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Pharmacology ATI > Pharmacology Principles > Flashcards

Pharmacology Principles Flashcards

1
Q

What is the definition of drugs?

A

Medications or other substances that have a physiological on the body

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2
Q

What is absorption?

A

The drug travels from the site of administration to the blood

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3
Q

What is distribution?

A

The medication is distributed throughout the body to the target cells

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4
Q

Drug bioavailability

A

Factors that affect whether drug is able to enter the cell and enact effect, including an affinity for drug-receptor sites and binding to plasma proteins

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5
Q

Pharmacodynamics

A

Physiological effect a drug has on the body (what is the drug’s mechanism of action?)

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6
Q

Pharmacogenetics

A

How people’s genes affect response to medication

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7
Q

Why may someone need several doses of an oral medication for it to enact effect?

A

The first pass effect: after making it to the intestines, liver enzymes will metabolize the drug rendering some inactive. Some will escape metabolism completely and enter the blood to become either plasma protein bound (inactive) or bound to the receptor site (active).

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8
Q

What route of admin does not undergo absorption?

A

Intravenous

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9
Q

Pros and cons of transdermal application

A

Pros: slow, steady stream of the drug directly to the blood without passing through liver.
good for a long period of time
more convenient than frequent injections or inhalation
Cons: Lipophilic and small molecules only

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10
Q

What are factors that affect drug absorption in neonates and pediatrics?

A

Acid-producing cells in stomach are immature until ages 1-2.
Gastric emptying may be decreased because of slow/irregular peristalsis.
Higher drug levels in blood due to immature liver

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11
Q

What affects oral medication absorption in the elderly?

A

Decreased blood flow to GI tract
Changes in gastric pH
Variations in plasma proteins

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12
Q

What affects subcutaneous, intramuscular, and transdermal medication absorption in the elderly?

A

Lower cardiac output and decreased peripheral circulation
Less body fat decreases absorption for transdermal

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13
Q

What causes drug side effects?

A

A drug primarily binds to its target receptors to enact or block an effect.
If it also binds to other unintended receptors, it can cause side effects.

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14
Q

Are most drugs bound to plasma proteins or free?

A

95-98% is bound to plasma proteins and can act as a reservoir that is slowly released over time

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15
Q

Why does a patient taking several highly protein-bound medications experience more side effects?

A

The drug that has the higher affinity for plasma proteins will bind first, which prevents the other drug from binding strongly to protein and the target site (some will but there will be a lot of active form in circulation without strong albumin binding)

Secondary medications float in circulation and are more likely to bind unintended receptors.

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16
Q

How do medications pass the blood-brain barrier?

A

They must be lipid soluble or have a “carrier” medication that can get through

Ex: Sinemet (Parkinson’s drug) is a combo of carbidopa (carrier) and levadopa (converted into dopamine)

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17
Q

What are considerations regarding medical distribution for neonates and pediatrics?

A

Decreased fat content due to greater total body water
Liver is still forming and protein binding capacity is decreased = more active drug in circulation
BBB is developing and allows more drugs to enter the brain

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18
Q

What are considerations for medication distribution in the elderly?

A

Decrease in total body water and muscle and increase in fat (longer duration of action for meds)
Albumin decreases = more active free drug in circulation (need lower dose!)

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19
Q

What is the first pass effect?

A

Orally administered drugs are broken down in the liver (converts a portion of the drug into a water-soluble waste form to be better excreted by the kidneys)

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20
Q

Why do we say the liver detoxifies?

A

The metabolites that are produced after enzymatic breakdown are less chemically active

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21
Q

What affects drug metabolism in neonates and pediatrics?

A

In babies and young children: developing liver produces fewer enzymes (less metabolism = more active drug in blood)
In older children: increased metabolism = higher doses needed

22
Q

What affects drug metabolism in the elderly?

A

Significant decline in metabolism, including first-pass metabolism
Liver disease
Dosages should be adjusted according to liver function and anticipated metabolic rate

23
Q

Why does grapefruit juice increase certain drug levels in the blood?

