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581 - Pharmacology I > Exam 1 - Math / Interactions / Absorption > Flashcards

Exam 1 - Math / Interactions / Absorption Flashcards

1
Q

1 pound

A

16 ounces

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2
Q

1 ton

A

2000 pounds

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3
Q

1 cup

A

8 oz

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4
Q

1 pint

A

2 cups

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5
Q

1 quart

A

2 pints

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6
Q

1 gallon

A

4 quarts

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7
Q

3 base units of metric system

A
  • length (m)
  • volume (L)
  • weight (g)
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8
Q

Order of metric bases

A 
Kilo
Hecto
Deka 
(Unit)
Deci
Centi
Milli
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9
Q

Abbreviation for micron

A

mc

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10
Q

1 kg

A

2.2 pounds

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11
Q

1 pound

A

454 grams

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12
Q

1 inch

A

2.54 cm

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13
Q

1 teaspoon

A

5 mls

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14
Q

1 tablespoon

A

15 mls

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15
Q

1 Liter

A

1.06 quarts

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16
Q

Weight volume solution

A

Solid is solute

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17
Q

Volume volume solution

A

Liquid is solute

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18
Q

ml or cc on chart?

A
  • mL
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19
Q

gtt

A

Drops

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20
Q

Types of syringe tips

A
  • lure lock
  • slip
  • eccentric
  • catheter
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21
Q

Macrodrip

A
  • fast infusion
  • fluid resuscitation
  • drug bolus
  • potential for overdose
  • bad for titration
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22
Q

Microdrip

A
  • good for titration
  • avoids overdose
  • no resuscitation
  • bad for large bolus
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23
Q

Isotonic solution

A
  • 0.9 NaCl

- 5% Dex

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24
Q

Naming of drugs

A
  • Brand name = Advil
  • Generic name = Ibuprofen
  • Chemical name = blah blah blah
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25
Q

Indications / Usage

A
  • FDA-approved

- reasons why you would take drug

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26
Q

Contradictions

A
  • warnings
  • who should not take drug
  • when you shouldn’t take drug
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27
Q

Drug interactions happen when:

A
  • combo therapy is preferable/necessary to produce effect
  • single pathology may have multiple symptoms
  • may suffer from more than one pathology
  • modification of drug effect when given with another drug
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28
Q

Beneficial drug interaction

A
  • drug combo therapy
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29
Q

Harmful drug interaction

A
  • adverse side effects
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30
Q

Addictive interactions

A
  • Adds two drug effects for overall greater effect

- doubling up

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31
Q

Synergistic drug interactions

A
  • bad if used together

- too much effect (overkill)

32
Q

Potentiation drug interactions

A
  • one drug increases the response of another drug, which normally has lesser effect
33
Q

Adverse drug reactions (ADR)

A
  • unintended side effects
  • 5% of hospitalization
  • tremors / bronchospasm / headache / vomiting / etc
  • Not all ADRs are allergies
34
Q

Drug allergy

A
  • immune mediated
  • induce hypersensitivity rxn
  • mild hives to anaphylactic shock
  • one example of an ADR
35
Q

Pharmacokinetics

A
  • what body does to a drug
  • Absorption (input)
    • move from admin site to plasma
    • rate limiting is how fast it is dissolved
    • Small / non polar / lipophillic will go through
  • Distribution
    • dissemination of drug through body
    • bloodstream is major vehicle
    • influenced by flow / solubility / protein binding
  • Metabolism
    • transformation into secondary components (metabolites)
    • preparing drug for elimination…more water soluble
    • performed by liver… cytochrome P-450 enzyme systems
  • Elimination (output)
    • removal via urine, bile, feces
    • also via pulmonary, skin, hair, saliva, and expiration
36
Q

Pharmacodynamics

A
  • what the drug does to the body
37
Q

Routes of administration

A
  • determined by property of drug
    • solubility
    • ionization
  • how fast we want it to act
  • need for long term treatment
  • if need to restrict to local site
38
Q

Enteral

A
  • through digestive tract
  • usually through mouth
  • most common / safest / convenient / economical
39
Q

Parenteral

A
  • through outside of digestive tract directly into circulation
  • IV / IM / SC
  • Good:
    • drugs poorly absorbed via GI
    • patients who can’t take oral drugs
    • need rapid onset
    • highest bioavailability
    • most control over dosage
  • Bad:
    • irreversible
    • cause pain and fear
    • local tissue damage
    • infections
40
Q

Sublingual

A
  • under tongue
  • bypass GI
  • rapid absorption
41
Q

Buccal

A
  • Between gums and cheek
  • directly into circulation
  • bypass GI
  • rapid absorption
42
Q

Oral administration

A
  • easily self administered
  • antidote for overdose
  • low stomach pH inactivated some drugs
    • can use enteric coating to get to small intestine
    • enteric coating good for acid unstable drugs
  • most complicated absorption
43
Q

Extended release prep

A
  • special coatings or ingredients that control release
  • slow absorption
  • prolonged duration of action
  • less frequent dose (improved compliance)
  • useful for short half lives
44
Q

IV

A
  • drug into vein
  • most common parenteral route
  • rapid effect / max control
    Bad:
    • infection
    • hemolysis
    • no drug recall
    • ADRs
45
Q

