EXAM 1 Material Only Week 1

Question 1

Pharmacokinetics

Answer 1

ADME of drugs

Question 2

Absorption

Answer 2

Route of administration to body

Question 3

Routes of Administration

Answer 3

IV, PO, Sublingual, Topical, Opthalmic, Rectal

Question 4

Bioavailability

Answer 4

Amount of drug available after absorption/metabolism to produce an active effect

Question 5

Which routes avoid first-pass effect

Answer 5

Iv, Sublingual, Buccal, and Rectal

Question 6

Distribution

Answer 6

Process of drug movement through the body

Question 7

Distribution dependant on

Answer 7

Size, Charge, and structure

Question 8

Drugs can passively diffuse when

Answer 8

Small and uncharged

Question 9

Weak acids will be trapped in

Answer 9

Basic environments

Question 10

Weak bases will be trapped in

Answer 10

Acidic environments

Question 11

Drugs bind to plasma proteins to

Answer 11

Normalize concentration in body
Bypass liver and kidney
Stay in body longer

Question 12

Plasma Protein concentration affected by

Answer 12

Malnourishment
Liver disease
MI
Stress
Infection

Question 13

Albumin

Answer 13

Major protein of blood
Normally too large to be excreted by the kidneys

Question 14

Volume of distribution

Answer 14

Dose of Drug/Plasma concentration of drug

Question 15

Metabolism

Answer 15

Process of making a drug more hydrophilic for excretion

Question 16

Phase 1 Metabolism involves what rxn

Answer 16

Reduction, Oxygenation, Hydrolysis

Question 17

Metabolism primarily occurs in

Answer 17

Smooth Endoplasmic Reticulum in liver cells but can occur throughout body

Question 18

Phase 2 Metabolism involves what rxn

Answer 18

Conjugation/Synthetic
More polar and easier to excrete

Question 19

Phase 1 Metabolism uses what main enzyme family

Answer 19

Cyp450 (Primarily CYP3A)

Question 20

Main Family and Subunits of CYP450?

Answer 20

CYP3 (CYP3A4, 5, 7)

Question 21

Phase 2 uses what main enzyme family?

Answer 21

UGT

Question 22

What are SNP

Answer 22

Single Nucleotide Polymorphisms - Minor mutations in a protein that lead to metabolic activity changes

Question 23

What is a Prodrug

Answer 23

Inactive components that need to be metabolized to become active

Question 24

Example of a Prodrug (Opioids)

Answer 24

Codeine (inactive) to Morphine (active)

Question 25

What is a Metabolite

Answer 25

Product of metabolism (Active or inactive)

Question 26

Lipophilic Drugs can/can't be excreted?

Answer 26

Can't

Question 27

Excretion

Answer 27

Removal of drugs from system

Question 28

Excretion Organs

Answer 28

Kidney, Lungs, Biliary system, Intestines Also skin, saliva, breast milk

Question 29

Metabolites must be ____ to be readily excreted by the kidneys

Answer 29

Water soluble

Question 30

Normal GFR is

Answer 30

125mL/min

Question 31

Filtration in Glomerulus dependent on

Answer 31

Molecule, Size, Charge, and % of protein binding

Question 32

Will blood/protein bound drugs be filtered out by the glomerulus?

Answer 32

No. Too Large

Question 33

Passive Diffusion is most effective for

Answer 33

Uncharged/Unionized drug

Question 34

Acidic Urine will increase excretion of ___ and is made acidic by

Answer 34

Basic drugs/metabolites, Ammonium Chloride

Question 35

Basic urine will increase excretion of ___ and is made basic by

Answer 35

Acidic drugs/metabolites Sodium Bicarb

Question 36

Tubular Reabsorption/Secretion primarily occurs in

Answer 36

Proximal tubule

Question 37

Tubular Reabsorption reabsorbs

Answer 37

Ions, Amino Acids, and Glucose

Question 38

Biliary Excretion occurs through ____

Answer 38

Liver secretions (Eg Digoxin)

