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Pharmacology > Pharmacokinetics > Flashcards

Pharmacokinetics Flashcards

1
Q

Therapeutic Index

A

A measure of drug safety. it is a ratio between the dose that produces toxicity (in half the population) to the dose that provides clinical effects (in half the population)

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2
Q

Volume Distribution

A

The amount of drug which needs to be in the body to get a certain concentration in the plasma

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3
Q

Total Body Clearance

A

The sum of all clearances by the drug-metabolizing and drug eliminating organs

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4
Q

Factors that can affect elimination

A

Kidney function, blood flow, rate of drug metabolism

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5
Q

Dose vs Dosage

A

Dose is the amount of drug to be given at a specific time. Dosage is the full description of how the dose is administered (specific amount, number and frequency of doses and time frame)

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6
Q

Bioavailability

A

rate/extent to which a drug reaches systemic circulation

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7
Q

First order kinetics

A

amount of drug is less than available enzymes. metabolism depends on the amount of drug present

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8
Q

Zero order kinetics

A

amount of drug exceeds available enzymes and therefore metabolism is proportional to the rate of enzyme function

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9
Q

What needs to be done to metabolize (and then excrete) drugs (lipid-soluble)?

A

drugs need to be hydrophilic to be excreted by the kidneys. The drug is either oxidized, hydrolyzed or hydroxylated (H->OH) by cytochrome P450 in the liver. If the drug still cannot be excreted, it is attached to a larger, hydrophilic drug.

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10
Q

First Pass metabolism

A

concentration of a drug is greatly reduced before it reaches the systemic circulation (specifically when administered orally). drugs absorbed through the GI tract enter portal circulation and undergo metabolism in the liver prior to entering systemic circulation

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11
Q

Contraindications: relative vs absolute

A

contraindications are factors that if they are present, the drug shouldn’t be given. Relative: we don’t know much about the effects of the drug during pregnancy (but in an emergency we would give it). absolute: the patient is allergic and will die if it is given to them

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12
Q

Synergistic effects of two drugs

A

The sum of the effects of both drugs together is greater than each drug independently.

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13
Q

How does pregnancy affect plasma volume and cardiac output?

A

pregnant women have an increase in plasma and therefore there is a decrease in the concentration of certain drugs. Pregnant women have increased blood flow to organs - this means that they are absorbed more quickly and also excreted quickly (kidneys)

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14
Q

How does pregnancy affects GFR?

A

GFR is increased therefore the drug is eliminated more quickly

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15
Q

How does increased body fat during pregnancy affect drug distribution

A

gives lipophilic drugs a greater reservoir for distribution

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16
Q

Drug characteristics which increase placental drug transfer?

A
  • lipophilic
  • small molecular size
  • use of placental transporters
  • low degree protein binding
17
Q

How does pediatrics affect drug distribution? (how do they vary physiologically)

A
  • lower muscle mass
  • lower body fat
  • lower plasma protein concentration
  • increased body water
  • BBB is more permeable
18
Q

Explain how you would set up for an IV

A 
•SITE SELECTION
•ASSEMBLE EQUIPMENT
•TOURNIQUET APPLIED•
CLEANSE SITE•
CHECK CATHETER FOR INTEGRITY
•STABILIZE VEIN
ATTACK VEIN (45⁰ ANGLE) (BEVEL UP)
•OBSERVE FOR FLASH
•ADVANCE CATHETER 2MM (DROP ANGLE)
ADVANCE CATHETER
•RELEASE TOURNIQUET
•APPLY TRANSPARENT DRESSING
•CONNECT IV LINE OR LOCK
•ASSESS PATENCY
•PLACE 2 X 2 DRESSING
•SECURE•
19
Q

What is a macro vs micro drop set?

A

Macro: 10 gtts/ml
- it takes 10 drops to get 1 ml
- used to infuse large volumes more quickly
Micro: 60 gtts/mL
- it takes 60 drip to get 1 mL
- used for smaller quantities that need to be more specific (pediatrics)

20
Q

What are some complications of IV initiation/therapy?

A
  • infiltration
  • catheter shear
  • phlebitis
  • abscess
  • hypothermia
21
Q

Describe Infiltration (IV)

A

occurs when the tip of the needle escapes the vein and fluid accumulates in the soft tissue surrounding it.

  • pain and swelling
  • can lead to necrosis
  • evaluate PMS
22
Q

Describe catheter shear (IV)

A

occurs when the catheter breaks off from the needle. It can either stay in the vein location or embolize
- can occur when provider tries to pull catheter back over needle

23
Q

Describe Phlebitis (IV)

A

inflammation of the vein

24
Q

Crystalloid infusions

A

fluids that supply water and electrolyte.
- does NOT contain proteins (colloids)
-compensates for fluid loss
- manage specific fluid and electrolyte imbalances
ex hypertonic saline

25
Q

crystalloid infusion contraindications

A

should not be administered when there is evidence of fluid overload or severe left ventricular dysfunction

26
Q

Colloid infusion

A 
contains large molecules  and maintains high osmotic pressure in the blood (may draw fluid from extracellular space)
- does not contain electrolytes
- considered blood product 
- ex albumin
contains proteins (albumin)
27
Q

Packed Red Blood Cells (PRBC)

A
  • contain red blood cells and 20% plasma
  • refrigerated product
  • Tx of anemia
28
Q

Fresh Frozen Plasma (FFP)

A
  • contains acellular blood products (clotting factors; prothrombin & fibrinogen, albumin)
29
Q

cryoprecipita

A

made from FFP

  • contains clotting factors
  • frozen
  • used primarily to replace fibrinogen
30
Q

Hypernatremia

A
  • high salt to total body water ratio due to high water loss

S/S: thirst, confusion, neuromuscular hyper excitability, seizures

31
Q

Hyponatremia

A

loss of salt

S/S: weakness, confusion, muscle cramps, irritability, seizures

32
Q

Hyperkalemia

A

excess potassium

S/S: paralysis, flaccid

33
Q

Hypokalemia

A

loss of potassium

S/S: muscle weakness, hypoventilation, paralysis, dysrhythmias, hypotension

34
Q

Hypercalcemia

A

too much calcium

S/S: abdominal pain, confusion, delirium, neuromuscular weakness, renal failure

35
Q

hypermagnesemia

A

excess magnesium

36
Q

chemical buffers (4)

A
  • Protein: anion at physiological pH but have the ability to donate and accept H+ as required to neutralize pH changes
  • hemoglobin: carries 60% of the CO2 in blood
  • phosphates:
  • bicarbonate-carbonic acid
37
Q

Physiological buffers (2) and how capable are they of restoring normal pH

A

Respiratory: regulation of CO2 excretion

  • minutes to hours
  • 50-75% effective

Renal: regulation of HCO3 excretion and re-absorption.

  • occurs per hours to days
  • capable of fully restoring pH
38
Q

Respiratory compensation (what happens if there is an increased presence of acid in the blood?)

A
  • detected by chemoreceptors in the medulla.
  • immediate response is an increase in rate and depth of breathing (++ minute volume)
  • this leads to increased CO2 excretion which reduces H+ via the buffer system
  • cannot fully restore pH
39
Q

kidney compensation

A

regulate excretion and reabsorption of HCO3

- reabsorption of HCO3 leads to direct acid excretion

Pharmacology (3 decks)

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