Pharm Quiz

Question 1

Pharmacokinetics

Answer 1

how drug enter and exits the body, what YOU do to the DRUG

Question 2

Pharmacokinetics steps

Answer 2

absorption, distribution, metabolism, excretion

Question 3

absorbtion

Answer 3

drug transfer from site of administration to blood stream

Question 4

distribution

Answer 4

central circulation to peripheral tissue

Question 5

metabolism

Answer 5

bio-transformation: converting molecules

Question 6

excretion

Answer 6

removal

Question 7

pH changes and drug absorption

Answer 7

low pH (acid) increases absorption of weak acids (furosemide, phenobarbital)
high pH  (base) increases absorption of weak based, and decrease absorption of weak acid

Question 8

neonate distribution

Answer 8

body composition: water( 70-75% and fat 15-28% term; protein binding: low albumin concentration, less binding

Question 9

neonate metabolism

Answer 9

liver- deficiency in enzymes

Question 10

PHASE I liver metabolism

Answer 10

P450, oxidation, reduction, hydrolysis

Question 11

PHASE II liver metabolism

Answer 11

conjugation w/sulfate, acetate and glucoronic acid

Question 12

neonate excretion

Answer 12

kidneys GFR tubular secretion and re-absorption

neonate has: larger volume of distribution, delay excretion, need higher mg/kg dose, longer dosing intervals

Question 13

bioavailibility

Answer 13

fraction of the administered drug that reaches circulation; IV 100%

Question 14

half life

Answer 14

is the time it takes for half of the drug to clear the plasma or the time it takes to reduce concentration in half

Question 15

steady state

Answer 15

concentration of the drug in the maternal circulation that determines the amount of drug available to the fetal compartment; rate of drug administration equals rate of excretion

Question 16

loading dose

Answer 16

long half life…long time to achieve plateau…larger initial dose

Question 17

placental transfer of drugs

Answer 17

increase in maternal far, decrease in serum protein, changes in P450 and UGT; placental changes (surface and thickness);

Question 18

teratogenic

Answer 18

anything external to fetus that causes structural or functional disability in prenatal or postnatal life

Question 19

pregnancy risk categories DRUGS

Answer 19

A-safe
B-animal safe, no human data
C-animal adverse effect; no human date; benefits outweigh the risk
D human risk; potential benefit outweigh risk
X fetal abnormalities, risk> benefits

Question 20

AGONIST

Answer 20

activator of the receptor; stimulates response; has affinity and intrinsic activity

Question 21

ANTAGONIST

Answer 21

inhibitor of receptor, blocks agonist, block response; has affinity but no intrinsic activity

Question 22

METABOLISM

Answer 22

the rate of drug metabolism is the
primary determinant of both duration and
intensity of drug action

Question 23

Pharmacodynamics

Answer 23

What DRUGs do to YOU

• Receptors and mechanisms of action
• Stimulators (agonists)
• Blockers (antagonists)
• Dose-response relationships
• Therapeutic effects versus toxic effects

Question 24

example of teratogenic drugs

Answer 24

thalidomide, valproic acid, carbamazepine, ACE inhibitor, ARBs, tetrecycline, paroxetine, AEDs

Question 25

neonatal gastric acid production

Answer 25

low at birth few hours of life pH 1-3 first 10 days of life...near neutral premature: pH 6-8 first 14 days of life

Question 26

drug specific factors DISTRIBUTION

Answer 26

molecular size, ionization constant, relative hydrophilic/lipophilic properties; protein bounding

Question 27

infant specific factors DISTRIBUTION

Answer 27

body composition, membrane/tissue permeability; cardiac output

Question 28

volume of distribution

Answer 28

Vd: hypothetical fluid volume through which the drug is dispersed

Question 29

NEONATE Vd

Answer 29

Vd is high/large, lowering max drug concentration, drug clearance is slow...need higher dose

Question 30

delay drug clearance causes?

Answer 30

prolonged half-life

Question 31

FAS

Answer 31

greatest single drug-induced cumulative preventable intellectual deficit in children

Question 32

NAS opioids

Answer 32

clinical presentation: CNS and GI S&S

Question 33

intubation meds

Answer 33

fentanyl 1-3ug/kg or midazolam 0.1mg/kg

Question 34

circumcision meds

Answer 34

PO sucrose, acetaminophen, lidocaine block

Question 35

chest drain meds

Answer 35

fentanyl, local anesthetic, non-pharm measures

Question 36

ophthalmology exam meds

Answer 36

anesthetic drops, sucrose, containment

Question 37

post op

Answer 37

police and around the clock, preventative, morphine, fentanyl, acetaminophen

Question 38

therapeutic drug monitoring

Answer 38

appropriate dosing, modification for desired drug concentrations (t) tau interval, (n) number of doses

Question 39

peak level

Answer 39

30 minutes post end of infusion

Question 40

trough level

Answer 40

60 minutes prior next dose administration

Question 41

NEO meds requiring monitoring

Answer 41

gentamicin, vancomicin, phenobarbital