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Nurse 252 Pharmacology Review > Week 1 Basics > Flashcards

Week 1 Basics Flashcards

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1
Q

What is pharmacokinetics?

A

The study of what the body does to the drugs

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2
Q

What is the Acronym to remember the 4 phases of pharmacokinetics?

A

ADME

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3
Q

What does ADME stand for?

A

Absorption
Distribution
Metabolism
Elimination

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4
Q

What are the three aspects of absorption?

A
  1. Routes of administration
  2. Methods of Absorption
  3. Factors that affect absorption
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5
Q

What are the three routes of administration?

A
  1. Enteral - Within the GI tract
  2. Parenteral - IV, IM, Subcutaneous
  3. Other- Inhalation, transdermal, nasal, thecal, opthalmic, interventricular
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6
Q

What are the three most common methods of absorption?

A
  1. Passive
  2. Active
  3. pincytosis
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7
Q

What is passive absorption?

A

Simple diffusion.
Dependent on a concentration gradient
Requires no energy
High concentration to low concentration

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8
Q

What is the most important mechanism for drug absorption?

A

Passive absorption

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9
Q

What must drugs be in order to utilize passive absorption?

A

Small, lipid or fat-soluble, non-ionized

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10
Q

Acidic environments favor the non-ionization of ___

A

Weak acids

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11
Q

Basic environments favor the non-ionization of ___

A

Weak bases

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12
Q

What is active absorption?

A

Active transport
Requires energy
Moves particles from a low concentration to a high concentration
opposite of passive absorption

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13
Q

What is pincytosis?

A

Process that allows cells to carry drugs across their membranes by engulfing the drug particle

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14
Q

What are the three main factors that affect drug absorption?

A
  1. Rate of dissolution
  2. Blood flow
  3. Contact time
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15
Q

The rate of dissolution determines ____

A

the rate of absorption

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16
Q

How does blood flow impact absorption?

A

The more blood flows the more absorption via more drug being available to the tissue that is doing the absorbing.

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17
Q

Which has more blood flow the stomach or the intestines?

A

The intestines.

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18
Q

How might shock affect drug absorption?

A

Reduces blood flow to the skin or other absorptive tissues

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19
Q

How does contact time affect the absorption?

A

The more contact time the more absorption. Vice Versa

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20
Q

Give an example of altered contact time.

A

Diarrhea causes reduced contact time in the intestines d/t increased gastric motility

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21
Q

What are some other factors that may affect absorption?

A

Drug-Drug and Drug-food interactions

Various disease processes

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22
Q

What are some factors that may affect the bioavailability of a drug?

A

Metabolism, surface area, food intake at the time of administration

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23
Q

What is the bioavailability of IV drugs?

A

100%

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24
Q

What is the bioavailability of non-IV drugs?

A

Less than 100%

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25
Q

What are the two main reasons oral drugs have a bioavailability of less than 100%?

A
  • Absorption is decreased

- Possible first-pass effect

26
Q

What is the first-pass effect?

A

Some drugs only become active after they have traveled from the intestines, through the portal vein, and through the liver for metabolism. Therefore, the active amount of that drug is less than the dose after ingestion.

27
Q

What are bound drugs?

A

Drugs that are bound to a carrier protein in the plasma.

28
Q

What is the most common plasma protein that binds to drugs?

A

Albumin

29
Q

Are bound drugs pharmaceutically active?

A

No

30
Q

What are free drugs?

A

Drugs that are not bound to plasma proteins in the blood

31
Q

Are free drugs pharmaceutically active?

A

Yes

32
Q

What is the main concern for patients with hypoalbuminemia when considering medications?

A

With less albumin, there is an increase in active drug availability for drugs that are normally protein bound. Therefore there is an increased risk for toxicity and dose adjustments are likely to be needed.

33
Q

Where are drugs initially distributed to?

A 
Areas of high blood flow.
Heart
Liver
Kidneys
Brain
34
Q

If an area has low blood flow, what should be considered if it is a target for a medication?

A

Consider an alternate route of administration

35
Q

The blood-brain barrier becomes more permeable when it is _____

A

Inflammed

36
Q

Why is high blood concentration associated with water-soluble drugs?

A

High water content allows them to easily stay in the blood.

37
Q

___ Soluble drugs are associated with a large volume of distribution within the body tissues

A

Fat/lipid

38
Q

Metabolism of a drug is often associated with a ____ of the action of the drug with the exception of ___

A

termination

pro-drugs

39
Q

What is a pro-drug?

A

A drug that must first be metabolized to become active

40
Q

What is the primary site of drug metabolism?

A

The liver

41
Q

What are some factors that can alter drug metabolism?

A

Genetics
disease
concurrent use of other drugs

42
Q

What are the 8 major routes of drug excretion?

A 
Urine
Bile
Feces
Expired air
Sweat
tears
saliva
titty milk
43
Q

What is the primary route of drug excretion?

A

Urinary

44
Q

Low urinary pH increases the excretion of ____

A

Weak bases

45
Q

High urinary pH increases the excretion of ___

A

Weak Acids

46
Q

What is the t1/2 of a drug?

A

The drugs elimination half-life.

47
Q

What does the t1/2 describe?

A

The drugs duration of action

48
Q

How can renal disease affect drug excretion?

A

Decreased ability to filter and excrete drugs. Increases the risk of toxic build up of drugs that are excreted renally

49
Q

How is renal function evaluated?

A

Creatinine clearance

50
Q

When multiple drugs with high % protein-bound are taken, what is likely to occur?

A

Competition for serum protein and the toxic build-up of one or more of the drugs via more active drug being available due to less of the drug being bound than normal.

51
Q

What is pharmacodynamics?

A

The study of how drugs affect the body

52
Q

What does the therapeutic index measure?

A

the margin of safety for the drug

53
Q

A high therapeutic index indicates a ___ margin of safety

A

A wide margin of safety

54
Q

A low therapeutic index indicates a ___ margin of safety

A

Narrow

55
Q

What are the 8 most common low therapeutic index medications?
WLDPGA5A

A 
Warfarin
Lithium
Digoxin
Phenytoin
Gentamycin
Amphotericin -Anti-fungal
5-fluorouracil - Cough/Skin Cancer
AZT (zidovudine) - HIV
56
Q

What is an agonist drug?

A

A drug that activates a receptor and produces the same type of response as the endogenous substance

57
Q

What is a partial agonist drug?

A

A drug that activates a receptor but has a reduced effect compared to the endogenous substance

58
Q

What is an antagonist drug?

A

A drug that competes for a receptor site and once bound, prevents its activation

59
Q

What is an addictive drug interaction?

A

When two drugs with similar effects compound and increase that effect. example- Nitroglycerin and ED drugs can interact causing a severe hypotensive episode

60
Q

What is a synergistic drug effect?

A

When two drugs work together to improve the actions of one another.

61
Q

What is an antagonistic interaction?

A

When a drug cancels out the effect of another.

Nurse 252 Pharmacology Review (14 decks)

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