Week 2- 5 P's Flashcards
Where does chloroquine concentrate?
Liver
What four plasma proteins do drugs bind to?
- Serum albumin
- Lipoprotein
- Glycoprotein
- Globulins
Decreased drug metabolism results in what two things?
Accumulation of drugs and
Prolonged action of the effects of the drugs
What is the most important factor that affects the increase or decrease of drug metabolism?
Drug / drug interactions
What is first-pass effect?
Metabolism of a drug by the liver and its passage from the liver into the circulation.
Drugs administered to the lower portion of the rectum are absorbed where?
Inferior vena cava
What is excretion?
Elimination of drugs from the body
What are the six types of drug therapy?
- Acute
- Maintenance
- Supplemental
- Palliative
- Supportive
- Prophylactic
What are three major categories of drug routes?
- Enteral
- Parenteral
- Topical
In drug monitoring, what kind of effects don’t we want?
Side effects
What are three areas of slow distribution?
- Muscles
- Fat
- Skin
What is intraarticular?
Drug injected into joint space
What are six enteral routes?
- Oral
- Sublingual
- Buccal
- Nasogastric tube
- Gastrostomy feeding tube
- Rectal
What are the five “P’s” of Pharmacology Principles?
- Pharmaceutics
- Pharmacokinetics
- Pharmacodynamics
- Pharmacotherapeutics
- Pharmacognosy
Which goes through first pass - druges administered to the lower or upper portion of the rectum?
Upper
What is onset?
Time needed for the drug to elicit a therapeutic response.
What is duration?
Length of time that a drug concentration is sufficient to ellicit a therapeutic response.
Due to a drugs ______, some drugs bind to plasma proteins and others do not.
Molecular structures
What is the main site of drug metabolism?
Liver
What is intrathecal?
Drug injected into subarachnoid space of spinal cord
What is maintenance therapy?
Long term
What two things does drug form influence?
Rate of dissolution and absorption.
What are gels and magmas?
Minerals suspended in water.
What is a drug’s generic name?
- non-propriety name
- name registered by US Adopted Name Council
Tablets can be formed in what four ways?
- Compressed powders or granules
- Sugar coated
- Coated with volatile liquid
- Enteric-coated
What are capsules?
Gelatin coated
What is palliative therapy?
Treating symptoms
What are four types of drug interactions?
- Additive effect
- Synergistic effect
- Antagonistic effect
- Incompatibility
What is a drug’s trade name?
- propriety name
- registered trademark
- name restricted by drug’s owner
Drug moves from blood to what three places?
- Tissues
- Organs
- Body Fluids
What is the major organ of elimination?
Kidney
What is creatinine clearance?
Volume of serum or plasma that is cleared of creatinine in one minute via urinary excretion.
Creatinine clearance compares levels of creatinine in what two things?
Urine and blood
What are three classes of drugs that could cause drug / drug interactions?
- Other prescribed drugs
- OTC medications
- Herbal therapies
What three substances are used to dissolve drugs?
Water, oil, alcohol
What is an adverse drug event?
Human medication errors that result in patient harm.
What is oral?
Swallowing
What is absorption?
Movement of a drug from its site of administration into systemic circulation (blood).
What is buccal?
Between gum and cheek
What affects the rate of distribution?
- Membrane permeability
- Blood perfusion
What are eight forms of excretion?
- Kidneys
- Saliva
- Liver
- Bowel
- Sweat
- Lungs
- Hepatobiliary
- Breast milk
What are iatrogenic responses?
Unintentional adverse effects that are treatment-induced.
Drugs given via oral route may undergo _________ _________ _____________ prior to reaching systemic circulation.
Extensive liver metabolism
What kinds of tablets can be cut in half?
Scored
What are the steps in drug monitoring?
- Evaluating the effectiveness of drug therapy
- Observing for any adverse drug effects
- Making adjustments as needed
What are emulsions?
Mixtures of oil and water that improve taste of otherwise distasteful products
Oral drugs come in what two states?
Solid or liquid
What is bioavailability?
Fraction of unchanged drug (therapeutically active) that reaches systemic circulation and is available at target site.
What is a carcinogenic effect?
Cause cancer
What is rectal?
Inserted into rectum
What is acute therapy?
Very serious / right now
What is pharmacodynamics?
What the drug does to the body.
Biochemical and physiological effect of the drug on body tissue and microorganisms in/on the body.
What are the four distribution patterns?
- Drug stays within vascular system
- Drug distributes throughout body water
- Drug concentrates in specific tissues
- Drug distributes throughout body and tissue
What kind of drug has bioavailability - bound or unbound?
Unbound
What is tolerance?
