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MLT 203 > therapeutic drugs/toxicology > Flashcards

therapeutic drugs/toxicology Flashcards

1
Q

the analysis, assesment, and evaluation of circulating concentrations of drugs in serum, plasma, whole blood

A

therapeutic drug monitoring

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2
Q

therapeutic drug monitoring is often ordered with what other tests

A

creatinine, BMP, CMP, hepatic function panels

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3
Q

why do we do TDM

A

to assess drug dosages and see if drug is effective

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4
Q

advantages of TDM

A
  • identifying non-compliant patients
  • maximizing therapeutic effect
  • optimizing a dosing regimen based on drug-drug interactions
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5
Q

mechanism of action for TDM

A
  • interaction of a drug at its receptors/targets

- drug+receptor–> drug receptor complex –> effect

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6
Q

factors that effect drug effect and dosage

A
  • age
  • weight
  • tolerance
  • rate of elimination
  • time of administration
  • genetic factors
  • metabolism of other medications
  • protein binding
  • disease states
  • medication errors/compliance
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7
Q

involves the dynamics associated with movement of drugs across cell membranes

A

Pharmacokinetics

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8
Q

5 pharmacological parameters

A
  • liberation (route of admin)
  • absorption
  • distribution
  • metabolism
  • excretion
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9
Q

only ___ fraction of drugs can interact with site of action, resulting in biologic response

A

free fraction

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10
Q

routes of administration

A
  • injection
  • inhaled
  • absorbed
  • rectal
  • oral
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11
Q

routes of injection administration

A
  • circulation (IV)
  • muscles (IM)
  • Skin (subcutaneous)
  • epidermal
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12
Q

rate at which drug leaves the site of administration and the extent to which this happens

A

absorption

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13
Q

mechanism of absorption

A

passive diffusion, active transport

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14
Q

the fraction of a drug that is absorbed into systemic circulation

A

bioavailability

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15
Q

dristribution of drugs

A
  • blood flow
  • capillary permeability (pH gradients, lipid solubility)
  • binding of drugs to proteins (free form reacts with receptor)
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16
Q

biotransformation of the parent drug molecules into one or more metabolites by enzymes

A

metabolism of drug

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17
Q

converts hydrophobic substances into water soluble, which are then transported into bile or released into circulation

A

MFO, hepatic mixed function oxidase

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18
Q

major enzymes that metabolize drugs

A

Cytochrome P450

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19
Q

interactions that can alter drug processes

A

drug-drug
drug-food
drug-beverage (alcohol/caffeine)

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20
Q

effectiveness of a drug over a population

A

Pharmacogenomics

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21
Q

patients benefitting from therapeutic and desired effects of drug

A

responders

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22
Q

patients not benefitting from therapeutic/desired effects of drugs

A

non-responders

23
Q

gene group family that affects drug metabolism, functions in oxidizing drugs

A

Cytochrome P450

24
Q

rate of change of drug concentration over time varies continuously with the concentration of the drug

A

elimination

25
Q

elimination routes

A

hepatic metabolism, renal filtration, skin, lungs, mammary glands, salivary glands

26
Q

hepatic disease (cirrhosis) results in ___ rate of clearance with ____ half-life

A

slow, longer

27
Q

goal of dosage regiments

A

achieve troughs in therapeutic ranges and peaks that are non-toxic

28
Q

time needed for serum drug concentration to decrease by 1/2

A

half life

29
Q

time at which rate of elimination = rate of administration

A

steady state

30
Q

how long does it take to reach steady state

A

approx. 5-7 doses

31
Q

half life of theophylline

A

6-12 hours

30-84 hours to steady state

32
Q

valporic acid half life

A

8-20 hours

40-140 steady state

33
Q

digoxin

A

used to treat CHF

  • peaks at 2 hours
  • allows cardiac muscle contractions
34
Q

cardioactive drugs

A

digoxin
lidocaine
quinidine
procainamide

35
Q

lidocaine

A

used to treat premature ventricular contractions, affects timing of cardiac contraction

36
Q

quinidine

A

-treat cardiac arrhythmia

37
Q

procainamide

A

treat cardiac arrhythmia

affects muscle contraction

38
Q

antibiotic drugs

A

ahminoglycosides, vancomycin

39
Q

aminoglycosides

A
  • treat gram-negative bacteria
  • inhibits protein synthesis
  • nephrotoxic, otoxic
40
Q

vancomycin

A
  • treat gram-positive cocci,bacilli

- inhibit cell wall synthesis

41
Q

antiepileptics

A

-phenoarbital, dialntin, valporic acid, carbamazepine, felbamate, gabapentin, levetiracetam, etc…

42
Q

psychotherapeutic drugs

A

treat manic depression

43
Q

lithium, TCAs, Clozapine

A

psychotherapeutic drugs

44
Q

antiasthmatic drugs

A

theophylline, theobromine, bronchodilators

45
Q

bronchodilators

A

help relax smooth muscles of airways to prevent inflammation

46
Q

immunosuppresive drugs

A

cyclosporine, tacrolimus (prograf)

47
Q

monitoring of this group of drugs is important to prevent organ-rejection

A

immunosuppresive

48
Q

antineoplastics

A

inhibit RNA or DNA synthesis of tumor cells

49
Q

preferred specimen of immunosuppressive drugs

A

whole blood

50
Q

methotrexate

A

antineoplastic

51
Q

protease inhibitors

A

antiviral drugs used to treat HIV and Hep C

-inhibit viral replication

52
Q

ex. of protease inhibitors

A
  • indinavir
  • ritonavir
  • lopinavir
  • nelfinavir
53
Q

timing of TDM

A

trough: right before next dose
peak: verify drug protocol
- random

54
Q

TDM specimen type

A

serum/heparinized plasma
SST unacceptable
EDTA, Citrate, Oxalate unacceptable

MLT 203 (10 decks)

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