Pharmacology Flashcards
What is meant by Pharmacokinetics
Describes the movement of a drug from “consumption” to “elimination
What is meant by Pharmacodynamics
Describes how the drug works at the target tissue.
Explain Pharmacodynamics simply
What the drug does to the body
Explain Pharmacokinetics simply
What the body does with the drug.
List the Four processes of pharmacokinetics
ADME
Drug Absorption
Drug Distribution
Drug Metabolism
Drug Excretion
What are the 2 major routes of administration? whats the main diffrence
enteral & parenteral.
enteral involves the digestive system, while parenteral bypasses it.
List the enteral routs of adminstration
Oral, sublingual and rectal
List the Parenteral routs of adminstration and the diffrences
IV: allows the most control over the circulating level
IM:allows for administration of drugs without IV access
Subcutanous: This can also help to localize a drug effect
IV offering fast, controlled delivery, IM providing a middle ground with options for both fast and slow release, and subcutaneous offering a versatile approach for both rapid or sustained effects.
What is Bioavailability?
How much of the drug stays intact and reaches the bloodstream.If a lot of the drug is broken down before reaching the bloodstream, its bioavailability is lower, meaning less of the drug is available to work in the body.
How to measure bioavailability and give an example
plasma levels of drug after administration compared to IV injection. For example IV goes directly into circulation so thats 100% bioavailability.
List some important factors that affect absorption (related to the drug)
1) lipid vs water
2) Size
3)fromula, concentration
List some important factors that affect absorption (related to the body)
1)pH of stomach
2)Presence of other food
3)Disease/ routes of administration
List the factors that affect Drug Distribution
1) blood flow
2)Capillary permiabillity
3)Drug structure
4)Binding to plasma proteins
Explain Blood flow in drug distribution
Organs with high blood flow, like the brain, liver, and kidneys, get the drug first and in larger amounts. On the other hand, tissues with low blood flow, like cartilage, connective tissue, and abscesses, have a harder time getting the drug
Explain Capillary permiability in drug distribution
-The structure of the capillaries affects how much of their surface is open for molecules to pass through.
-Most capillaries allow large molecules to pass through easily, but factors like inflammation can make the capillaries more or less permeable.
The blood-brain barrier in the brain is special because the capillaries there have tight connections between their cells, making it much harder for drugs to pass through. However, drugs that are lipid-soluble or have specific transport systems can cross the barrier more easily.
Explain drug structure in drug distribution
Nonpolar, hydrophobic drugs can move easily through membranes, while polar or charged drugs need to pass through small gaps between cells.
Explain binding to plasma proteins in drug distribution
When a drug binds to plasma proteins, it can’t reach its target and work effectively because it’s “stuck” in the blood. Some drugs bind tightly and can’t be released, which means they’re lost, while others bind loosely and can be released to become active when needed.
The active drug is the one that is not bound to proteins, as only the free drug can reach its target and produce effects. This binding is often non-specific, meaning drugs and natural substances in the body can compete for the same protein binding sites. Albumin is the main protein that holds drugs in the bloodstream, serving as a sort of “storage” for the drug until it’s needed.
Explain the Binding of Drugs to Plasma Proteins
When drugs bind to plasma proteins like albumin, they become inactive. Only the free drug (not bound to proteins) can work in the body and be eliminated.
Drugs bind to albumin in a reversible way, meaning they can attach and detach. The binding capacity of albumin can be low (one drug molecule per albumin) or high. The strength of this binding varies: weak acids and hydrophobic (fat-loving) drugs bind strongly, while hydrophilic (water-loving) and neutral drugs bind weakly or not at all.
Explain the classes of Plasma protein Binding
Class I: These drugs don’t have much of it in the bloodstream compared to the amount of albumin available to bind to it. So, a big part of these drugs is stuck to albumin. Most common medications fall into this group.
Class II: These drugs have a lot of it in the bloodstream, and only a small part of the drug sticks to albumin. Because of this, Class II drugs can push Class I drugs off the albumin, making more of the Class I drug free and active in the body.
