Pharm final 2 Flashcards
1
Q
The inventor of the drug
A
Brand name
2
Q
ED50 is the dose of the drug that produces
A
An effect in 50% of the population
3
Q
TD50 is the dose of the drug that produces
A
Toxicity in 50% of the population
4
Q
Formula for therapeutic index
A
TD50/ED50
5
Q
Larger TI means the drug is
A
Safer
6
Q
If a drug has a low TI, then there’s only a __ gap between what’s effective and what’s toxic
A
Small
7
Q
With a Los TI, if the dose is off by even a small amount you could have
A
Toxicity
8
Q
2 we’ll know drugs with low TI
A
Warfarin and phenytoin
9
Q
If switching from generic to brand name, you need to be careful because
A
The potency could vary between the two
10
Q
Drugs take something the body already does and alters it, but it doesn’t
A
Gives new functions
11
Q
Process of a drug has three parts
A
- Delivered to tissue
- Effect on tissue
- Eliminated from body
12
Q
Pharmacokinetics
A
What does your body do to a drug
13
Q
4 parts of pharmacokinetics (similar to the drug process slide but little more details)
A
Absorption
Distribution
Biotransformation
Excretion
14
Q
Absorption is the site of administration to
A
Plasma
15
Q
Distribution is plasma to site of action and
A
Other sites too because drugs are stupid and don’t know exactly where to go
16
Q
Biotransformation is ___ altering the drug
A
Chemically
17
Q
Excretion is
A
Removal of drug
18
Q
Word for “how does the drug work”
A
Pharmacodynamics
19
Q
What does your body do to a drug
A
Pharmacokinetics
20
Q
Phrase describing that the form in which the drug is taken can impact the pharmacokinetics
A
Pharmaceutical phase
21
Q
Pharmaceutical phase aka
A
Route and form
22
Q
Pharmaceutical phase doesn’t change what the drug ___ but it changes the speed at which it works
A
Does
23
Q
Examples of drugs that work by targeting enzymes
A
ACE inhibitors and aspirin
24
Q
Examples of drugs that work by altering cell membrane activity
A
Local anesthetics
25
Examples of drugs that work by targeting receptors
Antihistamines and beta blockers
26
Examples of drugs that work by neutralizing small molecules
Antacids
27
Absorption, distribution, and elimination depend on the ability of a drug to cross the
Cell membrane
28
__ soluble drugs cross the membrane faster
Lipid soluble
29
Most common way that drugs move across the cell membrane
Diffusion
30
Diffusion is driven by
Concentration gradients
31
How much of the active drug is available to tissues after being administered
Bioavailability
32
IM has a ___ bioavailability than oral
Higher
33
In which part of the 4 parts of Pharmokinetics does the the drug exert its effects
Distribution
34
During biotransformation, the body chemically alters the drug in order to ___ it
inactivate it
35
Does pH affect absorption
Yes
36
Weak acids are better absorbed in ___ environments
acidic
37
Bases are better absorbed in ___ environments
basic
38
Most drugs are best absorbed by which organ
small intestine
39
99% of the time, higher drug concentration means ___er absorption
higher
40
constant % of the drug released at set intervals
1st order pattern
41
constant amount (i.e. in milligrams) released at set intervals
0 order pattern
42
An example of 0 order is the use of __ ___ capsules
time released capsules
43
Enteral route is anything to do with the _ _ tract
G I
44
Enteral route is not the quickest or most ___
reliable
45
Stomach has no significant
absorption
46
Not even __ is absorbed in the stomach even though it's acidic
aspirin
47
Rectal administration is good because is very ___ but bad bc it has small ___
vascular, surface area
48
Another advantage of rectal is that it bypasses the
first pass effect
49
An important concern of IV is that you don't go
too fast
50
Intrathecal is aka ___ aka ___ space
spinal aka subarchnoid space
51
For an intrathecal aka spinal you need to monitor
BP
52
Medication delivered by an epidural most travel through the
meninges
53
Effects of an epidural are ___er than a spinal
slower
54
Medication delivered by the ears, eyes, skin, nasal mucosa
topical
55
One factor effecting distribution is __ __ binding
plasma protein
56
Some drugs have a high affinity for binding with
protein
57
If a drug is stuck to a protein it can't get to the
tissue
58
2 drugs that almost completely bind to protein
warfarin and diazepam
59
Being bound to a protein is ___ (it changes)
dynamic
60
Drugs that bind to protein have a ____er duration of action. The protein slowly releases the drug.
