Pharmacology

Question 1

What is meant by Pharmacokinetics

Answer 1

Describes the movement of a drug from “consumption” to “elimination

Question 2

What is meant by Pharmacodynamics

Answer 2

Describes how the drug works at the target tissue.

Question 3

Explain Pharmacodynamics simply

Answer 3

What the drug does to the body

Question 4

Explain Pharmacokinetics simply

Answer 4

What the body does with the drug.

Question 5

List the Four processes of pharmacokinetics

Answer 5

ADME
Drug Absorption
Drug Distribution
Drug Metabolism
Drug Excretion

Question 6

What are the 2 major routes of administration? whats the main diffrence

Answer 6

enteral & parenteral.
enteral involves the digestive system, while parenteral bypasses it.

Question 7

List the enteral routs of adminstration

Answer 7

Oral, sublingual and rectal

Question 8

List the Parenteral routs of adminstration and the diffrences

Answer 8

IV: allows the most control over the circulating level
IM:allows for administration of drugs without IV access
Subcutanous: This can also help to localize a drug effect

IV offering fast, controlled delivery, IM providing a middle ground with options for both fast and slow release, and subcutaneous offering a versatile approach for both rapid or sustained effects.

Question 9

What is Bioavailability?

Answer 9

How much of the drug stays intact and reaches the bloodstream.If a lot of the drug is broken down before reaching the bloodstream, its bioavailability is lower, meaning less of the drug is available to work in the body.

Question 10

How to measure bioavailability and give an example

Answer 10

plasma levels of drug after administration compared to IV injection. For example IV goes directly into circulation so thats 100% bioavailability.

Question 11

List some important factors that affect absorption (related to the drug)

Answer 11

1) lipid vs water
2) Size
3)fromula, concentration

Question 12

List some important factors that affect absorption (related to the body)

Answer 12

1)pH of stomach
2)Presence of other food
3)Disease/ routes of administration

Question 13

List the factors that affect Drug Distribution

Answer 13

1) blood flow
2)Capillary permiabillity
3)Drug structure
4)Binding to plasma proteins

Question 14

Explain Blood flow in drug distribution

Answer 14

Organs with high blood flow, like the brain, liver, and kidneys, get the drug first and in larger amounts. On the other hand, tissues with low blood flow, like cartilage, connective tissue, and abscesses, have a harder time getting the drug

Question 15

Explain Capillary permiability in drug distribution

Answer 15

-The structure of the capillaries affects how much of their surface is open for molecules to pass through.
-Most capillaries allow large molecules to pass through easily, but factors like inflammation can make the capillaries more or less permeable.

The blood-brain barrier in the brain is special because the capillaries there have tight connections between their cells, making it much harder for drugs to pass through. However, drugs that are lipid-soluble or have specific transport systems can cross the barrier more easily.

Question 16

Explain drug structure in drug distribution

Answer 16

Nonpolar, hydrophobic drugs can move easily through membranes, while polar or charged drugs need to pass through small gaps between cells.

Question 17

Explain binding to plasma proteins in drug distribution

Answer 17

When a drug binds to plasma proteins, it can’t reach its target and work effectively because it’s “stuck” in the blood. Some drugs bind tightly and can’t be released, which means they’re lost, while others bind loosely and can be released to become active when needed.

The active drug is the one that is not bound to proteins, as only the free drug can reach its target and produce effects. This binding is often non-specific, meaning drugs and natural substances in the body can compete for the same protein binding sites. Albumin is the main protein that holds drugs in the bloodstream, serving as a sort of “storage” for the drug until it’s needed.

Question 18

Explain the Binding of Drugs to Plasma Proteins

Answer 18

When drugs bind to plasma proteins like albumin, they become inactive. Only the free drug (not bound to proteins) can work in the body and be eliminated.

Drugs bind to albumin in a reversible way, meaning they can attach and detach. The binding capacity of albumin can be low (one drug molecule per albumin) or high. The strength of this binding varies: weak acids and hydrophobic (fat-loving) drugs bind strongly, while hydrophilic (water-loving) and neutral drugs bind weakly or not at all.

