Test1 Flashcards
T1/2 time required for amount of drug in the body to decline by 50%
Drug half life
Large initial doses used rapidly to achieve a therapeutic level
Loading doses
Point at which the amount of drug eliminated between doses equals the amount of drug administered
Steady state
During steady state what happens to the average drug concentration?
It remains constant
How many half lives until the steady state it reached?
4
IV given at 0800 on monday with a 24 hour half life. What is the steady state?
Friday 0800
Space between the MEC and toxic concentration
Therapeutic range
The plasma level below which therapeutic effects
Minimum effective concentration
The plasma level where toxicity begins
Toxic concentratiom
The smaller therapeutic index the —– the drug
More dangerous
Tell enzymes to metabolize drug faster
Enzyme inducer
Stop the breakdown of other drug
Enzyme inhibitor
Increase levels of object drug
Enzyme inhibitor
Removal of drug from the body
Excretion
Number one method if excretion
Renal
Decrease levels of object drug
Enzyme inducer
The study of the biochemical and physiological effects of drugs and the molecular mechanisms by which those effects are produced
Pharmacodynamics
The largest effect a drug can produce
Maximal efficacy
Refers to the amount of drug needed to elicit an effect
Relative potency
Crank until you can’t crank no more
Sealing effect
Any functional macromolecule in a cell to which a drug binds to produce its effects
Receptor
Molecules which activate receptors
Agonist
Molecules which prevents receptor activation by endogenous regulatory molecules
Antagonist
What is also known as an antagonist?
A blocker
Can act as both an antagonist and agonist
Partial agonist
What are the 2 rules for receptors?
1) all they can do is mimic/block to the body’s own process
2) cannot give new functions
Decrease number of receptors because receptors go away because of constant use
Receptor down regulation(desensitization)
Increase number of receptors
Receptor up regulation
Effective dose in 50% of population
ED50
Lethal dose in 50% of population
LD50 (study in animals)
any chemical agent that affects the processes of living
Drug
the study of drugs and their interactions with living systems
pharmacology
use of drugs in the treatment and prevention of disease or conditions
pharmacotherapy
provide maximum benefit with minimum harm
therapeutic objective
the study of the absorption, distribution, metabolism, and excretion of drugs
pharmacokinetics
what are the 9 characteristics of the ideal drug?
effective MOST IMPORTANT safety selective-perfect drug is 100% effective reversibility predictable easily administered void of drug interactions inexpensive chemically stable
every patient is unique
individual variation
new drugs undergo testing for toxicity reviewed by FDA
The Food and Drug Cosmetic Act
1st legislation to regulate drug safety
The Food and Drug Cosmetic Act
drugs with potential abuse must be tightly regulated
Controlled Substances Act
How is the scheduling of controlled substances controlled?
I-worse; no medicinal value and greatest potential for abuse (heroine, meth)
II-medicinal abuse and greatest potential for abuse (dilaudid, percocet, ritalin, morphine)
III-
IV-
V-cough syrup, steroids
the most reliable way to evaluate all new drugs
randomized controlled trial RCT
features controlled binding, and randomization
what are the 3 ways to move your drug
channels and pores
active transport
direct penetration of membrane
what is the most common way to move your drug?
direct penetration of membrane
what characteristics will absorb and pass through?
nonpolar
nonionized
lipophilic
minimal protein bound
what characteristics will not absorb and pass through?
polar
ionized
hydrophilic
maximal protein bound
an acid in acid is
nonionized
the effects of the body on the drug
pharmacokinetics
the effects of the drug on the body
pharmacodynamics
larger surface area
greater the Absorption
are trade vs. generic drugs created equal?
yes within 5%
drugs move from ___ concentrations to ___ concentrations
high to low
advantages of enteral medications
reversible
easy
safe
inexpensive
disadvantages of enteral medication
GI toxicity variable absorption (not as predictable as IV) first pass affect (liver wipe out)
advantages of parenteral medication
precise control
no barriers to absorption
emergencies large volume
disadvantages of parenteral medication
infection
irreversible
embolism
fluid overload
the movement of drugs throughout the body (from the blood to the tissues)
volume distribution
what characteristics have a high volume of distribution?
nonpolar
nonionized
lipophilic
minimal protein bound
acceleration of renal excretion is a major part of
metabolism/biotransfusion
what is the most important function of the liver?
acceleration of renal excretion (metabolism)
the study of biochemical and physiologic effects of drugs on the body
pharmacodynamics
removal of drug from the body
excretion
ways of excretion
RENAL -glomerular filtration -passive reabsorption -active transport and non renal
any noxious, unintended, and undesired effect that occurs at a normal drug dose
Adverse Drug Reactions ADR
where are ADRs most common
elderly >60 (50%) of ADR
very young
the more _____the more ADRs
drugs
what is the 4th leading cause of death?
ADR
unavoidable secondary drug effect produces at therapeutic doses
side effect
NSAIDS>ulcers
any severe ADR regardless of the dose
toxicity
immune response
allergic reaction
mild rash>anaphylactic reaction>skin peel off
uncommon drug response resulting from genetic predisposition
idiosyncratic effect
disease produced by drugs (our fault)
Iatrogenic Disease
drugs cause cancer
carcinogenic effect
drug induced drug effect
teratogenic
FDA Medical Products Reporting Program for ADR stage 4 clinical trials
Medwatch
with ADRs what do you think first?
think DRUG first
any preventable event that may cause or lead to inappropriate medication use or patient harm, while the medication is in the control of the health care professional, patient, or consumer
Med Errors
Fatal Errors
#1 reason overdose #2 wrong drug #3 wrong route
report it! even near misses
!!
decrease responsiveness to drug as a result of repeated drug administration
tolerance
pt. requires increase drug levels to produce effects that could formerly be produced at decreased drug levels
pharmacodynamic tolerance
what happens during pharmacodynamic tolerance?
MEC goes up
due to accelerated drug metabolism
metabolic tolerance (MEC doesn’t rise)
reduction in responsiveness brought on by repeated dosing over a short period of time
tachyphylaxis
the component of the drug response that is caused by physiologic factors and not by the biochemical or physical properties of the drug
placebo effect
pts. feel like they are getting better
positive placebo effect
pts. are negative
negative placebo effect
a major cause of altered cause of altered drug response are alterations in genes that code for drug-metabolizing enzymes and drug targets
genetics
provide ______ treatment for the mother while avoiding ___ to the fetus
effective; harm
what kind of drug do you want to give to a mother so that it won’t get to the baby?
polar ionized, hydrolipophilic, max. protein bound
When are medications the most dangerous to take?
1st trimester; 3-8 weeks; embryonic period
when would birth defects take place?
2nd trimester
what rated drug would be ok to take during pregnancy?
A
what rated drug would you not want to take while pregnant?
X
When breast feeding when do you want to take a drug?
right after feeding and we want drugs with a short half life
generally responsible for enhanced drugs in the very young
organ system immaturity
what kind of meds should we be careful with with infants?
creams-doesn’t take much