longer
61
You have a drug that's bound to protein. You add a 2nd drug that also binds. This causes some of the 1st drug to
release from the protein
62
Only __ soluble substances can cross the BBB
lipid soluble
63
Pregnancy category A
safe for pregnant women
64
Pregnancy category X
unsafe for pregnant women
65
Biotransformation inactivates a drug by making it more
water soluble
66
The water soluble a drug is the more easily it is
eliminated
67
A series of enzymes in the liver used for eliminating drugs
p450
68
p450 enzymes can be ___ed or ___ed by certain drugs
inhibited or induced
69
The basis for a lot of drug interaction is the __ enzyme
p450
70
Metabolism is a synonym for
biotransformation
71
A higher dose is needed for oral medication because of the
first pass effect
72
major organ of excretion is
the kidneys
73
With ethanol, once you reach saturation level
only a set amount can be excreted at a time
74
A saturation level, ethanol kind of follows a __ ___ pattern
0 order
75
Urinary __ can be altered to enhance excretion of poisons or medications taken in toxic doses
pH
76
To enhance excretion of an acid, make environment more
basic
77
The time it takes to reach the MEC (minimal effective concentration)
Onset of action
78
The most stable blood levels will be accomplished with
IV
79
__ frequent dosing gives you more extremes in the blood levels
Less
80
The frequency of dosing is partially determined by
how much the blood levels can fluctuate before getting close to toxic levels or below the MEC
81
the study of substances that interact with living systems through chemical processes
pharmacology
82
the 2 major branches of pharmacology
Medical, Toxicology
83
any substance used in the diagnosis, cure, treatment or prevention of a disease
drug
84
A drug usually has 3 names
chemical
generic
trade/brand
85
With some exceptions, most FDA-approved generic drugs are ___ equivalent to their brand name counterparts
therapeutically
86
interaction between drug and body; absorption, distribution, biotransformation, and elimination
pharmacokinetics
87
interaction between drug and body; practical importance in designing a drug regimen for a patient
pharmacokinetics
88
interaction between drug and body; concerned with the mechanism of action of drug on the tissue
pharmacodynamics
89
interaction between drug and body; receptor theory
pharmacodynamics
90
interaction between drug and body; various drug forms influence pharmacodynamics and pharmacokinetics
pharmaceutical phase
91
the lipid bilayer prevents movement of highly __ or __ soluble molecules
polar or water soluble molecules
92
term used to describe the extent of absorption
bioavailability
93
refers to the percentage of active drug substances absorbed and available to target tissues follow administration
bioavailability
94
bioavailability of IV and IM
100%
95
bioavailability of oral
20%
96
drugs classified as weak acids get absorbed more readily in __ pHs
acid pHs
97
Constant % of drug absorbed over time
1st order
98
Constant amount of drug absorbed over time
0 order
99
not the quickest or most reliable route
oral/enteral
100
gastric absorption is not
significant
101
3 disadvantages of intravenous high __, ___y, and ___y
high cost
difficulty
irreversibility
102
advantages of intravenous are rapid onset, large __, and use of ___ drugs
large amounts can be given
| used of irritant drugs
103
5 parenteral routes
```
subcutaneous
IM
IV
intrathecal
epidural
```
104
Topical administration includes eyes, ears, skin, and
nasal mucosa
105
Distribution is affected by lipid solubility, regional blood flow/cardiac output, and ___ __ binding
plasma protein binding
106
drug-protein complex is not biologically active because it's too large to
cross the plasma membrane by diffusion
107
bound drugs have a ___er duration of action
