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Advanced Pharmacology Exam 1 > Pharmacokinetics & Pharmacodynamics > Flashcards

Pharmacokinetics & Pharmacodynamics Flashcards

1
Q

Pharmacokinetics

A

The study of the time course of a drugs journey through the body

Absorption, distribution, metabolism, elimination

what the body does to the drug

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2
Q

Phamacodynamics

A

The study of the existing biological effects resulting from the interaction between drugs and biological systems

what the drug does to the body

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3
Q

Active drug

A

Free drug

Drug that is not bound to protein

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4
Q

Peds most reliable route of med admin

A

IV

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5
Q

Peds most desirable route of med admin

A

Enteral

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6
Q

Topical med admin in peds

A

Reduces as skin matures

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7
Q

absorption

A

transfer of drug from the site of administration into circulation

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8
Q

bioavailability

A

amount of drug absorbed into circualtion

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9
Q

distribution

A

partitioning of drug from the circulation into various body fluids, organs, and tissues

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10
Q

metabolism

A

biotransformation of the drug

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11
Q

elimination

A

elimination of the drug from the body

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12
Q

primary site of metabolism

A

the liver

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13
Q

primary site of elimination

A

kidneys

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14
Q

potency

A

amount of drug required to cause effect

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15
Q

efficacy

A

response of the drug (even less efficacious drugs may not have full efficacy)

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16
Q

phase I reactions

A

simple reactions

CYP450

oxidation, reduction, hydrolysis

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17
Q

phase II reactions

A

more complex reactions with molecules added together

conjugation, glucuronidation, sulfation, acetylation, methylation

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18
Q

clearance

A

rate at which drug is eliminated

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19
Q

factors that affect GFR

A

protein binding
renal blood flow
area and nature of glomerular membrane

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20
Q

methods of elimination

A

glomerular filtration, tubular secretion, tubular reabsorption

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21
Q

single compartment kinetics

A

drug is delivered to the central compartment, then eliminated and has action

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22
Q

multicompartment kinetics

A

drug is delivered to central compartment, and rapidly distributed to the peripheral compartment

23
Q

alpha phase

A

distribution phase of multicompartment kinetics

drug is still being eliminated - blood levels are high

DO NOT DRAW LEVELS DURING THIS PHASE

24
Q

beta phase

A

phase of gradual elimination - like single compartment kinetics

25
Q

volume of distribution

A

size of compartment in which drug distributes

Vd=dose/concentration

26
Q

half life

A

time for the drug concentration to decrease by one half

generally takes 5 half-lives to eliminate drug from the body

27
Q

first order kinetics

A

linear or exponential clearance - constant fraction or proportion of drug is removed per unit of time

ideal for drug calculations!

28
Q

zero order kinetics

A

mechanisms for elimination become saturated - more drug is present than system can process, so drug is NOT eliminated at a constant (linear) rate

a small increase in dose will result in a large increase in the plasma concentration

29
Q

clearance

A

rate of elimination / drug concentration

single most important factor in determining drug concentrations

depends on: dose, organ blood flow, intrinsic function of the liver or kidneys

30
Q

is it ok to draw peaks/troughs off schedule?

A

okay to get peaks late and troughs early

do not obtain peaks early!!!
do not get troughs late!!!

31
Q

how to titrate meds based on peaks and troughs?

A

peaks - adjust dose

troughs - adjust interval

32
Q

sensitivity

A

concentration required to produce 50% of maximum effect

33
Q

type I reaction

A

anaphylactic

34
Q

type II reaction

A

cytolytic

ex. hemolytic anemia, ABO mismatch

35
Q

type III reaction

A

arthrus

ex. serum sickness, RA, SLE, cephalosporin rxn

36
Q

type IV reaction

A

delayed hypersensitivity reaction

ex. contact dermatitis

37
Q

adverse drug event

A

any untoward medical occurance that may present during treatment with a pharmaceutical product but which does not necessarily have a causal relationship with this treatment

ex. falls

38
Q

medication error

A

any PREVENTABLE event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer

39
Q

tool used to determine risk of drug interactions for hepatic failure

A

childs-pugh classification

considers bilirubin, albumin, ascites, encephalopathy, prothrombin time

40
Q

important meds to evaluate for in hepatic failure

A

drugs that depend on hepatic metabolism for clearance
high hepatic extraction ration
degree of protein binding

free drugs have greater effect to target sites

benzos, fluoroquinolones, H2 antagonists, loop diuretics

41
Q

renal failure changes

A

changes in protein binding
altered volume of distribution d/t fluid overload or altered tissue binding
decreased clearance

42
Q

cockcroft-galt equation

A

estimates CrCl

CrCl = (140-age)(ABW in kg)/72(Scr)

females - CrCl * 0.85

Normal = >90 ml/min
ABW = actual body weight
43
Q

important meds to monitor in renal failure

A

drugs that may worsen renal function
are renally eliminated
are metabolized to active/renally eliminated metabolites
are highly protein bound

44
Q

CHF changes

A

decreased blood flow to GI and muscles - decreased absorption
decreased interstitial fluid, decreased Vd, decreased hepatic blood flow, decreased clearance

45
Q

drug interactions

A

occurs when the effects of one drug are altered by the co-administration of another substance

46
Q

phase of pharmacokinetics that causes the most adverse drug reactions

A

metabolism

47
Q

common inducers of drug metabolism

A

carbamazepine
phenobarbital
phenytoin
rifampin

48
Q

common inhibitors of drug metabolism

A

omeprazole
trimethoprim
metronizadole

49
Q

creatinine clearance for peds

A

K * L/SCr

L = length in cm
K = constant
SCr= serum creatinine in mg/dL
50
Q

do peds require larger or smaller doses than adults?

A

larger per kg

51
Q

average CrCl for elderly patients

A

50-80 ml/min

52
Q

creatinine clearance =

A

(140-age)(ABW) /72(Scr)

53
Q

factors that make meds easy to pass into breast milk

A

small size
weak base
low binding
lipid soluble

Advanced Pharmacology Exam 1 (4 decks)

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