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Nursing Pharmacology > Pharmacokinetics & Pharmacodynamics > Flashcards

Pharmacokinetics & Pharmacodynamics Flashcards

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1
Q

what are the four parts to the phamacokinetic phase?

A
  • absorption
  • distribution
  • metabolism
  • excretion
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2
Q

What are the three parts to the pharmacodynamic phase?

A
  • receptor binding
  • postreceptor effects
  • chemical reaction
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3
Q

Drug movement from GI tract into bloodstream

A

drug absorption

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4
Q

what does drug absorption require?

A
  • -disintegration

- dissolution

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5
Q

breakdown of oral drug form into small particles

A

disintegration

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6
Q

process of combining small drug particles with liquid to form a solution

A

dissolution

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7
Q

enteral

A

by mouth

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8
Q

what are the different absorption methods?

A
  • passive transport
  • active transport
  • pinocytosis
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9
Q

most drugs are taken by this route

A

enteral

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10
Q

resist disintegration in the gastric acid of the stomach, may be delayed in onset

A

EC Enteric Coated Drugs

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11
Q

Where are EC drugs absorbed at?

A

small intestine

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12
Q

what factors affect drug absorption?

A
  • bloodflow, pain, stress, gastric pH
  • food texture, fat content, temperature
  • route of administration
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13
Q

less blood flow =

A

less absorption

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14
Q

shock, BP bottoms out =

A

decreased blood absorption

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15
Q

which route of administration has the fastest onset of action?

A

IV

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16
Q

Which route of administration is slower, dependent on blood flow area?

A

SubQ

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17
Q

Which route of administration has a slow onset and is unpredictable?

A

Oral

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18
Q

passive transport occurs through

A
  • diffusion

- facilitated diffusion

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19
Q

drugs move across the cell membrane from an area of higher concentration to lower concentration

A

diffusion

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20
Q

relies on a carrier protein to move the drug from an area of higher concentration to lower

A

facilitated diffusion

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21
Q

which transport does not require energy?

A

passive

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22
Q

requires a carrier such as an enzyme or protein to move the drug against a concentration gradient

A

Active Transport

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23
Q

energy is required for which transport?

A

active

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24
Q

cell carries drug across membrane by engulfing drug particles

A

pinocytosis

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25
Q

after absorption of oral drugs from the GI tract, they pass from the intestinal lumen via what?

A

portal vein

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26
Q

what organ metabolizes drugs?

A

Liver

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27
Q

List drug movement in order starting with GI tract

A
  • portal vein
  • liver
  • body
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28
Q

when the liver metabolizes a drug to an inactive form and is excreted, reducing the amount of active drug available to exert a pharmacologic effect

A

first pass affect or first pass metabolism

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29
Q

affected by the first past affect

A

bioavailability

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30
Q

% of administered medication that reaches systemic circulation (amount of drug actually available for use)

A

bioavailability

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31
Q

factors that affect bioavailability

A
  • absorption
  • first pass metabolism
  • drug form
  • route
  • gastric mucosa and motility
  • administration with food and other drugs
  • changes in liver metabolism
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32
Q

decreasing liver function increases what?

A

bioavailability

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33
Q

movement of drug from circulation to body tissues

A

drug distribution

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34
Q

what are the influencing factors of drug distribution?

A
  • protein binding
  • free drugs
  • blood brain barrier
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35
Q

as drugs are distributed in the plasma, many bind with

A

plasma proteins

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36
Q

list the different plasma proteins

A
  • albumin
  • lipoproteins
  • Alpha-h acid-glycoprotein
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37
Q

what happens if a drug binds to protein?

A

it doesn’t work

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38
Q

the portion of the drug bound to protein is inactive because

A

it is not able to interact with tissue receptors and is unable to exert a pharmacologic effect

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39
Q

portion of drug that is not bound to protein and is free

A

free drug

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40
Q

able to exit blood vessels and reach site of action causing a pharmacologic response

A

free drug

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41
Q

blood vessels of the brain made of special endothelial lining where the cells are pressed tightly together and protects the brain from foreign substances

A

blood brain barrier

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42
Q

what drugs are able to cross the blood brain barrier?

A

drugs that are highly lipid soluble and of low molecular weight such as benzo’s

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43
Q

can drugs cross the placenta?

A

yes

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44
Q

drug metabolism is also known as

A

biotransformation

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45
Q

process of body chemically changing drug into form that can be excreted

A

drug metabolism

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46
Q

if the liver function is decreased, what happens to the drug effects?

A

increases

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47
Q

biologically inactive compound which is metabolized into the body and to produce a drug

A

prodrug

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48
Q

used to improve drug delivery, decrease toxicity or to target specific cells or tissues

A

prodrug

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49
Q

example of prodrug

A

codeine

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50
Q

why is codeine and example of a prodrug?

A
  • little activation of opioid receptors as codeine
  • metabolized into morphine by liver
  • morphine activates opioid receptors
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51
Q

period of time required for concentration or amount of drug in body to be reduce by one-half

A

half life

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52
Q

affected by metabolism and elimination

A

half life

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53
Q

used to determine dosing interval

A

half life

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54
Q

decrease in liver and kidney function leads to an increase or decrease in half life?

A

increase

55
Q

if you have a long half life, do you have to give a medication as often?

A

no

56
Q

long half life leads to increase in

A

compliance

57
Q

plateau drug level

A

steady state

58
Q

steady state takes how many half lives?

A

4

59
Q

large initial dose or series of doses to rapidly achieve therapeutic concentration and steady state

A

loading dose

60
Q

example of loading dose

A

Z Pac

61
Q

what are different ways that drugs are excreted?

