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N216 A/B > PD > Flashcards

PD Flashcards

1
Q

What is the “expected” glomerular filtration rate (GFR)?

A

125 mL/min

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2
Q

Why does the formula for estimating creatinine clearance ask us to x0.85 if the patient is female?

A

Females have decreased kidney functions compared to males, so their rate of clearance will be lower.

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3
Q

Define half-life.

A

Measured length of time required for a drug to decrease in plasma by one half (50%)

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4
Q

How many half-lives should pass before we consider the drug to be “cleared”?

A

4 half-lives

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5
Q

What does it mean when we say a drug is “unchanged” in ADME?

A

Biotransformation of the drug is not required for it to be excreted.

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6
Q

What is a loading dose?

A

Repeated or large doses of a drug given to quickly have plasma concentration reach the therapeutic range.

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7
Q

______ does are given after a loading dose in order to:

A

Maintenance; keep the drug within therapeutic range.

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8
Q

What are the 4 categories of factors that influence a patient’s response to drugs?

A
  1. Clinical factors
  2. Administration
  3. PK
  4. PD
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9
Q

What is ED50?

A

Median therapeutic dose; dose required to produce a therapeutic effect in 50% of the population.

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10
Q

What is TD50?

A

Median toxicity dose: elicits a toxic response in 50% of patients.

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11
Q

The therapeutic index (TI) of a drug is the ratio between the drug’s ____ and _____.

A

TD50 and ED50 (TI = TD50:ED50)

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12
Q

What are 4 notable drugs with narrow TIs?

A
  1. Digoxin (Lanoxin)
  2. Warfarin (Coumadin)
  3. Phenytoin (Dilantin)
  4. Tracrolimus (Prograf)
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13
Q

Most drugs bind to _____ in the body.

A

Receptors.

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14
Q

What are 3 characteristics of drug-receptor binding?

A
  1. Saturable.
  2. Can increase or suppress existing processes.
  3. Only blocks the receptor.
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15
Q

What are the 6 major receptor types?

Technically she combined 2 of them under 1 name so you should be able to list 5 names

A
  1. G-protein (GPCR)
  2. Ion channels
  3. Nuclear receptors.
    4&5. Enzyme types.
  4. JAKSTAT
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16
Q

Define receptor affinity.

A

Strength or length of binding.

17
Q

Define drug efficacy.

A

Effectiveness; degree to which a drug induces the maximum therapeutic effect.

18
Q

Do antagonists have any efficacy?

A

No: they only block the receptors, but do not elicit responses.

19
Q

Define drug potency.

A

How much of a drug is required to elicit a certain therapeutic response.

20
Q

What is an agonist?

A

A drug that mimics the endogenous substance, producing similar effects.

21
Q

What is a primary or “full” agonist?

A

A drug that will extensively bind to the existing receptor(s), successfully eliciting the expected response.

22
Q

What is a partial agonist?

A

Lower efficacy agonist: maximum response is smaller even if all receptors are occupied.

23
Q

Why do we consider partial agonists to be antagonists when full agonists are present?

A

The partial agonist acts as competition for the saturable receptor sites, meaning the full agonist cannot elicit its full effects.

24
Q

What are inverse agonists?

A

Drugs that bind to receptors and induce the OPPOSITE effects of the endogenous substance.

25
Q

What are pure antagonists?

A

Drugs that block the receptor site to prevent endogenous (or endogenous-like) substances from binding.

26
Q

Can you OD on a pure antagonist?

A

Not technically: the drug itself has no effects that will harm you, but the blocking of receptors may be harmful.

27
Q

What are 2 physiological causes of tolerance? (Think receptors)

A
  1. Receptor desensitization (ex: due to overusage)

2. Decreased number of viable receptors to a substance.

28
Q

What are some common drugs that cause ODs? (7)

A
  1. Acetylsalicylic acid (Aspirin)
  2. Acetaminophen (Tylenol)
  3. Fentanyl
  4. Cocaine
  5. Benzodiazepines (sedatives/hypnotic)
  6. Alcohol (ETOH)
  7. Antidepressants
29
Q

What does the acronym ABCDE stand for re:clinical procedures?

A 
Airway
Breathing
Circulation
Disability
Exposure
30
Q

What are some common signs & symptoms of acetylsalicylic acid (ASA) toxicity? (6)

A
  1. Confusion
  2. Tachycardia
  3. Tachypnea
  4. Hyperthermia
  5. Diaphoresis
  6. Vomiting
31
Q

What are some common signs & symptoms of acetaminophen toxicity? (5)

A
  1. Abdominal pain
  2. Loss of appetite
  3. Nausea, vomiting
  4. Diaphoresis
  5. Somnolence (drowsiness)
32
Q

What are 4 common signs & symptoms of opioid toxicity?

A
  1. Bradypnea/apnea
  2. Bradycardia
  3. Solnolence/coma
  4. Constricted pupils
33
Q

What are 6 common signs & symptoms of cocaine (or other stimulant) toxicity?

A
  1. Agitation/tremors
  2. Tachycardia
  3. Tachypnea
  4. Hyperthermia
  5. Diaphoresis
  6. Dilated pupils
34
Q

How do we treat drug toxicities? (4 ways)

A
  1. Adsorption: binding the drugs to decrease their absorption
  2. Induce metabolism
  3. Increase elimination
  4. Antagonism
35
Q

What is an example of an agent we can use for adsorption?

A

Activated charcoal

36
Q

What is a non-invasive way that we can increase renal elimination in cases of drug toxicity?

A

Urinary alkalization: adding alkaline substances will cause acidic drugs causing toxicity to ionize (neutralize) & be excreted in the urine

N216 A/B (26 decks)

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