Midterm Flashcards
(105 cards)
1
Q
What is pharmocokinetics
A
the study of absorption, distribution, metabolism, and excretion of drugs
2
Q
What is pharmaceutics?
A
the formulation and preparation of drugs
3
Q
What is pharmacoeconominics?
A
the study of the economic impact of drugs
4
Q
What is toxicology?
A
the study of the harmful effects of chemicals
5
Q
What is pharmacognosy?
A
the study of the medicinal uses of naturally occurring compounds
6
Q
What is pharmacy?
A
the preparation and dispensing of drugs
7
Q
What is pharmacogenetics?
A
genetic influences by and on drugs
8
Q
What is pharmacodynamics
A
physiological and biochemical mechanism of action of drugs
9
Q
What is pharmacogenomics?
A
identifies discrete genetic differences among individuals that play a critical role in drug response
10
Q
What is pharmacoepidemiology?
A
the study of the use and effects of drugs on large groups of people
11
Q
What is a ligand?
A
chemical substance that binds to a specific receptor
12
Q
What does an agonist do?
A
Bind to a receptor and stimulates that receptor response
13
Q
What does an antagonist do?
A
Binds to a receptor and blocks that receptor response
14
Q
Competitive binding vs. noncompetitive binding
A
competitive binding is reversible (most drugs) and noncompetitive binding is nonreversible
15
Q
What does ED50 mean?
A
Effective dose for 50% of the population
16
Q
What does TD50 mean?
A
Toxic dose for 50% of the population
17
Q
What does LD50 mean?
A
Lethal dose for 50% of the population
18
Q
What does LD50/ED50 indicate?
A
The therapeutic index
19
Q
What does therapeutic index mean?
A
estimation of drug dosage which can treat disease effectively while staying within safety range
20
Q
What is the receptor theory?
A
The concept that certain drugs produce their effects by acting specifically at a receptor site on a cell or within a cell or its membrane
21
Q
Types of bonds from strongest to weakest
A
covalent , ionic, hydrogen, hydrophobic, van der Waals
22
Q
What is efficacy?
A
the amount of drug to produce the desired effect
23
Q
what is individual variability?
A
some variability in one person due to outside factors
24
Q
What does the drug response curve show?
A
allows you to determine the: 1. affinity (potency) 2. Efficacy 3. Variability 4. Slope
25
What is therapeutic range?
The blood levels needed for drug to be effective without being toxic
26
What is down-regulation?
Continued simulation of cells by an agonist causing desensitization from continued or subsequent exposure to the same concentration of drug
27
What is up-regulation?
Continued exposure to an antagonist leading to increase in number and sensitivity of the receptors as a response to a chronic blockade
28
Pregnancy category A
Controlled studies show no risk to fetus
29
Pregnancy category B
animal-reproduction studies have not demonstrated fetal risk, but there are no studies in woman
30
Pregnancy category C
Studies in animals have revealed adverse effects and no studies in women or no studies in animal or women are available. Medicine should only be given if potential benefit outweighs potential risk
31
Pregnancy category D
Positive evidence of fetal risk but benefits to treat serious disease in women may be acceptable despite risk
32
Pregnancy Category X
Studies in women and animals show fetal abnormalities and should never be given to women who are or may become pregnant
33
What is bioavailability?
The amount of drug absorbed into the blood from the different routes
34
Bioavailability of IV
100%
35
Bioavailability of IM
75-100
36
Bioavailability of SQ
75-100
37
Bioavailability of PO
5-100, may have significant first-pass effect
38
Bioavailability of rectal
30-100, less first pass than oral
39
Bioavailability of Inhalation
5-100, rapid onset
40
Bioavailability of Transdermal
80-100, slow absorption, prolonged duration of action
41
What is drug ionization?
pKa is the ionization constant of a chemical compound. the pH at which the drug will exist in solution as 50% ionized and 50% non-ionized.
