Quiz 1 Flashcards
What are the rights of drug delivery?
What are the other 4 Rs?
Drug Delivery:
Patient
Drug
Dose
Route
Time
Documentation
4 Rs:
Reason
Response
Refuse
Expiration Date
How are drugs distributed?
through blood
What are agonist and antagonist drugs?
Agonists = mimic (promote) normal receptor activity
Antagonists = inhibit (block) normal receptor activity
What fruit is a suicide inhibitor of CYP3A4?
grapefruit
It destroys some of the CYP3A4 in the small intestine
What happens when a substrate and inhibitor interact?
The inhibitor “gums up” the substrate
(holding the person up at checkout)
What types of drugs can cross the blood-brain barrier?
lipid-soluble drugs because our cells are made of lipid bilayer
Which route is the first pass effect?
The liver, with the drug taken orally
What is the fastest way a drug is administered?
IV
What does a narrow therapeutic drug index (TDI) mean?
The drug is dangerous if more than the recommended dose is taken
What is a prodrug? Example?
a pharmacologically inactive compound that is converted into an active drug within the body
Codeine → Morphine
Which population has the slowest drug metabolism?
Neonates
What happens to lipid-soluble drugs in the kidney?
Lipid-soluble drugs can pass through cell membranes and may be reabsorbed in the renal tubules instead of being excreted.
What is an adverse drug reaction? Example?
Adverse drug reactions (ADRs) refer to harmful effects caused by medications, such as liver toxicity from excessive acetaminophen use.
What is genetic polymorphism?
Genetic polymorphism is a variation in a gene that affects how a person metabolizes and responds to drugs
Which of the following drugs is most affected by genetic polymorphism?
A) Penicillin
B) Warfarin
C) Acetaminophen
D) Aspirin
Warfarin
Genetic differences in CYP450 enzymes can significantly impact warfarin metabolism, affecting drug efficacy and safety.
What does a drug inhibitor do?
Inhibitors prevent enzyme activity, leading to slower drug breakdown and increased drug levels in the body. (metabolism)
Which drug property makes it harder to cross cell membranes?
Ionized (charged) drugs do not easily pass through lipid membranes and often require transport mechanisms.
Which routes bypass the first pass effect?
IV, IM, and SUB-Q
What is a loading dose?
A loading dose is a high initial dose used to quickly achieve therapeutic levels in the body.
Achieving plateau in a drug with a long half-life can be expedited by giving a large initial loading dose
What is first-order drug elimination?
What is zero-order drug elimination?
First-order elimination is a process where a percentage of the drug is cleared per unit of time
Zero-order elimination occurs at a fixed rate, so excess drug can accumulate and cause toxicity (e.g., alcohol).
Which of the following is a type of hypersensitivity reaction that can lead to anaphylaxis?
A) Type I (IgE-mediated)
B) Type II (cytotoxic)
C) Type III (immune complex)
D) Type IV (delayed hypersensitivity)
Type I reactions (IgE-mediated) can cause anaphylaxis, a severe and potentially fatal allergic response.
What are the four stages of pharmacokinetics?
Absorption, Distribution, Metabolism, Excretion.
What is the first-pass effect?
The liver metabolizes oral drugs before they reach systemic circulation, reducing effectiveness.
What factors affect drug absorption?
Route of administration, solubility, blood flow, pH, and ionization.
What happens to weak acids in acidic environments?
What happens to weak bases in basic environments?
They remain non-ionized and are more easily absorbed.
How do ionized and polar drugs enter cells?
Through specialized transporters.
- active transport and protein binding
What is the blood-brain barrier (BBB)?
A selective barrier that only allows lipid-soluble drugs and those with special transporters to pass.
How does protein binding affect drug distribution?
Drugs bound to plasma proteins (e.g., albumin) are inactive until they unbind.
What factors affect drug distribution?
Blood flow, lipid solubility, protein binding.
What happens to drugs stored in fat?
They are released slowly, prolonging their effects.
What enzyme family is involved in drug metabolism?
Cytochrome P450 (CYP450).
What does CYP450 in the liver do to drugs?
Metabolizes drugs into active, inactive, or toxic forms.
What happens when a drug is a CYP450 inhibitor?
What happens when a drug is a CYP450 inducer?
Inhibitor: It slows metabolism, increasing drug levels (risk of toxicity).
Inducer: It speeds up metabolism, decreasing drug levels (reducing effectiveness).
How are lipid-soluble drugs excreted?
They must first be metabolized into water-soluble forms.
Which drugs are excreted through exhalation?
Anesthetics
What is the most common form of drug elimination?
First-order elimination (percentage per unit of time).
What is the minimum effective concentration (MEC)?
What is the toxic concentration?
MEC: The lowest blood level of a drug needed for therapeutic effects.
TC: The blood level at which a drug starts causing toxicity.
What is steady state? How many does does it take to reach steady state?
When the amount of drug eliminated between doses = the dose administered
5 doses
What is a maintenance dose?
Regular doses given to maintain steady state.
After a loading dose
What is a teratogenic drug?
A drug that harms fetal development.
What are the signs of anaphylaxis?
Swelling, hives, difficulty breathing.
What is a prolonged Q-T interval drug?
A drug that delays heart repolarization, increasing the risk of heart arrhythmias.
What are the most common drug allergies?
Penicillin, sulfa drugs.
Vocab
PharmacoTHERAPEUTICS
PharmacoECONOMICS
PharmacoEPIDEMIOLOGY
PharmacoGENOMICS
PharmacoMETRICS
Pharmaceuticals
PharmacoVIGILANCE
PharmacoTHERAPEUTICS: how to use the drug.
PharmacoECONOMICS: compare prices of drugs
PharmacoEPIDEMIOLOGY: the human response to the drug
PharmacoGENOMICS: individual variations; specifically how genes can affect a person’s response to a drug; we respond differently to drugs!
PharmacoMETRICS: measurement; quantitative analysis
Pharmaceuticals (AKA Big pharma): the manufacturers of a drug
PharmacoVIGILANCE: drug safety.
Pros and Cons of Short half life
Pros and cons of long half life
short:
pros: frequent doses = faster steady state
rapid discontinuation
less expensive
cons: peaks and valleys are extreme
poor compliance with frequent dosing
more missed doses
long:
pros: peaks and valleys are not extreme
good compliance with better dosing
fewer missed doses
cons:
less frequent doses= long steady state
cannot be discontinued rapidly
more expensive
What is drug half-life? What is is dependent on and what does it determine?
Drug half-life = amount of time required for serum concentration of a drug to decrease by 50%
- dependent on rate of drug excretion
- determines frequency of administration
