Mod 1 Farm (Lectures) Flashcards
What is pharmacokinetics?
How the drug concentrations change over time as they are moved through the body
What are the 4 principles to pharmacokinetics?
Absorption
Distribution
Metabolism
Elimination
What does po stand for
Oral administration
What does sl stand for?
Sublingual absorption
What does pr stand for?
rectal administration
What is the difference between enteral and parenteral routes of absorption?
enteral is through GI tract
parenteral is outside GI tract
What is the abbreviation IM?
Intramuscular
What is the abbreviation IV?
Intravenous
What is the abbreviation IC?
Intracoronary
What is the abbreviation sc or sq?
subcutaneous
What type of molecules pass trough the cell membrane easily through passive diffusion
lipid soluble
Which types of molecules can only cross through aqueous channels with passive diffusion
H20 molecules
If a molecule cannot pass through lipid membrane or aqueous channels what does it need to pass?
A carrier protein or active transport
A molecule needs to be ____ soluble to pass through GI tract
H20
Why might a drug have an enteric coating? Where are enteric coatings are dissolved?
To avoid side effects in the stomach
small intestine
What type of drug is slowly absorbed
Sustained Release
What is bioavailability?
percent of drug that gets into systemic circulation
Drugs given through ___ will have a 1st pass. What is 1st pass?
GI
a % of the drug that is eliminated through gut or liver before it reaches systemic circulation
What kind of drug administration will have no 1st pass
IV
Where are drugs primarily stored and can serve as a reservoir?
Adipose tissue
What is the storage site for toxic agents like heavy metal and lead
bone
What organs may drugs be stored in?
liver and kidney
What organ does most of drug metabolism
the liver
Where are most drugs excreted from
kidneys
What is steady state
holding constant blood level, have to take medication at routine times
What is the difference between agonist and antagonist?
The agonist stimulate a receptor and enhances a physiological effect (has affinity and efficacy)
The antagonist inhibits a receptor and decreases physiological effect (has affinity, NO efficacy)
What is potency? What does it mean if a drug has a higher potency?
Potency is the amount of drug required to achieve an effect
If a drug is more potent, it can be given in a smaller dose to have same effect
Aspirin and perastine,
P2Y12 inhibitors – plavix (clopidogrel) Brilinto (ticagrelor)
are all ____
Anti-platelets
What do anti platelets do
inhibit platelet aggregation
tPA
TNKase (tanectase)
Retevase (reteplase) are all types of
Thrombolytics
Convert plasminogen to plasmin
Thrombolytics
What might you use for DVT fast
IV heparin
Heparin, coumadin, and direct Xa inhibitors are all examples of
Anti-coagulants
What drugs are thrombin inhibitors
influence thrombin from converting fibrinogen –> fibrin
Anti-coagnulants
What anti clotting might someone with valve disease, afib, and increase risk for DVT might be put on
coumadin
What anti clotting drug might someone with nonvalvular Afib and VTE might be put on
Direct Oral Anticoagulants
What do you use to monitor Heparin and Coumadin
aPTT 60-80s (?)
Diuretics are used to treat
hypertension
What class of drugs increases renal excreation of H20 and Na+ in order to decrease BP
Diuretics
What loop diuretic might be given to someone to manage CHF/pulmonary edema
Lasix (furosenide)
What thiazide diuretic is given first line for patients who are black
Hydrodiuril (hydrochlorothiazide)
What are the side effects of anti-hypertensive drugs
hypotension, dehydration, ototoxicity, hypokalemia, hyperglycemia
how do Sympatholytic Drugs (B Blockers and A blockers) influence HR, heart contractility, and sympathetic influence
Decrease
What is the SE of blocking B2 receptors, why is this bad for diabetics?
decrease glucogenesis and glucagon secretion and might mask symptoms of hypoglycemia
people with DM will get selective BB
why would you not give a patient with CHF a sympatholytic drug
it decreases myocardial contractility
What kind of drug dilates peripheral vasculature by inhibiting smooth muscle contraction
Vasodilators
Apresoline (hydrazoline) is a ____ which will _____
arterial dilator
decrease BP
What kind of drug decreased BP by inhibiting actin/myosin coupling in smooth muscle
Calcium Channel blockers
_______ (a type of Ca channel blocker): Norvasc (amlodipine) and Procardia (nifedipine) will ___ RHR and MHR and decrease BP
Dyhydropyramines
increase
_____ (type fo Ca channel blocker): Diltiazem, Verapamil will __ RHR, and ___ conduction through the AV node
Benzothiazepines
decrease
slow
Benicar (olmesartan)
Cozaar (losartan)
Diovan (valsartan)
What kind of anti-hypertensive drug?
