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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

A

2nd

25
Q

Which class: Asenapine

A

2nd

26
Q

Which class: Clomipramine

A

TCA

27
Q

Which class: Amoxapine

A

TCAs

28
Q

Which class: Amitriptyline

A

TCA

29
Q

Which class: Desipramine

A

TCA

30
Q

Which class: Nortriptyline

A

TCA

31
Q

Which class: Doxepin

A

TCA

32
Q

Which class: Trrimipramine

A

TCA

33
Q

Which class: Imipramine

A

TCA

34
Q

Which class: Protriptyline

A

TCA

35
Q

Which class: Citalopram

A

SSRI

36
Q

Which class: Fluvoxamine

A

SSRI

37
Q

Which class: Paroxetine

A

SSRI

38
Q

Which class: Phenelzine

A

MAOI

39
Q

Which class: Tranylcypromine

A

MAOI

40
Q

Which class: Selegeline

A

MAOI

41
Q

Schedule 1 meds

A 
Non medicinal
High abuse potential
Used for research only
Not legally available by prescription
Examples are heroin and marijuana
42
Q

Schedule 2 meds

A

Medicinal drugs in current use

No telephone orders allowed
No refills allowed on a prescription

Morphine, fentanyl, oxycodone, other pain meds, amphetamines, methylphenidate

43
Q

Schedule 3 meds

A

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
Q

Schedule 4

A

Less abuse potential

Xanax and the other benzos, modafinil, armodafinil, phenobarbital, zolpidem (ambien), eszopiclone (Lunesta)

45
Q

Schedule 5 meds

A

Medicinal drugs with the lowest abuse potential
Handled in a way similar to non-controlled meds
Buprenorphine, cheratussin (robitussin) with codeine

46
Q

Possible risks of meds during pregnancy

A 
Problems with appetite
Transient agitation or sedation
Premature labor
Drug discontinuation symptoms 
Teratogenic effects
47
Q

Pregnancy ratings for meds

A 
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
Q

Teratogenic effects of benzos

A

Floppy baby syndrome, cleft palate

49
Q

Teratogenic effects of carbamazepine

A

Neural tube defects

50
Q

Teratogenic effects of Lithium

A

Epstein anamoly

51
Q

Teratogenic effects of divalproex sodium (depakote)

A

Neural tube defects (specifically spina bifida), atrial septal defect, cleft palate, long term developmental deficits.

52
Q

Meds that can induce depression

A 
Beta blockers
benzos
Steroids
Interferon
Isotretinoin
Some retroviral drugs
Antineoplastic drugs
Progesterone
53
Q

Medications that can induce mania

A

Steroids
Disulfiram
Isoniazid
Antidepressants in persons with bipolar

54
Q

Meds that can cause a false positive Amphetamine screen

A 
Stimulants
Bupropion
Fluoxetine
Pseudoephedrine
Trazadone/Nefazodone
Ranitidine
55
Q

Meds that can cause a false positive Alcohol screen

A

Valium

56
Q

Meds that can cause a false positive Benzos screen

A

Sertraline

57
Q

Meds that can cause a false positive Cocaine screen

A

Amoxicillin
Antibiotics
NSAIDs

58
Q

Meds that can cause a false positive Heroin/morphine screen

A

Quinolones
Rifampin
Codeine
Poppy seeds

59
Q

Meds that can cause a false positive Methadone/PCP screen

A

Dextromethorphan, nyquil

Board Certification 2 (Purple book) (22 decks)

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