week 2: Ch. 3-4 [Pharmacokinetics/dynamics]

Question 1

Pharmaco means:

Answer 1

medicine

Question 2

Kinetics means:

Answer 2

movement

Question 3

Pharmacokinetics means:

Answer 3

what the body does to drugs after administration

[study of drug movement throughout body]

Question 4

What are 2 barriers to drugs attempting to reach target cells?

Answer 4

Many membranes must be crossed

Physiological processes

Question 5

4 processes of Pharmacokinetics

Answer 5

absorption
distribution
metabolism
excretion

Question 6

Drugs use _________ and ______ __________ to cross plasma membranes to reach target cells

Answer 6

diffusion, active transport

Question 7

2 types of diffusion:

Answer 7

simple diffusion
passive transport

Question 8

diffusion is the movement of a chemical from an area of :

Answer 8

higher to lower concentration

Question 9

diffusion assumes a chemical can cross :

Answer 9

plasma membranes freely

[not the case for all drugs]

Question 10

What factors affect movement across plasma membranes?

Answer 10

size of drug molecule
ionization of drug molecule
lipid solubility

Question 11

Facilitated diffusion utilizes ____1____ ________ to cross membranes.

does it require energy? 2:

Answer 11

carrier proteins

2- no

Question 12

Active transport pumps require:

Answer 12

cell energy

Question 13

_________ is the first step toward reaching the target cell for a drug

Answer 13

Absorption

Question 14

Absorption is the movement from site of administration to:

Answer 14

bloodstream

Question 15

The primary factor for determining the onset of drug action:

Answer 15

absorption

Question 16

Enteral route of administration

Drugs delivered to__________________
~orally or through ______________________________________________________________

~common: ______________________

[slow onset bc must absorb as goes through system to be available]
~Oral liquid absorbed much faster

Answer 16

Drugs delivered to GI tract
~orally or through NG tube or gastromy tubes

~common: tablets/capsules [slow onset bc must absorb as goes through system to be available]
~Oral liquid absorbed much faster

Question 17

Explain enteric-coated tablet/capsule

Hard, waxy coating to resist ________________________________contents
~designed to dissolve in _____________ environment of small intestine

Answer 17

Hard, waxy coating to resist strongly acidic stomach contents
~designed to dissolve in alkaline environment of small intestine

Question 18

Explain extended-release tablets/capsule

Designed to dissolve ____________ over longer time = ____________duration of action

Answer 18

Designed to dissolve slowly over longer time = longer duration of action

Question 19

The following should never be chewed/crushed/opened:

Answer 19

extended-release formulations
enteric coated drugs
oral cavity drugs

Question 20

Tablets/capsules go through a first-pass effect: drugs absorbed from the stomach and small intestine travel to liver, where they may be:

Answer 20

inactivated before reaching target organs

Question 20

Recent devlopments of med administration (within enteral route) include

Answer 20

orally disintegrating tablets ODT
oral soluble films

Question 21

Describe sublingual/buccal routine of medication (enteral)

medications kept in mouth

dissolves in_____________________

not subjected to ______________________________________________________________

sublingual- _____________
buccal- ___________________

[in case of multiple meds, oral meds first, then sublingual]

Answer 21

medications kept in mouth

dissolves in under 30 seconds

not subjected to stomach acid/ first-pass effect

sublingual- under tongue
buccal- in cheek

[in case of multiple meds, oral meds first, then sublingual]

Question 22

Explain medications given through nasogastric and gastromy tubes

drugs usually_____________, to prevent _____________________

do not use ________________________ meds

Answer 22

drugs usually liquid, to prevent clogging tubes

do not use sustained release meds

Question 23

Explain absorption of topical route meds

usually_________ absorption

drugs must penetrate ___________________________

ex) ________________ patch- like sticker- rate of delivery varies; can depend on amount of ______

Answer 23

usually slower absorption

drugs must penetrate thick skin layer

ex) transdermal patch- like sticker- rate of delivery varies; can depend on amount of hair

Question 24

3 types of topical routines include opthalmic route- otic roue- intranasal route- vaginal route- rectal route-