Explain the 3 renal excretion processes
1)Passive glomerular filtration
2)Active tubular secretion in proximal tubules
3)passive distal tubular reabsorption
What factors infleunce renal secretion
Glomerular filtration rate: how much gets filtered up there
Change in urinary pH affect excretion of wak acid and basic drugs:
Name 6 different types of soild drugs
capsules
sustained release
enteric coating
caplets
gelcaps: oil in gelatin capsule
granules= gradual release
what is fluid extract medicine
Concentration solution of a drug removed
from plant by mixing with a solvent
What is Tincture
liquid extract of herbs or plants, made by soaking them in alcohol or vinegar. It’s usually stronger and used in small doses.
What is an Emulsions
a mixture of two or more liquids that are normally immiscible, or do not mix
What is Liniments
liquid suspensions for external
application to skin
Explain sublingual entral route
under the tongue used when rapid action is desired.
Explain bucal entral route,
between gums and teeth used over sublingual route for sustained-release delivery
Explain ID or intradermal injections
-inner forearm
-allergy tests, anastheitcs or tb
Explain subcutanous injections
-given into upper arms,
back, or abdomen
-commonly used for insulin
Explain Intramuscular injections
-upper arm, thighs hip muscle
-Commonly used for drugs that
irritate subcutaneous tissue
Explain IV injection
-directly into the vein
What is the difference between atomization and aerosolization in nebulizer therapy
Atomization delivers larger droplets, while aerosolization suspends smaller droplets in gas, allowing them to travel further into the respiratory system.
What is first-pass effect
When a drug is taken orally, it first passes through the liver before it can circulate throughout the body. his can reduce the drug’s strength or effectiveness.
Explain phase I and phase II reactions
Phase I: Think of it as the “prep” phase. The drug gets a “makeover” to make it fit for Phase II. “Modify” is the key word here.
Phase II: Think of this as the “exit” phase. The modified drug gets “conjugated” with another substance, making it bigger and water-soluble, ready to be “excreted”.
Phase 1 “Modifies to fit,”
Phase 2 “Conjugates to quit.”
What is Biotransformation
the conversion of drugs in two stages:
Phase I
* Oxidation: combining with oxygen
* Reduction: gaining electrons
* Hydrolysis: cleaving into simpler compounds
Phase II
* Conjugation: combining with glucuronic or sulfuric acid, terminating
biologic activity
What is The P450 system
plays a key role in breaking down many substances, including both substances the body produces (endogenous) and substances from outside the body (exogenous), like drugs.
aka This is a group of enzymes found in many cells in the body, but they’re most concentrated in the liver and GI tract. These enzymes help metabolize substances.
Renal excretion is the process of 3 processes explain them…
1)passive glomerular filtration
2) Active tubular secretion in proximal tubules
3)passive distal tubular reabsorption
What are the factors affecting renal excretion
-Glomerular filtration rate: only free unbound water soluble drugs with lowmolecular weight are filtered.
-Change in urinary pH affect excretion of weak acid and basic drugs:
Alkalinization of urine by sodium bicarbonate increases excretion of acidic
drugs, Ex. aspirin. Acidification of urine with Vit C increases excretion of
basic drugs Ex. amphetamine
What is a drugs half life?
it’s the time it takes for half of the drug to be eliminated from the body.
shorter half life= drug is cleared from the body faster, so it needs to be taken more often to maintain its effect.
longer half life=. vise versa.
What are the There are 4 main drug actions:
- depressing
- stimulating
- destroying cells
- replacing substances
What is median effective dose (ED50)
amount of a medication required to produce a specific effect in 50% of the patients who take it
How do drugs work
Drugs work by changing the way cells and tissues behave. Each drug targets specific receptors (mostly proteins) on the outside or inside of cells. This helps the drug cause its effect.
How do drugs interact with cells to produce their effects?
Drugs can either bind to specific receptors (alpha or beta) on the cell surface, triggering second messenger events inside the cell, or act independently of receptors, changing cell permeability, affecting cellular pumps, or reducing membrane excitability (e.g., anesthetics, diuretics).
list the type of drug receptors
- Ligand-gated ion channels
- G-protein-coupled receptor systems
- Enzyme embedded in the cell membrane
- Transcription factors
list the Chemical shape and properties of drugs.
Complementary to receptor binding site:
The shape of a drug must match the shape of the receptor’s binding site, like a key fitting into a lock.
Determines if the drug is an agonist or antagonist:
The drug’s shape and properties affect whether it will activate the receptor (agonist) or block it (antagonist).