IM

A
  • directly into muscle
  • aqueous solutions absorbed fast
  • specialized depot preps
46
Q

SC

A
  • into subcutaneous tissue of skin
  • via diffusion
  • slower drug onset vs IV
  • constant, slow, sustained effects
  • insulin
47
Q

Oral / Nasal

A
  • airways and lungs
  • rapid delivery
  • patients with respiratory disorders
  • direct delivery to site of action
48
Q

Intrathecal / Intraventricular

A
  • into cerebrospinal fluid
  • rapid delivery
  • good if need to bypass blood-brain barrier
  • epidural / antibiotics for meningitis
49
Q

Topical

A
  • onto skin
  • good for local effect
  • acne
50
Q

Transdermal

A
  • via the skin
  • gets into systemic circulation
  • control rate of absorption
  • sustained delivery
  • patches
51
Q

Rectal

A
  • via rectum
  • avoid stomach acid
  • good to avoid vomiting
  • Bad:
    • erratic and variable absorption
    • irritate rectum
    • not well accepted route
52
Q

Rate of absorption depends on:

A
  • environment
  • chemical characteristics of drug
  • route of admin
53
Q

Oral cavity

A
  • slightly acidic
  • thin epithelium / high vascularity
  • bypass hepatic system (no 1st pass)
54
Q

Stomach

A
  • very acidic
  • folds increase SA
  • no absorption
  • just digestion
55
Q

Small Intestine

A
  • site of absorption

- deep folds with villi and microvilli

56
Q

Large intestine

A
  • little absorption (just water and Na)

- bypass hepatic system

57
Q

Absorption mechanisms from GI

A
  • Passive (aqueous or lipid)
  • Facilitated
  • Active
  • Endo/Exocytosis
58
Q

Passive diffusion

A
  • most common mechanism for drugs
  • [ ] gradient is driving force
  • not saturable
  • low specificity
  • through aqueous channel pore or lipid membrane
59
Q

Fick’s law

A
  • applies to aqueous and lipid

- Net diffusion = (area)([ ] gradient) / thickness of membrane

60
Q

Facilitated diffusion

A
  • via transmembrane carrier proteins
  • conformational change allows passage
  • high [ ] to low [ ]
  • no energy
  • saturable
  • inhibited by competitors
61
Q

Active transport

A
  • drugs that resemble natural metabolites
  • energy dependent
  • against gradient
  • saturable
  • selective
  • competitively inhibited
62
Q

Endo and Exocytosis

A
  • for large molecules across membrane

- in or out

63
Q

Factors that influence absorption

A
  • pH
  • Blood flow (direct)
    • intestine gets more flow so intestine is favored
    • in shock… low skin flow makes SC absorption poor
  • Surface area (direct)
    • intestines have 1000x greater than stomach
  • Contact time
    • Stomach…slow emptying = decrease absorption
    • intestine… slow transit time = better absorption
  • P-glycoproteins
    • transmembrane transport protein that pumps out drugs
    • reduces drug absorption
    • liver / kidneys / placenta / intestines / brain
64
Q

Acidic drugs

A

HA H+ + A-

  • release a proton
  • HA is drug
  • acidic environment shifts rxn left
  • acidic drugs more soluble in acidic pH and visa versa
65
Q

Basic drugs

A

BH+ B + H+

  • accept protons
  • B is drug
  • basic environment shifts rxn right
66
Q

Low pKa

A
  • more acidic drug is
67
Q

High pKa

A
  • more basic drug is
68
Q

pH < pKa

A
  • protonated form dominates

- HA and BH+

69
Q

pH > pKa

A
  • deprotonated form dominates

- A- and B

70
Q

Clinical application of pH of drugs

A
  • can trap in urine by ionizing them
  • acidic drugs excreted faster in basic urine
  • basic drugs excreted faster in acidic urine
  • can also trap drugs in:
    • stomach
    • small intestine
    • breast milk
    • aqueous humor
    • vaginal/prostatic secretions
71
Q

Bioavailability

A
  • fraction of drug unchanged following administration
  • important foe calculating drug dosages for non-IV
  • determined by:
    • compare plasma levels of drug after IV admin
    • compare plasma levels of drug after non-IV admin
    • Area under curve is extent of absorption
    • %BioComp. = AUC oral / AUC IV
72
Q

Factors that influence bioavailability

A
  • 1st pass hepatic metabolism
    • decreases absorption if goes through 1st pass
  • solubility of drug
    • hydrophilic poorly absorbed
    • extremely lipophilic also poor
    • ideal is weak acid / weak base
  • chemical instability of drug
    • pH of stomach can lead to this
    • Degradative enzymes in GI tract too (like on insulin)
  • nature of drug formulation
    • particle size
    • salt form
    • enteric coatings
    • binders and dispersing agents
73
Q

Drug pathway

A
  • 1st dissolved

- 2nd absorbed

74
Q

Bioequivalence

A
  • comparable:
    • Bioavailability
    • Time to peak [ ]
75
Q

Pharmaceutical equivalence

A
  • Bioequivalent but also:
  • same amount of active drug
  • same dose
  • same admin route
76
Q

Therapeutic equivalence

A
  • Bioequivalent
  • Pharmaceutically equivalent but also:
  • Comparable:
    • clinical effect
    • safety profile
  • These are generic drugs

581 - Pharmacology I (6 decks)

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