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PATHO > Pharmacology Principles > Flashcards

Pharmacology Principles Flashcards

1
Q

3 phases of pharmacology

A

Pharmaceutic, Pharmokinetic, Pharmacodynamic

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2
Q

Pharmaceutic phase

A

Dissolution occurs—drug begins to dissolve in order to be absorbed; tablet—granula—particle—GI solution—absorption

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3
Q

Pharmacokinetic phase

A

4 stages—absorption into the blood thru the GI tract, distribution at the site of action (effect exerted), metabolism by the liver, excretion by the kidneys (and a small part of the liver)

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4
Q

Cell membrane—phospholipid bilayer

A

Drug passes thru the cell membrane in the intestinal walls to the blood and travels to the site of action if lipid soluble (needs facilitator if water soluble)

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5
Q

First pass effect

A

A % of a drug is broken down by the liver in a first pass before systemic circulation; bioavailability of the drug decreases accordingly for drugs that pass thru the GI tract instead of going directly into the blood (IV)

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6
Q

Bioavailability

A

Amount of drug available in the blood; drugs with lower bioavailability may require higher dose or more frequent dose

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7
Q

Where does the first pass effect NOT occur

A

IV, highly vascularized tissues like SL, buccal, rectal, parenteral, topical meds

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8
Q

Enteral

A

By way of the GI tract (PO, oral, rectal, small intestine); first pass occurs

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9
Q

Parenteral meds

A

SQ, IM, IV, intrathecal (spinal cord), epidural (space around spinal cord); no first pass

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10
Q

Topical meds (transdermal)

A

Apply to body surfaces; eyes, skin, ears, nose, lungs;no first pass effect occurs

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11
Q

Distribution

A

Mvt of drug thru body; drug arrives at site of body

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12
Q

What does distribution depend on?

A

Blood circulation; less blood flow, less circulation; harder to reach tissue (abscesses, tumors, peripheral vascular disease)

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13
Q

Blood brain barrier

A

Cells in capillary wall in brain have tight junctions that prevent drug passage except for lipid soluble drugs; not fully developed in infants; alcohol and glucose can cross

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14
Q

Protein binding effect

A

Temporary storage of a drug molecule that lets a drug be available for longer periods of time; unbound drug binds to a protein and becomes bound; binding is reversible and unbound molecules are active and free to exert effect

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15
Q

Goal of dosing

A

Maintain a steady state of free drug concentrations

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16
Q

Albumin

A

Primary blood protein that molecules bind to

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17
Q

Hypoalbuminemia

A

Low protein levels cause by liver disease or malnutrition; more free drug availability and higher chance of overdose and toxicity (drugs that bind highly to proteins will have a stronger effect on people with low protein levels like Coumadin)

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18
Q

Metabolism (biotransformation)

A

Method by which drugs are inactivated into metabolites; liver converts lipid-soluble drugs into water-soluble metabolites so the kidneys can excrete them

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19
Q

CYP450 family

A

Group of enzymes that metabolize about 1/2 of all drugs; causes lots of drug-drug interactions

20
Q

CYP450 substrate

A

For metabolism; a substrate (drug) can bind to CYP450 and it will activate the drug

21
Q

CYP450 inducer

A

Speeds up metabolism of CYP450; causes a decreased amount of a drug in the body and therapeutic effect

22
Q

CYP450 inhibitor

A

Slows CYP450 metabolism; increased amount of drug in body and increased toxicity (ex: grapefruit juice)

23
Q

Excretion

A

Removal from body via pee

24
Q

How do the kidneys excrete?

A

With glomerular filtration, tubular secretion, tubular reabsorption; some drug is excreted and some is reabsorbed in the renal tubules

25
Q

How does kidney disease affect excretion?

A

Causes toxicity thru improper excretion

26
Q

Half life

A

Time required for serum concentration of drug to drop by 50%; determines dosing; takes 4-5 half lives to achieve a steady state (drug intake equals amount metabolized/excreted)

27
Q

Around the clock dosing (ATC)

A

Goal is to maintain 50% concentration in body

28
Q

Drug onset

A

Time for drug to reach therapeutic response

29
Q

Drug peak

A

Time to reach max therapeutic effect

30
Q

Drug duration

A

Time it takes drug concentration to elicit a therapeutic response

31
Q

Pharmacodynamic phase

A

Drugs can increase, decrease, replace, inhibit, destroy; exert multiple effects on the body (desired, undesired, adverse)

32
Q

Receptors

A

Proteins on cell surfaces that can be hormones or NTs

33
Q

Agonist

A

Drug that initiates a therapeutic effect by binding to a receptor

34
Q

Antagonist

A

Prevents or inhibits/blocks other substances from binding and causing a response

35
Q

Receptor-less activation

A

No receptor involved; act thru simple physical/chemical intake of small molecules

36
Q

Therapeutic index

A

Measure of safety; range in which a drug is safe

37
Q

Narrow therapeutic index

A

Small range of safety for a drug; often monitored with blood tests

38
Q

Black box warning

A

Required by the FDA for especially dangerous drugs; strongest warning; appears prominently on the package or insert

39
Q

Med errors

A

Major cause of mortality and morbidity; variables include fatigue and staffing; prevention includes reminders, standardizing, watching for similar drug names

40
Q

High alert meds (Institute for Safe Medicine Practices)

A

More likely to cause harm (insulin, heparin, opioids, IV, KCl, chemo)

41
Q

Drug-drug interactions increase with…

A

Especially with NTIs; intended or unintended; polypharm— nurse can bring attention to or may be able to consolidate; food, herbs, and disease

42
Q

Additive effect

A

2 drugs taken with similar MOA that amounts to a similar effect as that of the drugs separately

43
Q

Synergism

A

Difference MOA but make an effect greater than 1 drug alone

44
Q

Activation of drug metabolizing enzymes in the liver causes…

A

Decreased metabolism of the drug

45
Q

Displacement

A

One drug from a pharma protein-binding site displaced by a second drug and causes an increased effect of the displaced drug

46
Q

Antidote

A

Antagonized other drug (naloxone)

47
Q

Barrier to intestinal absorption

A

Lack of anatomy to break down meds

PATHO (32 decks)

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