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Week 2 Flashcards

1
Q

Pharmacokinetics?
faar·muh·kow·kuh·neh·tuhks

A

Absorption, distribution, metabolism and elimination of drugs
–”What the body does to the drug”
-How moving into the body

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2
Q

Pharmaceutics?
faar·muh·soo·tuhks

A

preparing drugs for administration
“Dosage Forms”

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3
Q

Pharmacodynamics?

A

Action or effects of drugs on living systems
“What the drug does to the body”

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4
Q

Levels of Drug Activity? 4

A

Body Systems
Component Tissues
Cellular Level
Molecular Level

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5
Q

Drugs modify existing functions　
What are they? 3

A

Interrupt
-ipratropium/slow down mucus membrane
Replace
-Fe for anemia
-insulin
Potentiate
-Cathartics before sigmoidoscopy

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6
Q

Beta-Blockers
a) Body Systems
b) Component Tissues
c) Cellular Level
d) Molecular Level

A

a) Reduces pulse rate
b) Negative chronotrope
c) Prevents elevation of cAMP
d) Competitive antagonism of norepinephrine to cardiac beta1 receptors

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7
Q

Agonist?

A

Activates!!
A drug interact with a receptor and fully activate it.
Intrinsic activity equals 1

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8
Q

Partial Agonism

A

A drug interact with a receptor and partially activate it
Intrinsic activity between 0(0%) and 1(100%)

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9
Q

Antagonism?

A

A drug binds a receptor and prevents a response from occuring
Blocking receptor to being fully stimulate

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10
Q

Competitive Antagonism?

A

Agonist and antagonist both trying to bind to the same receptor

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11
Q

Noncompetitive Antagonism?

A

Binding of an antagonist to one receptor prevents an agonist from bind to another receptor

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12
Q

Eternal administration
Mouth

A

Thin lining, rich blood supply
Sublingual and buccal routes

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13
Q

Eternal administration
Stomach

A

Medium surface area, rich blood supply
Acidic pH
Drugs don’t stay long

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14
Q

Eternal administration
Small Intestine

A

Hugh surface area
Rich blood supply
Basic pH

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15
Q

Parenteral Administration
Advantages

A

Can be used for drugs that are poorly absorbed
Can provide an immediate onset of action (IV)
Can provide a longer lasting effect (IM/SQ)
Can concentrate drug at a specific location
Can provide a more predictable response
Can provide titratable dosage

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16
Q

Parenteral Administration
Disadvantages

A

Pain
Irreversible
Extravasation　血管外漏出
Phlebitis　静脈炎
Not useful for self-administration
Contamination/infection

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17
Q

Parenteral Administration 7

A

Intravenous into a vein
Intra-arterial into a artery
Intramuscular into the muscle
Epidural epidural space
Intrathecal into the CSF
Subcutaneous into the sab layer of the skin
Intra-articular Joint

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18
Q

Topical Administration
Skin

A

Ointments, creams, patches
Local and systemic

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19
Q

Topical Administration
a) Eyes
b) Ears
c) Intranasal

A

a)Drops, ointments
Local distribution

b)Local distribution

c)Spray and drops
Local and systemic

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20
Q

Topical Administration
a) Inhalation
b) Vaginal

A

a) Local and systemic
b) Local and systemic

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21
Q

Oral Dosage Forms 8

A

Dissolved Liquid (elixir, syrup)
Suspensions
Powders
Capsules
Tablets
Coated Tablets
Enteric-Coating
Sustained-Release

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22
Q

Pharmacokinetic Phase
Absorption

A

Movement of drug molecules into the body

Passive: high to low
Facilitated diffusion: solutes through transport proteins in the plasma membrane.

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23
Q

Pharmacokinetic Phase
Rate of absorption can determine?

