Clinical Pharmo Lect 1

Question 1

whats different about clinical pharmo?

Answer 1

take principles (that apply to any organism) and apply specifically to humans

Question 2

what is therapeutics?

Answer 2

rests on clinical pharmo
2nd step
the art of treatment - rather than hard science

Question 3

teratogenic means:

Answer 3

malformations in unborn kid

Question 4

what should we remember when drugging?

Answer 4

every patient is unique (even in normal)
drug and regime need to be tailored

e.g. age, weight, sex, pregnancy history etc. skinny cause they’re anorexic or they run 20kms

Question 5

what’s pharmacodynamic?

Answer 5

study of how it works

and the description of the mechanism of particular drug

Question 6

what’s pharmacokinetics?

Answer 6

how the body handles a particular drug

Question 7

what’s pharmacogenetics? (this is least embraced)

Answer 7

enzyme and proteins and how they change the effect of drug - in terms of how and where

Question 8

3 terms for pharmocokiniteics

Answer 8

clearance
volume of distribution
half life of elimination (different to half life of effect)

Question 9

what influences half life

Answer 9

a

Question 10

why do we need clearance

Answer 10

maintenance dose

Question 11

why need volume of distribution

Answer 11

loading dose

Question 12

why half-life

Answer 12

dosing interval

Question 13

what does area under curve mean

Answer 13

a

Question 14

what is clearance

Answer 14

vol of plasma or blood cleared - from which drug is completely removed, per unit time

this is not a biological reality, mere calculations

this is (L/h), but can be different

Question 15

maintenance dose

Answer 15

dose rate need to maintain plasma conc in equilibrium

equi is steady state

Question 16

what the volume of distribution

Answer 16

total vol of plasma if drugs only dissolved in water…

usually mg/L

Question 17

whats half life of elimination

Answer 17

conc of drug in plasma or drug at time A, keep measuring until it falls by half

gives time course of elimination, and accumulation
can give dosing interval

Question 18

whats biavailability

Answer 18

fraction of given dose of drug, which reaches systemic circulation

amounts of drug that gets into blood that can be measured, nothing on required site etc.

if required site in behind some barrier - does not tell anything

this is the acceptable technique to measure how drug is in the body - can’t open someones brain up to check

Question 19

parenteral?

Answer 19

= 100%

Question 20

orally?

Answer 20

depends

Question 21

what are drug transporters, what are their roles

Answer 21

membrane (of individual cells) efflux pumps

limiting absorption from the gut
blood-brain barrier
protects testes, ovaries, adrenal cortex
excretion liver and kidney
protects feotus

Question 22

p-glycoprotein

Answer 22

this is a member of ABC cassette transport protein

Question 23

MDR gene

Answer 23

drug resistance, gene switched on, and making p-glycoprotein

blocking gene
or make more

Question 24

drug metabolism

Answer 24

this eliminates drugs
make highly lipid soluble more water soluble

e.g. cytochrome P450 2D6

Question 25

where is the most used age range of clinical trials?

Answer 25

18-60

Question 26

what happens when you get older

Answer 26

kidney
liver
brain
all go downhill

these could affect drug interactions

Question 27

what are the physiological changes of importance when drugging

Answer 27

age

pregnancy

Question 28

what about pathological things to look out for in the liver

Answer 28

primary - decrease in enzyme capacity
-change in blood flow, leading to decreased drug transporters

secondary - bilirubin
circulating proteins will decrease

Question 29

what about the kidney

Answer 29

both primary and secondary conseuences

Question 30

conjugated drugs?

Answer 30

this mean its processed to make it more water soluble