Answer 24

opthalmic route- treating local conditions in eye otic route- in ear intranasal route- within nose vaginal route- local conditions or BC rectal route- local or systemic; ex) suppository or enema; avoids first-pass effect

Question 25

Describe parenteral route of drug administration ______________ & ______________ administration ~any medication penetrating through skin ~__________________ adminstration- drug into large muscle (thigh/arm/bottom); rapid onset of action ~_______________ administration: directly to bloodstream; fastest onset but most dangerous [miscalculation or reaction can lead to bad outcome]

Answer 25

intradermal & subcutaneous administration ~any medication penetrating through skin ~intra muscular adminstration- drug into large muscle (thigh/arm/bottom); rapid onset of action ~intravenous administration: directly to bloodstream; fastest onset but most dangerous [miscalculation or reaction can lead to bad outcome]

Question 26

major difference between intradermal & subcutaneous administration

Answer 26

depth of injection [intradermal more superficial]

Question 27

Examples of subcutaneous administration drugs:

Answer 27

insulin heparin vitamins vaccines

Question 28

for most drugs, higher doses produce:

Answer 28

faster and greater drug response & greater concentration gradient for diffusion

Question 29

Most absorption of drug occurs in:

Answer 29

GI tract (small intestine)

Question 30

why does digestive motility vary among patients?

Answer 30

different amount of acid in stomach, or quicker digestion

Question 31

Presence of food in stomach _______ absorption

Answer 31

slows [with very few exceptions] Usually best to take med on empty stomach or between meals

Question 32

Drugs are absorbed faster from areas of the body where blood flow:

Answer 32

is high

Question 33

How can blood flow be purposefully manipulated to slow absorption?

Answer 33

vasoconstrictors [constricts blood flow] ice packs

Question 34

Depending on the pH of surrounding fluid, most drugs are either :

Answer 34

charged or uncharged state

Question 35

__________ of a drug affects its ability to cross plasma membranes and to be excreted by the body

Answer 35

Ionization

Question 36

acids are absorbed in acids because they are:

Answer 36

nonionized

Question 37

bases are absorbed in bases because they are:

Answer 37

nonionized

Question 38

Drug interactions can be-

Answer 38

drug-drug or drug-food

Question 39

drug interactions can potentially affect-

Answer 39

absorption of drugs

Question 40

high fat meals can slow:

Answer 40

stomach motility

Question 41

Drugs are absorbed faster when applied to:

Answer 41

regions with larger surfacer area, like small intestine or lung

Question 42

Distribution describes movement of medication throughout the body after

Answer 42

absorption

Question 43

What 4 factors affect drug distribution? ___________ to tissues drug ___________ tissue __________ drug-protein ___________

Answer 43

blood flow to tissues drug solubility tissue storage drug-protein binding

Question 44

drug-protein complexes cannot cross :

Answer 44

capillary membranes

Question 45

only ________ drugs reach target cells

Answer 45

unbound

Question 46

What does the blood brain barrier do? special anatomic _________ protects brain from ____________________________ ____________________ drugs are able to cross [not fully developed in neonates] Inflammation can increase ____________________

Answer 46

special anatomic barriers protects brain from pathogens and toxins lipid-soluble drugs are able to cross [not fully developed in neonates] Inflammation can increase permeability

Question 47

Fetal-placenta barrier prevents harmful substances passing from:

Answer 47

mother's bloodstream to fetus [not as efficient as blood brain barrier] Inefficient with- alcohol, cocaine, caffeine, prescriptions can cross

Question 48

metabolism __________ the structure and function of drugs, nutrients, vitamins, and minerals

Answer 48

alters

Question 49

where is the primary site of metabolism?