A decreasing response to repetitive drug doses.
What is prophylactic therapy?
Preventitive
In distribution, the highest concentration are often in organs of what?
Elimination
What does half-life measure?
Drug elimination
What makes the chances greater of drug treatment being successful?
The more patient knows and understands about how to take the medication and why it is prescribed.
What is pharmacotherapeutics?
The use of drugs and the clinical indications for drugs to prevent and treat disease.
What is intravascular (IV)?
Drug injected into bloodstream
What is supplemental therapy?
Addition to (nutrition)
In creatinine clearance calculation, what must you do to a woman’s weight?
multiply by 0.85
What is intradermal (ID)?
Drug injected into skin
What two properties does an inactive metabolite have?
- More soluble compound
- More potent metabolite
What is an adverse drug reaction?
Any unexpected drug reaction that is NOT desired that occurs with a normal therapeutic dose.
What may lead to excess free (unbound) drug?
Diminished quantity of plasma proteins.
Renal function can be tested prior to prescribing drugs with what two processes?
Serum creatinine or urine creatinine clearance
Can protein binding be reversible, irreversible, or both?
Both
What four factors affect the extent of distribution?
- Lipid solubility
- Plasma pH
- Plasma protein binding
- Intracellular binding
Drugs exist in plasma in what two forms?
Bound and unbound
What is the therapeutic index?
Ratio between a drug’s therapeutic benefits and its toxic effects
What affects drug concentration?
Drug distribution
What is subcutaneous (Subq)?
Drug injected beneath the skin into subcutaneous tissue
Areas of more rapid distribution will result in what?
High conentration of drug.
What is the best IM administration site for children?
Vastus lateralis
What is the most common distribution pattern?
Drug distributes throughout tissues / body fluids
What do basic drugs bind to?
Glycoproteins / globulins
What are the five sources of drug derivation?
- Plants
- Humans / Animals
- Minerals
- Manufactured synthetics
- Genetically engineered
What could one drug do to another in terms of the same binding site?
Displace (push off the binding site)
What are side effects?
Expected well-known reactions that result in little or no change in patient management.
What are three forms of solid oral dosage?
Tablets, capsules, lozenges
What is pharmaceutics?
The study or science of how various drug forms influence pharmacokinetics and pharmacodynames.
What are five sites of drug metabolism?
- Liver
- Kidney
- Lungs
- Plasma
- Intestinal mucosa
What are solutions?
Drug substances in a homogenous mixture with a liquid.
What is half-life?
The time it takes for 1/2 of the original amount of drug to be removed from the body.
What are four contributing factors to reduced plasma proteins?
- Malnutrition
- Renal disease
- Liver disease
- Catabolic state
What are aromatic waters?
Aqueous solutions containing volatile oils
What is the fastest delivery into blood circulation?
Intravenous (IV)
What is pharmacology?
The study or science of drugs.
What are seven forms of luid oral drugs?
- Solutions
- Syrups
- Aromatic waters
- Liquors
- Suspensions
- Emulsions
- Gels and magmas
What are six topical routes?
- Skin
- Eyes
- Ears
- Nose
- Lungs
- Vagina
What is a drug?
Any chemical that affects the process of a living organism.
What is drug action?
- Cellular processes involved in the drug/cell interaction
- What happens at the cellular level
What are the four steps in reversible protein binding?
- State of equilibrium created between bound and unbound drug
- Bound portion of drug acts as a reservoir
- Reservoir slowly releases unbound drug to replace active drug as it’s eliminated
- Active drug is continually replaced
What is intraosseous?
Drug injected into bone marrow
Where does tetracycline concentrate?
Bones / teeth
What are four areas of rapid distribution?
- Heart
- Liver
- Kidneys
- Brain
What are liquors?
Liquid drugs with alcohol as the solvent
What two variables affect the fraction of unbound drugs?
Amound and quality of plasma proteins
What are the three organs of elimination?
- Kidney
- Liver
- Intestine
What is drug metabolism also known as?
Biotransformation
What are drugs classified by?
Physical state and chemical compositions.
What are caplets?
Oblong tablets
What are six risks with IV?
- Infection
- Fluid overload
- Electrolyte imbalance
- Phletbitis
- Extravasation
- Embolus
What is pharmacognosy commonly known as?
Herbals
What is intramuscular (IM)?
Drug injected into skeletal muscle
Drugs administered to the upper portion of the rectum are absorbed where?
Portal veins
What determines whether a drug action is local or systemic?
Drug form
What is the caluclation for creatinine clearance?
(140 - age in years) x (weight in kg)
(72 x serum creatinine mg/dL)
What are topical routes?
