Midterms Flashcards
Anong concept: Acid + acid = absorb
Changes in Gastric pH
Anong concept: Chelation and Complexation
Complexation
Anong concept:
↑ GER= ↑ GI motility=↓absorption=↓GET
Changes in GI motility
Anong concept:
Rifamycin’s + OCP’s
Alteration of GI flora
Anong concept:
Aluminum based drug + TDDS
ALTERATION OF TRANSDERMAL DRUG ABSORPTION
Anong concept:
ALBUMIN AND ALPHA 1-GLYCOPROTIEN IN DRUG DISTRIBUTION
PROTEIN BINDING
SICKFACES.COMGQR (INHIBITOR)
SCRAPGPT (INDUCER)
ENZYME INHIBITION AND INDUCTION
COMPETETIVE TO RENAL TUBULAR TRANSPORTERS
ALTERED EXCRETION
Absorb or excrete:
Lipophilic
absorb
Absorb or excrete:
Ionized
excrete
Acidic or basic:
Intestine
Basic
Acidic or basic:
stomach
Acidic
Acidic or basic:
Aspirin
acidic
Acidic or basic:
dipyridamole
acidic
Acidic or basic:
Diazepam
acidic
Acidic or basic:
furosemide
Acidic
Acidic or basic:
Diclofenac
Acidic
Acidic or basic:
OH- Containing drugs
basic
Acidic or basic:
Bicarbonates
basic
Acidic or basic:
proton pump inhibitors (prazoles)
basic
enteric or not:
Bonamine (antiemetic)
not
enteric or not: Aspirin
(nsaid)
enteric/ acidic
A Dic O sa aFam, tig Bente
enteric or not: Diclofenac
(nsaid)
enteric/ acidic
A Dic O sa aFam, tig Bente
enteric or not: Omeprazole
(PPI)
enteric/Basic drug
A Dic O sa aFam, tig Bente
enteric or not: Famotidine
(GERD)
enteric
A Dic O sa aFam, tig Bente
enteric or not: Bentyl
(antispasmodic)
enteric
A Dic O sa aFam, tig Bente
case:
Kapag nagtake ng diazepam at aspirin together. what happens
Aspirin will be metabolized in the stomach.
increase risk of PUD.
Weak acid+ weak base
Ionized so excreted. Almost all drug are weak acid and weak base. if pinagsama ang acid + base= formation of salt also.
(+) charged + (-) charged
ionization
It is a type of complexation where metal is used.
Chelation
- charged metal
binding of ion
Charged particles bind
complexation
Identify if chelation or complexation:
Cholestyramine + digoxin/ warfarin
complexation
Identify if chelation or complexation:
Metamucil + digoxin/ warfarin and salicylates
complexation
Identify if chelation or complexation:
Na polystyrene sulfate + Antacid
complexation??
Identify if chelation or complexation:
Sevelamer + ciprofloxacin/ Levothyroxine
complexation
Identify if chelation or complexation:
Activated charcoal + iron sulfate
chelation
Identify if chelation or complexation:
Vitamins + tetracycline
chelation
Identify if chelation or complexation:
vitamins + fluoroquinolones
chelation
increase or decrease GI motility:
Bisacodyl, cascara, senna
↑ GI motility
increase or decrease GI motility:
Sorbitol
↑ GI motility
increase or decrease GI motility:
Psyllium
↑ GI motility
increase or decrease GI motility:
tegaserod
↑ GI motility
increase or decrease GI motility:
Asapride
↑ GI motility
increase or decrease GI motility:
Methylnaltrexone
↑ GI motility
increase or decrease GI motility:
Metoclopramide
↑ GI motility
increase or decrease GI motility:
Erythromycin
↑ GI motility
increase or decrease GI motility:
Hyosyamine (IBS), Anticholinergic
↓ GI motility
increase or decrease GI motility: propantheline (antimuscarinic)
↓ GI motility
increase or decrease GI motility:
TCA’s (tricyclic antidepressants)
↓ GI motility
- anti cholinergic side effect
increase or decrease GI motility:
Opioids
↓ GI motility
- agonist of mu-opioid receptor
increase or decrease GI motility:
Diphenhydramine (antihistamine)
↓ GI motility
- anti cholinergic effect
Prokinetic drug
Asapride
selective agonist of serotonin in GI
Asapride
selective antagonist of the mu-opioid receptor
Methylnaltrexone
- treat opioid-induced constipation
Blocks GI dopamine receptor 1,2,3 in the GUT
Metoclopramide
-prokinetic and anti-emetic
Anti-biotics/Colonic cleansing + vit K
no synthesis of vit K
- vit K defficiency
rifamycin + OCP
sub therapeutic effect of OCP
Anti-biotic/colonic cleansing + Digoxin
increased digoxin
digoxin is metabolized in GUT bacteria
called EGGERHELLA
Epinephrine + Lidocaine TDDS
prolong anesthetic effect of lidocaine
Aluminum based drug + TDDS
drugs in TDDS will not be absorbed
Menthol + TDDs
chang in skin pH will cause irritation= inflammation (skin will buldge)= pores constrict = TDDs drugs won’t pass through
when drugs stay in the blood stream what is affected in ADME?
