Intro

Question 1

A response to a drug which is noxious and unintended, and which at doses normally used in man

Answer 1

Adverse drug reaction

Question 2

1 out of ____ elderly patients admitted to hospital with ADR or had one during stay.

Answer 2

10

Question 3

What are factors that predispose patients to develop ADRS?

Answer 3

• unlicensed/off label Rx
• Pharmacokinetics/pharmacodynamics
• OD
• underreporting (not identified

Question 4

What are medications involved with ADR ED visit?

Answer 4

insulin/anticoagulant/antibiotics/OD/ibuprofen

allergic reactions

Question 5

What are the demographic variables for adherence

Answer 5

age
literacy
language
education level.

Question 6

Medical variables for adherence?

Answer 6

severity/duration of illness
impairment
stress

Question 7

What is pre-clinical development process of drugs?

Answer 7

target audience identified
Chemist make compounds
Testing occurs

Question 8

What are phases of drug development process?

Answer 8

Saftey
Safe + effective
Safe and EFFECTIVE
SAFE

Question 9

drug names based on

Answer 9

source
chemistry
effect
regulation

Question 10

What are the pharmacokinetics

Answer 10

Absorption
Distribution
Metabolism
Elimination

Question 11

What is absorption influenced by?

Answer 11

Physiochemical properties
Lipid/water coefficient (lipid better)
Blood flow to side of administration
Dosage form (liquid)
Temp(high)

Question 12

What are the physiochemical properties?

Answer 12

non-ionized absorb better

acids better in low pH base at high.

Question 13

Distribution of drug depends of what?

Answer 13

where blood flows and presence of plasma proteins (albumin)

Question 14

hypothetical concept to describe where drug exists in body?

Answer 14

Volume of distribution

dose/ plasma concentration

Question 15

a small Vd is?

large?

Answer 15

drug confined to plasma

drug passes easily and distributed.

Question 16

modifies drug to facilitate excretion

Answer 16

Metabolism

Question 17

Phase 1 of metabolism?

Answer 17

reactions make drug more water soluble

done by p450 enzymes

Question 18

Phase 2 of metabolism?

Answer 18

conjugation reaction.

adding endogenous polar molecule to drug.

Question 19

What happens in elimination of pharmacokinetics?

Answer 19

drugs undergo glomerular filtration to enter tubular fluids.

reabsorbed if not water soluble.

Question 20

% of given dose that reaches systemic circulation?>

Answer 20

Bioavailability

IV=100%

Question 21

Bioavailability is reduced by:

Answer 21

• incomplete absorbtion

- first pass metabolism.

Question 22

Drug increases activity of enzymes responsible for its metabolism?

decreased?

Answer 22

enzyme induction

inhibition

Question 23

rate of elimination proportionate to concentration

Answer 23

first order elimination

Question 24

time is takes for concentration of drug to decrease to half the value it had at start of dosing interval?

Answer 24

half-life elimination.

Question 25

A constant amount of drug is lost per unit time?

Answer 25

zero-order elimination

Question 26

What are the enteral routes of administration?

Answer 26

oral/sublingual/rectal Parenteral: injection/inhale/topical/transdermal/IV

Question 27

What is the goal of dosing?

Answer 27

to maintain a plasma concentration with a specified range over long periods of time

Question 28

What does dosing take into consideration?

Answer 28

clearance desired plasma concentration bioavailability

Question 29

Sites of drug action?

Answer 29

-receptor/ion channels -transport molecules enzymes direct bind to nucleic acids non-human targets

Question 30

What is drug-receptor interaction?

Answer 30

drug combines with molecule on cell to produce biologic effect transmits conformational change to generate signal.

Question 31

Transmembrane spanning proteins that allow selective passage of specific ions

Answer 31

ion channels

Question 32

a compound that binds to a receptor and produces the biological response?

Answer 32

agonist partial agonist cant produce 100% response.

Question 33

Blocks or reverse effect of agonist?

Answer 33

antagonists. competitive make less potent non-competitive bind to dif site.

Question 34

dose at 1/2 Emax?

Answer 34

Kd/ EC50 small kd= more potent

Question 35

What is equation for therapeutic index? do you want it big or small?

Answer 35

TD50/ED50 big so that more causes harm.

Question 36

what changes in pharmacokinetics with age?

Answer 36

liver fx declines renal clearance declines maintenance dose decreases

Question 37

expect a _____ increase in plasma drug levels at temps higher than 30 deg C

Answer 37

1.5-2.5 fold

Question 38

Why is there delay in absorbtion of oral drugs with exercise?

Answer 38

slow gastric emptying. and slow bowel transit time.

Question 39

What is reduced with exercise meaning more rapid elimination?

Answer 39

Vd

Question 40

Low hepatic extraction drugs are generally not affected by change in blood flow due to exercise but may be affected by ____

Answer 40

level of fitness.

Question 41

For high extraction ratio drugs, there is _______ during exercise

Answer 41

less metabolism

Question 42

Regular exercise caused greater _____ and shortened ____

Answer 42

metabolism t1/2

Question 43

GFR decreases______ with exercise. meaning

Answer 43

30%.. decreased elimination

Question 44

What are some assumptions with exercise and drugs?

Answer 44

- decreased GI absorbtion - increased subQ/IM/transdermal absorption - reduced Vd/metabolism/elimination