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Clinical Nursing Jan exam > Pharmacology > Flashcards

Pharmacology Flashcards

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1
Q

Define pharmocokinetics

A

What the body does to the drug

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2
Q

Define pharmoacodynamics

A

What the drug does to the body

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3
Q

What are different methods of drug transfer across membranes

A 
Aqueous diffusion
Passive lipid diffusion
Facilitated diffusion
Pinocytosis (budding of membrane to ingest into cell)
Active transport
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4
Q

What factors affect rate of membrane transport according to ficks law?

A 
Diffusion coefficient
Surface area
Membrane thickness
Partition coefficient (how drug distributes in liquid vs oil)
Concentration gradient
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5
Q

What are the methods of drug disposition?

A

Absorption
Distribution
Metabolism
Excretion

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6
Q

Define bioavailability

A

Fraction of dose reaching systemic circulation after administration compared to same dose given intravenously

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7
Q

What factors affect drug absorption?

A

Route of administration

Formulation

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8
Q

How does ionisation affect absorption of drugs?

A

Drugs are weak acids or bases, with ionisation affected by their pKa and surrounding pH
pH changes with infection etc
Non-ionised drugs- cross by passive diffusion
Ionised drugs- cross by transport mechanisms, facilitated diffusion or pinocytosis

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9
Q

List routes of drug administration and how it affects drug absorbtion

A

Intravenous- rapid absorption as directly into systemic circulation
Intramuscular- speed dependent on local blood flow and diffusion of muscle
Subcutaneous- slower and less predictable, depends on site, temperature, hydration etc.
Oral- mainly absorbed in small intestine, effected by GI motility, splanchnic blood flow, drug size etc., will undergo first pass metabolism
Inhalational- causes local effect or absorbed into circulation
Epidural, transmucosal, transepithelial- effects at site of admin, can be taken up systemically

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10
Q

What is meant by first pass metabolism?

A

Concentration of drug given orally is reduced before entering systemic circulation

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11
Q

What determines volume of drug distribution?

A

Amount administered and concentration of the drug in plasma

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12
Q

How does protein and tissue binding of a drug affect its distribution?

A

Albumin binds weak acids
Alpha-1-acid glycoprotein binds weak bases
Only unbound drugs can interact and cause effect on the body
(Tissue binding can be specific or non-specific)

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13
Q

How does organ blood flow, membrane permeability and drug solubility effect drug distribution?

A

Drugs initially go to tissues with high blood flow

Highly lipid soluble drugs will accumulate in fat

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14
Q

Define clearance

A

Volume of plasma from which drug is completely removed per unit of time

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15
Q

Define half-life

A

Time taken for plasma concentration to fall 50% of original level

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16
Q

What factors affect drug metabolism and excretion?

A

Clearance and half life

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17
Q

Define biotransformation

A

Alteration of substance within the body

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18
Q

Name the stages of drug metabolism

A

Biotransformation

Excretion

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19
Q

Why do most drugs need to undergo biotransformation before they can be excreted by the kidneys?

A

Lipophilic and highly bound

Kidneys excrete polar water soluble compounds most easily

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20
Q

What is the main organ of metabolism and how does it work?

A

Liver
Phase one- convert drug to polar metabolites allowing renal excretion
Phase two- conjugation/combining with substrates

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21
Q

What can be the effects when drugs are activated by metabolism?

A

Become active drug
Produces active metabolites causing further effects
Produces toxic metabolites

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22
Q

What is the most common excretion of drugs and how does it work?

A

Renal
Active- tubular secretion
Passive- glomerular filtration

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23
Q

What other methods of drug excretion are there other than renal?

A

Biliary system
Exhalation
GI system

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24
Q

What is meant by enterohepatic circulation?

A

Pathway drugs take until plasma concentration drops

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25
Q

Describe the pathway taken by drugs in enterohepatic circulation

A 
Drug metabolised by liver
Biliary excretion
Deglucorinidation/reverse metabolism by gut microflora
Reabsorption in gut
Drug metabolised by liver
26
Q

List the stages a drug takes when causing an effect on the body

A

Drug site of action
Pharmacological effect
Clinical response- therapeutic effect and toxicity

27
Q

Define clinical response

A

What is seen due to drug

28
Q

Define therapeutic effect

A

Desired effect of a drug

29
Q

Define toxicity

A

Side effects of a drug

30
Q

List non-cellular mechanisms of effect of drugs

A

Physical
Chemical
Physiochemical
Modification of body fluid composition

31
Q

List cellular mechanisms of effects of drugs

A

Alter physicochemical mechanisms of the body
Cell membrane structure and function modification
Enzyme inhibition
Receptor mediation

32
Q

Define therapeutic index

A

Maximum non-toxic/minimum effective dose of a drug based off 50% of animals

33
Q

Why is using therapeutic index for drugs flawed?