A
  • kidney
  • liver
  • lungs
  • saliva, sweat, and breastmilk
62
Q

what is the main route of drug excretion?

A

kidneys

63
Q

how are drugs excreted from the liver?

A

through bile

64
Q

how are drugs excreted through the lungs?

A

exhaled respiratory system

65
Q

liver dysfunction leads to

A

decreased metabolism

66
Q

kidney dysfunction leads to

A

decreased excretion

67
Q

urine pH affects

A

excretion

68
Q

acidic urine promotes elimination of

A

weak base drugs

69
Q

alkaline urine promotes elimination of

A

weak acid drugs

70
Q

which drug is excreted rapidly in alkaline urine?

A

salicylic acid (aspirin)

71
Q

treatment of salicylate toxicity includes

A

IV admin of sodium bicarbonate

72
Q

common tests to determine renal function

A
  • creatinine

- BUN

73
Q

study of the way drugs affect the body

A

pharmacodynamics

74
Q

desirable response

A

primary effect

75
Q

desirable or undesirable response

A

secondary effect

76
Q

primary effect morphine

A

pain relief

77
Q

secondary effect of morphine

A

constipation (undesirable)

diarrhea (desirable)

78
Q

primary effect benedryl

A

treat allergy

79
Q

secondary effect benedryl

A 
sleep (undesirable) 
bed time (desirable)
80
Q

how much drug to get significant response

A

potency

81
Q

no matter how much more you take of a medication it won’t increase therapeutic effect

A

maximal efficacy

82
Q

amount of med to give to produce effect

A

therapeutic dose

83
Q

difference between potency and maximal efficacy

A

therapeutic index

84
Q

ED50

A

therapeutic dose

85
Q

give drug to 100 people and only half have a response to this. this is what type of dose?

A

therapeutic

86
Q

give drug to the same 100 people and half show toxicity, this is what type of dose?

A

toxic

87
Q

with narrow effect the nurse should monitor

A

drug toxicity and blood levels

88
Q

what medications have a narrow effect?

A
  • warfarin
  • digoxin
  • phenytoin
89
Q

time it takes drug to reach minimum effective concentration

A

onset

90
Q

highest concentration in blood

A

peak

91
Q

small amount of drug necessary to get effect of drug

A

minimum effective concentration

92
Q

length of time taken for a drug to exert therapeutic effect

A

duration

93
Q

time to take next dose to keep wave going

A

term of action

94
Q

measure taken after drug administration to monitor for toxic levels

A

peak drug level

95
Q

measure before next dose, lowest drug level gets

A

trough

96
Q

peak level of IV

A

30-60minutes

97
Q

peak level of oral drug

A

3

98
Q

receptor theory

A

drugs bind to receptors

99
Q

drugs bind to receptors to inactivate a receptor by

A

blocking a response

100
Q

activate receptors

A

agonists

101
Q

prevent receptor activation

A

antagonists

102
Q

block response

A

antagonist

103
Q

affect multiple receptor sites

A

nonspecific drugs

104
Q

affect multiple receptor types

A

nonselective drugs

105
Q

decrease response to drug and need to increase dosage to get effect

A

tolerance

106
Q

suddenly drug stops working after one or several doses

A

tachyphylaxis

107
Q

predictable, not signs of toxicity

A

side effects

108
Q

what is good for patient to know of drugs

A

side effects

109
Q

undesirable effects, unexpected more severe, can occur at normal dosage

A

adverse reaction

110
Q

drug level exceeds therapeutic range, too much of the drug and drug accumulation (liver or kidney dysfunction)

A

drug toxicity

111
Q

highest risk in elderly, 1 in 5

A

drug interaction

112
Q

when one drug affects another

A

drug interaction

113
Q

what people are at risk for drug interactions?

A
  • chronic health
  • patient taking a lot of medication
  • those taking different dietary supplements
  • those who see more than 1 provider
  • patient who use multiple pharmacies
114
Q

changes occurring in absorption, distributions, metabolism, and excretion

A

phamacokinetic interactions

115
Q

changes gastric pH

A

absorption

116
Q

increase or decrease gastric emptying time

A

absorption

117
Q

cause formation of drug complexes

A

absorption

118
Q

induce production of hepatic enzymes

A

metabolism

119
Q

metabolism can inhibit production of hepatic enzymes which means

A

drugs are metabolized slowly

120
Q

what are impotent inhibitors that increase toxicity

A
  • alcohol
  • food
  • grapefruit juice
121
Q

diuretics cause what?

A

electrolyte imbalance

122
Q

electrolyte imbalances cause what?

A
  • decrease in cardiac output
  • decrease of blood flow to kidneys
  • decrease of excretion of other drugs
123
Q

sum of effects of two drugs

A

additive

124
Q

example of additive drugs

A
  • hydralazine and nitro

- both cause vasodilation and cause low BP

125
Q

effect is much greater than affects of either drug alone

A

synergistic

126
Q

example of synergistic

A

amoxicillin and coagulonate (antibiotics)

127
Q

one drug reduces or blocks effects of other drug

A

antagonistic

128
Q

example of antagonistic

A
  • desirable nalaxone (narcan) (opioid overdose) blocks opioid receptor
  • protamine sulfate (blocks heparin)
129
Q

food may increase, decrease or delay drug response

A

drug nutrient interactions

130
Q

drugs may cause misinterpretation of drug results

A

drug laboratory interaction

131
Q

skin reaction caused by sunlight exposure

A

drug induced photosensitivity

132
Q

cause BP to rise to dangerous levels

A

MAOI (monoamine oxidase inhibitor)

133
Q

Is alcohol a drug?

A

yes

134
Q
A

Nursing Pharmacology (40 decks)

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