Introduction Flashcards

1
Q

Define pharmacology

A

Study of interactions of exogenously administered drugs with living system

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2
Q

Define drug

A

Any substance that is used or is intended to be used to modify or explore physiological systems or pathological states for the benefit of the recipient

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3
Q

Pharmacotherapuetics

A

Application of pharmacological info with knowledge of disease for prevention mitigation and cure

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4
Q

Clinical pharmacology

A

Scientific study of drugged in man

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5
Q

Chemotherapy

A

Treatment of systemic infection/ malignancy with specific drugs that have selective toxicity

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6
Q

Drugs divided into

A

Pharmacodynamic agents
Chemotherapeutic agents

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7
Q

Pharmacology divided into

A

Pharmacodynamics - what drug does to the body
Pharmacokinetics - what body does to the drug

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8
Q

Four major routes of drug administration

A

enteral
parentral
pulmonary
topical

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9
Q

Commonly used routes:

A

Commonly used routes: oral(po), intravenous(iv), intramuscular(im), and subcutaneous(sc)

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10
Q

Weak acids exist more in non-ionized form in

A

Weak acids exist more in non-ionized form in the stomach, more in ionized form in the intestine

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11
Q

ion trapping

A

Non-ionized form of acidic drug which crosses the gastric mucosal membrane, reverts into ionized form(pH 7.0) and then slowly passes into ECF

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12
Q

Bioavailability (F)

A

Bioavailability (F)is the term used to indicate the fraction of the administered dose reaching systemic circulation

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13
Q

Rate of absorption must be at least …. times greater than rate of elimination to achieve meaningful plasma concentration

A

10

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14
Q

Distribution of drugs-

A

Distribution of drugs-is the process of dissemination of drug molecules from the blood stream to body tissues and fluids

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15
Q

Four basic patterns of drug distribution:

A

1) Drugs with relatively high molecular weight e.g. dextran are confined to plasma water
2) Drugs that can pass capillary wall but can not pass across cell membranes e.g mannitol
3) Drugs that can pass freely across cell membranes but do not have a special affinity for a specific tissue e.g. alcohol
4) Drugs that concentrate specifically in one or more tissues of the body e.g. chloroquine in the liver

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16
Q

Apparent volume of distribution(Vd ) can be calculated by

A

Apparent volume of distribution(Vd ) can be calculated by dividing the administered dose with plasma concentration

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17
Q

Vd implications

A

Drugs extensively bound to plasma proteins are largely restricted to vascular compartment and have low Vd values,e.g. warfarin(99% bound) has a Vd 0.15L/kg

Drugs sequestered in other tissues have values much greater than the total body water or body mass,e.g. chloroquine Vd approx. 13000L

18
Q

PPs that bind acidic drugs

PPs that bind basic drugs:

A

PPs that bind acidic drugs: albumins (mol. wt 66000);
PPs that bind basic drugs: alpha1 –acid glycoproteins

19
Q

Drug metabolism (biotransformation):

A

Drug metabolism (biotransformation): irreversible chemical alteration of the drug in the body to another compound(metabolite

20
Q

Biotransformation reactions are classified into two:

A

Biotransformation reactions are classified into two: phase I and phase II reactions

21
Q

phase 1

A

Phase I introduce or unmask functional groups(-OH, -NH2, -SH)

Reactions involve oxidation, reduction and hydrolysis

22
Q

phase 2

A

endogenous substrates such as glucuronic acid, sulphate, acetic acid or an amino acid combine with newly incorporated functional groups to form a highly polar conjugate

23
Q

microsomal enzymes

A

These are located on
smooth endoplasmic reticulum

monooxygenases, cytochrome P450, UGTs,
epoxide hydrolases

They catalyse most of the oxidations, reductions, hydrolysis and glucuronide conjugation.

24
Q

non microsomal enzymes

A

Present in the cytoplasm and mitochondria of hepatic cells as well as plasma. The
esterases, amidases, some flavoprotein oxidases and most conjugases are nonmicrosomal.

Reactions catalysed are:
Some oxidations and reductions, many hydrolytic reactions and all conjugations except glucuronidation.

25
Microsomal drug oxidations require
cytochrome P450, P450 reductase, NADPH and molecular oxygen Drug+O2 +NADPH+H+ =Drug-OH +H2O+NADP+
26
Enzyme induction
process by which the expression and activity of an enzyme is increased in response to a specific stimulus, typically a molecule or compound that the enzyme is capable of metabolizing.
27
consequences of inducers
results in accelerated metabolism of the inducer(autoinduction) and other co-administered drugs decreased efficacy of drugs(e.g. failure of contraception with oral contraceptives); tolerance development Prodrug’s effect is increased with inducers
28
Possible uses of enzyme induction:
Possible uses of enzyme induction: Congenital nonhemolytic jaundice(due to deficient glucuronidation of bilirubin) ; phenobarbitone hastens clearance of bilirubin Cushings syndrome; phenytoin reduces manifestations by enhancing degradation of adrenal steroids Chronic poisoning; by faster metabolism of accumulated poisonous substance Liver disease
29
Enzyme inducers include
Enzyme inducers include barbiturates, carbamazepine, rifampin, phenytoin, etc.
30
Enzyme inhibition: and inhibitor-
Enzyme inhibition: Some drug substrates inhibit CYP enzymes Inhibitors: cimetidine, erythromycin, ketoconazole, etc.
31
Clinical consequences of enzyme inhibition:
increased concentration of the inhibitors or co-administered drugs which increases the effect, with likelihood of toxicity Prodrugs effect can be decreased
32
Excretion of drugs and metabolites by kidney involves three processes:
Excretion of drugs and metabolites by kidney involves three processes: Glomerular filtration Active tubular secretion and Passive tubular reabsorption(urinary pH plays a key role)
33
Drug elimination is the sum total of
Drug elimination is the sum total of metabolic inactivation and excretion
34
Kinetics of elimination:
Kinetics of elimination: First order (exponential)kinetics Zero order(linear) kinetics
35
first order
36
zero order
37
half life
t1/2= 0.7xVd /CL
38
maintainance dose
Cpss × C- ------------- F
39
loading dose
target cpss x Vd ---------------------- F
40
cpss max
Cp,ss max =F x Dose / Vd / fraction lost in a dosing interval
41
cpss min
cpss max x fraction remaining
42
Revised dose rate
Revised dose rate = Previous dose rate x Target Cpss/ Measured Cpss