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pharma Flashcards

1
Q

what are the 4 types of pharmacokinetics?

A

Absorption, Distribution, Metabolism, Excretion

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2
Q

what is bioavailability of an IV drug?

A

1

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3
Q

what factors affect absorption of a drug?

A

motility of GI tract, acid/base balance of drug

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4
Q

why does acidity of a drug affect absorption?

A

ionised form cannot cross membranes and therefore the acidity (equilibrium between ionised and unionised) affects absorption

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5
Q

what are 3 locations drugs can be distributed to?

A

proteins, tissues, effect site

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6
Q

what affect do protein-bound drugs have on the body?

A

no effect while protein bound

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7
Q

what happens to strength of a drug administered with another if both have high protein affinity?

A

strength of drug will be more as they compete for proteins to bind to

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8
Q

what is a common example of an enzyme inducer drug?

A

Alcohol

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9
Q

what happens to slow and fast metabolisers who are administered codine?

A

slow- no effect

fast- very quick … respiratory arrest

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10
Q

warfarin and which type of juice can cause a serious interaction?

A

grapefruit juice

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11
Q

what effect do agonists have on receptors?

A

bind to receptors causing activation

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12
Q

what effect to antagonists have on agonists?

A

reduce effect of agonists

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13
Q

what are the routes of drug administration? (10)

A

orally, subcutaneously, IV, IM, topically, sublingually, intra arterial, rectal, intrathecal, inhalation

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14
Q

which vaccinations make up the 6 in 1?

A

diphtheria, hep B, polio, Hib, tetanus, whooping cough

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15
Q

what is another name for diamorphine?

A

heroin

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16
Q

what is the reverse drug to opioids?

A

naloxone

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17
Q

order the routes of administration from quickest to slowest

A

IV, subcut & IM, oral

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18
Q

what is potency of a drug?

A

how many mg are required to produce a given effect, highly potent drug requires less mg for desired effect

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19
Q

what is efficacy of a drug?

A

the drugs ability to produce a desired effect, what effect do you get when binding occurs

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20
Q

what is tolerance in relation to drugs?

A

down regulation of receptors due to over stimulation therefore higher dose required, subjects get a reduced reaction to drug over long-term usage

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21
Q

what is dependence in relation to drugs?

A

neurones adapt to repeated exposure and individual functions normally only in the presence pf drug, psychological - craving, euphoria, physical effects too

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22
Q

how do opioids produce the euphoric effects?

A

inhibit pain transmitter release at spinal cord and midbrain

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23
Q

which receptors do opioids work on?

A

M receptors

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24
Q

where do opioids act, in addition to the pain system, and what are the consequences?

A

M receptors are found in pain system, gut and respiratory system
constipation and respiratory depression are common side effects