Question 19

Explain the classes of Plasma protein Binding

Answer 19

Class I: These drugs don’t have much of it in the bloodstream compared to the amount of albumin available to bind to it. So, a big part of these drugs is stuck to albumin. Most common medications fall into this group.

Class II: These drugs have a lot of it in the bloodstream, and only a small part of the drug sticks to albumin. Because of this, Class II drugs can push Class I drugs off the albumin, making more of the Class I drug free and active in the body.

Question 20

Explain the 3 renal excretion processes

Answer 20

1)Passive glomerular filtration
2)Active tubular secretion in proximal tubules
3)passive distal tubular reabsorption

Question 21

What factors infleunce renal secretion

Answer 21

Glomerular filtration rate: how much gets filtered up there
Change in urinary pH affect excretion of wak acid and basic drugs:

Question 22

Name 6 different types of soild drugs

Answer 22

capsules
sustained release
enteric coating
caplets
gelcaps: oil in gelatin capsule
granules= gradual release

Question 23

what is fluid extract medicine

Answer 23

Concentration solution of a drug removed
from plant by mixing with a solvent

Question 24

What is Tincture

Answer 24

liquid extract of herbs or plants, made by soaking them in alcohol or vinegar. It’s usually stronger and used in small doses.

Question 25

What is an Emulsions

Answer 25

a mixture of two or more liquids that are normally immiscible, or do not mix

Question 26

What is Liniments

Answer 26

liquid suspensions for external application to skin

Question 27

Explain sublingual entral route

Answer 27

under the tongue used when rapid action is desired.

Question 28

Explain bucal entral route,

Answer 28

between gums and teeth used over sublingual route for sustained-release delivery

Question 29

Explain ID or intradermal injections

Answer 29

-inner forearm -allergy tests, anastheitcs or tb

Question 30

Explain subcutanous injections

Answer 30

-given into upper arms, back, or abdomen -commonly used for insulin

Question 31

Explain Intramuscular injections

Answer 31

-upper arm, thighs hip muscle -Commonly used for drugs that irritate subcutaneous tissue

Question 32

Explain IV injection

Answer 32

-directly into the vein

Question 33

What is the difference between atomization and aerosolization in nebulizer therapy

Answer 33

Atomization delivers larger droplets, while aerosolization suspends smaller droplets in gas, allowing them to travel further into the respiratory system.

Question 34

What is first-pass effect

Answer 34

When a drug is taken orally, it first passes through the liver before it can circulate throughout the body. his can reduce the drug's strength or effectiveness.

Question 35

Explain phase I and phase II reactions

Answer 35

Phase I: Think of it as the "prep" phase. The drug gets a "makeover" to make it fit for Phase II. "Modify" is the key word here. Phase II: Think of this as the "exit" phase. The modified drug gets "conjugated" with another substance, making it bigger and water-soluble, ready to be "excreted". Phase 1 "Modifies to fit," Phase 2 "Conjugates to quit."

Question 36

What is Biotransformation

Answer 36

the conversion of drugs in two stages: Phase I * Oxidation: combining with oxygen * Reduction: gaining electrons * Hydrolysis: cleaving into simpler compounds Phase II * Conjugation: combining with glucuronic or sulfuric acid, terminating biologic activity

Question 37

What is The P450 system

Answer 37

plays a key role in breaking down many substances, including both substances the body produces (endogenous) and substances from outside the body (exogenous), like drugs. aka This is a group of enzymes found in many cells in the body, but they're most concentrated in the liver and GI tract. These enzymes help metabolize substances.

Question 38

Renal excretion is the process of 3 processes explain them...

Answer 38

1)passive glomerular filtration 2) Active tubular secretion in proximal tubules 3)passive distal tubular reabsorption

Question 39

What are the factors affecting renal excretion

Answer 39

-Glomerular filtration rate: only free unbound water soluble drugs with lowmolecular weight are filtered. -Change in urinary pH affect excretion of weak acid and basic drugs: Alkalinization of urine by sodium bicarbonate increases excretion of acidic drugs, Ex. aspirin. Acidification of urine with Vit C increases excretion of basic drugs Ex. amphetamine

Question 40

What is a drugs half life?