Drug applied to skin or mucosa or inhaled
What do parenteral medications require for administration?
Needle / catheter
What three things consequently happen if drug concentration is too high or the number of plasma proteins is too low?
- All binding sites on protein become saturated
- Excess drug remains unbound and biologically active
- Active drug levels may reach toxic levels
What are syrups?
Solutions of sugar and water, usually flavoring the drug
What is a drug’s chemical name?
The drug’s chemical composition and molecular structure.
What is dependence?
A physiologic or psychologic need for a drug.
What are enteral routes?
Drug is absorbed into systemic circulation through alimentary canal.
What is extravasation?
Accidental infusion of IV meds / fluids into surrounding tissue instead of vein
What is a teratogenic effect?
Affects babies in womb
What do acidic drugs bind to?
Albumin
What are five factors that decrease metabolism?
- Cardiovascular dysfunction
- Renal insufficiency
- Starvation
- Obstructive jaundice
- Erythromycin or ketoconazole drug therapy
What is the possible result of administratng two or more protein-binding drugs? What can this lead to?
- Dramatically alter therapeutic effect of one or more drugs
- Toxic drug levels
What muscle is not an appropriate IM injection site for infants and why?
- Gluteals
- Muscle not well developed yet
What are suspensions?
Insoluble drug contained in a liquid
A drug cannot make a cell or tissue do what?
Perform a function it was not designed to perform.
What three kinds of patients need rectal drugs?
- Patients with nasuea / vomiting
- Patients who are unconscious
- Infants who can’t swallow pill
Half-life is significant when measuring what three things?
- Steady state of drug
- Toxicity of drug
- Sub-therapeutic drug levels
Through what system are the majority of drugs excreted by?
Renal
What are major factors affecting distribution?
- Protein-binding properties
- Water-soluble vs. fat soluble
- Blood brain barrier
What is sublingual?
Under the tongue
What are the four parts of pharmacokinetics?
- Absorption
- Distribution
- Metabolism
- Excretion
What kinds of drugs stay in vascular system?
- Large molecular weight drugs
- Drugs tightly bound to plasma proteins
Once the drug reaches the site of action, what can it do?
Modify cellular / tissue function
Is an adverse event preventable or not preventable?
Preventable
What is pharmacokinetics?
What the body does with the drug.
Where does iodine concentrate?
Thyroid glands
Is an adverse drug reaction preventable or not preventable?
Not preventable
What kinds of drugs are distributed in body water?
Low molecular weight in molecules
What is distribution?
Delivery of drug rom the blood to the end target.
What are drug / drug interactions?
Altered drug action by interaction with another drug.
What are the normal creatinine levels for men and women?
91 to 137 ml/min for men
88 to 128 ml/min for women
What are two factors that increase drug metabolism?
- Barbituates
- Rifampin therapy
Reversible protein binding maintains what kind of state for active drug?
Equilibrium
What kind of oral drug is more GI ready?
Liquids
What are the three names of a drug?
- chemical
- generic
- trade
What is a mutagenic effect?
Altering DNA
What is peak?
Time needed for a drug to reach its maximum therapeutic response.
What gives the fastest absorption rates for oral preparations? the slowest?
- Liquids, elixirs, syrups
- Enteric-coated tablets
In pharmacodynamics, where is drug action?
Cellular level
What are three general factors affecting distribution?
- Drug characteristics
- Tissue properties
- Blood flow
What is affinity?
Attraction for
What are nine factors affecting drug absorption?
- route of administration
- bioavailability of drug
- type of membrane transport
- dosage form
- concentration of a drug
- co-administration of food or fluids
- acidity of stomach
- status of GI motility
Where can emergency administration of epinephrine take place?
Anywhere
What are ten routes that avoid first-pass?
- Sublingual
- Buccal
- Intramuscular
- Intravenous
- Subcutaneous
- Intranasal
- Inhalation
- Transdermal
- Intraosseous
- Vaginal
What are five IM injection sites?
- Deltoid
- Dorsogluteal (gluteus medius)
- Ventrogluteal (gluteus medius)
- Rectus femoris
- Vastus lateralis
What are two major conditions that impair renal function?
- Hypertension
- Diabetes
What are sustained-release (SR) capsules (spansules)?
Dissolved at a pedertimed rate over longer period of time
What is mechanism of action (MOA)?
The ways by which drugs produce therapeutic effects.
Biologic transformation of a drug turns it into what?
Inactive metabolite
What is drug effect?
- Physiologic reaction of the whole body to the drug
- Overall effect on the body
What is pharmacognosy?
The study of natureal (plant and animal) drug sources.
