Prescribing in Clinical Dentistry Flashcards

1
Q

What does enteral administration?

A

oral

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2
Q

What are the advantages of oral administration of a drug?

A

socially acceptable

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3
Q

What are the 4 disadvantages of oral administration?

A

slow onset
variable absorption
gastric acid may destroy drug
‘first pass’ metabolism

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4
Q

Where does blood from the GI tract enter?

A

liver

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5
Q

How does the blood from the GI tract travel to the liver?

A

hepatic portal vein

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6
Q

Where do drugs absorbed sublingually go?

A

straight to systemic circulation

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7
Q

When do drugs reach systemic circulation?

A

only after passing through the liver once

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8
Q

What is an example of a drug which need to be absorbed not orally?

A

glyceryl trinitrate

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9
Q

Why is more glyceryl trinitrate needed to achieve the desired effect?

A

as it is inactivated by the liver when taken orally, need to have higher dose or take sublingually/intravenous

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10
Q

When can first pass metabolism (through liver) activates a drug?

A

simvastatin

less needed

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11
Q

Why is it important to consider liver function/health when prescribing?

A

it metabolises the drug, making it active or inactive.

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12
Q

Does non-oral drug admiration have first pass metabolism?

A

no

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13
Q

What can you predict about non-oral drug administration?

A

plasma levels

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14
Q

What are disadvantages of non-oral administration?

A

allergic reactions more severe

access difficulties/self-medication

drug cost higher

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15
Q

What are factors effecting oral absorption?

A

lipid solubility and ionisation

drug formulation

GI motility

interactions with other substances in gut

GI tract disease (chron’s)

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16
Q

What is bioavailability?

A

proportion of an ingested drug that is available for clinical effect

17
Q

How is a drug distributed?

A

tissue fluid

18
Q

Is the drug distributed equally to all tissues?

A

no

example, drugs transported in blood, tissues with high blood flow receive high levels of the drug

19
Q

How does the drug distribute around the body? (2 ways)

A

plasma proteins and fatty tissue (lipid binding)

20
Q

What tissue absorbs the drug and releases it slowly back into plasma?

A

fatty tissue

(lipid binding)

21
Q

What are ways plasma proteins effect drugs?

A
  1. inactivate
  2. competitive binding warfarin and aspirin
22
Q

What is an example of competitive binding of drugs?

A

warfarin and aspirin

23
Q

What is phase 2?

A

preparing the drug for elimination from the body

24
Q

What are examples of phase 1 reactions?

A

oxidation

reduction

hydrolysis

25
Q

What are phase 2 reactions?

A

CONJUGATION

  • glucuronidation, sulphation, methylation, acetylation …
26
Q

What are examples of drug excretion methods?

A

renal - urine

liver - bile

lungs - exhale

sweat

saliva

27
Q

What can saliva samples test?

A

nicotine levels, smoking compliance

28
Q

If the method of secretion of the drug is faulty, e.g. liver disease/renal disease, what should be done?

A

reduce drug dose

29
Q

What does the blood alcohol elimination curve show?

A

the level of alcohol at a specific time, you can trace back the predicted levels