Answer 40

it's the time it takes for half of the drug to be eliminated from the body. shorter half life= drug is cleared from the body faster, so it needs to be taken more often to maintain its effect. longer half life=. vise versa.

Question 41

What are the There are 4 main drug actions:

Answer 41

1. depressing 2. stimulating 3. destroying cells 4. replacing substances

Question 42

What is median effective dose (ED50)

Answer 42

amount of a medication required to produce a specific effect in 50% of the patients who take it

Question 43

How do drugs work

Answer 43

Drugs work by changing the way cells and tissues behave. Each drug targets specific receptors (mostly proteins) on the outside or inside of cells. This helps the drug cause its effect.

Question 44

How do drugs interact with cells to produce their effects?

Answer 44

Drugs can either bind to specific receptors (alpha or beta) on the cell surface, triggering second messenger events inside the cell, or act independently of receptors, changing cell permeability, affecting cellular pumps, or reducing membrane excitability (e.g., anesthetics, diuretics).

Question 45

list the type of drug receptors

Answer 45

* Ligand-gated ion channels * G-protein-coupled receptor systems * Enzyme embedded in the cell membrane * Transcription factors

Question 46

list the Chemical shape and properties of drugs.

Answer 46

Complementary to receptor binding site:
The shape of a drug must match the shape of the receptor's binding site, like a key fitting into a lock. Determines if the drug is an agonist or antagonist:
The drug’s shape and properties affect whether it will activate the receptor (agonist) or block it (antagonist). Three points of contact for specific interaction:
To bind specifically to a receptor, the drug needs to interact at three distinct points on the receptor for a strong connection, much like how Velcro sticks better with more contact points. Chiral vs. non-chiral:
Drugs can have different shapes (chiral or non-chiral), affecting how they fit receptors. A chiral molecule is like a left and right hand—similar but not identical. Only one version might bind well. Flexibility and rotation of internal bonds:
The drug's internal structure needs to be flexible, allowing it to rotate and adapt to fit snugly into the receptor.

Question 47

What is Agonist-antagonist:

Answer 47

partial agonist: only slight intrinsic activity. Can act as both agonist (alone) or antagonist (competes with other drug)

Question 48

When is a drug said to be a good agonist

Answer 48

A drug is said to be an agonist when it binds to a receptor and causes a response or effect. It has intrinsic activity = 1

Question 49

When is a drug said to be an antagonist

Answer 49

A drug is said to be an antagonist when it binds to a receptor and prevents (blocks or inhibits) a natural compound or a drug to have an effect on the receptor. An antagonist has NO activity. Its intrinsic activity is = 0 1. Competitive They compete for the binding site * Reversible * Irreversible 2. Non-competitive Bind elsewhere in the receptor (Channel Blockers).

Question 50

Drugs That Produce Pharmacologic Effects in Nursing Infants

Answer 50

Antibiotics, Sedatives, narcotics, Alcohol, lithium.

Question 51

List the ADME Pharmokinetic changes in older ages:

Answer 51

Absorption: different nutritional habits, slower gastric emptying Distribution: increased body fat, reduced total body water Metabolism: heart failure and disease that affect liver function more common. Elimination:Liver and kidney dysfunction may cause intensified drug effects because of increased half-life.

Question 52

What is Polypharmacy and Problems with it

Answer 52

Taking multiple medication at the same time, can… increase risk of toxicity Increase risk of drug to drug interaction Increases risk of mistakes in taking their medication

Question 53

Explain Antihypertensives

Answer 53

anti high blood pressure) this works in opposite way meaning meds that lower high blood pressure can lead to hyperglycaemia, hyperuricemia and HYPOkalemia

Question 54

Explain Cardiac glycosides and give example

Answer 54

These drugs can become toxic more easily, which can be dangerous, because they have longer half life and narrow therapeutic range. Eg is digoxin

Question 55

Antiarrhythmic drugs...