Distribution
will a drug ellicit effect when it is binded to a protein?
no
protein binding can prolong duration of action
yes
bound drugs acts as a reservoir
yes
protein binding protects drug from metabolism and excretion
yes
which protein does it bind to:
WARFARIN (ACIDIC DRUG)
ALBUMIN
which protein does it bind to:
SALICYLATES
ALBUMIN
which protein does it bind to:
DIGOXIN
ALBUMIN
which protein does it bind to:
IBUPROFEN
ALBUMIN
Which protein does it bind to:
FLUOXETINE
ANTI-DEPRESSANTS
ALBUMIN
which protein does it bind to:
CITALOPRAM
ANTI -DEPRESSANT
ALBUMIN
which protein does it bind to:
KETOCONAZOLE
ANTI FUNGAL
ALBUMIN
which protein does it bind to:
PHENYTOIN
ANTI EPILEPTIC
ALBUMIN
which protein does it bind to:
PREDNISOLONE
CORTICOSTEROID
ALBUMIN
which protein does it bind to:
NAFCILLIN
BETA LACTAM ANTIBIOTIC
ALBUMIN
Which protein does it bind to:
CARBAMAZEPINE
ANTI CONVULSANT
ALPHA 1 ACID GLYCOPROTEIN
which protein does it bind to:
LIDOCAINE
ARRHYTHMIA/ ANESTHESIA
ALPHA 1 ACID GLYCOPROTEIN
Which protein does it bind to:
LOPINAVIR
ANTI- RETROVIRAL PROTEASE INHIBITOR
ALPHA 1 ACID GLYCOPROTEIN
which protein does it bind to:
METHADONE
ANALGESIC (SYNTHETIC OPIOID AGONIST)
ALPHA 1 ACID GLYCOPROTEIN
which protein does it bind to:
PRAZOSIN
(HIGH BLOOD ; ANTI ADRENERGIC AGENT )
ALPHA 1 ACID GLYCOPROTEIN
which protein does it bind to:
QUININE
(MALARIA AND BABESIOSIS)
ALPHA 1 ACID GLYCOPROTEIN
which protein does it bind to:
COCAINE
ALPHA 1 ACID GLYCOPROTEIN
ERYTHROMYCIN
ALPHA 1 ACID GLYCOPROTEIN
Identify if the concept is for normal drug or for pro drug:
Enzyme inhibition: increased effect
normal drug
Identify if the concept is for normal drug or for pro drug:
enzyme induction: increased effect
pro drug
- the enzyme in charged for activating the drug is induced
Identify if the concept is for normal drug or for pro drug:
enzyme inhibition: decreased effect
prodrug
- the enzyme in charge of activating a drug is inhibited
Identify if the concept is for normal drug or for pro drug:
enzyme inducer: decrease effect
normal drug
fluconazole + warfarin
inhibitor
Fluconazole inhibits the enzyme responsible in metabolizing warfarin
= bleeding
grapefruit juice + drug
inhibitor
grapefruit is an inhibitor
ssri’s +mao’s
inhibitor
- LEADS TO SEOTONIN SYNDROME
SSRI- INHIBITS SEROTONIN RE UPTAKE
MAO- PREVENTS METABOLISM OF SEROTONINSEROTONIN
SMOKING + CLOZAPINE (ANTI -CONVULSANT)
INDUCER
- SMOKING IS AN INDUCER
- DECREASED EFFECT OF CLOZAPINE
ST. JOHNS WORT + CYCLOSPORINE (IMMUNOSUPRESSANT)
INDUCER
- ST. JOHNS WORT IS AN INDUCER
- IMMUNOSUPPRESANT WILL NOT TAKE EFFECT
PHENYTOIN
INDUCE ITSELF
in or out:
urate
in
in or out: acetic acid
out
in or out: uric acid
out
in or out:
acetate
in
↑ GFR= ? urinary drug excretion= ? Renal blood flow
↑ GFR= ↑ urinary drug excretion
= ↑ renal blood flow (direct relationship)
no active tubular secretion = ? drug effect = ? clearance
↑ drug effect (might cause toxicity)
↓ clearance
there is a problem (impaired)
↑ urine pH and amphetamine
amphetamine is a basic drug
↓ basic + basic = reabsorption
clearance
↓ urine pH and salicylate
acid + acid = reabsorption
↓ clearance
↑ urine pH and salicylate
base + acid= ionization = excretion
↑ clearance
truTruee or false: methylxanthine’s affects renal blood flow
true
- theophylline (1, 3 dimethylxanthine)
- Caffeine (1,3,7 trimethylxanthine)
- theobromine (1,7 dimethylxanthine)
dimethylxanthine are competitive antagonist of what?
Adenosine receptor
- adenosine receptor is a nucleotide that causes constriction.
methyl xanthine antagonize these receptor causing now vasodilation and dilation of renal blood vessel
probenecid inhibits secretion of penicillin
Probenecid (anti gout) flushes urate out of the body. Urate is a competitor of penicillin in Active renal secretion . it competitvely bind to organic an ion transporter, making it the first one to be excreted. On the other hand, penicillin stays longer in the body prolonging its effect
cimetidine inhibits secretion of metformin and phenytoin
cimetidine blocks transport of
- organic cat ion (transporter of metformin)
- Multi drug and toxic compound extrusion
causing intoxication.
*Same concept on verapamil
Acid or basic: Antacid
Basic
Increase urine pH
Acid or base:
Sodium bicarbonate
Basic
Increase urine pH
Acid or base:
Sodium bicarbonate
Base
Increase urine pH
Acid or base;
Acetazolamide
Basic
Increase urine pH
Acid or base:
Vit c
Acidic
Decrease urine pH
Acid or base:
Ammonium chloride
Acidic
Decrease urine pH
Acid or base:
Ammonium chloride
Acidic
Decrease urine pH
Acid or base:Methanamine
Base
Decrease urine pH