Question 39

Biliary excretion enhanced by

Answer 39

Conjugated Metabolites

Question 40

Enterohepatic Cycling

Answer 40

Drug excreted in bile, reabsorbed by intestines, excreted in bile again Extends time drug remains in body

Question 41

Other sites of Excretion

Answer 41

Pulm - Volatile Ketones Saliva - Erthromycin

Question 42

Breast milk accumulates

Answer 42

Basic drugs. It's more acidic than plasma

Question 43

First Pass Effect

Answer 43

Metabolism of a drug by the liver after oral admin

Question 44

First-Order Kinetics

Answer 44

Half-Life Elimination (concentration halved each time) Med will reach peak and trough in 4-5 HL Dose to reach Css

Question 45

Zero-Order Kinetics

Answer 45

Consistent amount of med is eliminated Slower rate of removal

Question 46

Phase 1 Metabolism converts drug to

Answer 46

Metabolite (Active or Inactive) by adding polar groups Makes more hydrophilic

Question 47

SNP Variations that affect metabolism of drugs

Answer 47

Poor Metabolizer - PM Intermediate Metabolizer - IM Extensive Metabolizer - EM Ultrarapid Metabolizer - UM

Question 48

CYP3A4 works on what % of drugs

Answer 48

50%

Question 49

What is CYP450

Answer 49

Most common enzyme system for drug metabolism

Question 50

Which enzymes have the highest genetic variability

Answer 50

CYP2D6, 2C9, and 3A4

Question 51

Herbal Medications are used by what % of adults in US

Answer 51

40%

Question 52

What % of adults tell their physician about herbal use

Answer 52

33.4%

Question 53

Do herbs fall under FDA medication guidelines?

Answer 53

No, considered a food. They do package based on GMP

Question 54

Saw Palmetto (Indication)

Answer 54

Decreases symptoms of an enlarged prostate due to BPH.

Question 55

Saw Palmetto (ADR)

Answer 55

dizziness, headaches, nausea, vomiting, constipation, diarrhea, and slow clotting response have been reported.

Question 56

Saw Palmetto (Drug Interaction)

Answer 56

Anticoagulation - Use with caution or d/cM

Question 57

Melatonin

Answer 57

Hormone produced by Pineal gland in 4th stage of REM sleep. Similar action to GABA

Question 58

Melatonin consumption overtime can lead to

Answer 58

negative feedback and normal secretion

Question 59

Melatonin (MOA)

Answer 59

Produced when serotonin is broken down in the pineal gland with the help of two enzymes; arylalkylamine N-acetyl transferase (AA- NAT) and hydroxyindole-O-methyl transferase

Question 60

Melatonin (Use)

Answer 60

Induce sleep Prevent Jet Lag

Question 61

Melatonin (ADR)

Answer 61

Altered sleep patterns, confusion, headache, tachycardia, and hypothermia. Potentiates benzodiazepines and succinylcholine, thereby blocking the action making it dangerous Used long-term, can increase prolactin secretion, which can decrease luteinizing hormone, progesterone, and estradiol levels. Also resets the sleep–wake cycle and contribute to disturbed sleep cycling.

Question 62

St John's Wort (Use)

Answer 62

Depression, Mood regulation

Question 63

St John's Wort (ADR)

Answer 63

trouble sleeping, vivid dreams, restlessness, anxiety, irritability, stomach upset, fatigue, dry mouth, dizziness, headache, skin rash, diarrhea, and tingling.

Question 64

St John's Wort (Drug Interaction)

Answer 64

SSRIs, cyclosporin, birth control pills, antidepressants, some cancer and HIV medications, warfarin, oxycodone, and digoxin

Question 65

Glucosamine

Answer 65

Amino acid, stimulates chondrotinin/glucosamine production for production of cartilage

Question 66

Glucosamine (Use)

Answer 66

Osteoarthritis (comparable to celecoxib)

Question 67

Glucosamine (ADR)

Answer 67

Minor (Constipation, Diarrhea, Drowsiness, H/a, heartburn, nausea, rash)