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Pharm quiz 2 Flashcards

Pharmacokinetics & pharmacodynamics

1
Q

What is the most you should give per an IM injection?

A

3cc/ 3 ml

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2
Q

When should you not give a patient oral medication?

A

if they are vomiting, sedated, NPO (not my mouth), or unconscious.

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3
Q

Define pharmacokinetics.

A

PK is what the BODY does to the drug, how the drug moves into, through and out of the body
A.D.M.E.

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4
Q

ADME

A

Absorption
Distribution
Metabolism
Elimination

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5
Q

Define Pharmacodynamics

A

PD is what the DRUG does to the body, or how the drug works. how a medication changes the body to produce a therapeutic affect

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6
Q

Describe absorption

A

how will the drug get into the body

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7
Q

Describe distribution

A

Where the drug goes in the body. physiological movement of drugs from circulation to tissue.

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8
Q

Describe Metabolism

A

How the drug is broken down (liver)

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9
Q

Describe Elimination

A

How the drug leaves the body

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10
Q

Passive transport

A

molecules move thru the plasma membrane from an area of high concentration to an area of low concentration, Small, non-ionized, lipid soluble molecules

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11
Q

What must drugs cross in order to produce an effect?

A

The plasma membrane (lipid bi-layer)

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12
Q

What is another name for passive transport?

A

Diffusion

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13
Q

Active transport

A

Chemicals move against concentration or electrochemical gradient. Large, ionized , water soluble molecules/ have difficulty bypassing the lips bi-layer

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14
Q

What kind of energy does active transport require?

A

ATP

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15
Q

what is the primary PK factor that determines the time for the drug to produce an effect?

A

Absorption

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16
Q

what factors can effect absorption?

A

dosage other drugs
Route of administration certain foods
size of drug molecules laxatives/herbals
surface area of absorption site
digestive motility (diarrhea)
Blood flow
Lipid solubility of the drug

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17
Q

What gets more blood flow? Deltoid or glute?

A

Deltoid

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18
Q

Why does grapefruit interact with most drugs?

A

the chemicals in grapefruit cause your body to absorb either too much or not enough medicine into the bloodstream. Can destroy CYTOCHROME P-450

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19
Q

Describe what cations such as calcium (found in supps, anti-acids, dairy) do to inhibit drug absorption.

A

they bind (chelate) tetracycline abx and inhibit absorption

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20
Q

what herbal drug can decrease the effectiveness of Coumadin?

A

St. John’s wart

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21
Q

Name some factors that effect distribution of a drug.

A

Membrane permeability
Tissue affinity
Volume of distribution
Protein binding

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22
Q

what does the BBB (Blood Brain Barrier) do?

A

It is a protective mechanism for the brain that not all medications can pass through

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23
Q

Fetal-Placental Barriers

A

Protect fetus.

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24
Q

What are some things that can get through the bbb?

A

Alcohol

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25
Q

metabolism of medications

A

chemically converts drugs so that they can easily be removed from the body

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26
Q

Where is the primary site of metabolism of medications?

A

Liver

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27
Q

What type of drugs pass through the liver First?

A

Oral medications

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28
Q

how does the liver metabolize a drug?

A

they metabolize oral drugs before they reach central circulation

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29
Q

Name a drug that is ONLY given sublingually

A

Nitro

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30
Q

Name two drugs that can NOT be given orally

A

Nitro and Insulin

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31
Q

First Pass Metabolism

A

“First passage” of frug through the liver, after it is absorbed from the GI tract

32
Q

How does the first pass metabolism travel?

A

From the portal vein to the liver

33
Q

describe how a blood travels to reach its target tissue through oral medication

A

Travels through esophagus to the stomach where some acid breaks down the drug. The drug then travels to the small intestines where some will continue on to be excreted, and the rest will travel through the portal vein back up to the liver, where it will be metabolized and then travel to the heart and get disbursed through circulation of the body

34
Q

a drug that is inactive until it has been metabolized into active metabolites

A

a pro-drug

35
Q

bioavailability

A

how fast it gets into the bloodstream

36
Q

describe how a sublingual, buccal, vagina, rectal drug is absorbed

A

they dissolve into the mucous membrane which goes directly into the systemic blood stream, traveling straight to the brain and other organs (skips first pass )

