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Pharmacology > Chapter 1-6 textbook > Flashcards

Chapter 1-6 textbook Flashcards

1
Q

Vd formula

A

Amount in body/plasma drug concentration

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2
Q

Clearance formula

A

0.693(Vd)/half life

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3
Q

Water weight at birth

A

75-80%

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4
Q

Infant’s stomach pH

A

alkaline: >4

Decreased absorption of weakly acidic drugs and increased absorption of weakly basic drugs

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5
Q

Gastric emptying in infants

A

Prolonged

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6
Q

Percutaneous administration of meds in infants

A

Increased absorption due to decreased thickness of skin

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7
Q

Pulmonary absorption in infants

A

Decreased due to lower tidal volumes and increased respiratory rates

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8
Q

Volume of distribution in infants

A

Increased due to increased total body water

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9
Q

Metabolism in infants

A

Delayed–can cause increase in toxicities

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10
Q

Physiologic changes in pregnancy

A

Increased blood volume, increased CO, decreased systemic vascular resistance, increased pH of intestinal secretions, increased gastric emptying time, decreased gastric acid secretions, decreased intestinal motility, increased renal blood flow, increased GFR, increased uterine blood flow

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11
Q

Progesterone effects on GI

A

Decreased GI motility–delays absorption or orally administered drugs

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12
Q

Which drugs are more likely to cross placenta

A

Lipid soluble, nonionized, lower molecular weight, unbound and free drugs

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13
Q

pharmacokinetic changes in elderly

A

Decreased blood flow to GI, increased gastric pH, delayed gastric emptying, decreased albumin and lean body mass, increased total body fat and decreased total body water, decreased liver blood flow and enzymes, decreased GFR and secretion

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14
Q

Pharmacokinetics

A

how the drug moves through the body

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15
Q

4 parts of pharmacokinetics

A

Absorption, distribution, biotransformation (metabolism), excretion/elimination

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16
Q

Bioavailability

A

how much of the drug reaches the site of action

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17
Q

F value

A

The fraction of the drug that reaches the systemic circulation
Depends on first pass metabolism

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18
Q

What routes will bypass first pass metabolism

A

IV and sublingual

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19
Q

Bioequivalent

A

Contains same active ingredient
Identical in strength, dosage, and route of administration
Same rate and extent of biovailability

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20
Q

Factors influencing absorption

A

Formulation, concentration, lipophillic, acidic vs basic

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21
Q

Distribution

A

Transport of drug in body fluid from site of absorption

Delivery of drug to various tissue

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22
Q

Factors to consider in distribution

A

Plasma protein binding, obesity, edema, tissue binding

Drug’s affinity for certain tissues

23
Q

What portion of drug is available to exert effects

A

Free drug–not protein bound

Someone with liver disease and decreased albumin will have less protein binding and can have more toxic levels of drug

24
Q

Biotransformation

A

Chemical inactivation of a drug through conversion to a water soluble compound that can be excreted

25
Q

2 major organs of excretion

A

Liver and kidney (also fecal, respiration and breastmilk)

Kidney greater–depends on GFR which depends on cardiac and kidney function

26
Q

Pharmacodynamics

A

How the drug affects the body

27
Q

High affinity drug

A

Agonist

28
Q

Low affinity drug

A

Antagonist

29
Q

First order kinetics

A

If you give a drug, the same amount of drug will be eliminated over time depending on half life

30
Q

Zero order kinetics

A

You excrete a constant amount of drug no matter how much you give
Causes accumulation and receptor saturation–toxicity

31
Q

Examples of drugs that undergo zero order kinetics

A

Phenytoin, alcohol, aspirin, dilantin, theophylline

32
Q

Elderly have a decreased sensitivity to

A

Beta blockers and warfarin/heparin

33
Q

Not recommended to give ____ to elderly due to fall risk

A

antihistamines

34
Q

When do kidneys reach maturation in children

A

2 years old

Can reach toxic levels quickly prior to this

35
Q

Metabolism in children

A

Slower–fewer liver enzymes

36
Q

Examples of drugs that cross placenta easily

A

Acetaminophen, caffeine, cocaine, labetalol, morphine, penicillins, theophylline

37
Q

Examples of drugs that do not cross placenta easily

A

Heparin and insulin

38
Q

Category A medications

A

Studies in women showed no risk to fetus demonstrated in first trimester and no evidence of risk at later trimesters
Ex. folic acid and thyroid hormone

39
Q

Category B medications

A

Animal studies have not shown a fetal risk and no controlled studies have shown an adverse effect in first trimester and no evidence of risk in later trimesters
Ex. Erythromycin and penicillin

40
Q

Category C medications

A

Studies in animals have shown adverse effect on fetus and no controlled studies in women
Only give drugs if benefits justifies risk
Ex. Labetalol, nifedipine, ACE Inhibitors

41
Q

Category D medications

A

There is positive evidence of human fetal risk but benefits may be acceptable despite risk
Ex. Glyburide, diazepam, aspirin, ACEI

42
Q

Category X medications

A

Studies in animals or humans have demonstrated fetal abnormalities
Drug is contraindicated
Ex. oral contraceptives, lovastatin, isotretinoin

43
Q

MEC

A

Minimum effective concentration

44
Q

MTC

A

Minimum toxic concentration

45
Q

How to make urine more acidic

A

Cranberry juice, vitamin c, NH4Cl

46
Q

How to make urine more alkaline

A

Aspirin

47
Q

Phase 1 of drug metabolism

A

Modify drug by oxidation, reduction and hydrolytic reactions

48
Q

Phase 2 of drug metabolism

A

Conjugation of drug molecule with transferase

49
Q

Examples of general inducers of CYP450

A 
Anti-seizure drugs (carbamazepine + phenytoin)
Rifampin
HIV drugs
Chronic alcohol
Glucocorticoids 
Barbiturates 
St Johns Wort
50
Q

Therapeutic index

A

TD/ED

51
Q

Examples of general inhibitors of CYP450

A 
Proton pump inhibitors 
Azoles
Macrolides 
Grapefruit juice 
SSRI's
Acute alcohol 
Cimetidine
Amiodarone 
Non-dihydropyridine calcium channel blockers 
Protease inhibitors
52
Q

Gs protein

A

Stimulated protein; activates aneylyl cyclase which increases cAMP

53
Q

Gi protein

A

Inhibitory; decreases cAMP

54
Q

Gq protein

A

Activates phospolipase C; Activates DAG + IP3 which increases Ca

Pharmacology (56 decks)

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