Answer 55

Higher chance of toxcitiy

Question 56

Narcotic analgesics:

Answer 56

painkillers that can make you sleepy: Narcotic painkillers make you sleepy, which can also slow your breathing. This is more risky for elderly patients because their respiratory systems are often weaker.

Question 57

Explain NSAID (Non-Steroidal Anti-Inflammatory Drugs)+ give examples

Answer 57

group of medications used to reduce inflammation, pain, and fever. Common examples include ibuprofen, aspirin,

Question 58

Explain Corticosteroids

Answer 58

medication that mimic the effects of hormones your body produces naturally in the adrenal glands. They help reduce inflammation and suppress the immune system.. ANY MEDICATION THAT ENDS WITH “SONE” or “ONE” THESE CAUSE OSTEOPOROSIS.

Question 59

What is Aminoglycosides

Answer 59

Antibiotic treat serious infections over long periods of time and use toxic to the kidneys

Question 60

In what cases would pregant women need medication?

Answer 60

High risk, gestational diabetes or hypertension need to be treated.

Question 61

When giving medications to a pregnant patient, what are 3 factors that need to be considered?

Answer 61

Ability to cross the placenta: Some drugs can pass from the mother to the baby through the placenta, which may affect the baby. Pregnancy-related changes: During pregnancy, the body undergoes changes like hormone fluctuations and changes in blood flow, which can affect how drugs work and are processed. Cardiac and blood flow changes: Pregnancy causes changes in the heart’s output and blood volume, as well as blood flow to different parts of the body, which can impact how medications are absorbed and distributed.

Question 62

How does Pregnancy changes affect how a drug is processed

Answer 62

GI motility (how food moves through the stomach) is slower. Distribution to plasma proteins is reduced. However, other processes like absorption, distribution, metabolism, and excretion are increased. Total body water increases by up to 81%, which affects how drugs are spread in the body.

Question 63

How do Drugs cross the placenta

Answer 63

Passive diffusion, Conjugated steroid and peptide hormones do not cross..

Question 64

What does Teratology mean

Answer 64

birth defects caused by harmful substances.

Question 65

IMPORTANT: The 4 established principles concerning a drug's potential to cause developmental disorders are:

Answer 65

1)Dose-effect relationship: The higher the dose of the drug, the greater the likelihood or severity of developmental harm. 2)Species susceptibility: Different species may respond differently to a drug. A drug that causes harm in one species may not affect others the same way. 3)Period of development: The timing of exposure matters. Some stages of development are more sensitive to drug exposure than others, so exposure during certain periods (e.g., early pregnancy) is riskier. 4)Mode of action: How the drug works (its mechanism) can affect how it impacts development. Some drugs may interfere directly with the processes that guide development.

Question 66

Explain difference between Lipid-soluble drug and Plasma-bound drugs when it comes to pregnancy.

Answer 66

Fat-soluble drugs can pass into breast milk and affect the baby. Drugs attached to proteins in the blood usually can't pass to the baby through the placenta.

Question 67

Explain Alcohol, Nicotine, opates and breastfeeding?

Answer 67

Alcohol: babies get 10% of the mother's alcohol if she drinks Nicotine: Can cause low milk supply and vomiting in baby Oppiates: make babies addicted to it

Question 68

Explain Caffience, Canabis, coccain and breastfeeding?

Answer 68

Caffiene:high amounts can cause irritability, poor sleep, and affect iron absorption. Cannabis:stored in the brain and fat. It may delay motor development Cocain:Cocaine clears from breast milk faster than cannabis but can still cause side effects like hypertonia (muscle stiffness), tachycardia (fast heart rate

Question 69

Explain the difference beween Adverse and side effects.

Answer 69

Side effects: unwanted effect that happens regardless of the dose. These are usually expected, explained to the patient, and often go away over time. Some medications are even used because of their side effects. Adverse effects: an unwanted effect that happens when a medication is taken correctly. It can be: Type A predictable and dose related Type B Unpredictable and not related to dose.

