General Principles of Pharmacology

Question 1

What are the routes of administration?

Answer 1

Parenteral: Injection
Enteral: oral ingestion

Question 2

What are the Phases of drug effect?

Answer 2

1) Pharmaceutical phase: how a drug progresses from solid to dissolved. Only applies to oral drugs
2) Pharmacokinetic phase: effect of drug on body. Subphases include absorption, distribution, metabolism, excretion

Question 3

What is passive and active absorption?

Answer 3

Passive: diffusion. No energy required
Active: involves a carrier such as a protein which will need energy

Question 4

What is pinocytosis?

Answer 4

When cells engulf a drug to move it across a cell membrane

Question 5

What factors affect drug absorption?

Answer 5

Drug pH, local blood flow to GI tract, hunger, food content in GI tract

Question 6

Why are drugs administered intramuscularly take up more readily?

Answer 6

Because of the number of surrounding blood vessels

Question 7

What affects the process of tissues absorbing the dissolved drug?

Answer 7

The concentration of the drug, the flow of blood to the tissue, percentage of drug bind to the protein

Question 8

What happens when a drug binds to a protein?

Answer 8

They are inactive in terms of creating a pharmacological response. The drugs bind to the protein at either a high, moderately high, moderate, or low level

Question 9

What is biotransformation? Where does it occur?

Answer 9

Metabolism. It happens in the liver (mainly) where drugs are inactive due to the enzymes in the liver. This is where it becomes excreted
Note that MOST drugs are inactive in the liver

Question 10

For the few drugs, CAN drug action happen in the liver? How?

Answer 10

It can but it happens sometimes the enzymatic actions that occur on a drug can produce an active metabolite that makes the drug response more noticeable

Question 11

What happens to the drug that’s not bound to protein, or active and exerts its effect?

Answer 11

The unbound drug are metabolized in liver and other tissues

Question 12

What is half life?

Answer 12

Time it takes for 1/2 a drug concentration to be eliminated

Question 13

Why is it important to know the half life of a drug?

Answer 13

So that we how long it will take for the drug to reach a stable concentration in the blood

Question 14

You have drugs in your system and they’re bound to be excreted. What factors into the excretion of these drugs?

Answer 14

Bile, feces, saliva, sweat, urine

Question 15

For any drugs that are in your blood plasma and NOT bound to a protein, where do they go?

Answer 15

To the kidneys to be filtered and excreted

Question 16

Kidneys are pretty good at filtering but is there anything that can affect the filtration?

Answer 16

Disease or any disorder that affects renal tubular secretion. There are also diseases that decrease blood flow to kidneys. Kidneys need the right amount of blood flow to function well

Question 17

What are transdermal medications and examples?

Answer 17

Transdermal medications are medications that go on your skin. Example: nicotine patch

Question 18

How do transdermal medications work?

Answer 18

You put the patch on your skin, you exercise to increase blood flow to the skin, and the drug gets absorbed

Question 19

Are there any side effects to transdermal medications in conjunction with exercise?

Answer 19

Drug related side effects can increase. Side effects include nausea and palpitations

Question 20

What is insulin glargine?

Answer 20

Man made insulin

Question 21

Is having too much insulin bad? Give an example of when it is bad.

Answer 21

Too much insulin causes cells to absorb too much glucose in the body and causes the liver to produce less glucose. (liver can produce and store glucose)
Example: exogenous insulin injected into thigh and then working out increased insulin absorption

Question 22

What is one downside of exercise while having drugs in your system?

Answer 22

One downside is that exercise can synthesize certain proteins, which means that more drugs can bind to the proteins thus making them inactive. This means you might have to give more of the drug to increase the effectiveness

Question 23

What is the mechanism of action?

Answer 23

Mechanism of action is when a drug produces an effect or alteration at it’s target cells

Question 24

How do we know what protein receptor the drug can be received by?

Answer 24

We know as certain drugs have a high affinity for a particular or active part of cell. A receptor is a keyhole and you need a certain drug to fit in to produce a response

Question 25

What is the agonist? What is an antagonist?

Answer 25

An agonist is a drug that combines w/ the receptor and leads to changes
An antagonist is a drug that interferes or counters the agonist action

Question 26

What is a competitive antagonist? What’s an example?

Answer 26

Antagonist agent that fights agonist for same receptor it wants to bind with. This prevents mechanism of action from happening
Example: Beta blocker taken in will block beta-1-receptor in cardiac cells. This is to slow down HR and decrease heart contractions

Question 27

Will agonists and antagonists produce the same effect for every receptor they go into?

Answer 27

No. The effects vary by location of the receptor in the body
Example: cholinergic receptors react with acetylcholine in the salivary gland will produce more saliva but the same reaction somewhere else can slow HR or constrict pupils

Question 28

How do enzymes affect drug and protein receptor interaction?

Answer 28

Enzymes control biochemical reactions and so it can bind to certain drugs to prevent a reaction from happening

Question 29

What is the therapeutic index?

Answer 29

It’s a term to describe the relative safety of a drug. It is the ratio b/n toxic dose and effective dose
Represented by TD50 and ED50, the 50 meaning 50% of humans tested and dose of a drug needed to be effective in 50% of like population

Question 30

In the therapeutic index, what do the numbers mean from 1-50

Answer 30

1-50 is the range of toxicity. The lower the number, the greater the toxicity

Question 31

How can exercise increase drug side effects?

Answer 31

There are parallel physiological pathways leading to similar outcomes which can cause side effects to worsen
Example: antihypertensive agents to lower blood glucose in diabetes patients. Exercise can lower BP after exercise and lower blood glucose during and after exercise which can lead to negative drug response

Question 32

What factors affect drug response?

Answer 32

Age: older you get, less the response. May need to give more drugs which in turn can affect drug efficacy or lead to side effects
Body mass: fatter you are, the more you need to up the concentration
Sex: women are smaller. Also includes pregnancy and lactation. Women are also fatter soooo
Other factors: time drug is given, existence of diseases, genetics, mood, mental state, environment, how much food you got in your stomach

Question 33

What happens if the patient misses a dose? (110)

Answer 33

Don’t take more to “make up” for the last time. Just follow what they were told