A

Onset of action
Duration of action
Intensity of response

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24
Q

Variables Affecting Absorption 4

A

Nature of absorbing surface
Surface area/small vs. large
Blood flow to site of administration
pH at the site of absorption

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25
Drug Excretion
Kidneys Lungs Sweat glands Salivary glands Mammary glands GI tract Excretion is the PHYSICAL removal of the drug from the body
26
Variables Affecting Dose/Response Body Weight
Larger doses are often given to patients with greater weight or BMI Dependent on where the drug distributes to – Muscle – Adipose – Body water
27
Variables Affecting Dose/Response Age
Altered capacity to metabolize and/or excrete drugs Most common in very young and very old (Usually decreased)
28
Variables Affecting Dose/Response Gender
Differences in body composition and hormonal activity
29
Variables Affecting Dose/Response Genetics
Enzymatic differences can lead to alterations in magnitude of effect Decrease or increase Therapeutic failure or toxicity
30
Variables Affecting Dose/Response Tolerance
Larger doses must be given to maintain the same effect Commonly seen with opioids
31
Variables Affecting Dose/Response Psychological factors / Beliefs
Placebo effect For example, if you get sick after eating a specific food -you may associate that food with having been sick and avoid it in the future
32
Variables Affecting Dose/Response Comorbid medical conditions
Can affect all phases of pharmacokinetic and pharmacodynamic response
33
a) Reversible antagonist? b) An irreversible antagonist?
a) A reversible antagonist binds non-covalently to the receptor. Therefore can be “washed out” b) An irreversible antagonist binds covalently to the receptor Cannot be displaced by either competing ligands or washing
34
Drug-Drug Interaction Definition? a) What response are they? b) A change in a drug's effect on the body when the drug is taken b______
a) The pharmacological or clinical b) together with a second drug
35
Types of Drug Interactions 4
1) Drug-drug 2) Drug-food 3) Drug-herbal medicine 4) Drug-laboratory
36
Types of Drug Interactions Pharmacokinetic
One drug alters the rate of absorption, distribution, metabolism or excretion of another drug Change in the plasma concentrations of another drug
37
Types of Drug Interactions Pharmacodynamic
One drug induces a change in a patient’s response to a drug without altering the object drug’s action
38
Types of Drug Interactions Pharmaceutical
Includes physical and chemical incompatibilities 両立しがたいこと IV chemical
39
Potential for Interactions a)______ drugs available in US b)______% of population on at least 5 products Possible combination is 525,000,000,000,000,000
a) 4000 b) 25
40
Patients at Greatest Risk 6
Multiple medications Multiple prescribers Multiple pharmacies Elderly Obese patients Critically ill patients
41
a) No concern b) Limited concern c) Limited concern d) Worse case Serious concern
42
The drug agonist binds to receptor A in the brain to raise blood pressure & the drug antagonist binds to receptor A in the brain to decrease blood pressure
Pharmacological antagonism One receptor/ same receptor
43
The drug agonist binds to receptor A in the brain to raise blood pressure & the drug antagonist bind to receptor B in the blood vessels to decrease blood pressure
Effect antagonism Opposite effect Two different receptor
44
Enteral administration from where to where?
Mouth to anus
45
Where is the location? a) Epidural b) Intrathecal c) Subcutaneous d) Intra-articular
a) epidural space b) into the CSF/cerebral spinal fluid c) into sub layer of skin d) joint
46
a) Disintegration 分解 b) Dissolution 溶解
47
What dose Disintegration means?
Increase the surface area of the drug and starts to break apart
48
What dose Dissolution means?
In order for drug to cross the biological membrane it needs to undergo dissolution.
49
List 4 variables that allow for increase absorption?
1: Natural of absorbing surface Thinner is better for absorption 2: pH Basic=good Acidic=poor 3: Large surface area Bigger= better 4: Blood supply to the site
50
Definitions of Time-Concentration Curve Minimum effective concentration
The amount of drug in the body it takes to provide benifit
51
Definitions of Time-Concentration Curve Duration of action
The period of time the drug is above the minimum effective
52
Definitions of Time-Concentration Curve Onset of action
When the drug starts having an effect
53
Definitions of Time-Concentration Curve Therapeutic range
Above this range is toxic, below is not effective
54
Definitions of Time-Concentration Curve Toxic level
Too high blood levels of the drug: will have negative
55
The form of drug elimination in which an active drug is metabolized into an inactive form is called the?
Biotransformation
56
What is the difference between excretion and elimination?
Elimination is the removal of the ACTION the drug from the body. Excretion is the PHYSICAL removal of the drug from the body
57
An interaction between drugs that have opposite effect, they can block or reduce the effect is called?
Antagonistic drug interaction
58
The combined effects of drugs when take together is greater than when take alone is called?
Synergistic drug interaction a: Decrease BP + b Decrease BP= double effect
59
Which characteristic are they? a) Change in plasma concentration occurs b) Incompatibilities prevent absorption
a) Pharmacokinetic b) Pharmaceutical
60
Which characteristic are they? a) A drug causes a change in the pt's response to another drug b) A drug alters the absorption and distribution if another drug
a) Pharmacodynamic b) Pharmacokinetic
61
Which characteristic are they? a) No change in the plasma concentration b) A drug alters the metabolism and excretion of another drug
a) Pharmacodynamic b) Pharmacokinetic
62
What is a enzyme and its function?
Enzymes are proteins Help speed up metabolism, or the chemical reactions in our bodies
63
Sodium-Potassium Pump?
The sodium–potassium pump is an enzyme (an electrogenic transmembrane ATPase) found in the membrane of all animal cells.
64
ligand-gated ion channels?
One type of membrane receptors They are transmembrane ion channels that open or close in response to the binding of a chemical signal like a ligand.
65
What are characteristic object drugs?
Have a narrow therapeutic range Used chronically Metabolize by hepatic enzymes 影響を受け，薬効や有害反応の直接の原因となる
66
What are characteristic of precipitant drugs?
The agent which precipitants such an interanion 相互作用を引き起こす医薬品
67

