Overview of Pharmacologic Principles

Question 1

What are 3 considerations for a single or first does administration?

Answer 1

1. Onset of effect
2. Duration of action
3. Therapeutic window

Question 2

What is the onset of effect?

Answer 2

Time to reach the MEC (minimum effective concentration)

Question 3

What is the duration of action?

Answer 3

Time above the MEC

Question 4

What is the Therapeutic window or index?

Answer 4

Difference in plasma concentration Cp, between desired and adverse response MEC

Question 5

What is steady state?

Answer 5

The goal of pharmacotherapy
When the rate of drug administration = rate of drug elimination
rate in = rate out

Question 6

What is the time to steady state?

Answer 6

4-5 half lives (when maintenance doses given at constant interval)

Question 7

What is the steady state concentration?

Answer 7

average Cp after steady state achieved

Question 8

What causes fluctuations ins steady state Cp?

Answer 8

number of half lives in dosing interval

time between doses

Question 9

How is the dosing regimen determined?

Answer 9

designed to maintain balance between rate of drug elimination and prescribed rate of drug administration
- ensure desired steady state Cp

Question 10

How are the drug and dose determined?

Answer 10

Pharmacodynamics

• disease targets
• drug regulation

Question 11

How is the route of administration determined?

Answer 11

Pharmacokinetics

• absorption
• distribution

Question 12

How is the dosage frequency determined?

Answer 12

Pharmacokinetics

• metabolism
• excretion

Question 13

How is the duration selected?

Answer 13

disease pathophysiology

Question 14

What are the 4 broad categories that are the critical areas of knowledge about any drug? (necessary for their safe and effective use in the clinical setting)

Answer 14

1. Pharmacodynamics/ mechanism of action
2. Pharmacokinetics
3. Therapeutic Uses
4. Adverse drug reactions/ side effects/ drug-dug interactions

Question 15

What are pharmacodynamics/ mechanisms of action of a drug?

Answer 15

What the drug does to the body

Drugs DO NOT have unique effects:

they DO ENHANCE or BLOCK
Normal physiology

Question 16

What are common drug targets?

Answer 16

membranes
intracellular receptors
enzymes (in critical biosynthetic pathway)
membrane transport protein

Question 17

What is pharmacokinetics?

Answer 17

What the body does to the drug

• absorption
• distribution
• elimination

Question 18

What is bioavaliblity?

Answer 18

F

How much of the dose of a drug reaches its target

Question 19

What is volume of distribution?

Answer 19

Vd
What dose (mg) is necessary to obtain the desired plasma concentration (Cp) in mg/L
conversion factor to explain relationship between does and plasma concentration (Cp)

Question 20

What is time to peak effect?

Answer 20

Tmax or Cmax

How fast does the drug reach its target

Question 21

What is distribution?

Answer 21

Movement of drug from the bloodstream to tissue

Question 22

What is absorption?

Answer 22

passage of drug from site of administration into the blood

Question 23

What is the result of a drug administered to have systemic effects?

Answer 23

drug is absorbed into bloodstream and distributed to sites of action in the body

Question 24

What is the result of a drug administered to have topical effects?

Answer 24

drug mostly remains at site of application for local action

Question 25

What is the duration of action

Answer 25

half-life | How long a drug will stay at its target in the body

Question 26

What is clearance?

Answer 26

CL | refers to the elimination of drug activity via metabolism and excretion

Question 27

What organ is responsible for drug metabolism?

Answer 27

Liver

Question 28

What organ is responsible for drug excretion?

Answer 28

kidney

Question 29

How do drugs create a therapeutic effect?

Answer 29

act via ENHANCEment or BLOCKade of normal physiological pathways to ALTER PATHOPHYSIOLOGICAL DISEASE STATE

Question 30

What are side effects of a drug?

Answer 30

occur when the drug target is also located a non-target systems - seen at therapeutic dose - dose dependent - predictable

Question 31

What are extension effects?

Answer 31

Occur at the drug target in the target system - Seen at higher than therapeutic doses - dose dependent - predictable

Question 32

What are idiosyncratic reactions?

Answer 32

NOT at drug target - peculiar to an individual - less common - less predictable May be immunologic or metabolic

Question 33

What does an immunologic reaction mean?

Answer 33

allergic reaction

Question 34

What are the important side effects to know for a specific drug or drug category?

Answer 34

Most common | Most severe

Question 35

What does a metabolic reaction mean?

Answer 35

hepatotoxicity or blood dyscrasis

Question 36

What does the abbreviation SR stand for?

Answer 36

sustaind release

Question 37

What does the abbreviation IR stand for?

Answer 37

immediate release

Question 38

What does the abbreviation ER stand for?

Answer 38

extended release

Question 39

What is the action of an agonist?

Answer 39

agonists enhance a biological pathway

Question 40

What is the action of an antagonist?

Answer 40

antagonists block a biological pathway

Question 41

What is the mechanism of action of opiod pain killers such as vicodin?

Answer 41

agonist at u-opiod receptors | - enhance pain suppression pathway (analgesia)