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25
what steps should you take if suspecting someone of opioid induced respiratory depression?
call for help, ABC, naloxone IV
26
what is intrathecal administration?
through spinal cord into subarachnoid space
27
what is pinocytosis?
entry of substance into cell cytoplasm by budding
28
what is the difference between water and lipid solubility in ionised and unionised forms of drugs?
ionised-water soluble | unionised-lipid soluble
29
what is first pass metabolism?
drug metabolism can greatly reduce concentration of drug before it reaches circulation, barriers to circulation include: intestinal lumen, intestinal wall, liver, lungs
30
why is intestinal lumen a barrier to circulation? (1st pass metabolism)
bacteria and digestive enzymes may reduce or hydrolyse drugs
31
why is intestinal wall a barrier to circulation? (1st pass metabolism)
cellular enzymes, efflux transporters- transport drug back to lumen
32
how can liver metabolism of drugs delivered to digestive system be avoided?
deliver drugs to area not drained by splanchnic to liver, e.g. mouth and rectum
33
what are efflux transporters?
present in membrane of most cells and move substances out of cell, active process
34
what is a side effect?
an unintended effect related to pharmalogical properties of a drug
35
what do ABCDEF in Rawlins Thompson classification of adverse drug reactions stand for?
``` Augmented pharmacology Bizarre Chronic use Delayed presentation End of treatment Failure of therapy ```
36
what is an example for A of Rawlins Thompson classification?
Augmented pharmacological: Morphine and constipation
37
what is Rawlins Thompson classification used for?
Classifying adverse drug reactions
38
which types of reactions fall into A of the Rawlins Thompson classification?
Augmented pharmacological: Predictable, common, dose dependent reactions
39
what is an example for B of Rawlins Thompson classification?
Bizarre: Anaphylaxis and Penicillin
40
which types of reactions fall into B of the Rawlins Thompson classification?
Bizarre: unpredictable, not dose dependent, idiosyncratic (unique/peculiar)
41
what is an example for C of Rawlins Thompson classification?
Chronic use: Osteoporosis and long-term steroid use
42
what types of reactions fall into C of the Rawlins Thompson classification?
Chronic use
43
what is an example for D of Rawlins Thompson classification?
Delayed presentation: malignancies and immunosuppression drugs
44
what types of reactions fall into D of Rawlins Thompson classification?
Delayed presentation, years after exposure
45
what is an example for E of Rawlins Thompson classification?
End of treatment: opioid withdrawal
46
which types of reactions fall into E of Rawlins Thompson classification?
End of treatment, withdrawal from drugs
47
what is an example for F in Rawlins Thompson classification?
Failure of therapy: oral contraceptive pill failure with enzyme inhibitor drug
48
what does DoTS stand for?
Dose related Timing Susceptibility of patient
49
what is DoTS used for?
Classifying adverse drug reactions
50
what are risk factors associated with adverse drug reactions?
``` age- elderly, neonatal gender- female>male polypharmacy genetic predisposition allergy and hypersensitivity renal impairment non adherence hepatic impairment ```
51
what are the classic symptoms of acute anaphylaxis in response to drug?
``` rash (in minutes) vasodilation- red swelling urticaria angioedema bronchoconstriction ```
52
what is the difference between allergic anaphylaxis and non-immune anaphylaxis?
allergic happens upon second exposure to agent
53
what is treatment for anaphylaxis?
ABC | ADRENALIN! (EpiPen or 500mg IM)
54
what effects does adrenalin have on the body?
vasoconstriction, bronchodilation, reduces oedema, stimulation of B1 receptors in the heart
55
what category of drug is naproxen?
NSAID
56
which enzyme does naproxen inhibit?
cyclooxygenase
57
what are contraindications?
times when a drug shouldn't be prescribed due to harmful effects
58
which substances do NSAIDS inhibit synthesis of?
prostaglandins
59
what effect do NSAIDS have on patients with asthma?
can exacerbate asthma, causing bronchospasms | may cause allergic reaction symptoms
60
what risk factors are important when considering prescribing NSAIDS in a patient?
``` age>65 atherosclerosis chronic hypertension renal problems reduced blood volume ```
61
what is a common ACE inhibitor?
Ramipril
62
what are ACE inhibitors commonly used for?
hypertension, heart failure, diabetic nephropathy
63
what are the possible adverse effects of ACE inhibitors?
``` hypotension acute renal failure hyperkalaemia pregnancy- teratogenic effects to foetus cough- dry and persistent rash anaphalactic reactions ```
64
why is a cough common in patients taking ACE inhibitors?
ACE also breaks down bradykinin, so inhibition causes a build up of kinins in respiratory tract
65
where are ACE inhibitors metabolised?
kidneys
66
what is the mechanism of ACE inhibitors?
competitive inhibitors of ACE which converts angiotensin 1 to angiotensin 2
67
what effect do ACE inhibitors have of angiotensin 2 and therefore what occurs?
reduced angiotensin 2 production | BP reduced due to less vasoconstriction
68
what are ARBs?
angiotensin 1 receptor blockers
69
which receptors detect angiotensin 2?
angiotensin 1 receptors
70
if patients are struggling with ACE inhibitor cough, which drugs can be used in their place?
ARBs
71
what are examples of ARBs?
candesartan, valsartan
72
what is an example of a calcium channel blocker?
amlodipine
73
what type of calcium channels are targeted pharmacologically?
L type channels
74
what are the side effects of calcium channel blockers that work on peripheral vasodilation?
flushing, headache, oedema, palpitations
75
what is a common side effect of the calcium channel blocker verapamil?
constipation
76
what are common examples of beta blockers?
bisoprolol, metoprolol
77
what is selectivity of beta blockers?
some work on B1 receptors and others work on both B1&2 receptors (non selective)
78
what is the selectivity of Bisoprolol?
B1 selective
79
which 2 common resp conditions are worsened by beta blockers?
COPD and asthma
80
on which part of the nephron do thiazides work?
distal tubules
81
to which 2 groups of patients would you prescribe calcium channel blockers initially for hypertension?
age>55 | afro-Caribbean
82
which 6 types of drugs are used to manage IHD?
``` calcium channel blockers antiplatelet nitrates beta blockers statins ACE inhibitors ```
83
what is an example of a common nitrate used for IHD or angina?
GTN spray
84
which antiplatelet drugs are commonly administered for patients with IHD?
LD aspirin & clopidogrel
85
what is an example of a statin commonly used?
simvastatin
86
what do statins do?
reduce cholesterol
87
what do antiplatelets do?
thin blood, reduce clotting
88
what do nitrates do?
vasodilation

Phase2A (8 decks)

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