week 9 Flashcards by mia sweeting

Kaolin

treatment for acute diarrhoea.
Bulk forming and adsorbent

How well did you know this?

Not at all

Perfectly

Loperamide logP and pKa

logP= 4.5
pKa=9
lipophillic and charged

How well did you know this?

Not at all

Perfectly

Drivers for the MCR service

improves clinical outcomes ad concordance, promotes self care, reduces hospital admissions, reduces waste, reduction in prescribing errors.

How well did you know this?

Not at all

Perfectly

Who is eligible for MCR service?

new medications, high risk medications, smoking cessation, gluten free foods, have a chronic illness that requires medication.

How well did you know this?

Not at all

Perfectly

Who is not eligible for serial prescription service?

unstable conditions, patients with frequent medication changes, medications requiring close monitoring/titrating, no long term indication, weekly or daily installments.

How well did you know this?

Not at all

Perfectly

Benefits of serial prescribing

manages workload, reduces repeat prescribing in GPs, supports patients, increased direct contact with healthcare professionals (checkup consultations)

How well did you know this?

Not at all

Perfectly

mucosal malabsorption

issues relating directly to small intestine wall
crohn’s, coeliac, surgery

How well did you know this?

Not at all

Perfectly

pre mucosal malabsorption

nutrients aren’t available for absorption
pancreatitis, cystic fibrosis, lactase deficiency

How well did you know this?

Not at all

Perfectly

Typical deficiencies in crohn’s

iron deficiency anemia
b12/folate deficiency
vitamin d and calcium deficiency

How well did you know this?

Not at all

Perfectly

What is coeliac disease?

autoimmune condition where gluten activates an abnormal mucosal response. Chronic inflammation and damage to small intestine mucosa - villous atrophy.

How well did you know this?

Not at all

Perfectly

Cystic fibrosis - sodium and chlorine levels

decreased chlorine secretion
increased sodium absorption

How well did you know this?

Not at all

Perfectly

Water soluble vitamins

B , C

How well did you know this?

Not at all

Perfectly

Fat soluble vitamins

A, D, E, K

How well did you know this?

Not at all

Perfectly

Sources of cobalamin (vit b12)

meat fish dairy.
not synthesized within the body

How well did you know this?

Not at all

Perfectly

RDA for b12

1-2.5 micrograms

How well did you know this?

Not at all

Perfectly

Explain the two mechanisms of absorption of vitamin b12

Passive absorption; Though buccal, duodenal and ileal mucosa. Rapid but extremely inefficient. <1% of an oral dose is absorbed.
Active transport; Normal physiological mechanism is active transport. Occurs through the ileum mediated by gastric intrinsic factor. 70% of ingested amount is absorbed.

How well did you know this?

Not at all

Perfectly

Absorption of b12 from food.

is released from food and bound to haptocorrin (haptocorrin is produced by the salivary glands and is a glycoprotein)
Intrinsic factor is secreted by parietal cells. On reaching the duodenum haptocorrin is degraded releasing vitamin b12.
Vitamin b12 is captured by intrinsic factor.
Intrinsic factor-bound vitamin b12 passes along intestine. In the terminal ileum, intrinsic factor-bound vitamin b12 is endocytosed by cubam.
Inside the enterocyte, intrinsic factor is degraded.
An ABC (ATP Binding Casset) transporter releases vitamin b12 into the blood.
Vitamin b12 binds to transcobalamin II.

How well did you know this?

Not at all

Perfectly

Cellular uptake of b12

Vitamin b12 bound to transcobalamin II.
Internalization occurs in complex with transcobalamin receptor CD320 via endocytosis.
The transcobalamin is degraded, yielding vitamin b12. Excess b12 is sent to the liver for storage.

How well did you know this?

Not at all

Perfectly

What is the role of intrinsic factor in absorption?

ensures adequate amounts of b12 are absorbed - reducing the chances of megaloblastic anemia.

