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Board Certification 2 (Purple book) > Pharm principles > Flashcards

Pharm principles Flashcards

1
Q

Pharmacokinetics includes

A

How the body absorbs, distributes, metabolizes, and excretes the drug

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2
Q

PharmacoDynamics is what the Drug does to the body, such as

A

which receptors it binds to

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3
Q

Where are most oral meds absorbed

A

small intestine or liver

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4
Q

Distribution

A

When the drug leaves systemic circulation and enters the interstitium and cells

The drugs are re-distributed according to their protein and fat content

Most meds are lipophilic and highly protein bound. Only the unbound (free) portion is active. Therefore, if you have low protein (for example from malnutrition or aging) you will experience stronger med reaction or even toxicity.
Also, if you have high fat mass compared to lean body mass (such as older people), you will have erratic reactions to meds.

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5
Q

First pass metabolism

A

Process by which the med is changed by the P450 enzymes in the intestine/liver

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6
Q

Half life

A

This determines the dosing schedule and the time needed to reach steady state.

It takes about 5 half-lives to reach steady state, and 5 half lives to eliminate the drug

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7
Q

Metabolizing in special populations

A

10% of whites are poor metabolizers of P450 2D6

20% of asians are poor metabolizers of P450 2C19

Children may be faster metabolizers of several P450 enzymes compared to adolescents

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8
Q

Meds that inhibit P450 (which raises other med levels)

A 
Bupropion
SSRIs
Clomipramine (TCA)
Cimetidine
Clarithromycin
Fluoroquinolones 
Ketoconazole 
Nefazodone
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9
Q

Meds that induce P450 (which lowers other med levels)

A 
Carbamazepine 
Hypericum (St John's Wort)
Phenytoin
Phenobarbital 
Tobacco
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10
Q

Disease of which organs causes high or even toxic med levels

A

Liver and kidney

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11
Q

Renal Clearance

A

Meds that reduce renal clearance, like NSAIDs (Ibuprofen) can increase levels of meds that are renally excreted. That is why you can’t give ibuprofen with Lithium, it will raise the Li level.

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12
Q

Metabolism in older adults

A

Older people are more sensitive to meds because they have less intracellular water, protein binding, low muscle mass, decreased metabolism, and increased body fat concentration

Most meds are lipophilic and highly protein bound. This means that older adults (who have more fat to store meds and less protein for meds to bind to) have more meds active in their system. They can develop toxic levels.

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13
Q

Agonist vs inverse agonist

A

Agonist causes no effect, inverse agonist causes the opposite effect

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14
Q

Excitatory response

A

Depolarization, involve opening all of the sodium and calcium channels so these ions go into the cell

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15
Q

Inhibitory response

A

Repolarization, involves opening chloride channels so that chloride goes into the cell, potassium leaves the cell, or both

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16
Q

tachyphylaxis

A

The med suddenly becomes less effective

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17
Q

a DEA number is required for

A

prescribing controlled substances

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18
Q

Which class: Loxapine

A

1st gen

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19
Q

Which class: Thiorridazine

A

1st gen

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20
Q

Which class: Thiothixene

A

1st gen

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21
Q

Which class: Mesoridazine

A

1st gen

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22
Q

Which class: Perphenazine

A

1st gen

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23
Q

Which class: Trifluoperazine

A

1st gen

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24
Q

Which class: Iloperidone

25
Which class: Asenapine
2nd
26
Which class: Clomipramine
TCA
27
Which class: Amoxapine
TCAs
28
Which class: Amitriptyline
TCA
29
Which class: Desipramine
TCA
30
Which class: Nortriptyline
TCA
31
Which class: Doxepin
TCA
32
Which class: Trrimipramine
TCA
33
Which class: Imipramine
TCA
34
Which class: Protriptyline
TCA
35
Which class: Citalopram
SSRI
36
Which class: Fluvoxamine
SSRI
37
Which class: Paroxetine
SSRI
38
Which class: Phenelzine
MAOI
39
Which class: Tranylcypromine
MAOI
40
Which class: Selegeline
MAOI
41
Schedule 1 meds
``` Non medicinal High abuse potential Used for research only Not legally available by prescription Examples are heroin and marijuana ```
42
Schedule 2 meds
Medicinal drugs in current use No telephone orders allowed No refills allowed on a prescription Morphine, fentanyl, oxycodone, other pain meds, amphetamines, methylphenidate
43
Schedule 3 meds
Telephone order is allowed if followed by a written prescription Prescription must be renewed every 6 months Refills limited to 5 Appetite suppressants, butalbital, testosterone, buprenorphine/naloxone
44
Schedule 4
Less abuse potential | Xanax and the other benzos, modafinil, armodafinil, phenobarbital, zolpidem (ambien), eszopiclone (Lunesta)
45
Schedule 5 meds
Medicinal drugs with the lowest abuse potential Handled in a way similar to non-controlled meds Buprenorphine, cheratussin (robitussin) with codeine
46
Possible risks of meds during pregnancy
``` Problems with appetite Transient agitation or sedation Premature labor Drug discontinuation symptoms Teratogenic effects ```
47
Pregnancy ratings for meds
``` A - Studies show no risk B - No evidence of risk in humans C- Risk cannot be ruled out D- Positive evidence of risk X- Absolutely no ```
48
Teratogenic effects of benzos
Floppy baby syndrome, cleft palate
49
Teratogenic effects of carbamazepine
Neural tube defects
50
Teratogenic effects of Lithium
Epstein anamoly
51
Teratogenic effects of divalproex sodium (depakote)
Neural tube defects (specifically spina bifida), atrial septal defect, cleft palate, long term developmental deficits.
52
Meds that can induce depression
``` Beta blockers benzos Steroids Interferon Isotretinoin Some retroviral drugs Antineoplastic drugs Progesterone ```
53
Medications that can induce mania
Steroids Disulfiram Isoniazid Antidepressants in persons with bipolar
54
Meds that can cause a false positive Amphetamine screen
``` Stimulants Bupropion Fluoxetine Pseudoephedrine Trazadone/Nefazodone Ranitidine ```
55
Meds that can cause a false positive Alcohol screen
Valium
56
Meds that can cause a false positive Benzos screen
Sertraline
57
Meds that can cause a false positive Cocaine screen
Amoxicillin Antibiotics NSAIDs
58
Meds that can cause a false positive Heroin/morphine screen
Quinolones Rifampin Codeine Poppy seeds
59
Meds that can cause a false positive Methadone/PCP screen
Dextromethorphan, nyquil

Board Certification 2 (Purple book) (22 decks)

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