Non-Medical Prescribing Revision Flashcards
What does ADME stand for ?
Absorption
Distribution
Metabolism
Excretion
Most drugs are absorbed in what organ?
Small intestine
Factors that affect absorption?
Size of drug molecule
How lipophilic the drug is
How ionised the drug is
Surface area available
PH of food
What is first pass metabolism?
Where the drug is broken down (metabolised) in the liver before it ever reaches the systemic circulation
What affects drug absorption?
Food
Concordance
Formulation
Route of administration
Tell me 3 examples of routes of administration?
IV- complete absorption
Oral- partial absorption
Topical-partial and variable
What is a loading dose?
Dose to reach therapeutic levels
What is volume of distribution? (Vd)
Amount of drug that needs to be in the body to achieve a particular concentration
When a drug is highly protein binding, this means?
The drug is inactive
What affects metabolism?
Age
Other drugs
Genetic factors
What affect does enzyme inhibiting drugs have?
Reduce the affect of the medication and slow down the drug process.
How many phases of metabolism are there?
Two
Phase 1
Phase 2
For drugs to be excreted they need to be ?
Hydrophilic
What does EGFR mean ?
Estimate glomerular filtration rate - estimate of how well that kidneys are functioning.
What is half life?
Time required for the plasma concentration of a drug to reduce by half.
Explain
Inductor and inhibitor
Inductor- increases metabolic clearance
Inhibitor- slows down metabolism
What is an agonist?
An agonist is a chemical that activates a receptor to produce a biological response.
What is an antagonist?
A substance that stops the action or effect of another substance
What is affinity?
The strength of attraction between two substances
What is efficacy?
efficacy describes the maximum response that can be achieved with a drug
Drugs associated with displacing other medicines from plasma proteins are listed in the BNF as ?
Incompatible in Appendix 1
Pharmacodynamic interactions are common and fall into two categories
1- additive effects of drugs with similar reactions
2- competing effects of drugs with opposite actions
What is normally the first indicator of renal insufficiency?
Poor urinary output
An adverse drug reaction ADR is not the same as an adverse side effect ASE
TRUE
ADR is a negative event
ASE may have some beneficial side- effects
The study of ADRs is called ?
Pharmacovigilance
An ADR can be classified into how many classes
6
Type A, B, C, D, E and F
If a patient reports a ADR (Type A augmented effect) the prescriber may ?
Stop the medication
Reduce the dose of the drug
Switch to an alternative drug
Name 3 major group of drugs involved in adverse drug reactions
Antibiotics
Antipsychotics
NSAIDs
Drugs with narrow therapeutic window
Lithium
Diuretics
Benzodiazepines
Newly licensed drugs
The elderly often have changes in sensitivity to drugs because of ..
A reduction in drug binding sites
Impaired organ function
Altered metabolising enzyme systems in the liver
What is a ligand?
A ligand is defined as any molecule or atom that irreversibly binds to a receiving protein molecule
Explain the significance of the black triangle next to some drugs in the BNF
New or monitored drugs that are under surveillance
Explain phase 1 metabolism ?
Phase I reactions of drug metabolism involve oxidation, reduction, or hydrolysis of the parent drug, resulting in its conversion to a more polar molecule.
Explain phase 2 metabolism?
Phase II reactions involve conjugation by coupling the drug or its metabolites to another molecule, such as glucuronidation, acylation, sulfate, or glicine
What is a G protein linked receptor?
G protein-linked receptors (GPLR), form a large group of evolutionarily related proteins that are cell surface receptors that detect molecules outside the cell and activate cellular responses.
what is a ligand-gated ion channel?
Ligand-gated ion channels are ion channels that can open in response to the binding of a ligand. To form a channel, this type of cell-surface receptor has a membrane-spanning region with a hydrophilic (water-loving) channel through the middle of it. The channel lets ions to cross the membrane without having to touch the hydrophobic core of the phospholipid bilayer.
What is a kinase linked receptor?
A kinase-linked receptor (KLR) is a transmembrane receptor, which uses second messenger signalling that triggers a cascade of cellular events.
Explain bioavailability?
In pharmacology, bioavailability is a subcategory of absorption and is the fraction (%) of an administered drug that reaches the systemic circulation.