How well did you know this?

Not at all

Perfectly

What is the type of anemia that is due to the absence of intrinsic factor?

pernicious anemia

What can vitamin b12 deficiency be caused by?

diet, loss of gastric parietal cells or intrinsic factor, functionally abnormal intrinsic factor, bacterial overgrowth in intestine, disorders of plasma transport, dysfunctional uptake of b12

Consequences of low b12

paraesthia, sensory loss, gait ataxia, weakness in legs, infertiltiy, angina, dry tounge (Hunters glossitis)

What can be used to treat b12 deficiency?

oral cyanocobalamin or parenteral hydroxycobalamin

Sources of b9 (folate, folic acid)

green leafy vegetables, fruit, meat, seafood and fortified breads and cereals.

RDA of b9

200 micrograms, 400 during pregnancy

Absorption of folate

Natural folates are conjugated to a polyglutamyl chain but absorbed in the monoglutamate form - hydrolyzed Most absorption occurs in small intestine (duodenum and jejunum) with there being some absorption in the colon. Folate is absorbed form the lumen by a proton-coupled folate transporter PCFT. Absorption is also via a reduced folate carrier RFC with folate being exchanged for organic phosphate OP . Enterocytes also have folate receptors (binds folate and internalizes it by receptor mediated endocytosis).

Cellular uptake of folate

Most is transported as mono- glutamyl derivative. Most folate circulates free in the blood - some bound to albumin. Cellular uptake is by endocytosis.

Causes of folate deficiency

inadequate dietary intake. Congenital defects in the uptake system. Intestinal disease. Drug interaction e.g., cholestyramine, sulfasalazine, trimethoprim, methotrexate, metformin. Chronic alcohol use.

Results of b9 deficiency

* Sore tongue (glossitis) and pain upon swallowing * GI symptoms (nausea, vomiting, abdominal pain diarrhoea, especially after meals) * Neurologic (cognitive impairment, dementia, and depression) * megaloblastic anaemia

Treatment of b9 deficiency

oral folic acid for 1-4 months.

What are the three types of stoma?

colostomy, ileostomy and urostomy

Explain what a colostomy is.

Two types; Loop - bowel is lifted above skin level and formed in a stoma, essentially two stomas in one. Is generally temporary. End - part of bowel removed, remaining bowel is brought to the surface Generally on left side of body

Explain what a ileostomy is.

Usually created on right side of abdomen. Can be temporary or permanent. Bowel is brought to the surface of skin

Techniques for analysing pharmaceutical products.

UV/Vis spectroscopy High pressure liquid chromatography

Techniques for analysing the solid product.

Infrared spectroscopy X-ray diffraction Column chromatography

Put in order of energy level absorbance (lowest to highest) Electronic rotational vibrational

Rotational Vibrational Electronic

Rotational absorbs __ radiation

microwave

Electronic responds to __

UV light

Why are curves in a UV spectroscopy broad rather than sharp?

it is an average of all energy level values.

What does the slit do in a conventional spectrophometer?

selects wavelengths from the polychromatic light

Describe the action of a PDA spectrophotomer

whole spectrum is directed toward photodiode array. No need for repeats, as collects wavelength data simultaneously.

Absorption of IR causes transitions in __

vibrational energy levels, rotational energy levels

Molecular bending variations

In-plane rocking In-plane scissoring Out of plane wagging Out of plane twisting

Do amorphous forms diffract?

What are borderline substances?

nutritional or dermatological products that have been specially formulated to manage a medical condition e.g. gluten free foodstuffs

Purpose of a diluent in tableting?

increase weight and help uniformity. E.g. mannitol, lactose, sorbitol

Purpose and example of binder in tableting?

holds all components together and gives mechanical strength. Provides volume in low dose formulations E.g. starch, methyl cellulose

Purpose and example of glidant in tableting?

Helps powder to flow into the tableting machine. e.g. palmitates and stearates ie fatty acids