Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharm 1 > Pharm 1 > Flashcards

Pharm 1 Flashcards

(81 cards)

Start Studying
1
Q

Pharmacokinetics

A

what the body does to the drug
-ADME
-Concentration of drug in plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pharmacodynamics

A

what the drug does to the body
- concentration of drug at site of action
- drug effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Absorption

A

How administered drugs are absorbed into the body (depends on route).
- Bioavailability bc of first pass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Distribution

A

How drugs are distributed to the site of action
Depends on: Protein binding, solubility, perfusion to area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Metabolism

A

Biotransformation of the drug from active form to inactive form (liver-CYP450 enzyme)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Excretion

A

How the drug leaves the body -> through sweat, bowels, and urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

BEERs Criteria

A

Used to determine potentially inappropriate medications used in older adults (65+)

Common medications (beta blockers) are on list

Medicare D does not cover so may need GENERIC form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Receptor abundance

A

age related
Peds and gero = less receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Receptor affinity

A

age related
can change over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Agonists

A

CREATES RESPONSE
- Dose dependent
- Dependent on receptor sensitivity
- Full agonist = 100% of desired effect
- Partial agonist = Partial response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Antagonists

A

creates NO BIOLOGICAL RESPONSE
- Blocks receptors from agonists
- Competes for receptor sites
- Noncompetitive sites
Ex. Beta blockers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Pregnant woman Physiologic Changes

A

-fat distribution
-hormonal changes
-increased blood volume (dilutional effect)
-Decreased albumin % (less protein to bind to drug, INC free drug circulating)
-Decreased intestinal motility and increased gastric acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Factors PROMOTING transfer through placenta

A

-Lipid solubility (Hydrophobic)
-Smaller, lighter molecules
-Unbound or “free drug”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Factors INHIBITING transfer through placenta

A

-Highly ionized molecules
-Larger, heavier molecules (hydrophilic)
-Drugs with high protein binding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Therapeutic Window

A

The range of drug concentration in blood between minimally effective and toxic level

-Pill count and patient diary can help monitor adherence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

LD50

A

lethal dose in 50% of recipients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ED50

A

effective dose in 50% of recipients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Half life

A

Time required for 50% of the drug to be eliminated from the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

How many half lives is a drug considered fully cleared?

A

4-5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If the half life is 10 hours, then each 10 hours _____% of what is remaining will be eliminated

A

50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Older adults renal function

A

lower GFR - slower eliminating waste - Longer half-life - inc free drug - inc risk for toxicity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Factors that interfere with elimination

A
  • Renal failure - increases half life–> dose less
  • Hepatic disease - impacts prodrugs (CYP450 enzymes) increases half life
  • Exercising regularly vs. intermittently (increases blood flow, GI motility, body-temp increased which increases gastric absorption
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Properties that affect gastric absorption

A

GI motility - increased gastric emptying means less breakdown and decreased motility means it sits in the gut longer leaving more time for absorption

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Bioavailability

A

Rate and extent a drug is absorbed from a tablet/capsule and is available at the site of action