Angiotensin REceptor Blockers (ARBs)
How do ARBs work
block the action of angiotensin II (a constrictor) –> vasodilation
Capoten (captopril)
Vasotec (enalapril)
Altace (ramipril)
Zestril (lisinopril)
are what type of drugs
Angiotensin- converting enzyme (ACE) inhibitors
How do ACE inhibitors work?
inhibits the enzyme that converts ang I to ang II so no ang II is made. ACE inhibitors block ACE from breaking down bradykinin
bradykinin vasodilates
ACE is a vaso___
Bradykinin is a vaso___
vasoconstrictor
vasodilator
ACE inhibitors are frequently combined with a ___ or ___ for antihypertensive action
diuretic or B blocker
What drugs decrease myocardial demand
B Blockers
Ca Channel Blockers
Nitrates
What drugs decrease angina
Nitrates
B Blockers
Calcium Channel Blockers
What is the most common drug given for angina
nitrates
what is the best choice drug to give to someone with angina from coronary vasospasm
Calcium channel blockers (they dec spasm)
HMG-CoA reReductase inhibitors (statins) are what kind of drug
Anti - hyperlipidemic
How does lipitor (simvastatin) and Zocor (atorvastatin) work?
decrease production of cholesterol
What are the adverse effects of statins
myopathy
liver function abnormalities
cataracts
tendinopathy
inc risk of DM II in women
What 2 drugs together may cause profound weakness and myopathy?
high doses of triglyceride meds (fibric acids) and statins
What might someone go on if they can’t tolerate a statin
Ezetimide (zetia) or PCSK9 inhibitors
How does Ezetimide (zetia) work?
inhibits cholesterol absorption from GI tract
how does Pralvent (alirocrumab) and Repatha (evolocumab) work? How is it administered?
Works on cholesterol clearance by binding to protein PCSK9 to receptor on liver
IV
What do Fibric Acids (clofibrate and gemfibrozel) do?
Decrease trigliceride levels
What drugs together increase the risk of statin myopathy?
Statins + Fibric Acids
What are the 4 classes of Anti-Arrhythmics
1: Sodium channel blockers
2: B Blockers
3: Drugs that prolong repolarization
4: Calcium Channel Blockers
Pronestyl (procainamide)
Quinidex (quinidine)
mexitil (mexilitine)
What kind of drugs are they and how are they an anti-arrhythmic
sodium channel blockers:
decrease cell membrane excitability in cardiac cycle by inhibiting the Na Channels
What parts of the cardiac cycle do the Sodium channel blockers influence
P wave
tenormil (atenolol)
corgard (nadolol)
What kind of drugs are they and how do they work as anti-arrythmics
B Blockers:
decrease SNS response, decrease automaticity, prolong the refractory period
What is common to give someone with Afib and Aflutter
Beta Blockers
What part of the cardiac cycle are B Blockers influencing?
T wave are, the refractory period
Cordarone (amiodarone)
Bretylot (bretylium)
What kind of drugs are they and how do they work for anti-arrhythmic
Drugs that prolong repolarization
they prevent a new depolarization
Which anti-arrhythmic drug is most effective for ventricular dysrrhythmis and supreventricular dysrhythmia
Drugs that prolong repolaization (aminodarone and bretylium)
Calan (verapamil)
Cardizem (diltizem)
What kind of drugs are they and how do they work as an anti-arrhythmic
Calcium channel blockers
they alter excitability of cardiac tissue by inhibiting Ca movement in cardiac cycle
What phase of the cardiac cycle are the calcium channel blockers influencing
(s-t)
What drugs are common to give to someone for rapid rhythms and superventricular tachycardia
calcium channel blockers
Pressors cause ___
Inotropes cause ___
vasoconstriction
inc myocardial contractility
Why would someone be put on pressors or inotropes
Their very sick, their BP is very low so the meds will maintain their BP, prevent hypotension, and maintain cardiac output
Norepinepharine and vasopressin are examples of ____
dobutamine, dopamine, and milrinone are examples of ___
pressors
inotropes
What drugs significant decrease the risk of cardiovascular death/hospitalization in pts with heart faliure?
SGL2 (sodium glucose co-transport) Inhibitors
Jardiance (empagliflozin)
Farxiga (dapagliflozen)
What kind of drugs are they and how do they help?
SGL2 inhibitors
Decrease risk of hospitalization and death with CVD both with preserved and reduced ejection fracture
