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PAS 532 Practical Therapeutics 1 > introduction > Flashcards

introduction Flashcards

1
Q

pharmacology

A

study of how drugs act on the body and how the body responds to the drugs-includes actions, mechanisms, uses and adverse effects of drugs

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2
Q

pharmokinetics

A

absorption, distribution, metabolism, and excretion

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3
Q

mechanism of action

A

the detailed interaction with a specific site in the body to describe how a drug produces an affect in the body

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4
Q

pharmacodynamics

A

the body’s physiologic response to a drugr

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5
Q

absorption

A

movement of a drug from its site of administration into the blood-enteral (oral/GI tract) and parenteral (injection) or other routes

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6
Q

distribution

A

drug movement from the blood to the interstitial space of tissues and from there into cells

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7
Q

distribution is impacted by

A

blood flow, ability of drug to exit vascular system, and ability of drug to be absorbed by cells

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8
Q

volume of distribution

A

proportion constant that estimates the total amount of drug in the body to the plasma concentration at any given time
VD=amount of drug in body/plasma concentration of drug

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9
Q

drugs with high VD have greater

A

extravascular concentrations

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10
Q

metabolism

A

break down by liver enzymes or other enzymatic processes; metabolites may be the active drug or can be harmful if built up in the body

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11
Q

excretion

A

primarily refers to renal excretion, but can be fecal, breast milk, sweat, or other means for the drug of active drug metabolites to exit the body

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12
Q

intravenous (IV) absorption pattern

A

instantaneous

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13
Q

intravenous (IV) advantages

A

rapid onset –> ideal for emergencies
precise control over drug levels
permits use of large fluid volumes
permits use of irritant drugs

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14
Q

intravenous (IV) disadvantages

A

irreversible
expensive
inconvenient
difficult to do–>not suitable for self-administration
risk of fluid overload, infection, embolism
drug must be water soluble

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15
Q

intramuscular (IM) barriers to absorption

A

capillary wall-easy to pass

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16
Q

intravenous (IV) barriers to absorption

A

none

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17
Q

intramuscular (IM) absorption pattern

A

rapid with water-soluble drugs

slow with poorly soluble drugs

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18
Q

intramuscular (IM) advantages

A

permits use of poorly soluble drugs

permits use of depot preparations

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19
Q

intramuscular (IM) disadvantages

A

possible discomfort
inconvenient
potential for injury

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20
Q

subcutaneous (subQ) barriers to absorption

A

capillary wall-easy to pass

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21
Q

subcutaneous (subQ) absorption pattern

A

rapid with water-soluble drugs

slow with poorly soluble drugs

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22
Q

subcutaneous (subQ) advantages

A

permits use of poorly soluble drugs

permits use of depot preparations

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23
Q

subcutaneous (subQ) disadvantages

A

possible discomfort
inconvenient
potential for injury

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24
Q

oral (PO) barriers to absorption

A

epithelial lining of GI tract

capillary wall

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25
oral (PO) absorption pattern
slow and variable
26
Oral (PO) advantages
``` easy convenient inexpensive ideal for self-medication potentially reversible-->safer than parenteral routes ```
27
oral (PO) disadvantages
variability possible nausea/vomiting from local irritation patient must be conscious and cooperative inactivation of some drugs by gastric acid/digestive enzymes
28
most metabolism takes place in the
liver
29
most metabolism is performed by
a group of enzymes called cytochrome P450 system or CYP P450
30
cytochrome P450 System (CYP P450)
a group of 12 closely related enzyme families | each family is further designated to identify key individual enzymes
31
what are the 3 CYP families responsible for metabolizing drugs?
CYP1, CYP2, CYP3
32
metabolism can result in
metabolism can result in
33
first-pass effect
rapid hepatic inactivation of certain drugs upon oral absorption and "first pass" through the liver
34
half-life
the amount of time it takes for 50% of the drug to be eliminated (renally, liver metabolism, or other forms of excretion-often a combination)
35
the 3 big characteristics of the ideal drug
effective safe-often can be a risk vs. benefit discussion selectivity-limited side effects/ADRs/ADEs
36
additional desirable properties of the ideal drug
``` reversible action predictability ease of administration limited drug interactions low cost reasonable chemical stability ```
37
agonist
stimulates a particular receptor
38
antagonist
blocks a particular receptor
39
competitive inhibition
the antagonist must have a stronger affinity for the receptor than the agonist
40
non-competitive inhibition
irreversibly binds
41
partial agonist
only partially activates the receptor-prevents a ceiling effect
42
enzyme inhibitor
blocks a particular enzyme crucial in a biologic pathway
43
dose-response relationship determines
minimum amount of drug to elicit a response maximum response that can be elicited dosage to produce desired increase in response
44
maximal efficacy
maximum response a drug can elicit
45
potency
the amount of drug we must give to elicit a response
46
drug interactions
occur when two or more drugs change the therapeutic effect (increase or decrease) OR lead to adverse events can be a result of multiple drugs that treat the same condition or treating multiple conditions with different drug classes at times is due to changes in hepatic enzyme activity
47
CYP 3A4 inducers cause CYP 3A4 enzymes to
metabolize more than usual-->decreases therapeutic effect
48
CYP 3A4 inhibitors cause CYP 3A4 enzymes to
metabolize less than usual-->increases risk of side effects and increases therapeutic effect, at times to toxicity
49
minimizing drug interactions
limit the number of drugs a patient is on obtain a thorough medication history tailoring specific drug therapy to reduce adverse interactions
50
tailoring specific drug therapy to reduce adverse interactions
adjust doses in the presence of inducers/inhibitors adjust timing of administration to minimize interference with absorption monitoring more closely in additive or known agents that have drug interactions extra caution when a patient is on a drug with a known narrow therapeutic range
51
grapefruit juice
CYP 3A4 inhibitor-increases blood level of drugs
52
adverse drug reactions
any noxious, unintended, and undesired effect that occurs at normal drug doses
53
allergic reaction/anaphylaxis
more common with some classes of agents-all drugs have a listed 'contraindication for those allergic to agent or agents similar in structure'
54
other common ADRs
``` idiosyncratic carcinogenic teratogenic (birth defect inducing) hepatotoxic nephrotoxic QT interval prolonging drugs ```
55
idiosyncratic ADR
uncommon drug response resulting from genetic predisposition
56
medication guides
FDA approved patient education documents with information on how to minimize harm from potentially dangerous drugs-required for certain drugs (including sample dispensing)
57
US boxed warnings
strongest safety warning a drug can carry and still remain on the market-vitally important to adhere to and understand
58
Risk Evaluation and Mitigation Strategies (REMS)
a plan or program to minimize drug induced harm
59
practical therapeutics
the treatments used to treat or prevent a particular disease combination of pharmacology, pharmacokinetics, pharmacodynamics, DDIs, ADRs, and individual variation in addition to the clinical literature and the expert clinical guidelines
60
last-line agents are reserved for patients with specific criteria
significant ADRs, multiple treatment failures, or other extenuating circumstances

PAS 532 Practical Therapeutics 1 (4 decks)

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