

49
Q

What does pharmacodynamics mean?

A

Study of the way drugs affect the body

50
Q

What is the primary effect of pharmacodynamics?

What is the secondary effect of pharmacodynamics?

A

Desirable response

Desirable or undesirable ( side effect )

51
Q

It’s important to note that the reason why sometimes we may give a medication may not be for the primary effect ( desirable response ) but instead for?

A

The secondary effect

( that’s why on many medications there are other indications as well )

52
Q

What does dose response relationship mean?

A

The body physiologic response to changes in drug concentration at the site of action

53
Q

What is potency?
An example?

A

Amount of drug needed to elicit a specific response to a drug

Fentanyl has high potency so we give very low dose

54
Q

What does maximal efficacy mean?

A

Where we max out the drug usage or dose that it doesn’t provide any more therapeutic benefits

55
Q

What does therapeutic index mean?

A

Therapeutic dose and therapeutic toxic that helps a therapeutic effect

56
Q

Give me an example In where we would use the therapeutic index? And why?

A

Warfarin
Because it can suppress toxic and kill patient so we want to keep them safe

57
Q

For a therupetic index to be safe and administered to a patient, we must make sure of what?

And explain it more

A

Therapeutic range

( Where plasma drug levels are in that range and won’t cause adverse effects )

58
Q

What does onset mean?

A

How long the drug is taking to work

59
Q

What does peak mean?

A

The time it takes for a drug to reach its maximum therapeutic response

60
Q

What does duration mean?

A

The time a drug concentration is sufficient to elicit to a therapeutic response ( how long it works )

61
Q

Sometimes we have to monitor a patients therupetic ranges because it can either be good or toxic

In which we do a what?

A

Peak & trough

62
Q

What is a peak & trough?

A

Peak is highest plasma concentration of drug at a time
(30-60minsIV after infusion ends)

Trough is the lowest plasma concentration of drug
(Drawn just before the next dose)

63
Q

What is a receptor theory?
To what? (3)

A

Drugs act by binding to receptors

Activate, produce response, inactive a receptor

64
Q

What is agonists?
To produce what?

A

Medications that activate receptors to produce desired response

65
Q

What is partial agonists?
To prevent what?

A

Medications that elicit only moderate actively when binding to receptors

Prevent receptor activation by other drugs

66
Q

What is antagonist ?
Block what?

A

Prevent receptor activation
Block response

( turn it off )

67
Q

What is a nonspecific drug effect?

A

It affects multiple receptors sites
( affects the same type of receptors )

68
Q

What is a nonselected drug effect?

A

Affect multiple receptors
( affects multiple body systems )

69
Q

Notes
Mechanism of drug action

Stimulation
Depression
Irritation
Replacement
Cytotoxic action
Antimicrobial action
Modification of immune status

A
70
Q

What does side effect means?

A

Things we didn’t intend to do

( may be a yeast infection, but it’s unpleasant !! )

71
Q

What is an adverse reaction mean?

A

Allergy
We didn’t expect it and it’s undesirable effect

72
Q

What does drug toxicity mesn?

A

Too much drug

73
Q

What does tolerance mean?

A

Getting use to a medication overtime

You have ro give a higher dose to achieve same therapeutic effect

74
Q

What is tachyphylaxis?

A

Acute
Rapid decrease in response to a drug

It works but then stops
( change medication most of the time )

75
Q

What is placebo effect?

A

Sugar pill
It’s fake

76
Q

Why do we have to be careful of medication?

A

Because of drug interactions

( positive or negative ! Be careful )

77
Q

What does additive drug effect mean?

A

Two drugs work together
( but they work fine alone )

78
Q

What does synergistic drug mean?

A

Two drugs together work so much better than them being by themselves

79
Q

What is antagonistic drug effect?

A

One drug reduced or blocks the other drug

( narcan antagonistic to opioid )

80
Q

What is drug nutrient interactions?

A

Food increase, decreases or delay drug response

81
Q

What is drug laboratory interactions?

A

Drug may cause misinterpretation of test results

( think of like iron meds making poop black, then when you want a poop exam, it changes the test results )

82
Q

What is drug induced photosensitivity ?

A

Drug induced skin reaction cause by sunlight exposure

343 Pharm Exam 1 (12 decks)

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