Question 70

Explain the severity of mild adverse reactions

Answer 70

Severity of adverse drug reactions: MILD -usualy mild including digestive disturbance, headache, skin rashes, -Mild or moderate adverse drug reactions do not necessarily mean that a drug must be discontinued

Question 71

Explain the severity of severe adverse reactions

Answer 71

life threatening -abnormal heart rhythms, certain types of allergic reactions Severe reactions are relatively rare. People who develop a severe reaction usually must stop using the drug and must be treated. However, doctors must sometimes continue giving high- risk drugs (for example, chemotherapy to people with cancer or immunosuppressants to people undergoing organ transplantation).

Question 72

What are Idiosyncratic reactions

Answer 72

Unique, strange or unpredictable reactions to a drug (Ex. anaphylaxis)

Question 73

Give an example of positive drug interaction

Answer 73

Example of positive drug interaction is the co-administration of carbidopa with levodopa used in the treatment of Parkinson’s disease. Carbidopa prevents levodopa from breaking down before it reaches the brain. This makes levodopa more effective in treating Parkinson’s disease and reduces side effects like nausea.

Question 74

Explain Difference between pharmacokinetcis and pharmacodyanmic interactions.

Answer 74

Pharmacokinetic interaction: One drug changes how another is absorbed, distributed, metabolized, or excreted (ADME), affecting its concentration in the body (e.g., two drugs using the same liver enzyme or competing for protein binding). Pharmacodynamic interaction: One drug alters how the body responds to another, either enhancing (additive/synergistic) or reducing its effects (e.g., interactions with supplements)

Question 75

Explain different types of drug-drug interactions

Answer 75

Duplication: same medication Opposition:antagonism Alteration: of what the body does to one or both drugs.

Question 76

Provide an example of Drug-Drug interaction

Answer 76

-A cold remedy and a sleep aid both contain diphenhydramine (Benadryl), so taking both increases the dose unintentionally. -A cold remedy and a pain reliever both contain acetaminophen (Tylenol), which can lead to an overdose.

Question 77

Provide examples of drug-drug Opposition interation

Answer 77

-(like ibuprofen) make your body hold onto salt and water, but diuretics (like hydrochlorothiazide) help your body get rid of extra salt and water. If you take them together, the NSAID can cancel out what the diuretic is trying to do. -Beta-blockers (like propranolol) slow your heart and lower blood pressure, but they can block albuterol, which helps you breathe better during an asthma attack. This means albuterol might not work as well if you're also taking a beta-blocker.

Question 78

Explain drug to drug interaction of Alteration

Answer 78

One drug may alter how the body absorbs, distributes, metabolizes, or excretes another drug.

Question 79

Provide example of alteration drug to drug interaction.

Answer 79

-proton pump inhibitors and H2 blockers reduce stomach acid/higher pH which can stop drugs like anti fungal ketoconzole from being absorbed properly -Liver enzyme changes: Some drugs change how liver enzymes work, speeding up or slowing down how other drugs are broken down. For example, phenobarbital increases liver enzyme activity, causing the blood thinner warfarin to break down faster, which makes it less effective.

Question 80

Explain nutrient ineraction with biphosphonates

Answer 80

Any food, even orange juice, coffee, or mineral water, may markedly reduce the absorption and effectiveness of these drugs

Question 81

Explain nutrient ineractions with Anticoagulants (like warfarin)

Answer 81

Foods with a lot of vitamin K (like spinach and kale) can reduce the drug's effect, increasing the risk of blood clots.

Question 82

Explain nutrient interaction of grape juice

Answer 82

It blocks an enzyme (CYP3A4) that normally breaks down many drugs, like benzodiazepines and certain statins. This makes these drugs stronger because more of the drug stays in your body

Question 83

Explain what Digoxin is and its reactions

Answer 83

Digoxin: Medication used to treat heart conditions, eating too much fibre can block body from absorbing digoxin properly.