Three points of contact for specific interaction:
To bind specifically to a receptor, the drug needs to interact at three distinct points on the receptor for a strong connection, much like how Velcro sticks better with more contact points.
Chiral vs. non-chiral:
Drugs can have different shapes (chiral or non-chiral), affecting how they fit receptors. A chiral molecule is like a left and right hand—similar but not identical. Only one version might bind well.
Flexibility and rotation of internal bonds:
The drug’s internal structure needs to be flexible, allowing it to rotate and adapt to fit snugly into the receptor.
What is Agonist-antagonist:
partial agonist: only slight intrinsic
activity. Can act as both agonist (alone) or antagonist
(competes with other drug)
When is a drug said to be a good agonist
A drug is said to be an agonist when it binds to a receptor
and causes a response or effect.
It has intrinsic activity = 1
When is a drug said to be an antagonist
A drug is said to be an antagonist when it binds to a receptor and prevents
(blocks or inhibits) a natural compound or a drug to have an effect on the
receptor. An antagonist has NO activity.
Its intrinsic activity is = 0
1. Competitive
They compete for the binding site
* Reversible
* Irreversible
2. Non-competitive
Bind elsewhere in the receptor (Channel Blockers).
Drugs That Produce Pharmacologic Effects in Nursing Infants
Antibiotics, Sedatives, narcotics, Alcohol, lithium.
List the ADME Pharmokinetic changes in older ages:
Absorption: different nutritional habits, slower gastric emptying
Distribution: increased body fat, reduced total body water
Metabolism: heart failure and disease that affect liver function more common.
Elimination:Liver and kidney dysfunction may cause intensified drug effects because of increased half-life.
What is Polypharmacy and Problems with it
Taking multiple medication at the same time, can…
increase risk of toxicity
Increase risk of drug to drug interaction
Increases risk of mistakes in taking their medication
Explain Antihypertensives
anti high blood pressure) this works in opposite way meaning meds that lower high blood pressure can lead to hyperglycaemia, hyperuricemia and HYPOkalemia
Explain Cardiac glycosides and give example
These drugs can become toxic more easily, which can be dangerous, because they have longer half life and narrow therapeutic range.
Eg is digoxin
Antiarrhythmic drugs…
Higher chance of toxcitiy
Narcotic analgesics:
painkillers that can make you sleepy: Narcotic painkillers make you sleepy, which can also slow your breathing. This is more risky for elderly patients because their respiratory systems are often weaker.
Explain NSAID (Non-Steroidal Anti-Inflammatory Drugs)+ give examples
group of medications used to reduce inflammation, pain, and fever. Common examples include ibuprofen, aspirin,
Explain Corticosteroids
medication that mimic the effects of hormones your body produces naturally in the adrenal glands. They help reduce inflammation and suppress the immune system.. ANY MEDICATION THAT ENDS WITH “SONE” or “ONE” THESE CAUSE OSTEOPOROSIS.
What is Aminoglycosides
Antibiotic treat serious infections over long periods of time and use toxic to the kidneys
In what cases would pregant women need medication?
High risk, gestational diabetes or hypertension need to be treated.
When giving medications to a pregnant patient, what are 3 factors that need to be considered?
Ability to cross the placenta: Some drugs can pass from the mother to the baby through the placenta, which may affect the baby.
Pregnancy-related changes: During pregnancy, the body undergoes changes like hormone fluctuations and changes in blood flow, which can affect how drugs work and are processed.
Cardiac and blood flow changes: Pregnancy causes changes in the heart’s output and blood volume, as well as blood flow to different parts of the body, which can impact how medications are absorbed and distributed.
How does Pregnancy changes affect how a drug is processed
GI motility (how food moves through the stomach) is slower.
Distribution to plasma proteins is reduced.
However, other processes like absorption, distribution, metabolism, and excretion are increased.
Total body water increases by up to 81%, which affects how drugs are spread in the body.
How do Drugs cross the placenta
Passive diffusion, Conjugated steroid and peptide hormones do not cross..
What does Teratology mean
birth defects caused by harmful substances.
IMPORTANT: The 4 established principles concerning a drug’s potential to cause developmental disorders are:
1)Dose-effect relationship: The higher the dose of the drug, the greater the likelihood or severity of developmental harm.
2)Species susceptibility: Different species may respond differently to a drug. A drug that causes harm in one species may not affect others the same way.
