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5101-POP > Midterm > Flashcards

Midterm Flashcards

1
Q

What is pharmocokinetics

A

the study of absorption, distribution, metabolism, and excretion of drugs

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2
Q

What is pharmaceutics?

A

the formulation and preparation of drugs

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3
Q

What is pharmacoeconominics?

A

the study of the economic impact of drugs

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4
Q

What is toxicology?

A

the study of the harmful effects of chemicals

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5
Q

What is pharmacognosy?

A

the study of the medicinal uses of naturally occurring compounds

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6
Q

What is pharmacy?

A

the preparation and dispensing of drugs

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7
Q

What is pharmacogenetics?

A

genetic influences by and on drugs

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8
Q

What is pharmacodynamics

A

physiological and biochemical mechanism of action of drugs

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9
Q

What is pharmacogenomics?

A

identifies discrete genetic differences among individuals that play a critical role in drug response

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10
Q

What is pharmacoepidemiology?

A

the study of the use and effects of drugs on large groups of people

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11
Q

What is a ligand?

A

chemical substance that binds to a specific receptor

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12
Q

What does an agonist do?

A

Bind to a receptor and stimulates that receptor response

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13
Q

What does an antagonist do?

A

Binds to a receptor and blocks that receptor response

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14
Q

Competitive binding vs. noncompetitive binding

A

competitive binding is reversible (most drugs) and noncompetitive binding is nonreversible

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15
Q

What does ED50 mean?

A

Effective dose for 50% of the population

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16
Q

What does TD50 mean?

A

Toxic dose for 50% of the population

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17
Q

What does LD50 mean?

A

Lethal dose for 50% of the population

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18
Q

What does LD50/ED50 indicate?

A

The therapeutic index

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19
Q

What does therapeutic index mean?

A

estimation of drug dosage which can treat disease effectively while staying within safety range

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20
Q

What is the receptor theory?

A

The concept that certain drugs produce their effects by acting specifically at a receptor site on a cell or within a cell or its membrane

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21
Q

Types of bonds from strongest to weakest

A

covalent , ionic, hydrogen, hydrophobic, van der Waals

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22
Q

What is efficacy?

A

the amount of drug to produce the desired effect

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23
Q

what is individual variability?

A

some variability in one person due to outside factors

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24
Q

What does the drug response curve show?

A

allows you to determine the: 1. affinity (potency) 2. Efficacy 3. Variability 4. Slope

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25
Q

What is therapeutic range?

A

The blood levels needed for drug to be effective without being toxic

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26
Q

What is down-regulation?

A

Continued simulation of cells by an agonist causing desensitization from continued or subsequent exposure to the same concentration of drug

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27
Q

What is up-regulation?

A

Continued exposure to an antagonist leading to increase in number and sensitivity of the receptors as a response to a chronic blockade

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28
Q

Pregnancy category A

A

Controlled studies show no risk to fetus

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29
Q

Pregnancy category B

A

animal-reproduction studies have not demonstrated fetal risk, but there are no studies in woman

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30
Q

Pregnancy category C

A

Studies in animals have revealed adverse effects and no studies in women or no studies in animal or women are available. Medicine should only be given if potential benefit outweighs potential risk

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31
Q

Pregnancy category D

A

Positive evidence of fetal risk but benefits to treat serious disease in women may be acceptable despite risk

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32
Q

Pregnancy Category X

A

Studies in women and animals show fetal abnormalities and should never be given to women who are or may become pregnant

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33
Q

What is bioavailability?

A

The amount of drug absorbed into the blood from the different routes

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34
Q

Bioavailability of IV

A

100%

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35
Q

Bioavailability of IM

A

75-100

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36
Q

Bioavailability of SQ

A

75-100

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37
Q

Bioavailability of PO

A

5-100, may have significant first-pass effect

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38
Q

Bioavailability of rectal

A

30-100, less first pass than oral

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39
Q

Bioavailability of Inhalation

A

5-100, rapid onset

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40
Q

Bioavailability of Transdermal

A

80-100, slow absorption, prolonged duration of action

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41
Q

What is drug ionization?

A

pKa is the ionization constant of a chemical compound. the pH at which the drug will exist in solution as 50% ionized and 50% non-ionized.

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42
Q

What type of drug crosses the blood-brain barrier, ionized or non-ionized?

