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Internal Medicine > Chapter 3 And 4 > Flashcards

Chapter 3 And 4 Flashcards

1
Q

First pass

A

(Inactivation) in liver metabolized and destroyed
Drug is transported directly into the liver via the portal vein

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2
Q

Sublingual and buccal

A

Faster effects than swallowing the drug (for acute angina)

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3
Q

Rectal

A

Good for patient who is unconscious or when vomiting prevents drugs from being taken orally

Absorbed poorly or incompletely and irritation of the rectal mucosa

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4
Q

Paraenteral inhilation

A

Rapid entry into the bloodstream through diffusion into pulmonary circulation ( ex. Inhaler)

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5
Q

Intrathecal

A

Deliver injection fluid filled space between the thin layers of tissue that cover the brain and spinal cord
(Ex. Spinal subarachnoid space)

Allow certain drugs to bypass the blood brain barrier and reach the CNS

For tendon sheath or bursa to treatment

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6
Q

Iv and intra-arterial

A

Minimize first pass

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7
Q

Iv injection

A

Resulting in peak levels instantaneously and reach the target site rapidly
Iv cannula (line) allow prolonged and steady diffusion

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8
Q

Intra arterial injection

A

Relative difficult and dangerous procedure
Occasionally used in chemo to decrease exposure to healthy tissue

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9
Q

Subcutaneous injection

A

Relatively slower more prolonged release into the systemic circulation
( local anesthesia, insulin and hormonal contraceptive)

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10
Q

Intra muscular injection

A

Easily accessible
Realities steady prolonged release
Relatively rapid effect while avoiding large increase of plasma seen within the iv

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11
Q

Intra muscular injection

A

Easily accessible
Realities steady prolonged release
Relatively rapid effect while avoiding large increase of plasma seen within the iv

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12
Q

Transdermal

A

Absorbed through the dermal layers and into the subcutaneous tissues or the peripheral circulation

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13
Q

Iontophoresis

A

Use electrical current to deliver medication into the target tissue

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14
Q

Phonophoresis

A

Deliver the drug with the aid of ultrasound

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15
Q

Bioavalibility

A

The extent to which the drug reaches the systemic circulation
Ex. If 100 mg of a drug is given orally and 50 mg eventually make it into the systemic circulation the drug is said to be 50% bioavailable

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16
Q

Lipid soluble compounds

A

(Including most drugs) are able to pass directly through the membrane by dissolving in the lipid bilayer

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17
Q

Drugs will diffuse more readily through the lipid layer in its what type of state ?

A

Neutral, non ionized state

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18
Q

A weak base drug is absorbed where ?

A

In the duodenum it becomes nonionized and lipid soluble allowing it to be absorbed in the small intestine

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19
Q

A weak acid drug is absorbed where?

A

Gets absorbed in the stomach due to the acidic environment going to its neutral and nonionized form

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20
Q

Characteristic of active transports

A

Carrier specificity
Expenditure of energy (ATP hydrolysis)
Ability to transport substance against a concentration gradient

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21
Q

Facilitated diffusion

A

Had the features of both active transport and passive diffusion

An assisting protein carrier is present but no net energy is expended

Ex. Skeletal muscle glucose uptake

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22
Q

Passive diffusion

A

The driving forces WITHOUT EXPENDING any energy are the electrical (charged particles) chemicals and pressure differences on the two sides of the membrane

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23
Q

Alimentary canal

A

Enteral administration

24
Q

Non alimentary routes

A

Parenteral administration

25
Q

Diffusion between cell junctions

A

The primary way that a drug may diffuse across the barrier is by diffusing first into and then out of the other side of the cells compromising the barrier

26
Q

Exocytosis

A

A process by which the contents of a cell vacuole are releases to the exterior of the cell membrane

27
Q

Endocytosis

A

Taking in matter by a living cell by invagination of its membrane to form a vacoule
( swallows into the cell memebrane)

28
Q

Factors affecting distribution

A

Tissue permeability

Blood flow

Binding to plasma proteins (Ex. Albumin)
Only the unbound drug can reach the target tissue and exert an effect

Binding to subcellular components
(Ex. Binding to lysosome)

29
Q

Volume of distribution

A

Amount of drug distributed
(divided by )
Concentration of drug in plasma

30
Q

Drug storage sites

A

Adipose(primary)

