⭐ LECTURE 2: PHARMACOTHERAPEUTICS Flashcards

1
Q

What are the SIX types of THERAPIES?

A

Acute Therapy

Maintenance Therapy – common in elderly

Supplemental Therapy

Palliative Therapy

Supportive Therapy

Prophylactic Therapy – give medication to prevent certain kinds of diseases

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2
Q

Ratio between a drug’s therapeutic benefits and its toxic effects
Benefits > toxic effects

A

Therapeutic Index

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3
Q

decreasing response to a repetitive drug

A

Tolerance

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4
Q

physiological or psychological need for a drug

A

Dependence

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5
Q

Alteration of action of a drug by:
Other prescribed drug
OTC medications
Herbal therapies

A

Interactions

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6
Q

Preventable, Medication errors that may result in patient harm

A

Adverse drug EVENTS

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7
Q

Inherent and not preventable
Unexpected, undesirable, and occurs at doses normally used

A

Adverse drug REACTIONS

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8
Q

What are the undesirable response to drug therapy

A

Idiosyncratic,
Hypersensitivity reactions,
Drug interactions, Iatrogenic Responses

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9
Q

unintentional adverse effects that are treatment-induced

A

Iatrogenic Responses

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10
Q

What are the SIX factors influencing the efficacy of a drug?

A
  1. Route of Administration
  2. Rate of Absorption
  3. Distribution of the drug to the required site
  4. Rate of biotransformation or metabolism
  5. Presence of active metabolite
  6. Rate of excretion
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11
Q

Ability of the drug to cross the cell membrane is influenced by its solubility in water or fat, its size and shape

A

Absorption

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12
Q

What orally prepared drug has the FASTEST drug absorption rate?

A

Liquids, elixirs, syrups

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13
Q

What orally prepared drug has the SLOWEST drug absorption rate?

A

Enteric-coated tablets

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14
Q

Small water-soluble molecules which flow through the hydrophilic pores

A

Filtration

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15
Q

diffusion (high to low concentration)

A

Passive Transport

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16
Q

energy and carriers are required to move non-fat soluble substances across the cell membrane

A

Active Transport

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17
Q

What are the FIVE factors affecting the absorption rate (ka)?

A

Blood supply to the site of absorption
Formulation of the drug
Gut transit time
pH in the gut
Solubility of the product

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18
Q

How the drug is distributed through the bloodstream

A

Distribution

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19
Q

Major organs and blood vessels
Low lipid solubility (hydrophilic)
Low Vd

A

Central Compartment

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20
Q

Skin and fat stores
High lipid solubility (lipophilic)
High Vd

A

Peripheral Compartment

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21
Q

Amount of drug in the body to the concentration in the plasma

A

Volume Distribution (Vd)

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22
Q

Only free fraction can move to target site (ratio of 80% bound : 20% free)

A

Plasma protein binding

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23
Q

Active metabolites have more side effects than inactive metabolites

A

Metabolism

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24
Q

major organ of metabolism

A

Liver

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25
What are the factors affecting metabolism?
Genetic factors Other drugs Smoking Enzyme induction/inhibition Some foods Liver disease Age
26
Drug passes the liver before going into circulation
FIRST-PASS EFFECT
27
extensively metabolized by the liver before reaching the systemic circulation (high first-pass effect)
Oral route
28
bypasses the liver (prevents the first-pass effect)
IV
29
Metabolism of orally administered drugs in a single passage thru the gut wall and the liver
First-Pass (Presystemic Metabolism)
30
What are the TEN routes that bypass the liver?
Sublingual Transdermal Buccal Vaginal Rectal (high first pass) IM IV Subcutaneous Intranasal Inhalation
31
Process by which the drug is removed from the body
Excretion
32
primary site for drug excretion
Kidneys
33
What are the organs that facilitate primary excretion?
Kidneys (urine) Gut (feces) Skin (sweat) Lungs (Breath) Mouth (Saliva)
34
Extent to which active ingredients are absorbed and transported to site of action
BIOAVAILABILITY
35
IV administration equates to?
IV administration = higher – 100% bioavailability
36
PO administration equates to?
PO administration = less – <100% bioavailability
37
What are the factors of bioavailability?
Drug solubility Pharmaceutical formulation pH Food
38
Peaks and troughs in plasma levels with other routes of administration, Dose regimes are calculated to maintain therapeutic plasma
Plasma levels
39
Amount of plasma from which the drug can be totally removed per unit time
DRUG CLEARANCE
40
The time required for the body to eliminate 50% of the drug
Half life
41
needs to be given frequently
Short half-life (2-4hrs)
42
requires less frequent dosing
Long half-life (21-24hrs)
43
How many half lives are needed to to approx eliminate 98% of a drug from the body?
5-6
44
time in which the plasma concentration falls by 1/2
Plasma half life
45
time in which a pharmacological effect of a drug, and any of the active metabolites, has declined by 1/2
Biological effect half life
46
time in which the total amount of drug in the body after equilibrium of plasma with other compartments (fat and muscle) is halved
Biological half life
47
Plateau concentration is also known as?
Steady state concentration
48
It is the Indication of safety for a drug
Therapeutic Index / Ratio
49
Metabolism + Excretion = ?
Elimination
50
The formulation of the product for each delivery route is vital to ensure optimal activity and consistent delivery
Routes of Administration
51
absorption is hampered by food, drug may be destroyed or may not be absorbed, first pass metabolism
Oral
52
Tablets / Capsules / Elixirs /Syrups / Suspensions / Granules / Powders / Caplets / Drops are administered ____
Orally
53
ID / Subcutaneous / IM / IV / Intra-thecal / Epidural / Spinal / Depot are administered _____
Parenteral
54
Tablets / Sprays are administered _____
Sublingual / Buccal
55
no degradation by digestive juices and no first pass metabolism
ublingual / Buccal
56
Aerosol inhalers / Dry powder inhalers / Nebuliser solutions / Spacers are administered _____
Inhaled
57
Suppositories / Enemas are administered _____
Rectally (PR)
58
useful in patients who cannot swallow/vomit/uncooperative
Rectal administration
59
Pessaries / Creams / Vaginal tablets are administered _____
Vaginally
60
Creams / Gels / Patches are administered _____
Transdermal
61
Creams / Lotions / Gels / Nasal sprays / Shampoos / Suppositories / Peccaries are administered _____
Topically
62
Pills or tablets that are coated with substances which resist the acid juice of the stomach but permit disintegration in intestinal juices
ENTERIC-COATING
63
Release the active drug over an extended period of time
Sustained release