Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm > Lecture 4 > Flashcards

Lecture 4 Flashcards

1
Q

What is the fraction of administered drug that reaches systemic circulation following administration by any route?

A

Bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are three things that influence bioavailability?

A

1st pass hepatic metabolism
Solubility
Stability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is drug concentration measured?

A

In the plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What three things affect drug distribution into the tissue?

A

o Blood Flow
o Capillary permeability (ex- BBB)
o Drug structure (hydrophobic, hydrophillic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is volume of distribution?

A

Dose/ concentration of drug in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does a high volume of distribution mean?

A

Drugs distribute really well into the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

When a drug is bound to a protein is it active?

A

No, it is inactive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an example of a major protein that acidic drugs can bind to?

A

Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What route of administration avoids the blood brain barrier?

A

Intrathecal route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What type substances diffuse easily across the blood brain barrier?

A

Lipid-soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the fastest equilibrium b/w mother and fetus?

A

40 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What material move easily across the placenta?

A

Lipid-soluble

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where does most drug elimination take place?

A

Kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the disappearance of a drug when it is changed chemically into another compound?

A

Metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What type of drugs can kidneys not eliminate?

A

lipophilic drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What ability have neonates not fully developed?

A

Conjugation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is responsible for conjugating biliruben?

A

UDP-glucuronyl transferase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What competitively inhibits p450 enzyme?

A

Ketaconazole (binds to this instead of medication it should metabolize)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What drug permanently inactivates p450?

A

secobarbitol alkylates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

These drugs do what to P450? Cimetidine, ciprofloxacin, erythromycin, ketoconazole, OCPs, quinidine, ETOH

A

Inhibit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

These drugs do what to P450? Barbituates, phenytoin, steroids, isoniazid, rifampin, ETOH

A

Induce (increase metabolization)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What type drugs move easily across membranes?

A

Hydrophobic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What protein do acidic drugs bind to?

A

Albumin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What protein do basic drugs bind to?

A

Alpha 1-acid glycoprotein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

When you don’t want a drug to act on the brain should you use a water-soluble drug or a lipid-soluble drug?

A

Water-soluble as it can’t pass the BBB (ionized molecules also can’t pass this barrier)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the name of a drug that is administered in an inactive form and is then activated by metabolism?

A

Prodrugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Phase I of drug metabolism involved the ______ system.

A

Cytochrome P450 system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Whatare are P450 isozymes located?

A

In most cells but mainly liver and intestinal tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the primary families in the P450 system?

A

CYP1, CYP2, and CYP3 families

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is involved in phase II of drug metabolism?

A

Conjugation with 2nd endogenous substrate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Monoamine oxidase (MAO) involved the oxidation of catecholamines and tyramine. Does it use the P450 pathway?

A

No, it utilizes a different pathway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Small doses of what drug help treat jaundice as they upregulate the expression of UDPGT.

A

Phenobarbital

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Proximal tubular secretion involved in renal elimination of a drug is a _____ process

A

active

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Where are all of these eliminated? PCN, cephalosporins, salicylates, thiazides, “loop” diuretics, sulfonamides, lactic acid, uric acid

A

Proximal tubular secretions

35
Q

What type of drugs can’t be reabsorbed?

A

Ionized drugs

36
Q

What should you do to enhance the elimination of weak bases?

A

Acidify the urine with ammonium chloride

37
Q

What should you do the enhance the elimination of weak acids?

A

Alkalinize the urine with sodium bicarbonate

38
Q

What are 5 routes of elimination

A 
Renal
Biliary secretion and enterohepatic cycling
Exhalation
Sweat 
Secretion into breast milk
39
Q

What is is the time it takes for the plasma concentration or the amount of drug in the body to be reduced by 50%

A

half life

40
Q

What makes up total body clearance?

A

Cl renal + Cl hepatic + CL other

41
Q

What is non-linear kinetics where a constant amount of drug is metabolized per unit time

A

zero-order kinetics

42
Q

What is drugs catalyzed by enzymes and follows Michaelis-Menten kinetics

A

1st order kinetics

43
Q

In first order kinetics, the rate of metabolism is directly proportional to the ______

A

concentration of free drug

44
Q

What is when drug levels in blood when input= output?

A

Steady-state drug levels

45
Q

Steady state is about how may 1/2 lives?

A

4-5

46
Q

A loading dose is administered to achieve what?

