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Pharm > Midterm > Flashcards

Midterm Flashcards

1
Q

Which greek words was pharmacology derived from?

A

Pharmakon - remedy

logos - study

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2
Q

What are the three classifications or therapeutics?

A

1) drugs - chemicals
2) biologics - antibodies and hormones
3) natural health products - herbals, vitamins and minerals

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3
Q

Drugs are ___ but we think of them as pills or capsules

A

chemicals

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4
Q

What are the three ways to name drugs and which is used most commonly in pharm?

A

1) Chemical name - describes chemical structure
2) Generic name - identifies a drug and is most commonly used by health care professionals
3) Trade name - name assigned by the drug company - most commonly used by patients

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5
Q

What are the phases of approving drugs in Canada?

A

1) preclinical testing
2) clinical trial application
3) phase 1 clinical trial
4) phase 2 clinical trial
5) phase 3 clinical trial
6) new drug submission to Health Canada
7) phase 4 clinical trial

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6
Q

What is pharmacokinetics?

A

what happens to the drug inside the body

encompasses the absorption, distribution, metabolism and excretion (ADME)

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7
Q

Name two examples of physiological variables to drug transport?

A
  • intestinal villi

- tight junctions in some cells

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8
Q

What does the smooth ER do?

A

metabolizes drugs, carbs and steroids

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9
Q

What does the rough ER do?

A

synthesize proteins

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10
Q

What does the golgi apparatus do?

A

processes and packages proteins and lipids

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11
Q

What are the the three ways that drugs cross the cell membrane?

A

1) Direct penetration
2) Ion channels and pores
3) Specific transport proteins

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12
Q

In order for direct penetration, the drugs must be ___

A

lipophilic - lipid solube

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13
Q

In order for a drug to move through ion channels/pores it must be ___

A

small (<200) and specific to the channel

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14
Q

What are examples of compounds that move through channels?

A

sodium, potassium, and lithium

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15
Q

What are the two types of transporters?

A

uptake and efflux

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16
Q

What are uptake transporters important in mediating?

A

intestinal absorption, renal excretion and reaching target sites

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17
Q

What are efflux transporters important in mediating?

A

protecting cells in the intestine, placenta, kidney and the blood brain barrier

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18
Q

What are the 5 types of drugs?

A

1) polar
2) ions
3) quarternary ammonium compounds
4) ionizable molecules
5) lipophilic molecules

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19
Q

What is the key characteristic of polar molecules? List some examples?

A

water soluble with an uneven electrical distribution and no net charge
ex) water, glucose, antibiotic drug kanamycin

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20
Q

What is the key characteristic of ions?

A

total number of electrons is not equal to protons and therefore they have a net charge

THEY CANNOT PASS THROUGH CELL MEMBRANE
but smaller ions pass through ion channels

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21
Q

What is the key characteristic of quaternary ammonium compounds?

A

always have at least one nitrogen atom and a positive charge

UNABLE TO CROSS CELL MEMBRANE

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22
Q

What is the key characteristic of ionizable molecules?

A

they can exist in charged or uncharged form depending on the pH of the surrounding environment

ex) weak acid in acidic medium = non ionized
ex) weak acid in basic medium = ionized

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23
Q

Lipophilic molecules are ____ unlike polar, ions, quaternary ammonium structures and CHARGED ionizable molecules

A

lipid soluble

and can cross membrane

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24
Q

Only ____ drugs can penetrate the membrane?

A

non ionized

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25
Q

What is ion trapping?

A

when there is a difference in pH on different sides of the membrane. drugs accumulate on the side of the membrane where they are ionized

  • this is related to overdose
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26
Q

Many capillaries have large gaps between them, what are they called?

A

fenestrations

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27
Q

Lipophilic drugs can either___

A

pass betwen fenestrations
OR
directly through the plasma membrane of capillary endothelial cells

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28
Q

Hydrophilic drugs must ___

A

move through fenestrations or proteins because they can’t move through the membrane

29
Q

Blood brain barrier capillaries have ____ and do not have ___

A

have tight junctions and do not have fenestrations

30
Q

In order to pass the BBB, drugs must either be ___ or have ___

A

be lipophilic
OR
have specific transport proteins

31
Q

What is another definition of pharmacokinetics?

A

the study of drug movement in the body

32
Q

What are the four basic processes of pharmacokinetics?

A

ADME

33
Q

What does the rate of drug absorption determine?

A

how quickly the drug effect will occur

34
Q

What does the amount of drug absorption determine?

A

how intense the effect of the drug will be

35
Q

What are the six factors affecting absorption?