42
What type of drug crosses the blood-brain barrier, ionized or non-ionized?
non-ionized which is lipid soluble
43
Drug A is an acid compound with a pKa of 7.1, it is put into an acid environment pH 6.0. Determine ionization and solubility.
1. 7.1-6.0=1.1, therefore 99/1% 2. It is an acid in an acid environment, it is non-ionized 99/1. Non-ionized means it is lipid-soluble and will pass blood-brain barrier and also pass into the placenta
44
Drug B is an acid with a pKa of 5. It's in an environment pH 7.4. Determine ionization and solubility.
1. 5-7.4= 2.4, therefore 99/1% 2. It is an acid in a more basic pH therefore it is ionized 99/1. Ionized means it is water soluble and will not cross blood brain barrier or go to placenta.
45
Drug C is a base with a pKa of 7.8. It's placed into an environment pF of 7.4. Determine the ionization and solubility.
1. 7.8-7.4=0.4, therefore it is 75/25% 2. It is a base in a more acidic environment therefore it is 75% ionized and 25% non-ionized. The non-ionized will cross the blood brain barrier and into the placenta due to it's lipid solubility
46
Drug D is a base pKa 6.0. It's in an environment pH 3. Determine the ionization and solubility.
1. 6-3=3, therefore it is 99/1% 2. It is a base in a more acidic environment therefore it ionized. It will not be absorbed in this environment
47
What is the first phase of drug metabolism?
oxidation, reduction, and hydrolysis
48
What is the phase 2 of drug metabolism?
conjugation and synthesis
49
What is first-pass metabolism?
Presystemic metabolism in the liver or gut wall result in reduced bioavailability of the drug when given orally. Also known as first-pass effect
50
What is enzyme induction?
drugs, environmental chemicals, air pollutants, and components of cigarette smoke can stimulate the synthesis of drug-metabolizing enzymes leading to an elevated level of hepatic drug-metabolizing enzymes.
51
What is enzyme inhibition?
Certain substances can cause a decrease in enzyme production resulting in less metabolism of a variety of medication, leading to an increase in their effects.
52
What is the neurotransmitter at the parasympathetic preganglionic site?
acetylcholine
53
What is the neurotransmitter at the parasympathetic postganglionic site?
Acetylcholine
54
What is the neurotransmitter for the sympathetic preganglionic site?
Acetylcholine
55
What is the neurotransmitter for the sympathetic postganglionic site?
Norepinephrine
56
What is the receptor at both the parasympathetic and sympathetic preganglionic site?
Nicotinic cholinergic
57
What is the receptor at the parasympathetic postganglionic site?
muscarinic cholinergic
58
What is the receptor at the sympathetic postganglionic site?
adrenergic
59
What is a drug that mimics the parasympathetic system called?
parasympathamimic
60
What is a drug that mimics the sympathetic system called?
sympathamimic
61
What is stage 1 of Anesthesia?
the time between normal waking state and the loss of consciousness due to an anesthetic agent. Mild analgesia occurs at the end of stage 1.
62
What is stage 2 of anesthesia?
Loss of awareness and recall. Associated with cardiovascular instability excitation, dysconjugate ocular movement, and emesis.
63
What is stage 3 of anesthesia?
Surgical anesthesia, a state where movement in response to pain is suppressed. Various planes are identified with relation to responses and level of sedation.
64
What is stage 4 of anesthesia?
associated with cessation of spontaneous respiration and medullary cardiac reflexes, could lead to death
65
What is the ventilation effect?
The greater the alveolar ventilation, the faster the patient achieves anesthesia.
66
What is concentration effect?
The higher the concentration of anesthetic delivered, the faster anesthesia is achieved. Larger initial dose=faster onset of action
67
What is Blood gas solubility?
Indicator of an anesthetics speed of onset & emergence. Higher coefficient=slower anesthetic lower coefficient=faster anesthetic
68
What is the oil/gas solubility?
Indicator of an anesthetic's potency
69
What is the second gas effect?