Ex. 250mg oral drug -> first pass -> 125 enters the blood = 50% bioavailability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Pro Drug
A drug that is transformed from inactive to active after the first pass effect (precursor to active drug) - If hepatic disease drug will take longer to activate Ex. plavix
26
Gender in Pharmacokinetics
Women have higher body fat, which could alter the pharmacokinetic disposition of certain drugs Most drugs are tested on men so need to consider differences in women due to hormonal changes and different patterns of fat distribution - Inc progesterone can decrease gastric motility (constipation) (increased absorption)
27
Animal testing is done in which phase of clinical trial
Pre Clinical
28
Supervised studies on 20-100 healthy people and focuses on pharmacokinetics (ADME) Most effective administration routes and dose ranges are determined. Occurs inpatient.
Phase 1
29
Several hundred patients with the disease for which drug is intended. Approval of application means drug can be marketed
Phase 2
30
Thousands of people. Double blind research methods. When most risk is discovered. FDA Accepts or Rejects.
Phase 3
31
Post marketing surveillance. Compared with other drugs on the market and monitor for long term effectiveness and impact on quality of life.
Phase 4
32
Pharmacogenomics
Personalized medicine (breast cancer) - Can ID receptors and genes to generate a specific therapy -Inherited variations of genes dictate drug response -Cost effectiveness (insurance does not cover)
33
Schedule 1
High potential for abuse, no therapeutic effect Heroine, Cocaine, LSD
34
Schedule 2
Valid Medical use, but high potential for abuse -DAMMB -Dilaudid, Amphetamines, Methadone, Morphine, Barbituates
35
Schedule 3
Potential for abuse if taken as prescribed -Codeine, Percocet, Percodan
36
Schedule 4
Low potential for abuse if taken as prescribed -Ativan, Xanax, Benzos
37
Schedule 5
Least potential for abuse -Antitussives and antidiarrheals with small amount of narcotic (ie cough medicine with codeine, adderall)
38
NPI
Part of HIPPA, unique ID for practitioners for all administrative and financial transactions
39
Chlamydial Conjunctivitis in Newborn Treatment
Erythromycin ONLY
40
FIRST line treatment Nongonococcal/Nonchlamydial bacterial conjunctivitis
Erythromycin Ointment 1cm up to 6x per day 5-7 days Polymyxin B Trimethoprim Soln 1 drop q3-q4 for 5-7 days
41
Side effects Erythromycin ointment
blurred vision redness burning
42
Side effects Polymyxin B Trimethoprim Soln (Polytrim)
Lid edema Tears Irritation Rash
43
SECOND line treatment Nongonoccal/ nonchlamydial bacterial conjunctivitis
Ophthalmic Fluoroquinolone *expensive* Higher side effect profile -Moxifloxacin solution (Vigamox) 1 drop TID day for 7 days -Ofloxacin (Ocuflox) 1-2 drops q2-q4 x48hrs -> 1-2drops QID x 5 days
44
Side effects of Moxifloxacin (Vigamox)
Decreased visual acuity, dry eye, visual discomfort
45
Side effects of Ofloxacin (Ocuflox)
Ocular burning/stinging Itching redness blurred vision photophobia
46
FIRST LINE Treatment of nongon/nonchla bac conjunctivitis AIMED AT...
S. Aureus, S. Pneumoniae, H. influenzae
47
SECOND LINE Treatment of nongon/nonchla bac conjunctivitis AIMED AT...
Improves gram + coverage
48
FIRST line treatment of Dry Eye Disease (DED)
Mild: artificial tears (GenTeal, Systane) Moderate/Severe: Preserative Free artificial tear substitute if using reg more than 4x a day. Sjogrens -> Cholinergic Agonist
49
Cholinergic Agonist
Used in DED Oral pilocarpine or cevimeline Bind to muscarinic receptors to stimulate secretion of salivary and sweat glands...side effect excessive sweating
50
SECOND line treatment of Dry Eye Disease (DED)
Cyclosporine Ophthalmic Emulsion (Anti-inflammatory) 1drop BID Liftegrast (Xildra) 5% ophthalmic soln 1 drop q12h Topical Corticosteroids (to suppress irritation from inflammation, max use 2 weeks) SEVERE SE from long term use Tarsorrhaphy - refer to ophthalmologist - Surgery prevents reabsorption of tears made by eye since there is not enough tears in eye
51
CONTRAINDICATIONS of Cholinergic Agonist
Uncontrolled asthma Acute iritis Narrow angle glaucoma
52
MOA of cyclosporine ophthalmic emulsion
