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Internal Medicine > Pharm Ch. 2 and 3: Pharmacokinetics I and II > Flashcards

Pharm Ch. 2 and 3: Pharmacokinetics I and II Flashcards

Administration, Absorption, Distribution, and Elimination

1
Q

Alimentary Canal

A

Enteral administration

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2
Q

Non-alimentary routes

A

Parenteral administration

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3
Q

Oral

A

-High degree of lipid solubility to pass through GI mucosa
-Drugs enter system in controlled manner
-Final amount and rate are less predictable

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4
Q

First Pass

A

Drug is transported directly to liver via portal vein and may be metabolized before it can be used/effective

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5
Q

Sublingual and Buccal

A

Drugs can reach systemic circulation without being subjected to first pass. Faster than swallowing drug

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6
Q

Rectal

A

-Good for when patient is unconscious or vomiting and can’t take oral drugs
-Poorly absorbed, can irritate mucosa
-Best for treating local issues

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7
Q

Parenteral

A

-More direct
-More predictable quantity
-Not subject to first pass

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7
Q

Inhalation

A

-Rapid entry into bloodstream through diffusion to pulmonary circulation
-Can’t predict exactly how much will reach lungs due to compliance/other things in lungs

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8
Q

IV injection

A

-Frequently resulting in peak levels almost instantaneously and reach target site rapidly
-Lines allow prolonged and steady infusion

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9
Q

Intra-arterial injection

A

-Difficult and dangerous
-Occasionally used in chemo

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10
Q

Subcutaneous Injection

A

-Slower more prolonged release into systemic circulation
-Patients can perform on themselves

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11
Q

Intramuscular Injection

A

-Easily accessible
-Steady and prolonged release
-Relatively rapid effect without rapid plasma level spikes seen with IV

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12
Q

Intrathecal Injection

A

-Deliver medication in a sheath
-Bypass blood-brain barrier and reach CNS

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13
Q

Topical medications

A

-Direct to skin
-Absorbed poorly thru epidermis
-Also includes mucous membranes (eyedrops, etc)

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14
Q

Transdermal

A

-Absorbed thru dermal layers and into subcutaneous tissue or peripheral circulation
-Slow and controlled release, maintain constant level for prolonged period of time

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15
Q

Iontophoresis

A

Drives ionized form of medication into skin (like estim)

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16
Q

Phonophoresis

A

Uses ultrasound to enhance transmission of medication through dermis

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17
Q

Bioavailability

A

-Extent to which drug reaches systemic circulation
-Depends on route of administration and the drug’s ability to cross membrane barriers

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18
Q

Passive Diffusion

A

-Made possible through electrical, chemical, and pressure differences on either side of membrane
-Rate depends on magnitude of gradient, size, distance, and temperature

19
Q

Drugs diffuse more easily if they are in

A

Neutral, non ionized form

20
Q

Weak acid is in neutral form if

A

in acidic environment

21
Q

Weak base becomes non ionized in

A

duodenum, allows it to be absorbed into small intestine

22
Q

Drug should remain ___ in urine so it will be excreted

A

Ionized

23
Q

Active transport

A

Use membrane proteins to transport substances across cell membrane
-Carrier specificity
-Expenditure of energy
-Ability to transport substances against a gradient

24
Q

Facilitated diffusion

A

-Assisting protein carrier is present, but no energy expended
-Ex: skeletal muscle glucose uptake

25
Q

Factors affecting distribution: blood flow

A

Organs with rich blood flow will make distribution easier

26
Q

Factors affecting distribution: binding to plasma proteins

A

Ex: albumin
Only unbound drug can reach the target tissue and exert an effect

27
Q

Factors affecting distribution: binding to subcelluar components

A

Several drugs bound to organelles can’t be distributed to other compartments

28
Q

Volume of distribution

A

Amount of drug administered/concentration of drug in plasma

29
Q

Drug storage: adipose tissue

A

Primary site since most drugs are lipid soluble

30
Q

Drug storage: bone

A

Toxic agents and heavy metals

31
Q

Drug storage: muscle

A

May lead to long term storage

32
Q

Drug storage: organs

A

Ex: liver and kidneys
Enters passively or actively and forms bonds to subcellular components

33
Q

Adverse consequences of drug storage

A

-High concentrations can cause local damage
-Reservoir “soaks up” a drug and prevents it from reaching target site
-Can leak out and reintroduce drug long after dose should have been eliminated

34
Q

Biotransformation

A

Chemically altering a compound usually in liver so it is no longer active. Fast (minutes/hours)

35
Q

Excretion

A

Active form is excreted, slow and not very effective (good for removing byproducts of biotransformation)

36
Q

Phase 1 Reactions

A

Oxidation, reduction, hydrolysis. Conjugation happens afterwards

37
Q

Phase 2 Reactions

A

Conjugation

38
Q

Oxidation

A

Oxygen added or hydrogen removed

39
Q

Reduction

A

Oxygen removed or hydrogen added

40
Q

Hydrolysis

A

Original compound broken into 2 parts

41
Q

Conjugation

A

Intact drug or metabolite from one of earlier actions is coupled to endogenous substance

42
Q

Enzyme Induction

A

-Prolonged use of certain drugs induces body to adjust and destroy drug more rapidly than expected
-More enzymes being manufactured or less degraded
-Can lead to tolerance

43
Q

Excretion in Kidneys

A

-Traps ionized water soluble compounds for elimination via urine
-Can be reabsorbed back via passive diffusion

44
Q

Clearance

A

Organ/tissue ability to eliminate drug
-Depends on ability to extract drug and flow of blood (Q)

45
Q

Half-Life

A

-Amount of time it takes for 50% of drug remaining to be eliminated
-Function of both clearance and volume of distribution

46
Q

Dosing Schedules

A

Larger doses given further apart result in greater plasma fluctuations

Internal Medicine (5 decks)

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