A

non-ionized which is lipid soluble

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43
Q

Drug A is an acid compound with a pKa of 7.1, it is put into an acid environment pH 6.0. Determine ionization and solubility.

A
  1. 7.1-6.0=1.1, therefore 99/1% 2. It is an acid in an acid environment, it is non-ionized 99/1. Non-ionized means it is lipid-soluble and will pass blood-brain barrier and also pass into the placenta
44
Q

Drug B is an acid with a pKa of 5. It’s in an environment pH 7.4. Determine ionization and solubility.

A
  1. 5-7.4= 2.4, therefore 99/1% 2. It is an acid in a more basic pH therefore it is ionized 99/1. Ionized means it is water soluble and will not cross blood brain barrier or go to placenta.
45
Q

Drug C is a base with a pKa of 7.8. It’s placed into an environment pF of 7.4. Determine the ionization and solubility.

A
  1. 7.8-7.4=0.4, therefore it is 75/25% 2. It is a base in a more acidic environment therefore it is 75% ionized and 25% non-ionized. The non-ionized will cross the blood brain barrier and into the placenta due to it’s lipid solubility
46
Q

Drug D is a base pKa 6.0. It’s in an environment pH 3. Determine the ionization and solubility.

A
  1. 6-3=3, therefore it is 99/1% 2. It is a base in a more acidic environment therefore it ionized. It will not be absorbed in this environment
47
Q

What is the first phase of drug metabolism?

A

oxidation, reduction, and hydrolysis

48
Q

What is the phase 2 of drug metabolism?

A

conjugation and synthesis

49
Q

What is first-pass metabolism?

A

Presystemic metabolism in the liver or gut wall result in reduced bioavailability of the drug when given orally. Also known as first-pass effect

50
Q

What is enzyme induction?

A

drugs, environmental chemicals, air pollutants, and components of cigarette smoke can stimulate the synthesis of drug-metabolizing enzymes leading to an elevated level of hepatic drug-metabolizing enzymes.

51
Q

What is enzyme inhibition?

A

Certain substances can cause a decrease in enzyme production resulting in less metabolism of a variety of medication, leading to an increase in their effects.

52
Q

What is the neurotransmitter at the parasympathetic preganglionic site?

A

acetylcholine

53
Q

What is the neurotransmitter at the parasympathetic postganglionic site?

A

Acetylcholine

54
Q

What is the neurotransmitter for the sympathetic preganglionic site?

A

Acetylcholine

55
Q

What is the neurotransmitter for the sympathetic postganglionic site?

A

Norepinephrine

56
Q

What is the receptor at both the parasympathetic and sympathetic preganglionic site?

A

Nicotinic cholinergic

57
Q

What is the receptor at the parasympathetic postganglionic site?

A

muscarinic cholinergic

58
Q

What is the receptor at the sympathetic postganglionic site?

A

adrenergic

59
Q

What is a drug that mimics the parasympathetic system called?

A

parasympathamimic

60
Q

What is a drug that mimics the sympathetic system called?

A

sympathamimic

61
Q

What is stage 1 of Anesthesia?

A

the time between normal waking state and the loss of consciousness due to an anesthetic agent. Mild analgesia occurs at the end of stage 1.

62
Q

What is stage 2 of anesthesia?

A

Loss of awareness and recall. Associated with cardiovascular instability excitation, dysconjugate ocular movement, and emesis.

63
Q

What is stage 3 of anesthesia?

A

Surgical anesthesia, a state where movement in response to pain is suppressed. Various planes are identified with relation to responses and level of sedation.

64
Q

What is stage 4 of anesthesia?

A

associated with cessation of spontaneous respiration and medullary cardiac reflexes, could lead to death

65
Q

What is the ventilation effect?

A

The greater the alveolar ventilation, the faster the patient achieves anesthesia.

66
Q

What is concentration effect?

A

The higher the concentration of anesthetic delivered, the faster anesthesia is achieved. Larger initial dose=faster onset of action

67
Q

What is Blood gas solubility?

A

Indicator of an anesthetics speed of onset & emergence. Higher coefficient=slower anesthetic lower coefficient=faster anesthetic

68
Q

What is the oil/gas solubility?

A

Indicator of an anesthetic’s potency

69
Q

What is the second gas effect?

A

2 anesthetics with varying onset speeds are administered together thus allowing a faster anesthetic properties of the slower gas

70
Q

What occurs with N2O diffuses into closed spaces?

A

N2O expands closed gas spaces. Can cause complications when administered with pneumothorax, bowel obstruction, inner ear surgery, neurosurgical procedures with air injections, air embolism, use within 4 weeks of sulfur hexafluoride injection, and laparoscopy.

71
Q

What are the effects of V/Q issues r/t anesthesia?

A

reduces speed of onset, effects the faster agents more

72
Q

What is the effect of cardiac output on anesthesia?

A

An increase in cardiac output slows the onset of all anesthetics.

73
Q

Other name for Isoflurane?

A

forane

74
Q

Other name for Sevoflurane?

A

ultane

75
Q

Other name for Deslurane?

A

Suprane

76
Q

What is diffusion hypoxia?

A

When high levels of N2O are stopped and quickly dissipates and is replaced by nitrogen, hypoxia can occur. Place pt on 100% oxygen following discontinuation of N2O.

77
Q

Effect of pregnancy on anesthesia?

A

Cardiac output and minute ventilation are both increased in pregnant women. These two effects offset each other, no differences in pregnant vs non pregnant women

78
Q

Effect of pediatrics with anesthesia?

A

Despite increased CO and increased required dose, pediatric population achieve anesthesia faster d/t higher ventilatory rate and vessel right group

79
Q

Effect of obesity of anesthesia

A

Little effect on induction but may prolong emergence due to large amount of fat deposits.

80
Q

Effect of temperature on anesthesia?

A

The colder the core body temperature, the faster onset of induction

81
Q

What is the MAC, blood/gas coefficient, and oil/gas coefficient for Sevoflurane?

A

MAC- 2

B/G coefficient- 0.6

O/G coefficient- 50

82
Q

What is the MAC, blood/gas coefficient, and oil/gas coefficient of Isoflurane?

A

MAC- 1.15

B/G coefficient- 1.4

O/G coefficient- 99

83
Q

What is the MAC, blood/gas coefficient, and oil/gas coefficient of nitrous oxide?

A

MAC- 105

B/G coefficient- 0.47

O/G coefficient- 1.4

84
Q

What is the MAC, blood/gas coefficient, and oil/gas coefficient of Desflurane?

A

MAC- 5.8

B/G coefficient- 0.42

O/G coefficient- 18.7

85
Q

What does this graph represent?

A

the alveolar absorption. how fast you go to sleep

86
Q

What does this graph represent?

A

The cardiac output effect. The higher the CO, the slower onset of anesthesia

87
Q

What does the graph represent?

A

The second gas effect.

88
Q

How can a drug enter a cell?

A

Transmembrane proteins, Diffusion through membrane, and Ion channel

89
Q

What is the portion of the drug bound to plasma protein?

A

inactive, central compartment

90
Q

What does the binding of propfol to the GABA receptor cause?

A

Influx of chloride ions

91
Q

The newer patented drugs that exhibit less side effects are called?

A

S- and R- enantiomers

92
Q

Where is the vessel-rich group located?

A

Central compartment

93
Q

The vessel-rich group receive what percentage of CO?

A

75%

94
Q

What is the pharmacologically active portion of the drug?

A

non-ionized, lipophilic

95
Q

What happens when the pKa and the pH are equal?

A

non-ionized equals the ionized

96
Q

What route of administration has low bioavailabilty and high first pass?

A

oral

97
Q

What drug interaction is defined by 1+1=3

A

Synergy

98
Q

What binds to a specific receptor, mimics an endgrogenous ligand, and may cause maximal activation of the receptor?

A

Agonist

99
Q

How would you best describe the drug receptor coupling?

A

lock and key fit

100
Q

A ligand is best described as?

A

neurotransmitter, hormone, or drug

101
Q

How many hormone receptors are present on the cell membrane?

A

2,000-100,000

102
Q

What does Fluorine do to an anesthetic agent?

A

Increase solubility and makes them last longer

103
Q

Calculation to determine MAC99?

A

MAC x 1.3

104
Q

Calculation for celcius to farhenheit

A

(C x 1.8) + 32= F

105
Q

How do you determine amount of anesthesia pt is getting?

A

Pbr-pressure in the brain

PA=Pa=Pbr

Calculate from Fe (fracture exp)

5101-POP (1 decks)

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