Increase aqueous tear production Decrease ocular irritation by preventing T cells from activating and releasing cytokines
53
Side Effects of Cyclosporine Ophthalmic Emulsion
ocular burning discharge itching blurred vision
54
Side Effects of Lifitegrast (Xiidra) 5% ophthalmic soln
Taste alteration Decreased visual acuity
55
MOA Lifitegrast (Xiidra) 5% ophthalmic soln
Blocks interaction of cell surface proteins LFA-1 and intracellular adhesion molecule 1 and may inhibit T cell-related inflammation
56
First, Second, Third Line in Glaucoma Treatment
First - Prostaglandins Second - Beta blocker OR ADD if 1st agent fails to decrease IOP Third- ADD topical carbonic anhydrase inhibitor OR ADD adrenergic agonist
57
MOA Prostaglandin Analogs (Glaucoma)
"-prost" drugs. Increases level of matrix metalloproteinases in the ciliary muscles and sclera. These MMPs will then induce the decomposition of collagen within the extracellular matrix, resulting in improved uveoscleral outflow -Reduces IOP by 25-33% by improving uveoscleral outflow of aqueous humor - Cause iris color changes
58
MOA Beta blockers (Glaucoma)
"-olol" Reduce adenylyl cyclase activity, which in turn reduces the production of aqueous humor in the ciliary body (ABC to remember)
59
MOA Carbonic Anhydrase Inhibitor (Glaucoma)
"-amide" Work though the reversible and competitive binding of carbon acid, which plays role in fluid transport. Topical - Azopt, Trusopt Systemic - Diamox, Neptazane
60
MOA Adrenergic Agonists (Glaucoma)
"idine" activate presynaptic alpha 2 receptors, inhibiting the release of norepinephrine. Formation of aqueous humor is reduced
61
MOA Cholinergic Agonists (Glaucoma)
"ine" stimulate parasympathetic muscarinic receptor site to increase aqueous outflow through trabecular meshwork
62
MOA Rho Kinase Inhibitors (Glaucoma)
"dil" Increase aqueous humor outflow by relaxing cells that line Schlemm's Canal, reducing resistance of the flow Swirly brown lines
63
Combination Drugs (Glaucoma)
Can simplify administration and promote adherence to therapy
64
CONTRAINDICATIONS beta blocker ophthalmic sln in glaucoma
SB, Heartblock, CHF, asthma, cardiogenic shock, DM (may mask s/s of hypoglycemia), severe COPD (may use beta 1) Can result in systemic bradycardia, hypotension, worsening CHF, heart block, bronchospasm, hallucination and depression
65
Patient education Glaucoma drops
Wash hands Remove contacts apply to inner aspect lower eyelid Clean tip or dont let touch Separate drop by 10min
66
Blepharitis NON pharmacologic treatment
Eyelid hygiene Warm compresses
67
MGD treatment
-Cleaning, massage followed by warm compress to remove excess oil -Eyescrub or dilute baby shampoo -Chronic condition
68
FIRST LINE Treatment Staphylococcal Blepharitis
-Baci OR Erythromycin ointment (blurred vision, redness, burning, eyelid edema) - Erythromycin most effective but burdensome regimen IF CORNEAL ABRASION USE ABX EYE DROPS FLUROQUINOLONE "CIN" - Moxifloxacin (Vigamox) - - Azithromycin
69
SECOND LINE treatment blepharitis
Refer
70
FIRST line treatment Otitis Media
High dose Amoxacillin (after 48-72 hours of OBS) or Cefdinir if PCN allergy
71
SECOND line treatment Otitis Media
Augmentin then escalate to Ceftriaxone IM if Augmentin fails IF PCN Allergy Go from 3rd gen cefdinir to 2nd gen ceftin
72
Amoxicillin dosing Otitis Media
80-90mg/kg/d PO BID
73
Amoxicillin-Clavulanate (Augmentin) dosing Otitis Media
80-90mg/kg/d PO BID
74
2nd Gen Cephalosporin Dose
Cefuroxime (Ceftin) 30mg/kg/d PO BID
75
3rd Gen Cephalosporin
Cefdinir (Omnicef) 14mg/kg/d PO BID Cefpodoximine (Vantin) 10mg/kg/d PO QD Ceftriaxone (Rocephin) 50mg/kg/d IM QD 1-3 days - if unable to tolerate PO or for repeat ABX treatment use IM admin
76
ABX course length Age <2
10 days
77
ABX course length Age 2-5
7 days
78
ABX course length 6+
5 days
79
FIRST Line otitis Externa treatment
Fluoroquinolones "cin" Ciprofloxacin vs ofloxacin
80
SECOND line Otitis Externa Treatment
Neomycin/Polymixin (Worse side effects)
81
CONTRAINDICATIONS medications used in Otitis Externa
Herpes, Fungal, viral otitic infections, perforated ear drum Caution in breastfeeding

Pharm 1 (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions