Week 1 Basics

Question 1

What is pharmacokinetics?

Answer 1

The study of what the body does to the drugs

Question 2

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

Answer 2

ADME

Question 3

What does ADME stand for?

Answer 3

Absorption
Distribution
Metabolism
Elimination

Question 4

What are the three aspects of absorption?

Answer 4

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

Question 5

What are the three routes of administration?

Answer 5

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

Question 6

What are the three most common methods of absorption?

Answer 6

1. Passive
2. Active
3. pincytosis

Question 7

What is passive absorption?

Answer 7

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

Question 8

What is the most important mechanism for drug absorption?

Answer 8

Passive absorption

Question 9

What must drugs be in order to utilize passive absorption?

Answer 9

Small, lipid or fat-soluble, non-ionized

Question 10

Acidic environments favor the non-ionization of ___

Answer 10

Weak acids

Question 11

Basic environments favor the non-ionization of ___

Answer 11

Weak bases

Question 12

What is active absorption?

Answer 12

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

Question 13

What is pincytosis?

Answer 13

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

Question 14

What are the three main factors that affect drug absorption?

Answer 14

1. Rate of dissolution
2. Blood flow
3. Contact time

Question 15

The rate of dissolution determines ____

Answer 15

the rate of absorption

Question 16

How does blood flow impact absorption?

Answer 16

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

Question 17

Which has more blood flow the stomach or the intestines?

Answer 17

The intestines.

Question 18

How might shock affect drug absorption?

Answer 18

Reduces blood flow to the skin or other absorptive tissues

Question 19

How does contact time affect the absorption?

Answer 19

The more contact time the more absorption. Vice Versa

Question 20

Give an example of altered contact time.

Answer 20

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

Question 21

What are some other factors that may affect absorption?

Answer 21

Drug-Drug and Drug-food interactions

Various disease processes

Question 22

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

Answer 22

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

Question 23

What is the bioavailability of IV drugs?

Answer 23

100%

Question 24

What is the bioavailability of non-IV drugs?

Answer 24

Less than 100%

Question 25

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

Answer 25

- Absorption is decreased | - Possible first-pass effect

Question 26

What is the first-pass effect?

Answer 26

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.

Question 27

What are bound drugs?

Answer 27

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

Question 28

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

Answer 28

Albumin

Question 29

Are bound drugs pharmaceutically active?

Answer 29

No

Question 30

What are free drugs?

Answer 30

Drugs that are not bound to plasma proteins in the blood

Question 31

Are free drugs pharmaceutically active?

Answer 31

Yes

Question 32

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

Answer 32

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.

Question 33

Where are drugs initially distributed to?

Answer 33

``` Areas of high blood flow. Heart Liver Kidneys Brain ```

Question 34

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

Answer 34

Consider an alternate route of administration

Question 35

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

Answer 35

Inflammed

Question 36

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

Answer 36

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

Question 37

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

Answer 37

Fat/lipid

Question 38

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

Answer 38

termination | pro-drugs

Question 39

What is a pro-drug?

Answer 39

A drug that must first be metabolized to become active

Question 40

What is the primary site of drug metabolism?

Answer 40

The liver

Question 41

What are some factors that can alter drug metabolism?

Answer 41

Genetics disease concurrent use of other drugs

Question 42

What are the 8 major routes of drug excretion?

Answer 42

``` Urine Bile Feces Expired air Sweat tears saliva titty milk ```

Question 43

What is the primary route of drug excretion?

Answer 43

Urinary

Question 44

Low urinary pH increases the excretion of ____

Answer 44

Weak bases

Question 45

High urinary pH increases the excretion of ___

Answer 45

Weak Acids

Question 46

What is the t1/2 of a drug?

Answer 46

The drugs elimination half-life.

Question 47

What does the t1/2 describe?

Answer 47

The drugs duration of action

Question 48

How can renal disease affect drug excretion?

Answer 48

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

Question 49

How is renal function evaluated?

Answer 49

Creatinine clearance

Question 50

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

Answer 50

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.

Question 51

What is pharmacodynamics?

Answer 51

The study of how drugs affect the body

Question 52

What does the therapeutic index measure?

Answer 52

the margin of safety for the drug

Question 53

A high therapeutic index indicates a ___ margin of safety

Answer 53

A wide margin of safety

Question 54

A low therapeutic index indicates a ___ margin of safety

Answer 54

Narrow

Question 55

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

Answer 55

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

Question 56

What is an agonist drug?

Answer 56

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

Question 57

What is a partial agonist drug?

Answer 57

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

Question 58

What is an antagonist drug?

Answer 58

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

Question 59

What is an addictive drug interaction?

Answer 59

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

Question 60

What is a synergistic drug effect?

Answer 60

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

Question 61

What is an antagonistic interaction?

Answer 61

When a drug cancels out the effect of another.