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Pharmacology N2100 > *Unit 2 - Physiologic Concepts of Pharmacology > Flashcards

*Unit 2 - Physiologic Concepts of Pharmacology Flashcards

1
Q

Pathways for Drugs (3)

A
  • Direct penetration
  • passage through protein channels
  • carrier proteins
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2
Q

Mechanisms (3)

A
  • passive diffusion
  • facilitated diffusion
  • active transport
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3
Q

the study of the movement of drugs within the body

A

pharmacokinetics

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4
Q

4 ways of pharmacokinetics

A
  • absorption
  • distribution
  • metabolism
  • excretion
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5
Q

the rate and extent that a drug leaves the site of administration

A

absorption

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6
Q

which administration route has the fastest absorption rate

A

Intravenous (IV)

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7
Q

What is the advantage of administering a medication intradermally

A
  • it causes very slow systemic absorption (the blood stream doesn’t pick it up quickly and doesn’t deliver it to the rest of the body quickly so it stays localized) (ex. allergy shots & TB shots)
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8
Q

what would be the advantages of transdermal (on top of the skin) drug delivery systems (ex. rubbing cream, patch, etc.)

A
  • very slow, not readily absorbed
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9
Q

what would be the disadvantages of transdermal (on top of the skin) drug delivery systems (ex. rubbing cream, patch, etc.)

A
  • skin irritation

- may need additional drugs to control symptoms you’re trying to control (ex. pain meds)

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10
Q

what other factors effect drug absorption (6)

A
  • drug concentration and dose
  • GI tract environment
  • blood flow
  • drug ionization
  • interactions
  • surface area
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11
Q

the rate and extent to which the active ingredient is absorbed from a drug product and becomes available at the site of drug action or produce its effect

A

bioavailability

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12
Q

mechanism whereby drugs are absorbed, enter into the hepatic portal circulation, and are inactivated by the liver before they read the general circulation

A

first-pass effect

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13
Q

tablets or capsules designed to dissolve very slowly, resulting in a longer duration of action for the medication; also called long-acting sustained release

A

extended release

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14
Q

tablets that have a hard, waxy coating designed to dissolve in the alkaline environment of the small intestine

A

enteric-coated

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15
Q

bioavailability

A

the rate and extent to which the active ingredient is absorbed from a drug product and becomes available at the site of drug action or produce its effect

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16
Q

first-pass effect

A

mechanism whereby drugs are absorbed, enter into the hepatic portal circulation, and are inactivated by the liver before they read the general circulation

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17
Q

extended release

A

tablets or capsules designed to dissolve very slowly, resulting in a longer duration of action for the medication; also called long-acting sustained release

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18
Q

enteric-coated

A

tablets that have a hard, waxy coating designed to dissolve in the alkaline environment of the small intestine

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19
Q

molecules are going from high to low concentration

A

passive diffusion

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20
Q

molecules are going from high to low concentration, however, you need a carrier protein in order to help facilitate the diffusion

A

facilitated diffusion

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21
Q

requiring energy in order for the molecules to get through the cell membrane

A

active transport

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22
Q

how quickly a drug starts working

A

onset of action

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23
Q

will a drug act faster if i take a higher dose

A

Yes

page 30

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24
Q

True/False: food will ALWAYS slow down absorption

A

TRUE!!!

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25
Q

True/False: oral drugs can affect how fast/slow the GI tract moves

A

True

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26
Q

What affect on absorption does oral medications have on a patient who doesn’t have a lot of blood flow to the GI tract/small intestine?

A

???

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27
Q

Why do oral medications get more absorbed in the small intestine rather than in the stomach

A

???

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28
Q

True/False: most medication are absorbed in the stomach

A

FALSE! most are absorbed in the small intestine!

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29
Q

what is the major “transportation system” of drugs for distribution to the body tissues

A

cardiovascular system

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30
Q

True/False: Medications pick and choose where they want to go

A

FALSE! They travel throughout the whole body through the bloodstream and they react with certain receptors within certain areas of the body

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31
Q

the transport of a drug within body fluids to body tissues

A

???