2 anesthetics with varying onset speeds are administered together thus allowing a faster anesthetic properties of the slower gas
70
What occurs with N2O diffuses into closed spaces?
N2O expands closed gas spaces. Can cause complications when administered with pneumothorax, bowel obstruction, inner ear surgery, neurosurgical procedures with air injections, air embolism, use within 4 weeks of sulfur hexafluoride injection, and laparoscopy.
71
What are the effects of V/Q issues r/t anesthesia?
reduces speed of onset, effects the faster agents more
72
What is the effect of cardiac output on anesthesia?
An increase in cardiac output slows the onset of all anesthetics.
73
Other name for Isoflurane?
forane
74
Other name for Sevoflurane?
ultane
75
Other name for Deslurane?
Suprane
76
What is diffusion hypoxia?
When high levels of N2O are stopped and quickly dissipates and is replaced by nitrogen, hypoxia can occur. Place pt on 100% oxygen following discontinuation of N2O.
77
Effect of pregnancy on anesthesia?
Cardiac output and minute ventilation are both increased in pregnant women. These two effects offset each other, no differences in pregnant vs non pregnant women
78
Effect of pediatrics with anesthesia?
Despite increased CO and increased required dose, pediatric population achieve anesthesia faster d/t higher ventilatory rate and vessel right group
79
Effect of obesity of anesthesia
Little effect on induction but may prolong emergence due to large amount of fat deposits.
80
Effect of temperature on anesthesia?
The colder the core body temperature, the faster onset of induction
81
What is the MAC, blood/gas coefficient, and oil/gas coefficient for Sevoflurane?
MAC- 2
B/G coefficient- 0.6
O/G coefficient- 50
82
What is the MAC, blood/gas coefficient, and oil/gas coefficient of Isoflurane?
MAC- 1.15
B/G coefficient- 1.4
O/G coefficient- 99
83
What is the MAC, blood/gas coefficient, and oil/gas coefficient of nitrous oxide?
MAC- 105
B/G coefficient- 0.47
O/G coefficient- 1.4
84
What is the MAC, blood/gas coefficient, and oil/gas coefficient of Desflurane?
MAC- 5.8
B/G coefficient- 0.42
O/G coefficient- 18.7
85
What does this graph represent?
the alveolar absorption. how fast you go to sleep
86
What does this graph represent?
The cardiac output effect. The higher the CO, the slower onset of anesthesia
87
What does the graph represent?
The second gas effect.
88
How can a drug enter a cell?
Transmembrane proteins, Diffusion through membrane, and Ion channel
89
What is the portion of the drug bound to plasma protein?
inactive, central compartment
90
What does the binding of propfol to the GABA receptor cause?
Influx of chloride ions
91
The newer patented drugs that exhibit less side effects are called?
S- and R- enantiomers
92
Where is the vessel-rich group located?
Central compartment
93
The vessel-rich group receive what percentage of CO?
75%
94
What is the pharmacologically active portion of the drug?
non-ionized, lipophilic
95
What happens when the pKa and the pH are equal?
non-ionized equals the ionized
96
What route of administration has low bioavailabilty and high first pass?
oral
97
What drug interaction is defined by 1+1=3
Synergy
98
What binds to a specific receptor, mimics an endgrogenous ligand, and may cause maximal activation of the receptor?
Agonist
99
How would you best describe the drug receptor coupling?
lock and key fit
100
A ligand is best described as?
neurotransmitter, hormone, or drug
101
How many hormone receptors are present on the cell membrane?
2,000-100,000
102
What does Fluorine do to an anesthetic agent?
Increase solubility and makes them last longer
103
Calculation to determine MAC99?
MAC x 1.3
104
Calculation for celcius to farhenheit
(C x 1.8) + 32= F
105
How do you determine amount of anesthesia pt is getting?
Pbr-pressure in the brain
PA=Pa=Pbr
Calculate from Fe (fracture exp)