3)Period of development: The timing of exposure matters. Some stages of development are more sensitive to drug exposure than others, so exposure during certain periods (e.g., early pregnancy) is riskier.
4)Mode of action: How the drug works (its mechanism) can affect how it impacts development. Some drugs may interfere directly with the processes that guide development.
Explain difference between Lipid-soluble drug and Plasma-bound drugs when it comes to pregnancy.
Fat-soluble drugs can pass into breast milk and affect the baby.
Drugs attached to proteins in the blood usually can’t pass to the baby through the placenta.
Explain Alcohol, Nicotine, opates and breastfeeding?
Alcohol: babies get 10% of the mother’s alcohol if she drinks
Nicotine: Can cause low milk supply and vomiting in baby
Oppiates: make babies addicted to it
Explain Caffience, Canabis, coccain and breastfeeding?
Caffiene:high amounts can cause irritability, poor sleep, and affect iron absorption.
Cannabis:stored in the brain and fat. It may delay motor development
Cocain:Cocaine clears from breast milk faster than cannabis but can still cause side effects like hypertonia (muscle stiffness), tachycardia (fast heart rate
Explain the difference beween Adverse and side effects.
Side effects: unwanted effect that happens regardless of the dose. These are usually expected, explained to the patient, and often go away over time. Some medications are even used because of their side effects.
Adverse effects: an unwanted effect that happens when a medication is taken correctly. It can be:
Type A predictable and dose related
Type B Unpredictable and not related to dose.
Explain the severity of mild adverse reactions
Severity of adverse drug reactions: MILD
-usualy mild including digestive disturbance, headache, skin rashes,
-Mild or moderate adverse drug reactions do not necessarily mean that a drug must be discontinued
Explain the severity of severe adverse reactions
life threatening
-abnormal heart rhythms, certain types of allergic reactions
Severe reactions are relatively rare. People who develop a severe reaction usually must stop using the drug and must be treated. However, doctors must sometimes continue giving high-
risk drugs (for example, chemotherapy to people with cancer or immunosuppressants to people undergoing organ transplantation).
What are Idiosyncratic reactions
Unique, strange or unpredictable
reactions to a drug (Ex. anaphylaxis)
Give an example of positive drug interaction
Example of positive drug interaction is the co-administration of carbidopa with levodopa used in the treatment of Parkinson’s disease. Carbidopa prevents levodopa from breaking down before it reaches the brain. This makes levodopa more effective in treating Parkinson’s disease and reduces side effects like nausea.
Explain Difference between pharmacokinetcis and pharmacodyanmic interactions.
Pharmacokinetic interaction: One drug changes how another is absorbed, distributed, metabolized, or excreted (ADME), affecting its concentration in the body (e.g., two drugs using the same liver enzyme or competing for protein binding).
Pharmacodynamic interaction: One drug alters how the body responds to another, either enhancing (additive/synergistic) or reducing its effects (e.g., interactions with supplements)
Explain different types of drug-drug interactions
Duplication: same medication
Opposition:antagonism
Alteration: of what the body does to one or both drugs.
Provide an example of Drug-Drug interaction
-A cold remedy and a sleep aid both contain diphenhydramine (Benadryl), so taking both increases the dose unintentionally.
-A cold remedy and a pain reliever both contain acetaminophen (Tylenol), which can lead to an overdose.
Provide examples of drug-drug Opposition interation
-(like ibuprofen) make your body hold onto salt and water, but diuretics (like hydrochlorothiazide) help your body get rid of extra salt and water. If you take them together, the NSAID can cancel out what the diuretic is trying to do.
-Beta-blockers (like propranolol) slow your heart and lower blood pressure, but they can block albuterol, which helps you breathe better during an asthma attack. This means albuterol might not work as well if you’re also taking a beta-blocker.
Explain drug to drug interaction of Alteration
One drug may alter how the body absorbs, distributes,
metabolizes, or excretes another drug.
Provide example of alteration drug to drug interaction.
-proton pump inhibitors and H2 blockers reduce stomach acid/higher pH which can stop drugs like anti fungal ketoconzole from being absorbed properly
-Liver enzyme changes: Some drugs change how liver enzymes work, speeding up or slowing down how other drugs are broken down. For example, phenobarbital increases liver enzyme activity, causing the blood thinner warfarin to break down faster, which makes it less effective.