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32
Q

Drug distribution can be affected by the following variables:

A
  • blood flow
  • drug solubility
  • tissue storage
  • protein building
  • blood-brain, fetal-placental barrier
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33
Q

the changing a drug to be more easily excreted (scientific - technical term - know “metabolism” instead)

A

biotransformation

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34
Q

True/False: a drug that is active can be metabolized into inactive metabolites

A

true

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35
Q

True/False: a drug that is active can be metabolized into still active metabolites

A

true

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36
Q

True/False: a drug that is inactive is changed into an active drug through metabolism

A

true (prodrug)

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37
Q

a drug that is inactive is changed into an active drug through _____

A

metabolism

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38
Q

the body attempts to neutralize or ______ substances for excretion changing fat soluble drugs into water soluble metabolites that can be excreted from the kidney

A

detoxify

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39
Q

The body attempts to detoxify/neutralize substances for excretion changing ______ into _____ that can be excreted from the ________

A

fat soluble drugs
water soluble metabolites
kidney

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40
Q

???

A

substrates

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41
Q

increased enzyme production

A

induction

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42
Q

result of induction

A

more drug metabolized and need higher doses

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43
Q

inhibiting liver enzymes

A

inhibition

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44
Q

result of inhibition

A

less drug metabolized and more drug in blood

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45
Q

after absorption, drugs may be extensively metabolized before reaching the rest of the body

A

first-pass phenomenon

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46
Q

List the patient specific variables that effect metabolism

A
  • lifespan/age
  • lifestyle/habits
  • diet
  • liver disease
  • genetics

(3 paragraphs on page 35 for detailed explanation for variables that cause differences in metabolism in different patients)

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47
Q

elimination of a drug, either unchanged or as a metabolite, from the body

A

excretion

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48
Q

altered in renal failure

A

renal secretion

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49
Q

altered in liver failure

A

hepatic secretion

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50
Q

drug secretion in bile

A

bile is reabsorbed so metabolites may be recycled multiple times

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51
Q

Your patient has been and alcoholic for 25 years. What affects on pharmacokinetics for you expect?

A

??? they’re not going to be very efficient/fast ???

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52
Q

amount of drug in the blood

A

serum drug level

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53
Q

amount of drug in the blood required to get a drug action

A

minimum effective concentration (MEC)

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54
Q

too much drug causes toxic reactions

A

Toxic Concentration

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55
Q

between the MEC and the Toxic Concentration levels

A

Therapeutic Range

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56
Q

Periodic doses to keep blood levels in therapeutic range

A

Maintenance Dose

57
Q

a large initial dosing of a drug to achieve rapid minimum effective concentration in the plasma

A

Loading Dose

Plasma is in the blood: if you were to spin and separate the plasma from blood cells, the drug would be within the water/plasma part. The proteins are in the plasma.

58
Q

highest and lowest plasma concentration of a drug

A

Peak and Trough Levels

59
Q

FYI: Plasma drug concentration graph on page 38 to show therapeutic range

A

:)

60
Q

minimum effective concentration

A

onset

61
Q

highest blood level

A

peak

62
Q

length of pharmacological action

A

duration

63
Q

time required for serum concentration to be decreased by 50%

A

Serum Half-Life

64
Q

short half-life requires…

A

more frequent dosing

65
Q

long half life requires…

A

less frequent dosing

66
Q

the dose at which a drug will produce its therapeutic effect (How strong is it)

A

potency

67
Q

the greatest response that can come from a drug (Does it do what it’s supposed to do)

A

efficacy

68
Q

effect and potency of a drug action is dependent on…

A

the unique characteristics of the drugs and the receptors

69
Q

availability of receptor sites influences…

A

drug action

70
Q

chemical make-up of drugs affects…

A

the ability to bind to receptor sites

71
Q

these are drug binding sites

A

receptors

72
Q

the effect of what can stimulate or inhibit cell function

A

receptors

73
Q

drug binding to a _____ in the ________ can change the permeability of the cell membrane