A

Rapid plasma level

47
Q

Foods containing pyridoxine (vit B6) increases the metabolism of what drug?

A

levodopa in patient’s with Parkinson’s

48
Q

_______ can alter the urinary pH making the urine more alkaline thus increasing the proportion of non-ionized drug thus increasing reabsorption of the drug systemically.

A

Fruit juices

49
Q

A premature infant is considered less than how many weeks?

A

Less than 36 week gestational age

50
Q

A neonate is less than ____ days

A

30

51
Q

Gastric pH is _____ for the first two years of life.

A

Alkaline (improves absorption of weakly basic drugs and decreases absorption of weakly acidic drugs)

52
Q

Neonates in the first 24 hours of life have what?

A

Decrease gastric emptying
increased gastroesophageal reflux
irregular peristalsis
increased absorption size of duodenum

53
Q

Rectal absorption avoids what effect?

A

1st pass effect (drug absorbed by the hemorrhoidal veins which aren’t part of the portal circulation)

54
Q

Peds have lower ________ _________ __________ creating larger volume of distribution and increased free drug concentrations.

A

Plasma protein binding

55
Q

What drug could lead to gray baby syndrome?

A

Chloramphenicol

56
Q

When does GFR approach adult rates?

A

2 years

57
Q

When do tubular secretion and absorption reach adult rates?

A

5-7 months

58
Q

Injections are limited to how mLs in peds?

A

2 mL

59
Q

Elderly patients have decreased what affect?

A

First pass effect

60
Q

elderly have higher ___________ of these drugs- digoxin, warfarin, theophylline)

A

bioavailability

61
Q

Elderly will have an increased rate of absorption of ______ medications due to loss of subQ fat.

A

topical

62
Q

Are serum albumin levels altered in the majority of elderly?

A

No, unless they are severely malnourished or have advanced chronic disease

63
Q

What is the preferred drug pathway for geriatric patients?

A

Phase II (conjugation)

64
Q

After age 40, GFR decreases ____ to _____ % for every decade of life.

A

6-10%

65
Q

Why may geriatric patients have an artificially lowered BUN?

A

Inadequate protein intake

66
Q

Why may geriatric patients have an artificially lowered creatinine and not altered renal clearance?

A

Diminished muscle mass

67
Q

What type of antibiotics have poor absorption from the GI tract so they must be administered via a parenteral route?

A

Aminoglycosidae antibiotics

68
Q

What weight should be used for dosing of aminoglycoside antibiotics?

A

IBW or adjusted body weight

69
Q

almost all of the clearance of aminoglycoside antibiotics occurs where?

A

Renal

70
Q

What drugs inactive aminoglycosides invitro (clinically significant in patients w/ renal failure)

A

Extended-spectrum penicillin

71
Q

What is the normal 1/2 life for aminoglycoside antibiotics? what about for a dialysis patient?

A

2-3 hours

dialysis- 30-60 hours

72
Q

What is an aminoglycoside antibiotic that is given orally?

A

Neomycin (Gi infections)

73
Q

When do you want to take a peak sample?

A

1 hour after the end of the infusion

74
Q

When do you want to take a trough sample?

A

1/2 before next dose

75
Q

What drug is poorly absorbed orally but is useful in the treatment of C. difficile w/ the PO route.

A

Vancomycin

76
Q

When is the only time vancomycin will get into the meningeal system?

A

With inflamed meninges

77
Q

Clearance of vancomycin approximates what clearance?

A

Creatinine

78
Q

Vancomycin may increase levels/ effects of what drugs?

A

Aminoglycosides

79
Q

This drug is a P450 inducer, highly protein bound, has slow absorption from the oral route and goes into zero order kinetics?

A

Phenytoin

80
Q

In an acute setting how often should levels of phenytoin be monitored?

A

2-3 days after therapy initiation and another 3-5 days after

81
Q

Stable patients should have their phenytoin levels monitored how often?

A

At 3-12 month intervals

82
Q

What are some signs of phenytoin toxicity?

A 
Drowsiness fatigue
lateral nystagmus
ataxia, slurred speech
sever confusion
seizures, death
83
Q

What is a more soluble ester of phenytoin and can be administered IM?

A

Fosphenytoin (doesn’t use propylene glycol)

84
Q

What is the diluent in phenytoin IV that has cardiac depressant properties?

A

Propylene glycol (anti- freeze)

Pharm (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions