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Pharmacology 1 > pharmacology basics > Flashcards

pharmacology basics Flashcards

1
Q

what are the 6 rights of drug administration?

A 
Right Patient
Right medication
Right Dose
Right Route
Right Time
Right Documentation
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2
Q

what is pharmacology?

A

the science of the properties of drugs and their effect on the body

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3
Q

What is a drug/medicine?

A

any chemical agent that can have a biological response on the body - therapeutic or adverse

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4
Q

what names are used for drugs?

A

trade name

generic name

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5
Q

What are the medical sources of drugs/medicines?

A

plants
animal, microorganisms or by body
synthetic
complementary medicines

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6
Q

what acronym is used for drugs over the counter and prescription only?

A 
drugs over the counter (OTC)
prescription only (POM)
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7
Q

Name the two classifications that can be used for drugs

A

Pharmacological - how they work (beta blockers)

Therapeutic - what they do (anti-hypertensive)

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8
Q

What are we legally obligated to do as professionals in regard to drugs?

A

use standards/ guidelines
confirm accuracy of script
use knowledge and competence
have understanding of the drug

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9
Q

what should the targets of drugs be?

A

needs to bind to specific targets - the more specific the drug is to the target the better it works

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10
Q

What mechanism is used to describe the binding of drugs to their targets?

A

lock and key mechanism

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11
Q

name five targets which drugs use

A

membrane
nucleus - drugs need special properties to enable it to reach nucleus
cytosol
enzymes - drug slows/ speeds up reactions
foreign protein

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12
Q

name three areas with in the membrane that drugs can target

A

membrane receptors
ion channels
carrier molecules/ pumps

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13
Q

what does a drug influence when it targets the nucleus?

A

DNA production

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14
Q

What are drugs used to target?

A

bacteria
virus (retrovirals)
fungus
worms - ameboa

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15
Q

Give examples of 2 drugs which bind to enzymes

A

Aspirin - COX enzyme

Viagra - increases blood flow

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16
Q

Give examples of 3 drugs which bind to membrane receptors

A

Salbutamol - dilate airways
Beta blockers
anti-histamine - blocks effect of histamine

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17
Q

Give examples of 3 drugs which bind to ion channels

A

Local anaesthetics - blocks pain response

Benzodiazepines (valium) - blocks fluoride transport to brain

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18
Q

Give examples of 2 drugs which bind to carrier molecules (or pumps)

A

Omeprazole - blocks acid production

Cocaine - keeps noradrenaline active

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19
Q

Give an example of a drug which bind to DNA

A

Steroids - reduces inflammation

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20
Q

Give an example of a drug that binds to a foreign protein

A

Penicillin

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21
Q

what is an agonist?

A

Activates receptor

binds to a receptor and mimics chemicals in body

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22
Q

what is an antagonist?

A

doesn’t activate receptor but blocks it.

binds to receptor and stops chemicals producing response

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23
Q

what happens when a drug binds to a receptor?

A

drug binds
activation of 2nd messenger
cascade of enzyme reaction
results in response

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24
Q

describe some cellular responses to drugs

A 
muscle cell - contraction
glands - secretion
Muscle - excitation
Nerve - excitation/ inhibition
Tumour cell - interrupt cell cycle
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25
Q

Explain how steroids can target the nucleus

A

steroids are based on structure of cholesterol which is lipid soluble, therefore passes through membrane

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26
Q

explain the term potency and the effect that high potency has

A

Potency means that it has a high affinity with the receptor - the shape matches well
High potency means that a small dose is required for response

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27
Q

in children is potency higher or lower?

A

higher

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28
Q

Explain the steps involved in drug deposition

A 
Intake
Absorption
Distribution - drug can go to target and be directly excreted or be metabolism before drug cell interaction
Drug Cell Interaction
Metabolism
Excretion
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29
Q

List 8 way in which drugs can be administered

A 
Injection
Oral
Rectal
Topical
Vaginally
Inhalation
Transdermal - patches
Sustained release
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30
Q

name 6 types of injection

A 
epidural - into epidural space
intradermal - few layers of skin
intramuscular
subcutaneous - below subcutaneous layer
intravenous - (IV) 
intrathecal - into subarachnoid space
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31
Q

which is the most common route for drug administration?

A

oral

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32
Q

list some advantages of oral drugs

A

easy for patients to self administer
well absorbed - small intestine
suspension or pill

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33
Q

list some disadvantages of oral drugs

A

can interact with stomach acid - degradation

not suitable in vomiting/ diarrhoea/ frequent gastric emptying

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34
Q

list some advantages of topical drugs

A

convenient
overdose risk minimised
local effect

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35
Q

list some disadvantages of topical drugs

A

poorly absorbed

negative effect on skin

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36
Q

give 3 examples of transdermal drugs

A

HRT patches
nicotine patches
angina patches

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37
Q

list some advantages of transdermal drugs

A

long lasting
constant level of drug in blood
wide range of patients
high potency

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38
Q

list some disadvantages of transdermal drugs

A

variable absorption

drug needs to be very lipid soluble to cross cell membrane

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39
Q

rectal administration can produce a local or systemic effect?

A

both

40
Q

what patient would it be useful to use rectal administration?

A

a vomiting patient

41
Q

is rectal administration fast or slow acting?

A

fast

42
Q

give 4 examples of drugs which could be administered rectally

A

analgesics
diazepam
prednisolone
anti-fungals

43
Q

why does inhalation of drugs cause a rapid change in plasma concentration?

A

lungs have huge surface area and good blood flow

44
Q

does inhalation of drug cause a local or systemic effect?

A

both

45
Q

what is a disadvantage of inhalation of drugs?

A

drug doesn’t always reach target

46
Q

what are the advantages of parenteral routes

A

rapid action
bypass stomach
patient controlled syringe driver

47
Q

what are the disadvantages of parenteral routes

A

administration by a trained person
extreme care needed to deliver correctly
accidental overdose more likely
painful

48
Q

what is contained within a medicine?

A

active drug and excipients

49
Q

what are excipients used for?

A

help protect drug from gastric juices

provide sustained release - this impacts on bioavaliablity

50
Q

explain the steps involved in dissolution of oral drugs

A

tablet
granules to fine particles - in GI tract
solution - absorption in stomach and mainly SI

51
Q

explain the steps involved when lipid soluble drugs cross the cell membrane

A

they move via diffusion from the gut to epithelial cells to bloodstream

52
Q

what happens to water soluble drugs?

A

they remain in the gut and can not cross the epithelial cells to enter the blood

53
Q

give 3 examples of drugs which can be given by inhalation

A

nitrous oxide
GTN
salbutamol

54
Q

how do most drugs cross the cell membrane?

A

via passive diffusion

55
Q

what ways other than passive diffusion can drugs cross the cell membrane?

A

aquaporin’s
endocytosis - eg. insulin
facilitated transport - drugs move down conc. gradient via protein channels (no ATP needed)
active transport - drugs move against conc. gradient (ATP needed)

56
Q

what is bioavailability?

A

the amount of drug which ultimately enters the bloodstream

57
Q

what is the maximum bioavailability?

A

1 - only happens in IV administration

58
Q

explain what happens during first pass metabolism

A

liver responsible for metabolism
drug absorbed in SI then goes to liver
liver degrades drug causing low bioavailability

59
Q

why is angina drug administered under the tongue?

A

to bypass first pass metabolism

60
Q

what is distribution?

A

movement of drug to the body’s tissues

61
Q

what factors affect distribution?

A

lipid solubility
blood flow to organ - higher blood flow = better distribution
binding of drug to protein

62
Q

what is the blood flow to the liver and kidneys?

A

liver - 680 b/flow

kidneys - 3,333 b/flow

63
Q

which organ has the highest blood flow

A

kidneys

64
Q

why does the drug binding to protein affect distribution?

A

when drug binds to protein it is too large to cross the cell membrane or bind to target site

65
Q

what is polypharmacy?