A

receptor

cell membrane

74
Q

promote or produce a response

A

agonist

75
Q

block a response

A

antagonist

76
Q

puzzle pieces, locks and keys, little pieces of proteins that sit on the outside of cells and fit together with chemicals or drugs, very specific

A

receptors

77
Q

receptor desensitization can occur through repeated or long term stimulation

She talked about receptors

A

down regulation

78
Q

excess excitatory responses can be noted if receptor has been repressed for a long time and then a small dose of a stimulating drug is given

She talked about receptors

A

up regulation

79
Q

how many different kinds of receptors will lock with a certain drug or will a certain drug affect

A

specificity/selectivity

  • this is usually what causes adverse affects
80
Q

True/False: primary and secondary effects fall hand in hand with unlabeled uses

A

True, because though benadryl (Diphenhydramine) is used to help with hayfever symptoms, a sider effect is sleepiness, so it can also be used to help with sleeping

81
Q

indications for use and also used for other “non-approved” purposes

A

primary and secondary effects

82
Q

an effect that occurs other than the desired therapeutic effects of drug therapy, or an effect that is harmful

A

adverse effects

83
Q

minor vs. life-threathening

A

side effects vs. toxicity

84
Q

a warning that the drug has a risk of serious or potentially fatal effects

A

black box warning

85
Q

abnormal exaggerated response to an antigen

A

hypersensitivity

86
Q

abnormal reaction to a drug because a prior exposure stimulated the immune system to develop antibodies…antigen-antibody response

A

drug allergy

87
Q

Most serious allergic reaction. A medical emergency. Systemic reaction evidenced by dyspnea, cardiac arrhythmias, laryngeal edema, bronchospasm and circulatory collapse

A

Anaphylaxis

88
Q

A patient says they’re allergic to lortab because they keep throwing up, is throwing up because of a medication a true allergic response

A

NO!

89
Q

an allergic response actually means that the person is having a reaction with the ________

A

immune system

90
Q

Follow up question when asking what medication patients are allergic to. Why do we ask them this?

A

What does that medication do to you?

  • because throwing up is not necessarily an allergic response
  • because many people get itching from narcotics (ex. morphine), however unless they have hives or skin reaction in addition to itching, it’s not really considered a reaction (it’s more an benign side effect)
91
Q

Is itching because of morphine an allergy?

A

Not unless it is an addition to hives or a skin reaction@ If not, it’s a benign side effect.

92
Q

an unanticipated, unexplainable response to a drug

A

idiosyncratic drug response

93
Q

often referred to as a paradoxical response

A

idiosyncratic drug response

94
Q

another name for idiosyncratic drug response

A

paradoxical response

95
Q

is an idiosyncratic drug response considered an allergic reaction

A

NO

96
Q

drug that may cause cancer

A

carcinogen

97
Q

drug that may cause birth defects

A

teratogen

98
Q

3 types of adverse effects

A
  • idiosyncratic drug response
  • carcinogen
  • teratogen
99
Q

3 types of allergic reactions

A
  • hypersensitivity
  • drug allergy
  • anaphylaxis
100
Q

nonspecific and nonselective drug effects

A

specificity/selectivity

101
Q

the study of the mechanisms of drug action and how the body responds to it

A

pharmacodynamics

102
Q

Pregnancy Classifications - Teratogens

A 
A (no harm to babies)
B (pretty safe)
C
D
X (HARM TO BABIES)

(page 95)

103
Q

Types of Adverse Effects:

Neurotoxicity/central nervous system

A
  • depression (sleepy, lethargic)
  • stimulation (can’t sleep, anxious, excitable)
  • ototoxicity
104
Q