A

It affects the metabolic rate of SOME medications by lowering CYP3A4 (part of the CYP450 family of enzymes) in the intestines

24
Q

Which drugs interact with grapefruit juice?
What is the effect of the interaction?

A

Sertraline
Allegra
Procardia

CYP450 enzymes are reduced by grapefruit metabolism - more drug will be active in circulation

25
Q

Which drugs interact with dietary tyramine (wine, processed meats?
What is the effect?

A

Isocarboxazid
Tranylcypromine

hypertensive crisis

26
Q

Which drugs interact with milk?

What is the effect?

A

Tetracycline (sumycin)

reduced absorption = reduce therapeutic effect

27
Q

which drugs interact with protein?
effect?

A

Levadopa (parkinson’s drug)

SUDDEN loss of therapeutic effect

28
Q

Additive interactions

A

Combined effect of two similar drugs is equal to sum of each drug effect

1+1=2

Dangerous!

29
Q

Synergistic effect

A

one drug effect is greater if you give it with another drug

30
Q

Antagonistic effect

A

one drug is decreased or blocked if you give it with another drug

31
Q

Drug-food interactions

A

food changes way drug affects the body

increased blood levels (enzyme inhibitor) or decreased blood levels of med (enzyme enhancer)

32
Q

What is the Pregnancy and Lactation Labeling Rule?

A

mandates 3 sections for drug labelling:

pregnancy
lactation
reproduccutive potential

33
Q

What should be considered with medications and breastfeeding?

A
  • how much breastmilk the infant consumes
    -size of infant
34
Q

What happens if you administer a drug intramuscularly in a neonate (birth-1 month)

A

Absorption is delayed and erratic

35
Q

Onset of action

A

time it takes for drug to have a therapeutic response

36
Q

Peak effect

A

Time it takes for a drug to reach its full therapeutic effect

37
Q

Duration of action

A

Length of time the therapeutic effect lasts

38
Q

Trough drug level

A

point in time where the drug is at its lowest concentration in the blood

39
Q

Peak drug level

A

Point in time where concentration of drug is highest

40
Q

How do drugs enact a therapeutic effect?

A

Changes in cell function, changes in cell environment, and changes in enzyme action

41
Q

Agonist

A

Medication that binds a receptor and causes a greater than typical response

42
Q

Antagonist

A

Medication that binds a receptor and block a response or causes a less than typical response

43
Q

Competitive antagonists

A

Antagonist med that competes with agonists

At high doses, it causes a decreased therapeutic effect by agonists

44
Q

Noncompetitive antagonists

A

Completely block agonists from binding a receptor (at high enough doses)

45
Q

Selective drug interaction

A

medication has specific receptors it binds to in order to enact the desired effect
very selective - binds fewer receptors
low selection = binds a lot of receptors = more side effects

46
Q

Adverse drug reactions

A

Non-therapeutic and unintended response to a medication taken at a therapeutic dose

47
Q

Precautions

A

Steps taken against factors that can cause ADRs with a certain medication
Extra precautions taken if the client has multiple conditions or chronic disease

Example of a precaution: limit food or change admin schedule if drugs interact

48
Q

Contraindication

A

Conditions that can cause a serious adverse drug reaction and indicate the drug should not be prescribed

49
Q

Tolerance

A

decreased therapeutic response to a drug

Increase the dose to counteract

50
Q

Sensitivity

A

Drug accumulation in the blood, often due to changes in metabolism (liver damage or kidney damage)

51
Q

Toxicity

A

Adverse effects due to a toxic dose of a medication or kidney damage.

52
Q

General things that impact pharmacokinetics in old age?

A
  • increased body fat and decreased water
  • increased gastric pH
    -reduced peristalsis
    -declined liver and kidney functioning
    -fewer plasma proteins
    -reduced cardiac output, vascular disease

Pharmacology ATI (19 decks)

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