A

taking more than four drugs - drug interaction could be caused

66
Q

why is it important to concerned drug interactions when using drugs that bind to proteins?

A

if taking two drugs that bind to proteins the drugs will not work together
regular testing is needed to establish efficacy

67
Q

what is metabolism?

A

drug removal

68
Q

what needs to be adjusted in patients with liver disease?

A

doses must be adjusted as excretion of drug is less effective

69
Q

most drugs are lipophilic, how are lipophilic drugs excreted?

A

lipophilic drugs will recirculate in body - they need to become water soluble to be excreted

70
Q

how are lipophilic drugs converted to become water soluble

A

enzyme mediated conversion - carried out in the liver using hepatocytes (smooth ER)

71
Q

where does metabolism occur in the body?

A 
kidneys
liver
GI tract
brain
plasma
72
Q

how many phases does metabolism occur in?

A

2 - I and II

73
Q

describe what happens in phase I metabolism

A

(Producing a metabolite)
modify chemical structure of drug
make drug slightly more water soluble
preparing drug for phase II

74
Q

what usually happens to drugs following phase I metabolism?

A

drug is usually less active than parent drug

75
Q

what are pro drugs?

A

sometimes following phase I metabolism drugs become more chemically active (pharmacological activation) these are called pro drugs

76
Q

what is pharmacological activation?

A

a drug that become chemically active following phase I metabolism

77
Q

give two examples of pro drugs

A

prednisone - prednisolone
codeine - morphine
(second drugs are the metabolites)

78
Q

what happens during phase II metabolism?

A

‘conjugate’ drug to large molecule (eg. amino acid)

79
Q

what generally happens to drug following phase II metabolism?

A 
water soluble
easily excreted
increased molecular weight
inactive (pharmacological inactivation)
reduced affinity to binding site
80
Q

what can occur due to drug interactions?

A

drug metabolism could be induced or inhibted

81
Q

what would happen if drug metabolism was induced?

A

could speed up metabolism of another drug meaning it is metabolised too quickly to work

82
Q

what would happen if drug metabolism was inhibited?

A

stops drug from being metabolised quickly - thus producing toxic concentration

83
Q

give an example of a drug interaction

A

fluoxetine (Prozac) and grapefruit juice

84
Q

what is excretion?

A

removal of drug metabolites and water soluble drugs

85
Q

via what routes can excretion of drugs occur?

A

urine/ bile - often
faeces - less often
lungs / skin - sometimes

86
Q

what factors increase drug excretion?

A

increased blood flow to kidneys

reduced plasma protein binding

87
Q

what factors can increased or decrease drug metabolism?

A

genetic differences

drug interactions

88
Q

what is the therapeutic response to drugs related to?

A

level of drug in plasma

89
Q

what is the half life?

A

time it takes drug to drop by 50% from peak level

90
Q

how does half life influence drug dosing?

A

most likely that next dose of drug will be given after 1 half life (eg. HL 4hrs - next dose 4hrs)

91
Q

what is a therapeutic window?

A

window in which we see a therapeutic effect

92
Q

what precautions would you take if the drug to be given had a narrow therapeutic window?

A

not much difference between low and upper level

patients often need therapeutic concentration test to check drug within safe limits

93
Q

explain how the half life is determined

A

give drug

take measurement regularly and plot on graph

94
Q

work through this example to determine how much drug would be in the body after 10hrs. patient takes 20mg of drug with half life of 2hrs

A 
2hrs - 10mg
4hrs - 5mg
6hrs - 2.5mg
8hrs - 1.25mg
10hrs - 0.625mg (drug amount now negligible)
95
Q

97% of drugs are eliminated from the body after how many half lives?

A

5

96
Q

what would be required if a patient needed a drug to reach the therapeutic range quickly?

A

a loading dose would be given

97
Q

what is a compound medicine and give an example?

A

2 or more meds in one tablet (‘co’ used)

co-codamol - codeine / paracetamol

Pharmacology 1 (11 decks)

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