Gastrointestinal Effects

A 
NVDAC
Nausea 
Vomiting
Diarrhea
Anorexia
Constipation
105
Q

adverse effect on the bone marrow

A

hematological effects

106
Q
  • it can effect (reduce or damage) the production of white & red blood cells & platelets (any kind of blood cells)
A

hematological

107
Q

adverse effects that damage the kidneys

A

nephrotoxicity

108
Q

adverse effects that damage the liver

A

hepatotoxicity

109
Q

adverse effects that damage the heart

A

cardiotoxicity

110
Q

True/False: Most drugs are metabolized through the kidneys and excreted through the liver

A

FALSE! most drugs are metabolized through the liver and excreted through the kidneys

111
Q

adverse effects that damage the neurons/central nervous system

A

neurotoxicity

112
Q

True/False: a lot of drugs with have some sort of effect on the GI tract

A

True

113
Q

True/False: all of these are types of adverse effects:

  • hematological effects
  • dermatologic effects
  • muscles and tendons
A

True

114
Q

when 2 different drugs from the same therapeutic class are used together for a greater response

A

additive effect

115
Q

when 2 drugs create a bigger response than what you would think if you simply combined them together (meds from different classes)

A

synergistic effect

116
Q

one drug blocks the effects of another drug

A

antagonistic

117
Q

displacing one drug from protein binding sites increases the amount of free drug thereby increasing the drug effect (protein binding: in class object lesson)

A

displacement

118
Q

True/False: drug and food interactions can cause adverse effects due to changes in pharmacokinetics

A

True

119
Q

needing more drug to achieve the desired effect

A

drug tolerance

120
Q
  • withdrawal
  • physical dependence
  • psychological dependence (body thinks they need it in order to normally function…brainwashing itself)
  • drug seeking behavior
A

drug dependence

121
Q

achieving benefit from a compound that does not have the properties to produce the effect

A

placebo effect

122
Q

management of a drug overdose

A
  • recognition or identification of drugs taken
  • gastric lavage, activated charcoal, and whole bowel irrigation - pluses and minuses
  • treat life threatening symptoms (resp arrest, seizures, shock)
  • administer antidotes
123
Q

how do we prevent adverse effects in our patients

A

(page 53-54)

  • obtain thorough med history
  • thoroughly assess the patient and all diagnostic data
  • prevent med erros
  • monitor pharmacotherapy carfully
  • know the drugs
  • be prepared for the unusual
  • question unusual orders
  • teach patients about adverse effects
124
Q

most absorption occurs in the __________, because this portion of the GI tract in longer, and the absorptive surfaces of the microvilli are much more extensive as compared to the stomach

A

small intestine

125
Q

potential drug effect on absorption in the presence of food

A

decreased

126
Q

potential drug effect on absorption with drug-drug binding

A

decreased

127
Q

potential drug effect on distribution if displacement of drug from plasma protein binding site (protein binding: in class object lesson)

A

increased

128
Q

potential drug effect on metabolism with stimulation of CYP: enzyme induction

A

decreased

129
Q

potential drug effect on metabolism with inhibition of CYP: enzyme inhibition

A

increased

130
Q

potential drug effect on excretion if increased excretion

A

decreased

131
Q

potential drug effect on excretion if decreased excretion

A

increased

132
Q

Therapeutic Index =

A

median lethal dose (LD)/median effective dose (ED)

133
Q

True/False: The higher the value of a therapeutic index, the safer the medication

A

TRUE!

134
Q

a reflection of a drug’s ability to bind to a receptor

A

potency

135
Q

the ability of a drug to produce the desired therapeutic affect

A

efficacy

136
Q

What is the pharmacokinetic term for the breakdown of drugs in order to excrete them more easily?

A

Metabolism

137
Q

FYI: Need to know in future: highly protein bounded drugs need a lower dosage when administering it to the patient!

A

:)

138
Q

Fastest to Slowest drug routes

A
  • IV
  • IM
  • Oral/intradermal
139
Q

What type of drugs end in “pril”

A

ace inhibitors

Pharmacology N2100 (26 decks)

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