Explain nutrient ineraction with biphosphonates
Any food, even orange juice, coffee, or mineral water, may markedly reduce the absorption and effectiveness of these drugs
Explain nutrient ineractions with Anticoagulants (like warfarin)
Foods with a lot of vitamin K (like spinach and kale) can reduce the drug’s effect, increasing the risk of blood clots.
Explain nutrient interaction of grape juice
It blocks an enzyme (CYP3A4) that normally breaks down many drugs, like benzodiazepines and certain statins. This makes these drugs stronger because more of the drug stays in your body
Explain what Digoxin is and its reactions
Digoxin: Medication used to treat heart conditions, eating too much fibre can block body from absorbing digoxin properly.
Explain Mao inhibitors and its nutriitiional interaction.
MAO inhibitors: These are a type of antidepressants and they interact dangerously with food high in tyramine like poultry cheese
Explain Tetracyclins nutritional interaction
Taking calcium products with this antibiotic causes reduced absorption.
Explain Statins nutritional interaction
Antioxidants like vitamins A, C, E, B, and folic acid may reduce the effectiveness of statins by interfering with their cholesterol-lowering action
Explain Norvasc nutritional interaction
Norvasc is antihypertensive (used to lower BP). Eating foods high in sodium works against Norvasc by raising blood pressure, making the medication less effective.
Q: What is Long QT Syndrome
A disorder of the heart’s electrical system where the heart takes longer to “recharge” between beats, leading to a risk of dangerous arrhythmias.
Q: What is the name of the life-threatening arrhythmia associated with LQTS?
A: Torsades de pointes.
Why does the P450 enzyme profile vary between individuals, and how does this affect drug responses?
Why it varies: Differences in genetics cause some people to produce more or less of certain P450 enzymes, or enzymes that work faster or slower.
Effect on drug responses:
Fast metabolizers: Break down drugs quickly, which can make the drug less effective.
Slow metabolizers: Break down drugs slowly, which can lead to drug buildup and side effects.
Example: A “slow metabolizer” of codeine may not get pain relief because their body can’t convert codeine into its active form (morphine) efficiently.
Dong Quai
taken for menstrual control… Dont take with Warfrin some antibiotics
Echinacea
Do not take with with heart medications
Ephedra
Weight loss, reduce appetite and open airways. Do not mix with heart medication
Feverfew
Taken to reduce migraines dont take with other migraine medications, can raise heart rate. Dont take with warfarin
Ginkgo
: increases blood flow and circulation throughout the body, can also help
improve memory. DOnt take with aspirin, warfarin
Garlic
help lower cholesterol and prevent the formation of blood
clots.. Do not take with diabetes medication because it may cause a decrease in blood sugars
Ginseng
Benefits: Helps reduce stress, boost energy, improve stamina, and may lower cholesterol.
Side Effects: Can cause nervousness, headaches, insomnia, heart palpitations, and increase blood pressure.
Warnings: Avoid if taking high blood pressure medication or Coumadin (blood thinner).
Hawthorn
claimed to be effective in helping reduce angina attacks by lowering blood pressure and cholesterol levels.*Should not be taken with digoxin, a heart medication. The mix may lower heart rate too much
Kava
For stress relieve and nervousnes. is used to treat anxiety. It’s also used to relieve insomnia and nervousness.
* Do not take Kava if you have a history of liver problems. Also do not mix with
antidepressants, sedatives, and do not mix Kava with alcohol.
Liquorice
This medicine treats coughs, colds, and peptic ulcers, but high doses can raise blood pressure, cause water retention, and lower potassium, so avoid it with diuretics or digoxin to prevent further potassium loss.
St. John’s wort
Natural antidepressent, dont take with antidepressants, HIV medications, oral contraceptives, blood thinners,
Valerian
a mild sedative with hypnotic effects, used to promote sleep,
*Should not be taken with alcohol or Valium.
What are the 4C’s of Addiction
1) compulsion
2)Craving
3) consequence
4)Control
What is Teratogen
A substance or illness that can harm the fetus
Hepatotoxic effects
Medications which cause
damage to the liver. Liver function is determined
by the presence of aspartate
aminotransferase (AST) and
Alanine aminotransferase
(ALT) and the presence of
jaundice