A

1) rate of dissolution
2) surface area
3) blood flow
4) lipid solubility
5) pH partitioning
6) activity of drug transport proteins

36
Q

Drugs with a fast rate of dissolution will have a ___ onset of action

A

fast

37
Q

The larger the surface area, the ___ drug absorption is

A

faster

38
Q

Which has greater surface area? the stomach or the small intestine?

A

the SI because although the stomach has rugae, the SI has many villi

39
Q

Drug absorption is fastest in areas with ___ blood flow

A

high

because the faster the blood flow the greater the concentration gradient which drives absorption

40
Q

What can you do to increase blood flow?

A

exercise

41
Q

What causes decreased blood flow?

A

heart failure
severe hypotension
hypothermia
circulatory shock

42
Q

Drugs with high lipid solubility are absorbed more ___ than water soluble drugs

A

rapidly

because they can cross the cell membrane

43
Q

Drug absorption is greater when there is a difference in pH at the site of administration and the blood. What concept is this related to from module 1?

A

ion trapping

44
Q

What are the 8 major routes of drug administration?

A

1) oral (PO)
2) sublingual
3) transdermal
4) rectal
5) intravenous (IV)
6) subcutaneous (subQ or SC)
7) intramuscular (IM)
8) pulmonary

45
Q

What does enteral mean?

A

route of administration that involves the gastrointestinal tract

46
Q

What does parenteral mean?

A

rout of administration that does not involve the gastrointestinal tract

47
Q

Which routes of administration are enteral?

A

oral

rectal

48
Q

Which routes of administration are parenteral?

A

intravenous
intramuscular
subcutaneous

49
Q

What is the pharmaceutical phase?

A

after the patient swallows the tablet - it involves the disintegration of the tablet and the dissolution of the drug

50
Q

What is gastric emptying?

A

the movement of the stomach contents into the intestine

if you increase gastric emptying, you increase absorption in the intestine

51
Q

List 5 things that increase gastric emptying:

A
  • taking medication on an empty stomach
  • taking medications with cold water
  • lying down on the right side
  • high osmolality feeding
  • taking a prokinetic drug (increases GI motility)
52
Q

List 4 things that decrease gastric emptying:

A
  • high fat meal
  • heavy exercise
  • lying down on left side
  • taking a drug that inhibits the vagus nerve (anticholinergic drugs)
53
Q

What is an enteric coating and what is it’s function?

A

a special coating on drugs that prevents their dissolution in stomach acid
causes the drug to dissolute in the duodenum instead of the stomach

54
Q

What is bioavailability?

A

the fraction of a dose of drug that reaches the systemic circulation unchanged

55
Q

Bioavailability is influenced by:

A

1) drug formulation
2) route of administration
3) degree of metabolism

56
Q

What happens if a drug is administered sublingually?

A

the drug is placed under the tongue and is absorbed across the oral mucosa
the venous drainage from the oral mucosa is to the superior vena cava - therefore this method avoids first pass metabolism through the liver

57
Q

Drugs that are administered transdermally must be __ and __

A

lipophilic and hydrophilic

to pass through the membrane and then to dissolve in the extracellular fluid

58
Q

List some types of transdermal drugs?

A

patches
ointments
sprays
lotions

59
Q

What is a risk with transdermal preparations?

A

acquiring tolerance to the drug

but it minimizes peaks and troughs

60
Q

What are the factors affecting transdermal absorption?

A

1) thickness of skin
2) hydration
3) hair follicles
4) application surface area
5) integrity of the barrier

61
Q

When is rectal drug administration useful?

A

when the patient is unconscious or vomiting

inserted as a suppository

62
Q

What % of rectally administered drugs bypass the liver?

A

50%

63
Q

Which veins are commonly used for intravenous drug administration?

A

veins on the back of the hand, the median cubital vein or any vein

64
Q

What is the difference between an IV bolus and an IV drip?

A

bolus - single dose over a short time

drip - continuous infusion over a long period of time

65
Q

List some advantages and disadvantages of intravenous drug administration?

A

pros: no barrier to absorption, precise control
cons: expensive, invasive, cannot be removed once injected, risk of infection or overload

66
Q

With subcutaneous and intramuscular drug administration, what is the primary determinant of the rate of absorption?

A

blood flow and water solubility

67
Q

What are the pros and cons of intramuscular drug administration?

A

pros: poorly soluble drugs, drug can be slowly absorbed
cons: pain, can cause tissue or nerve damage

68
Q

What is a major factor affecting intramuscular absorption?

A

blood flow to muscle

69
Q

What are some pros of pulmonary drug administration?

A
  • absorption is very rapid due to large SA

- in the case of pulmonary disease, the drug is delivered to it’s site of action

Pharm (8 decks)

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