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MCN568 > Pharm Quiz > Flashcards

Pharm Quiz Flashcards

USA MCN568 FALL2019

1
Q

Pharmacokinetics

A

how drug enter and exits the body, what YOU do to the DRUG

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2
Q

Pharmacokinetics steps

A

absorption, distribution, metabolism, excretion

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3
Q

absorbtion

A

drug transfer from site of administration to blood stream

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4
Q

distribution

A

central circulation to peripheral tissue

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5
Q

metabolism

A

bio-transformation: converting molecules

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6
Q

excretion

A

removal

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7
Q

pH changes and drug absorption

A 
low pH (acid) increases absorption of weak acids (furosemide, phenobarbital)
high pH  (base) increases absorption of weak based, and decrease absorption of weak acid
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8
Q

neonate distribution

A

body composition: water( 70-75% and fat 15-28% term; protein binding: low albumin concentration, less binding

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9
Q

neonate metabolism

A

liver- deficiency in enzymes

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10
Q

PHASE I liver metabolism

A

P450, oxidation, reduction, hydrolysis

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11
Q

PHASE II liver metabolism

A

conjugation w/sulfate, acetate and glucoronic acid

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12
Q

neonate excretion

A

kidneys GFR tubular secretion and re-absorption

neonate has: larger volume of distribution, delay excretion, need higher mg/kg dose, longer dosing intervals

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13
Q

bioavailibility

A

fraction of the administered drug that reaches circulation; IV 100%

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14
Q

half life

A

is the time it takes for half of the drug to clear the plasma or the time it takes to reduce concentration in half

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15
Q

steady state

A

concentration of the drug in the maternal circulation that determines the amount of drug available to the fetal compartment; rate of drug administration equals rate of excretion

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16
Q

loading dose

A

long half life…long time to achieve plateau…larger initial dose

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17
Q

placental transfer of drugs

A

increase in maternal far, decrease in serum protein, changes in P450 and UGT; placental changes (surface and thickness);

18
Q

teratogenic

A

anything external to fetus that causes structural or functional disability in prenatal or postnatal life

19
Q

pregnancy risk categories DRUGS

A

A-safe
B-animal safe, no human data
C-animal adverse effect; no human date; benefits outweigh the risk
D human risk; potential benefit outweigh risk
X fetal abnormalities, risk> benefits

20
Q

AGONIST

A

activator of the receptor; stimulates response; has affinity and intrinsic activity

21
Q

ANTAGONIST

A

inhibitor of receptor, blocks agonist, block response; has affinity but no intrinsic activity

22
Q

METABOLISM

A

the rate of drug metabolism is the
primary determinant of both duration and
intensity of drug action

23
Q

Pharmacodynamics

A

What DRUGs do to YOU

  • Receptors and mechanisms of action
  • Stimulators (agonists)
  • Blockers (antagonists)
  • Dose-response relationships
  • Therapeutic effects versus toxic effects
24
Q

example of teratogenic drugs

A

thalidomide, valproic acid, carbamazepine, ACE inhibitor, ARBs, tetrecycline, paroxetine, AEDs

25
Q

neonatal gastric acid production

A

low at birth
few hours of life pH 1-3
first 10 days of life…near neutral
premature: pH 6-8 first 14 days of life

26
Q

drug specific factors DISTRIBUTION

A

molecular size, ionization constant, relative hydrophilic/lipophilic properties; protein bounding

27
Q

infant specific factors DISTRIBUTION

A

body composition, membrane/tissue permeability; cardiac output

28
Q

volume of distribution

A

Vd: hypothetical fluid volume through which the drug is dispersed

29
Q

NEONATE Vd

A

Vd is high/large, lowering max drug concentration, drug clearance is slow…need higher dose

30
Q

delay drug clearance causes?

A

prolonged half-life

31
Q

FAS

A

greatest single drug-induced cumulative preventable intellectual deficit in children

32
Q

NAS opioids

A

clinical presentation: CNS and GI S&S

33
Q

intubation meds

A

fentanyl 1-3ug/kg or midazolam 0.1mg/kg

34
Q

circumcision meds

A

PO sucrose, acetaminophen, lidocaine block

35
Q

chest drain meds

A

fentanyl, local anesthetic, non-pharm measures

36
Q

ophthalmology exam meds

A

anesthetic drops, sucrose, containment

37
Q

post op

A

police and around the clock, preventative, morphine, fentanyl, acetaminophen

38
Q

therapeutic drug monitoring

A

appropriate dosing, modification for desired drug concentrations (t) tau interval, (n) number of doses

39
Q

peak level

A

30 minutes post end of infusion

40
Q

trough level

A

60 minutes prior next dose administration

41
Q

NEO meds requiring monitoring

A

gentamicin, vancomicin, phenobarbital

MCN568 (11 decks)

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