Bone (toxic agents and heavy metals)

Muscles
Organs (kidney and liver)

31
Q

The use of specific drugs to prevent, treat, or diagnose disease is known as

A

Pharmacotheraputics

32
Q

Toxicology

A

The study of the harmful effects of chemicals

33
Q

The generic name of the drug

A

Is also known as the official or nonpropietary name
Is often derived from the chemical name
Tends to be somewhat shorter than the drugs chemical name

34
Q

The generic form of a drug is considered to be as safe and effective as the original brand name product if the generic form ______ as the brand name

A

Has the same type and amount of active ingredients
Uses the same administration route
Has the same pharmacokinetics profile (drug absorption, plasma levels, and so forth)
Produces the same therapeutic effects

35
Q

Regarding drug development and approval an orphan drug is a drug that is

A

Given special funding for development because it is uses in a small patient population with a relatively rare disease

36
Q

Prescription use of a drug to treat conditions other than those that the drug was originally approved to treat (off label prescribing)

A

Is legal and quiet common in the us

37
Q

When two drugs are compared the drug that requires a lower dosage to produce the same effect as a higher dose of the second drug is said to

A

Be more potent

38
Q

The______ effect occurs when drugs are transported initially to the liver where a significant amount of the drug may be metabolized and destroyed before the drug reaches its primary site of action

A

First pass

39
Q

The extent to which a drug reaches the systemic circulation is referred to as

A

Bioavailibility

40
Q

Osmosis refers to the special case of diffusion where the diffusing substance is

A

Water

41
Q

A drug that has a volume of distribution of approximately 42 L in a healthy 70kg man will typically be

A

Distributed uniformly throughout all of the body fluids

42
Q

Drug developers are exploring nano technology as a way to

A

Target deliver drugs to specific tissues within the body
Facilitate drug absorption from the gi tract
Enable drugs to cross the blood brain barrier more easily

43
Q

Drug metabolism that occurs when a drug is changed chemically following administration is also known as

A

Biotransformation

44
Q

Most drugs are metabolized by _____ to the drug molecule and the enzymes that catalyst these reactions are typically located at the_____ of specific cells

A

Adding or removing a hydrogen; smooth (agranular) endoplasmic reticulum

45
Q

Prolonged administration of therapeutic drugs and other substances may enhance the livers ability to metabolize certain drugs, thus decreasing their therapeutic effect. The process is known as

A

Enzyme induction

46
Q

Drugs and their metabolites are excreted from the body primarily by

A

Kidneys

47
Q

To calculate drug elimination rate blood flow to an organ and the function of drug removed from the plasma as it passes thought the organ are measures to determine drug

A

Clearance

48
Q

Drug metabolism by the liver and other organs typically creates more ________ compound this enables the compound to be ______when it reaches the nephron in the kidney

A

Polar;excreted

49
Q

The acetylcholine receptor located on the postsynaptic membrane of the skeletal neuromuscular junction is an example of a membrane receptor

A

Function as an ion channel or pore

50
Q

Some drugs affect the function of the adenylase cycles and enzyme located on the inner surface of the cell membrane. This enzyme is responsible for hydroxyzine adenosine triphoste (ATP) _____ which acts as a second messenger that activates other enzymes

A

Cyclic adenosine monophosphate

51
Q

A drug that binds readily to available receptors even if the concentration of drug is relatively low is said to have ______ for that receptor

A

High affinity

52
Q

The ability of a drug to bind to its receptor can be influenced by local chemicals such as guanine nucleotides ammonium ions and divalent cations. These local regulators are commonly known as

A

Allosteric modulator

53
Q

In constrast to an agonist a pharmacological antagonist

A

Has affinity for the receptor but lacks efficacy
Is also known as a blocker
Can be used to prevent endogenous chemicals from overstimulating the receptor

54
Q

A drug that fails to evoke a maximal response even though it occupies all available receptors is known as

A

A partial agonist

55
Q

Overstimulating of postsynaptic may lead to a decrease in responsiveness of the receptors. A fairly brief and transient decrease in receptor responsiveness is known as ______ whereas a more prolonged process in which the actual number of available receptors is diminished is known as _______

A

Desensitization; down regulation

Internal Medicine (5 decks)

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