Name 3 ways that drug interactions can occur as a result of altered absorption.

Complexation
pH change
GI motility change

68

What is enzyme induction?
 

Certain drugs capable of increasing metabolic enzymes in the liver

69

What is enzyme inhibition?
 

A number of drugs are capable of decreasing the activity of cytochrome P450 enzymes

70

Place either enzyme induction or inhibition

a. Happens slowly
b. Results in toxicity
c. Increases amount of enzyme
d. Happens quickly
e. Causes ineffective treatment
f. Most common way a serious DI can occur

a) induction
    a,c,e

b) inhibition
     b,d,f

71

Mechanism of altered absorption

Complexation

 

Bile acid resins
OTC+ prescription drug

Drug that from chemical complexes with other drug
lower the rate of drug absorption

"Take meds at different time!"

72

Mechanism of altered absorption

Change in pH

Most drug likes basic pH environment

If the drug change the pH, not absorb as suppose to be

Poop out then drug is not working

73

Mechanism of altered absorption

GI motility

Slowing motility
= increase absorption time

Speeding motility
=decrease absorption time
Problem with sustains-release meds

74

CYP2D6 is including what enzyme?

Cytochrome P-450
genetic enzyme 
someone has a lots, someone has a little

75

Factors affecting drug metabolism

Age
 

neonate, premature baby 
-not developed organs
-not have specific enzyme to metabolize

Elderly
-life experience(smoke, drinking)
-decease body function (liver, kidney)
 

76

Factors affecting drug metabolism

disease states

Hepatic cancer etc
OIs drug clear by liver?
overdose danger!

77

Factors affecting drug metabolism

pregnancy

Placenta has a lot of enzyme
smoke causes to produce more enzyme

After delivered placenta, need to adjust dosage

78

Enzyme induction

Active drug to inactive drug
Make more enzyme=decrease drug work

Onset 5days,max eff 2weeks (slowly work)
Offset 2-3 weeks

79

Enzyme inhibition

Increase plasma concentration
=stop breaking drugs
=more drug action

Onset reach max in 24 hours
Offset within 24h hours
Result toxicity

80

Pharmacodynamic interaction

Drug A increase HR
Drug B decrease HR

 

Antagonistic
Change nothing
Cancel out

81

Pharmacodynamic interaction

Taking lower BP med, 2 days later taking another lower BP med to have greater result

Synergistic/Additive Therapeutic Effect

82

Pharmacodynamic interaction

Taking a CNS drug and starts taking another drug also causes CNS depression

Synergistic/Advance Effects

Pharmacology (34 decks)

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