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NCC content Flashcards

1
Q

define pharmacodynamics

A

the ACTION part
“what the drug does to the body”
-the activity of the drug at the tissue receptor site; the free drug binds to a specific receptor site causing a desired response

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2
Q

define pharmacokinetics

A

the MOVEMENT part
“what happens to the drug once it enters the body”
-movement of a drug in, through, and out of the body

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3
Q

what are the four parameters of pharmacokinetics?

A

ADME

  • absorption
  • distribution
  • metabolism
  • excretion
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4
Q

what is active transport?

A

requires energy in order to move substance into intracellular space through pump (against concentration gradient)

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5
Q

what is facilitated diffusion?

A

when a substance needs an accessory protein to carry it through the cell membrane (follows concentration gradient)

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6
Q

define bioavailability

A

amount of drug dose that reaches systemic circulation

-IV route is 100% bioavailable

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7
Q

what is first pass metabolism?

A

when an organ (i.e. liver) utilizes a portion of the drug before it gets to the bloodstream

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8
Q

Why is absorption delayed via the PO route?

A
  • delayed gastric emptying
  • stomach pH is more neutral (7-8) until 2-3 months of age
  • NPO status
  • increased transit time
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9
Q

which environment provides best absorption for acidic drugs?

A

an acidic environment

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10
Q

why is absorption increased via the topical route?

A
  • higher surface area to body weight
  • increased permeability of skin
  • decreased stratum corneum
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11
Q

define distribution

A

transport of the drug from the bloodstream to the site of action

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12
Q

define absorption

A

getting the drug from the site of administration into the blood circulation

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13
Q

how does circulation affect distribution of a drug?

A

increased blood flow = increased drug delivery to tissue

-rate of blood flow to tissue

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14
Q

how does total body water content affect distribution?

A

increased total body water = more drug needed

-Vd = volume of distribution

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15
Q

how does protein binding affect distribution?

A

increased protein binding = less free drug available

-too much protein binding prevents a drug from having the ability to reach the tissue/receptor site

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16
Q

how does lipid solubility of a drug affect distribution?

A

lipid soluble drugs move better across membranes

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17
Q

how does tissue receptor affinity affect distribution?

A

increased affinity = increased delivery of drug to site

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18
Q

what are the 3 actions of metabolism?

A
  • biotransformation: the drug is chemically altered to an inactive form
  • changed to a water soluble drug (to be excreted through kidneys)
  • changed into an active metabolite
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19
Q

where does the majority of metabolism take place?

A

in the liver

cytochrome P450

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20
Q

why are preemies at higher risk for drug toxicity?

A
  • immature liver function for metabolism
  • decreased protein = more active free drug
  • immature renal function = cannot eliminate drugs as well; GFR is decreased, tubular function is decreased
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21
Q

why factors decrease drug metabolism in preemies?

A
  • prematurity
  • decreased cardiac output
  • renal insufficiency
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22
Q

what is 1st order elimination?

A
  • a constant fraction of drug is eliminated over time

- proportional to amount given

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23
Q

how many half lives does it take for an entire drug to be eliminated?

A

5 1/2 half lives

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24
Q

how many half lives does it take to reach steady state?

A

5 1/2 half lives

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25
Q

why is a loading dose sometimes necessary?

A

needed for drugs with a long half life

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26
Q

define steady state

A

the equilibrium point where the amount of drug in equals the amount of drug excreted

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27
Q

which organs are responsible for excretion of drugs?

A
  • kidneys
  • liver
  • intestine
28
Q

name drugs that have a narrow therapeutic range

A
  • gentamicin
  • vancomycin
  • amikacin
29
Q

what determines if a drug can cross the placenta?

A
  • lipid solubility
  • molecular weight of drug
  • protein bound
30
Q

how does surfactant function?

A

REDUCES alveolar surface tension

31
Q

how does albuterol work?

A

causes bronchodilation by acting on B2 adrenergic receptors and B agonist

32
Q

what are side effects of albuterol?

A
  • rebound tachycardia
  • hypokalemia
  • HTN
33
Q

what is albuterol used for?

A

-acute bronchospasm and to improve lung capacities in BPD infants

34
Q

what is atrovent used for?

A

-used to treat bronchospasm related to CLD

35
Q

how does atrovent work?

A

-inhibits parasympathetic bronchoconstriction

36
Q

how does dexamethasone work?

A

potent glucocorticoid that suppresses inflammation

-increases permeability of lung capillaries

37
Q

side effects of dexamethasone

A
  • suppresses immune response
  • hyperglycemia
  • hypertension
  • growth retardation
  • adrenal insufficiency if weaned too quickly
38
Q

indications for dopamine

A

hypotension and renal hypoperfusion

39
Q

how does dopamine work?

A
  • low doses work on dopaminergic receptors to produce renal perfusion
  • higher doses work on alpha and B1 adrenergic receptors to produce inotropic effect on heart
40
Q

dobutamine indications

A

treats low output heart failure and poor cardiac contractility

41
Q

how does dobutamine work?

A

B1 agonist increasing cardiac output

42
Q

what should you do before starting dopamine or dobutamine?

A

give fluid bolus first!

43
Q

why dopamine vs dobutamine?

A

dobutamine is a better choice if the problem is poor cardiac contractility

44
Q

digoxin indications

A

treat CHF and arrhythmias

45
Q

how does digoxin work?

A

increases intracellular calcium, thus improving cardiac contractility

46
Q

what are signs of digoxin toxicity?

A

bradycardia, vomiting, hypokalemia

47
Q

adenosine indication

A

treat SVT

48
Q

does for adenosine

A

0.05-0.2 mg/kg/dose

49
Q

in which condition should you not use adenosine?

A

2nd or 3rd degree heart block

50
Q

what is the benefit of ibuprofen over indomethacin?

A

causes less renal dysfunction

51
Q

how does prostaglandin E work?

A

relaxes smooth muscle of the ductus

52
Q

what are the side effects of prostaglandin E?

A
  • apnea
  • bradycardia
  • fever
  • hypotension
  • thrombocytopenia
53
Q

why is reglan not used as much in the neonatal population?

A

risk for tardive dyskinesia

54
Q

how does zantac work?

A
  • H2 receptor antagonist

- inhibits gastric acid secretion

55
Q

how does prevacid work?

A
  • proton pump inhibitor

- blocks production of gastric acid secretion

56
Q

what are the 3 most common infectious agents in the first week of life?

A
  • GBS
  • e. coli
  • listeria
57
Q

what are common infectious agents after the 1st week of life?

A
  • staph

- pseudomonas

58
Q

what drug reverses paralytics?

A

atropine

59
Q

how does caffeine work?

A

stimulates the respiratory center, improves respiratory muscle contraction

60
Q

how does phenobarb work?

A

raises the seizure threshold

61
Q

what is the loading dose for phenobarb?

A

20 mg/kg

62
Q

what are the side effects of lasix?

A
  • electrolyte instability
  • ototoxicity
  • nephrocalcinosis
  • renal calculi
63
Q

how does lasix work?

A

potent loop diuretic

64
Q

how does aldactone work?

A

potassium sparing diuretic

65
Q

how does chlorothiazide work?

A

non-calcium wasting diuretic

66
Q

how does hydrochlorothiazide work?

A

inhibits sodium reabsorption in distal tubules

Pharm (2 decks)

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