Answer 49

liver

Question 50

What are prodrugs? medications that require ________________ to produce their __________________ ~no pharmacological activity until after _______________

Answer 50

medications that require metabolism to produce their therapeutic actions ~no pharmacological activity until after metabolized

Question 51

What is a hepatic microsomal enzyme? enzyme____________ CYP450 an enzyme that _________________ many drugs

Answer 51

enzyme complex CYP450 an enzyme that metabolizes many drugs

Question 52

3 important consequences of CYP systems drugs as substrates ~may lead to _____________________________ drugs as enzyme inhibitors ~can contribute to _________________________in body drugs as enzyme inducers ~accelerate metabolism; drug level may _________________

Answer 52

drugs as substrates ~may lead to drug-drug interactions drugs as enzyme inhibitors ~can contribute to drug toxicity in body drugs as enzyme inducers ~accelerate metabolism; drug level may decrease rapidly

Question 52

Metabolism can vary due to genetic variations of _____ enzymes

Answer 52

CYP

Question 53

Enzyme activity is often _______ in older adults

Answer 53

reduced

Question 54

Liver impairment can lead to _________ metabolism

Answer 54

decreased

Question 55

Excretion is the process of:

Answer 55

removing drugs from the body

Question 56

Rate of excretion is determined by the

Answer 56

drug blood level

Question 57

Renal excretion occurs in

Answer 57

the kidney

Question 58

Drug excretion depends on urine:

Answer 58

pH [urine pH can be manipulated to help with drug excretion]

Question 59

Glandular secretion of drugs can happen in

Answer 59

saliva, sweat, breast milk

Question 60

Pulmonary excretion (example)

Answer 60

gases, volatile liquids

Question 61

Biliary excretion- some drugs are:

Answer 61

secreted in the bile

Question 62

drugs excreted into the bile will eventually leave in the

Answer 62

feces

Question 63

Enterohepatic recirculation: drug reabsorbed and goes back into _______________________________may recirculate drugs, metabolites, and prolong action

Answer 63

drug reabsorbed and goes back into hepatic system may recirculate drugs, metabolites, and prolong action

Question 64

The therapeutic response of most drugs depends on their concentration in:

Answer 64

the plasma

Question 65

What is the minimum effective concentration?

Answer 65

amount of drug required to produce a therapeutic effect

Question 66

________ concentration is level of drug that results in serious adverse effects

Answer 66

Toxic

Question 67

What is the therapeutic range of a drug?

Answer 67

range where the drug produces desired actions after peaking, drug plasma levels fall due to excretion

Question 68

The drug half-life provides an estimation of:

Answer 68

duration of action

Question 69

Plasma half-life is the time required for plasma concentration of drug to:

Answer 69

decrease by half

Question 70

If a drug has a short half-life, it is given

Answer 70

given more frequently

Question 71

A loading dose is a higher amount of drug given to:

Answer 71

"prime" the bloodstream [increase level at the beginning]

Question 72

a maintenance drug dose will keep concentration within:

Answer 72

therapeutic range

Question 73

Pharmacodynamics- how a drug

Answer 73

changes the body [involves drug mechanism of action] [involves effect of drug concentration on body responses]

Question 74

the median effective dose is the desired drug response in:

Answer 74

50% of subjects

Question 75

The median lethal dose is

Answer 75

lethal to 50% of animals during testing

Question 76

The median toxicity dose is the dose that produces

Answer 76

toxicity in 50% of subjects [animal data/ clinical trial data]

Question 77

The margin of safety MOS is the amount of drug lethal to ____of animals divided by amount of drug that produces _________________ effect in ______ of animals

Answer 77

1% of animals divided by amount of drug that produces therapeutic effect in 99% of animals

Question 78

Three phases of dose-response relationship

Answer 78

Phase 1- lowest dose phase 2- most desirable range phase 3- plateau reached

Question 79

Potency is the amount of drug needed to produce

Answer 79

a specified effect

Question 80

Receptor theory- most drugs produce their actions by activating or inhibiting:

Answer 80

specific cellular receptors

Question 81

Medications bind to receptors like a

Answer 81

lock and key

Question 82

Agonists ________ the action of endogenous substances

Answer 82

mimics

Question 83

Antagonists prevent action of:

Answer 83

endogenous substances

Question 84

Pharmacogenetics is the branch of pharmacology that studies:

Answer 84

role of genetic variation in drug responses ex) human genome project