longer
108
high protein binding increases the potential for __ effects
toxic effects
109
barriers to distribution include the BBB and
placenta
110
pregnancy category; adequate well-controlled studies in pregnancy have not shown an increased risk of fetal abnormalities (prenatal vitamins, insulin)
A
111
pregnancy category; animal studies have revealed no evidence of harm to the fetus but no adequate studies have been done in pregnant women OR animal studies have shown an adverse effect but studies in pregnant women have failed to demonstrate risk to the fetus (penicillin, acetaminophen)
B
112
pregnancy category; animal studies have shown an adverse effect but no adequate studies have been done in pregnant women OR no studies have been done in animals or humans (antihypertensives, corticosteroids)
C
113
pregnancy category; studies in pregnant women have demonstrated a risk to the fetus, however, the benefits of therapy might outweigh the potential risks (ACE inhibitors, alcohol)
D
114
pregnancy category; studies in animals or humans have demonstrated positive evidence of fetal abnormalities or risks. The use of this product is contraindicated in women who are or may become pregnant
X
115
chemically inactivating a drug by making it more water soluble
biotransformation
116
biotransformation chemically inactivates a drug by
making it more water soluble
117
biotransformation allows the drug to be eliminated via the
kidneys
118
biotransformation occurs primarily in the
liver
119
biotransformation occurs primarily in the liver via the cytochrome
p450
120
the cytochrome p450 enzyme is kind of the source of
drug interactions
121
factors that cause variation in rate of metabolism:
impaired __ __
a__
g_____
impaired liver function
age
genetics
122
during passive tubular reabsorption, __ soluble drugs move back into the blood while __ soluble drugs stay in the urine
lipid (move back to blood)
| water (stays in urine)
123
during __ __ __, pumps for organic acids and bases move drugs from blood to urine
active tubular secretion
124
urinary __ can be manipulated to promote excretion of poisons or medications taken in toxic doses
pH
125
aspirin poisoning can be treated by ___ing urinary pH
increasing (making it basic)
126
time at which no drug effect can be seen
termination of action
127
___ of action is the time interval during which a therapeutic response can be seen
duration of action
128
minimal concentration required to elicit a therapeutic response
minimal effective concentration
129
time it takes to eliminate 1/2 of a given concentration of a drug
t 1/2
130
primary dose, given to reach a desired concentration quickly
loading dose
131
the maintenance dose and time interval are chosen to minimize wide variations in ___ while maintaining a ___ dosing schedule
concentration
| workable
132
dosing interval is the
time between doses
133
the duration of action only includes the time that the drug is having a ___ effect
therapeutic effect
134
active site at which a drug interacts
receptor
135
drugs that bind to receptors and mimic the effects of the endogenous compound
agonists
136
drugs that interfere with the binding of the endogenous agonist
antagonist
137
the concentration of a drug needed to produce 50% of the maximal effect (EC50)
potency
138
refer to the maximal effect of the drug
Efficacy
139
example of sympathetic neurotransmitter
Norepi
140
example of parasympathetic neurotransmitter
Acetylcholine
141
sympathetic effect; heart rate
increase (B1 receptors)
142
sympathetic effect; blood vessels
a - constricts
| B2 - dilates
143
sympathetic effect; intestinal secretions
decrease
144
sympathetic effect; GI motility
decrease
145
sympathetic effect; sweat glands
increase
146
sympathetic effect; pupils
a1 - dialate
147
sympathetic effect; bronchioles