Question 84

Explain Mao inhibitors and its nutriitiional interaction.

Answer 84

MAO inhibitors: These are a type of antidepressants and they interact dangerously with food high in tyramine like poultry cheese

Question 85

Explain Tetracyclins nutritional interaction

Answer 85

Taking calcium products with this antibiotic causes reduced absorption.

Question 86

Explain Statins nutritional interaction

Answer 86

Antioxidants like vitamins A, C, E, B, and folic acid may reduce the effectiveness of statins by interfering with their cholesterol-lowering action

Question 87

Explain Norvasc nutritional interaction

Answer 87

Norvasc is antihypertensive (used to lower BP). Eating foods high in sodium works against Norvasc by raising blood pressure, making the medication less effective.

Question 88

Q: What is Long QT Syndrome

Answer 88

A disorder of the heart’s electrical system where the heart takes longer to "recharge" between beats, leading to a risk of dangerous arrhythmias.

Question 89

Q: What is the name of the life-threatening arrhythmia associated with LQTS?

Answer 89

A: Torsades de pointes.

Question 90

Why does the P450 enzyme profile vary between individuals, and how does this affect drug responses?

Answer 90

Why it varies: Differences in genetics cause some people to produce more or less of certain P450 enzymes, or enzymes that work faster or slower. Effect on drug responses: Fast metabolizers: Break down drugs quickly, which can make the drug less effective. Slow metabolizers: Break down drugs slowly, which can lead to drug buildup and side effects. Example: A "slow metabolizer" of codeine may not get pain relief because their body can’t convert codeine into its active form (morphine) efficiently.

Question 91

Dong Quai

Answer 91

taken for menstrual control… Dont take with Warfrin some antibiotics

Question 92

Echinacea

Answer 92

Do not take with with heart medications

Question 93

Ephedra

Answer 93

Weight loss, reduce appetite and open airways. Do not mix with heart medication

Question 94

Feverfew

Answer 94

Taken to reduce migraines dont take with other migraine medications, can raise heart rate. Dont take with warfarin

Question 95

Ginkgo

Answer 95

: increases blood flow and circulation throughout the body, can also help improve memory. DOnt take with aspirin, warfarin

Question 96

Garlic

Answer 96

help lower cholesterol and prevent the formation of blood clots.. Do not take with diabetes medication because it may cause a decrease in blood sugars

Question 97

Ginseng

Answer 97

Benefits: Helps reduce stress, boost energy, improve stamina, and may lower cholesterol. Side Effects: Can cause nervousness, headaches, insomnia, heart palpitations, and increase blood pressure. Warnings: Avoid if taking high blood pressure medication or Coumadin (blood thinner).

Question 98

Hawthorn

Answer 98

claimed to be effective in helping reduce angina attacks by lowering blood pressure and cholesterol levels.*Should not be taken with digoxin, a heart medication. The mix may lower heart rate too much

Question 99

Kava

Answer 99

For stress relieve and nervousnes. is used to treat anxiety. It's also used to relieve insomnia and nervousness. * Do not take Kava if you have a history of liver problems. Also do not mix with antidepressants, sedatives, and do not mix Kava with alcohol.

Question 100

Liquorice

Answer 100

This medicine treats coughs, colds, and peptic ulcers, but high doses can raise blood pressure, cause water retention, and lower potassium, so avoid it with diuretics or digoxin to prevent further potassium loss.

Question 101

St. John's wort

Answer 101

Natural antidepressent, dont take with antidepressants, HIV medications, oral contraceptives, blood thinners,

Question 102

Valerian

Answer 102

a mild sedative with hypnotic effects, used to promote sleep, *Should not be taken with alcohol or Valium.

Question 103

What are the 4C's of Addiction

Answer 103

1) compulsion 2)Craving 3) consequence 4)Control

Question 104

What is Teratogen

Answer 104

A substance or illness that can harm the fetus

Question 105

Hepatotoxic effects

Answer 105

Medications which cause damage to the liver. Liver function is determined by the presence of aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) and the presence of jaundice