A

Effective dose will vary depending on what is being treated

Wont account for idiosyncratic drug reactions (reactions unrelated to dose)

34
Q

Define affinity

A

How well a drug binds to its receptor

35
Q

Define intrinsic activity/efficiacy

A

Magnitude of effect once bound, measured 0-1

36
Q

Define agonist and state an example

A

Generate maximal response when bound to a receptor, have high affinity and intrinsic activity/efficacy
Morphine

37
Q

Define partial agonist and state an example

A

Intrinsic activity less than 1 so cant generate maximal response even with full receptor occupancy
Buprenorphine

38
Q

Define inverse agonist and state an example

A

Drug binding exerts opposite effect compared to endogenous agonist
Antihistamines

39
Q

Define antagonist and state and example

A

Exhibits affinity without intrinsic activity

Atipamezole

40
Q

Define potency

A

How much of the drug is needed to cause wanted response

41
Q

List the molecular targets for drugs

A 
Receptors
Enzymes
Transporters
Ion channels
Nucleic acid
42
Q

Define ligand

A

Substance that forms complex with boimolecule

43
Q

Define receptors

A

Protein interacting with extracellular physiological signals, converting them to intracellular effects

44
Q

Name an example of a receptor for drugs

A

Mu opioid receptor

45
Q

What is the difference in effect of agonists and antagonists on receptors?

A

Agonists- cause direct effects (ion channel opening/closing) or transduction mechanisms (enzyme activation or inhibition, ion channel modulation, DNA transcription) to cause effect
Antagonists- no effect caused or prevent agonist binding preventing or reversing effect of agonist

46
Q

List the 4 main types of receptor

A

Ligand gated ion channels (ionotropic- membrane bound)
G-protein coupled receptors (metabotropic- initiates metabolic processes to modulate cell activity)
Kinase linked receptors
Nuclear receptors

47
Q

What are the characteristics of ligand gated ion channel receptors? (Speed of action, how they cause effect, example)

A

Act in milliseconds
Hyperpolarise or depolarise
Nicotinic ACh receptor in neuromuscular junction post synaptic membrane

48
Q

What are the characteristics of G-protein coupled receptors? (Speed of action, how they cause effect, example)

A

Act in seconds
Change membrane excitability or second messengers cause effect leading to cellular effects
Muscarinic ACh receptor in smooth muscle of blood vessels

49
Q

What are the characteristics of kinase linked receptors? (Speed of action, how they cause effect, example)

A

Act in hours
Protein phosphorylation leading to protein synthesis and cellular effects
Cytokine recpetors

50
Q

What are the characteristics of nuclear receptors? (Speed of action, how they cause effect, example)

A

Act in hours
Gene transcription and protein synthesis causing cellular effects
Oestrogen receptor

51
Q

How do enzymes act as drug target and what is an example?

A

Become activated by agonists and inhibited by antagonists

Cyclooxygenase enzyme

52
Q

What effect do enzymes have on prodrugs?

A

Converts to active drug undergoing reaction to produce more effect on the body

53
Q

Define prodrug

A

Molecules converted into active drug

54
Q

How do transporters work as drug target and what is an example?

A

Agonists bind and move into cell
Antagonists bind and block transporter
Insulin

55
Q

How do ion channels work as drug targets and what is an example?

A

Agonists increase or decrease probability of opening
Antagonists block channel
Local anaesthetics on nerves channels

56
Q

How do nucleic acids work as drug targets and what is an example?

A

Alter gene transcription

Chemotherapy drugs

57
Q

How are antimicrobial agents classified?

A

Type of organisms effective against

Either bacteriostatic or bactericidal

58
Q

Define bacteriostatic

A

Prevent bacterial multiplication to remove infection by immune system

59
Q

Define bactericidal

A

Kill bacteria

60
Q

What are antibiotic dependent on to be effective?

A

Concentration- outcome related to peak antibiotic concentration at site of infection compared to minimum inhibitory concentration
Time- concentration needs to be above minimum for enough time between doses

61
Q

What are the mechanisms of action of antibiotics?

A

Cell wall- ruptures
Cytoplasmic membrane- altered structure
Nucleic acid metabolism- interfere with DNA replication or repair

62
Q

Explain the process of antibiotic therapy

A

Make diagnosis
Remove barriers which prevent antibiotics working
Decide if therapy is needed
Select best drug
Administer drug at best frequency and route
Test if drug has worked

Clinical Nursing Jan exam (7 decks)

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