Miscellaneous- Pharm Flashcards
What is pharmacokinetics
What the body does to the drug
What are the important factors involved in pharmacokinetics
ADME
Absorption
Distribution
Metabolism
Excretion
What happens in phase 1 metabolic reaction
Drug becomes more hydrophilic
What occurs in phase 2 metabolic reaction
Drug becomes more polar thus can now be renally excreted
What is pharmacodynamics
What the drug does to the body
What is affinity
How well the drug binds to its receptor
What is efficacy
How well the drug works on that specific receptor
What is potency
The amount of drug required to achieve a response
List 3 routes of enteral administration
Oral
Rectum
Sublingual
List 3 routes of paraenteral administration
Intramuscular
Intravenous
Subcutaneous
What is an agonist
Binds to receptor and activates it
What is a partial agonist
Binds to receptor but does not give full response
What is an antagonist
Binds to the receptor to prevent its activation
What is a competitive antagonist
Where antagonist competes with the agonist for the binding site
What is a non-competitive antagonist
Binds to allosyeric site to prevent receptor activation
What is bioavailability
Fraction of drug that reaches systemic circulation
What NT is used in the somatic nervous system
ACh
What NTs are used in the parasympathetic nervous system
Pre ganlionic- ACh on nicotinic receptors
Post ganglionic- ACh on muscuranic receptors
What NTs are used in the sympathetic Ns
Pre-ganlionic- ACh on nicotinic receptors
Post ganlioic- NA on adrenergic Receptors
Where are Muscuranic 1 receptors located
Brain (Gq)
Where are muscuranic 2 receptors located
Heart (lowers hr)
Where are muscuranic 3 receptors located
In all organs w/ parasympathetic innervation
What is adrenaline and noradrenaline synthesised from
Tyrosine
Where are alpha 1 receptors found and what is its role
Found in (ONE)
O- blood vessels
N- neck of bladder, prostate, stomach
E- eye (dilation)
Cause smooth muscle contraction
Where are beta 1 receptors found and it’s role
Beta 1- found in Heart and kidneys
Increase hr and renin production
Where are beta 2 receptors found and it’s role
Lungs, blood vessels, GI tract, liver bladder, uterus
Smooth muscle relaxation
Where are beta 3 receptors found
Adipose tissue
Bladder (relaxes)
Se of muscuranic 3 agonists
DUMBELS
Diarrhoea Urination Myosis Bradycardia Emisis Lacrimation Salivation
What drug can be given in opioid overdose
Nalaxone
Se of opioids
Respiratory distress Sedation Nausea Constipation Itching Immune suppression
What are the types of adverse drug reactions
Augmented Bizarre Continuous Delayed End of use Failure
What information is critical when filling out the yellow form
Suspected drug
Suspected reaction
Patients details
Reporters details
What is type 1 hypersensitivity reaction and give 2 examples
IgE mediated- igE binds to mast cells
Anaphylaxis
Atopy
What is a type 2 hypersensitivity reaction and give examples
IgG or IgM binds to Ag on cell surface
Autoimmune haemolytic anemia
Goodpastures
Pernicious anaemia
Rheumatic fever
What is a type 3 sensitivity reaction and give examples
Immune complex- free Ag and Ab combine
SLE, PSGN
What type 4 hypersensitivity reaction and give examples
Delayed- T cell mediated
GBS, MS, TB, Graft vs Host
Action of adrenaline on alpha1, beta 1 and beta 2 receptors
Alpha 1- vasoconstriction- increases BP and coronary perfusion
Beta 1- +ve chrono and ionotropic effects
Beta 2- bronchodilation
What is the management of anaphylaxis
Stop drug IM adrenaline (repeat after 5 mins if required) High flow O2 IV fluids Chloramphenamin/hydrocortisone
Moa of NSAIDS
Inhibits COX therefore less prostaglandins (constricts afterent arteriole)
Moa of antihistamines
H1 receptor antagonist. Prevents release of histamine from storage granules of mast cells
Moa of PPIs
Irreversibly bind to H+/K+/ATPase in gastric parietal cells to decrease H+ secretion
Moa of opioids
Activation of mu receptors in CNS
Se of amlodipine
Ankle swelling
Se of ACE inhibitors
Dry cough
Teratogenic
Hyperkalaemia
Renal dysfunction
Se of tamsulosin
Postural hypotension, retrograde ejaculation
Advice when taking bispohosphonates
Take tablet whole w/ plenty of water whilst sitting or standing
Take on empty stomach at least 30 mins before breakfast
Stay upright for at least 30mins after taking tablet
What is used for the prophylaxis of asthma
Clenil modulite (beclamethasone)
When should you stop taking bisphosphonates
Dysphagia
Heartburn
Odonophagia
What is sensitivity
R those that have the diseas and test positive
The probability of a person with disease obtaining a +ve test result
TP/TP+FN
What is specificity
Those that test -ve and do not have the disease
Probability of a person w/o disease testing -ve
TN/TN+FP
How to work out PPV
TP/TP+FP
How to work out NPV
TN/TN+FN
What reaction does COX mediate
Arachidonic acid —> prostaglandin H2
True or false. PPIs are prodrugs that he activated in the stomach
True
Moa of spironolactone and se
N]binds to aldosterone dependent na+/k+ transporter and and increase sodium and water excretion whilst retaining potassium
Se- Gynecomastia, hyperkalaemia, metabolic acidosis
Where do loop diuretics act
Act on Na+/K+/2Cl- Channel on thick ascending loop
Where do thiazide diuretics act on
Act on Na+/Cl- transporter in DCT
Name 3 drug targets
Receptors
Enzymes
Transporters
Ion channels
List 3 ways in which drugs can move between compartments
Simple diffusion
Facilitated diffusion
Active transport
Approximately how many litres of water would you expect to find in the following compartments A- extracellular B- intracellular C-plasma D- interstitial
A- 14L
B- 28L
C- 3L
D- 11L
What is tolerance
The reduction in drug effect over time (continuously repeated high conc)
What is desensitisation
Receptors become degraded/uncoupled/internalised
