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M104 T2 > M104 T2 L14 > Flashcards

M104 T2 L14 Flashcards

1
Q

What are the six rights of prescribing?

A 
Right patient
Right drug
Right route
Right dose
Right time
Right outcome
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2
Q

What is Pharmacokinetics about as a medical student?

A

it’s about relating its principles to clinical applications

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3
Q

What does having a knowledge of Pharmacodynamics help with?

A

the safe and effective use of medicines
working out the optimal dosage regimen
predicting potential drug interactions

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4
Q

How is the optimal dosage regimen worked out?

A

dose, route
dose interval
duration of treatment

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5
Q

What are the four subheadings of Pharmacokinetics? (ADME)

A

Absorption
Distribution
Metabolism
Excretion

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6
Q

Where does absorption of a drug take place normally?

A

a receptor site

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7
Q

What are the two types of routes for drug administration?

A

Enteral and Parenteral

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8
Q

What are the two routes of enteral drug administration?

A

Oral

Rectal

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9
Q

What are the two routes of parenteral drug administration?

A

Sublingual

Buccal

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10
Q

What happens to drugs administered buccally?

A

they are held or applied in the buccal area
they diffuse through the oral mucosa
they then enter directly into the bloodstream

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11
Q

What happens to drugs administered sublingually?

A

the drug is held under the tongue to dissolve

it is absorbed into the blood through the mucal membrane tissue there

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12
Q

What factors influence enteral absorption?

A 
GI motility
Absorptive area
GI blood flow
Drug properties
Drug physicochemical properties
Drug binding
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13
Q

How does rapid GI motility influence enteral absorption?

A

rapid GI motility means that there’s not enough time for the drug to maintain contact with the GI system
AAR it is not properly absorbed (fully)

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14
Q

How does inflammation influence enteral absorption?

A

it lowers the absorptive area available for the drug

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15
Q

How does GI blood flow influence enteral absorption?

A

lack of / suboptimal blood flow results in lowered absorption rates

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16
Q

What are two properties of drugs being absorbed?

A

particle size and formulation

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17
Q

How does drug binding influence enteral absorption?

A

the drug needs to be able to bind to cells in the GI system if it is going to be absorbed

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18
Q

What are examples of drug physicochemical properties that influence enteral absorption?

A

solubility

pH

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19
Q

How does solubility of drugs influence enteral absorption?

A

more lipid soluble, increased absorption

less more water soluble, decreased absorption

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20
Q

How does drug pH influence enteral absorption?

A

acidic drugs are better absorbed in acidic media

basic drugs are better absorbed in basic media

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21
Q

What types of molecules are not lipid soluble?

A

hydrophilic, polar or ionized mlcs, e.g. Na+, K+

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22
Q

What types of molecules are water soluble?

A

hydrophilic, polar or ionized mlcs, e.g. Na+, K+

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23
Q

Where are acidic drugs better absorbed?

A

in the stomach, e.g. aspirin

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24
Q

Where are basic drugs better absorbed?

A

in the intestines

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25
Q

Where are acidic drugs better absorbed?

A

in the acidic media

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26
Q

Where are acidic drugs better excreted?

A

in the basic media

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27
Q

Where are basic drugs better absorbed?

A

in the basic media

28
Q

Where are basic drugs better excreted?

A

in acidic media

29
Q

In what tissue layer are vaccines administered into?

A

vaccines

30
Q

What are less common routes of drug administration?

A

Topical
Transdermal
Inhalational
Intrathecal

31
Q

What are the more common tissue layers for drug administration?

A

subcutaneous

intradermal, intramuscular, intravenous

32
Q

What are the less common tissue layers for drug administration?

A

Topical
Transdermal
Inhalational
Intrathecal

33
Q

Between what levels is ideal dosing of a drug achieved?

A

below the MTC but above the MEC

34
Q

Is 250mg of paracetamol four times a day optimal?

A

no because it is below the MEC so it’ll be ineffective

35
Q

Is 3g of paracetamol four times a day optimal?