37
Q

name some variables that affect bioavailability of a drug

A

grapefruit juice
Liver disease
cirrhosis

38
Q

name the hepatic enzyme that is primarily responsible for the metabolism of a drug

A

Cytochrome P-450

39
Q

factors that can affect metabolism of drug

A

Age (infants and elderly have less active liver enzymes)
Chronic illness (liver disease)
Genomics

40
Q

name the primary organ or excretion

A

kidneys

41
Q

toxic concentration

A

level of drug that can produce serious adverse affects

42
Q

therapeutic range

A

Goal, where you want a drug to be (SWEET SPOT)

43
Q

minumum effective concentration

A

amount needed to produce a therapeutic affect

44
Q

Plasma half-life

A

length of time needed to decrease blood plasma concentration by one half (t1/2)

45
Q

examples of filtration

A

free drugs, water-soluble agents, electrolytes, small molecules

46
Q

examples of secretion

A

drug-protein complexes, large substances

47
Q

Name some non renal routes of excretion

A 
biliard  (fever)
pulmonary 
salivary
mammary
skin/dermal
gastrointestinal
genital
48
Q

Half life

A

the time it takes for the concentration of a drug in your system to drop by 50% (1/2)

49
Q

greater half life equals?

A

greater the time it takes to excrete

50
Q

Loading Dose

A

large initial dose of a drug to get levels up faster in order to reach therapeutic level

51
Q

therapeutic index

A

measure of a drugs safety margin . the higher the value, the safer the drug.

52
Q

when you reach a plateau, will increasing the dosage have a more therapeutic affect?

A

No, it will result in toxicity

53
Q

What do you call a drug that is really good at metabolizing?

A

“high first pass metabolism”

54
Q

inter-patient variability

A

Some people need more of a drug to have a therapeutic affect than others

55
Q

Therapeutic index

A

measure of a drug safety margin

56
Q

the higher the therapeutic value of a drug…

A

the safer the drug

57
Q

Potency

A

dose of a drug required to produce a therapeutic affect

58
Q

Efficacy

A

magnitude of maximum response that can be produced from a particular drug

59
Q

what is a drug receptor?

A

the molecule to which a medication binds in order to initiate a chain of events leading to drug action

60
Q

what are most drug receptors?

A

protein receptors

61
Q

antagonist

A

a drug that blocks the opioids buy attaching the opioid receptors without activating them
example: narcan

62
Q

full agonist

A

produce the same chain of events as the chemical. a drug that activates certain receptors in the brain.
example: heroin

63
Q

partial agonist

A

activates opioid receptors in the brain example: seboxone (heroin agonist)

64
Q

define Prodrug

A

a drug that is administered in its inactive form, but once absorbed, is converted into an active drug molecule.

65
Q

phagocytes

A

attempt to remove medicines seen as foreign

66
Q

co-transport

A

the movement of two or more chemicals across the membrane

67
Q

do molecules move from a high concentration to a low concentration, or from a low concentration to a high concentration?

A

higher to lower

68
Q

name some factors than can affect drug absorption.

A 
drug/drug interactions
food/drug interactions
dosage
route of administration
size of the drug molecule 
surface area of absorption
digestive motility 
blood flow
lipid solubility of drug
69
Q

name some body tissue that have a high affinity / attraction to certain medications.

A

bone marrow
teeth
eyes
adipose tissue

70
Q

what is the problem with drug-protein complexes?

A

never reach target cell bc they are too large and cannot cross capillary membranes and drug won’t distribute to body tissue.

71
Q

biotransformation

A

metabolism of medications

72
Q

Hepatic microsomal enzyme system

A

P-450 system

73
Q

metabolic activity may be decreased in what type of patients?

A

infants and elderly
patients with liver disease
patients with certain genetic disorders

74
Q

enterohepatic recirculation

A

drugs are secreted in bile, bile recirculates to liver, part of drug may be recirculated many times which prolongs the activity of the drug and can last after discontinuration

75
Q

what is the difference between potency and efficacy ?

A

higher potency means it can be used at a lower dose to produce a therapeutic affect, where efficacy is the magnitude of maximum response that can be produced from a particular drug.

76
Q

Name two basic receptor types.

A

Alpha and Beta

Micro (6 decks)

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