B2- dilate
148
sympathetic effect; bladder wall
relaxation (urinary retention) a1
149
sympathetic effect; lipolysis
increases B1 (increases so that you can use the energy)
150
parasympathetic effect; heart rate
decrease
151
parasympathetic effect; blood vessels
no change
152
parasympathetic effect; intestinal secretion
increase
153
parasympathetic effect; GI motility
increase
154
parasympathetic effect; sweat glands
no change
155
parasympathetic effect; pupils
constriction
156
parasympathetic effect; bronchioles
constriction
157
parasympathetic effect; bladder wall
constriction (voiding of urine)
158
parasympathetic effect; Lipolysis
no change
159
parasympathetic system is associated with ___ receptors
muscarinic
160
Synthesis of NE
___ ..... L-DOPA ..... ___ ..... NE ....____
tyrosine ....L-DOPA .... dopamine ..... NE ..... epinephrine
161
MAO stands for mono __ __
mono amine oxidase
162
COMT stands for catechol - O - methyl ___
transferase
163
DA is short for
dopamine
164
Parkinson's disease is progressive deterioration of neurons that are supposed to make
dopamine
165
To help with Parkinson's, ___ is given because it can cross the BBB and then start the pathway to dopamine
L-DOPA can cross the BBB
166
Imbalance in __, __, and maybe __ are linked to depression
serotonin, NE, and maybe DA
167
Tricyclic antidepressants work by blocking the __ pump. This increases the amount of __ in the synapse
block the amine pump, increases NE in the synapse
168
Prozac only effects levels of
serotonin
169
Prozac is an __
SSRI
170
SSRI stands for
selective serotonin reuptake inhibitor
171
MAO inhibitors knock out mono amine oxidase, which causes
increased NE
172
5 classes of drugs that affect the ANS
```
Sympathomimetics
Sympathetic blockers
Parasympathomimetics
Parasympathetic blocks
Ergot Alkaloids
```
173
2 kinds of sympathetic blockers
B blockers
| a blockers
174
2 kinds of Parasympathomimetic
Direct acting
| Acetylcholinesterase inhibitors
175
Have some properties related to ANS, but not a perfect fit
Ergot alkaloids
176
2 kinds of Sympathomimetic drugs
Direct and indirect
177
Direct sympathomimetic drugs are a___s of the SNS
agonists of the SNS
178
examples of Direct acting sympathomimetic drugs
Epi, Albuterol, Phenylephrine
179
Indirect sympathomimetics have the same result as direct but use a different
mechanism
180
Indirect sympathomimetics do not act as ___ agonists
receptor agonists
181
Epi activates both the a and B receptors which makes it
nonspecific
182
Epi effects which part of the nervous system
Sympathetic nervous system
183
Epi (and other nonspecific sympathomimetics) effect on HR
increase
184
Epi (and other nonspecific sympathomimetics) effect on BP
varies (low dose lowers BP, high dose raises it. Medium does gives no change)
185
Epi (and other nonspecific sympathomimetics) effect on bronchodilation
increase
186
Epi (and other nonspecific sympathomimetics) effect on insulin
decrease
187
Epi (and other nonspecific sympathomimetics) effect on GI
decrease
188
Epi (and other nonspecific sympathomimetics) effect on urinary retention
increase
189
Epi (and other nonspecific sympathomimetics) effect on wakefulness and anxiety
increase
190
The effectiveness of Epi (and other nonspecific sympathomimetics) depends on being able to cross the
BBB
191
Epi (and other nonspecific sympathomimetics) effect on arterioles in the lungs
constrict
192
Epi (and other nonspecific sympathomimetics) on appetite
decrease
193
```
Clinical uses:
Asthma
Anaphylactic Shock
ATHD
Cardiac arrest
Ocular surgery
Adjunct with local anesthetics
Premature labor
nasal docongestant
```
Epinephrine (and other nonspecific sympathomimetics)
194
```
Toxicity:
Tachycardia
Severe hypertension
Cerebrovascular hemorhage
Arrhythmias
```
Epi (and other nonspecific sympathomimetics)