A

no because it is above the MTC so it could be dangerous

36
Q

What are the pharmacokinetic concepts?

A 
Absorption
First-pass (pre-systemic metabolism)
Bioavailability
Bioequivalence 
Volume of distribution
Cytochrome P450 enzyme system
Half-life
Steady state
Clearance
37
Q

What is the maximum dosage of paracetamol four times a day?

A

8x 500mg tablets a day

38
Q

Will Crohn’s disease change the effectiveness of a contraceptive oral pill taken on a daily basis?

A

yes bc crohns can impair absorption

39
Q

What is the equation for calculating Bioavailability?

A

oral AUC / IV AUC

40
Q

What is the bioavailability of IV AUC?

A

100% bc all of it is directly entered into the bloodstream so all of it is absorbed

41
Q

Which method has a higher bioavailability, oral or IV?

A

IV bc not no drug administered orally will make it into the blood 100%, while IV will

42
Q

Which method has a higher bioavailability, oral or IV?

A

IV bc not no drug administered orally will make it into the blood 100%, while IV will

43
Q

If a drug has an oral bioavailability of 20%, how will the oral dose be adjusted to achieve therapeutic effectiveness?

A

it will be ~5x higher than the corresponding IV dose

44
Q

What is furosemide used to treat?

A

high bp, HF and oedema

45
Q

Why does congestive heart failure decrease the bioavailability of an orally administered drug?

A

bc congestion in the heart also causes the organs to have oedemas, including in the gut
this increases the distance the drug has to travel through the gut to get into the bloodstream

46
Q

What is the most suitable route of administration of drugs for stable HF?

A

orally

47
Q

What is the most suitable route of administration of drugs for decompensated HF?

A

IV

48
Q

What type of medication is furosemide?

A

a diuretic

49
Q

What is the most appropriate route of administration of drugs for a patient with severe CAP and why?

A

IV bc bioavailiability is 100% and quick treatment is needed as they are very ill if it is SEVERE CAP

50
Q

What is the most appropriate route of administration of drugs for a patient with CAP and why?

A

orally

51
Q

What are examples of bacterial infections Amoxicillin is used to treat?

A

pneumonia, skin infections, and UTIs

52
Q

How is Amoxicillin administered?

A

orally, less commonly by injection

53
Q

Which pharmacokinetic parameter(s) is/are affected if a patient for osteoperosis takes alendronic acid at least 30 minutes before breakfast?

A

bioavailability and absorption

the bioavailability would already have been low (20-30%) but the food would reduce it further

54
Q

What is the first pass metabolism otherwise known as?

A

pre-systemic metabolism

55
Q

What is the effect of a high first pass effect on bioavailability?

A

it reduces BAVT

56
Q

What is the effect of a low first pass effect on bioavailability?

A

it increases BAVT

57
Q

Why is the sublingual route of drug administration suitable for a patient with stable angina?

A

bc it will bypass the GI tract and be administered directly to the blood stream instead
it will be exposed to extensive first pass metabolism

58
Q

What type of medicine is glyceryl trinitrate?

A

a nitrate

59
Q

What is GTN used to treat?

A

angina - can help stop chest pain if an angina attack has already started. It can also help to prevent them from starting

60
Q

What can GTN ointment be used to treat?

A

tears in the skin around the bottom (anal fissures)

61
Q

How can GTN be administered?

A

tablets, spray under tongue

patches and ointment on skin

62
Q

When might GTN patches be used and for what purpose?

A

in hospital to make veins easier to see if administering a drip (infusion)

63
Q

Why might it be a concern that a patient on propranolol for hyperthyroidism has deranged liver function?

A

?

64
Q

What type of substance is propranolol?

A

a non-selective beta blocker

65
Q

When are two drugs considered bioequivalent?

A

when there is no significant difference in the rate or extent of bioavailability at the same molar dose and under the same conditions

66
Q

When might the bioequivalence of two drugs be relevant?

A

Different formulations from different companies

Different batches of drugs from the same company

M104 T2 (15 decks)

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