Lecture 4: Basic Principles of Pharm IV Flashcards

1
Q

What are the purpose of biotransformation?

A
  1. drug detoxification

2. prepare drug for exretion

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2
Q

What are the sites of biotransformation?

A
  1. liver

2. anywhere else in the body

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3
Q

Hepatic Microsomal Drug Metabolizing Systems

A
  1. both phase I and II processes
  2. induction
  3. inhibition
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4
Q

Non-microsomal systems

A
  1. other organs, plasma, red cells

2. usually phase 1 (eg: acetyl cholinesterase, alcohol dhydrogenase inhibition)

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5
Q

What are phase I reactions?

A
  1. drug oxidation
  2. reduction
  3. hydrolysis
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6
Q

What is drug oxidation?

A

add oxygen or change the proportion of oxygen in the molecule, the most common metabolic transformation

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7
Q

what is phase II rxn?

A

conjugation - synthesize a new molecule by combining the drug or metabolic product of phase I with a molecule provided by the cell

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8
Q

what are the resulting molecules after phase II

A
  1. larger
  2. charged
  3. water soluble
  4. inactive
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9
Q

biotransformation is

A

one method of clearing drug from plasma, ultimately terminating the drug effect

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10
Q

alcohol and smoking induces

A

P450

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11
Q

biotransformation of toxicants

A

can have a widespread influence on drug use

  1. route of administration
  2. dose
  3. effectiveness
  4. toxicity, safety
  5. duration of effect
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12
Q

phase 2 actions mainly take place in the

A

liver

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13
Q

what happens in phase 2 rxn?

A
  1. conjugation - synthesis of a new molecule, enxymes using endogenous substrates
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14
Q

what are the 4 consequences of conjugation?

A

larger, charged, water soluble, inactive

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15
Q

chronic alcoholics with liver dz will not do

A

the glucuronide formation

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16
Q

the enzyme system may be a rate limiting step in the

A

clearance of drug from plasma
A. when metabolism is more important than renal elimination (lipid, soluble drugs)
B. Rate limiting step for clearance when enzyme is relatively slow

17
Q

if there is conc of drug is less than Km (efficient enzyme systems)

A

first order

18
Q

if the drug is saturated, the conc of drug is more than Km (inefficient enzyme systems = saturated)

A

zero order

19
Q

only free drug molecules are

A

filtered

20
Q

inhibiton

A

usually competitive

21
Q

saturation can occur at

A

therapeutic doses or with overdoses (changes primary processes to zero processes)

22
Q

drugs are reabsorbed by

A
  1. passive

2. active

23
Q

two ways to enhance renal excretion?

A
  1. forced diuresis

2. manipulate the pH or the urine - trapping of ionized drug

24
Q

alkalization (sodium bicarbonate for phenobarbital overdose) change urinary excretion by

A

4 fold to 6 fold

25
Q

clearance is

A

a combination of biotransformation and excretion

26
Q

factors that influence clearance?

A
  1. body surface area
  2. protein binding
  3. cardiac output
  4. renal function
  5. hepatic function
  6. blood flow to systemic organs