Section B Flashcards

(53 cards)

1
Q

pharmacokinetics

A

effects of the body on the drug or fate of the drug in the body

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

pharmacodynamics

A

effects of the drug on the body

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

what are the various methods of administering drugs?

A

enteral, topical, parenteral

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

list 4 examples of enteral drug administration

A

oral, nasogastric, gastronomy, buccal/sublingual

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

list 4 examples of topical drug administration

A

skin, eyes/ears/nose, inhalation, rectal/vaginal

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

list 7 examples of parenteral drug administration

A

intravenous, intramuscular, subcutaneous, intradermal, intrathecal, epidural, intra-articular

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

bioavailability

A

the fraction of the drug administered that reaches the systemic circulation

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

first pass metabolism

A

orally, some of the drug is metabolized (inactivated) before entering circulation

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

enzyme induction and its clinical relevance

A

increase in drug metabolizing enzyme activity caused by a foreign compound (inducer)
- requires prolonged exposure to inducer
- causes accelerated clearance, reduced drug action and increased formation of toxic metabolites
can cause drugs to be less effective due to rapid clearance

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

enzyme inhibition and its clinical relevance

A

decrease in enzyme activity caused by a foreign compound
- requires only single dose
- causes impaired clearance and prolonged action
can cause therapeutic levels to rise to toxic levels in drugs with small therapeutic ratios due to prolonged clearance

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

half-life

A

time it takes to eliminate half of a drug from the circulation

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

affinity

A

attractive forces between the drug and the receptor (causes drug to bind to receptor)

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

efficacy

A

ability of the drug when bound to initiate change

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

potency

A

measure of the drug at which it is effective

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

specificity

A

ability of the receptor to recognize specific chemical configurations

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

agonists

A

bind to receptors, cause conformational change, result in a response

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

antagonists

A

bind to receptors, don not cause conformational change, no activation, no efficacy, blocks agonists from binding

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

partial agonists

A

bind to receptor, but do not elicit maximal response, must occupy a large number of receptors to elicit a response

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

why are elderly patients more at risk for ADRs? (8)

A
  1. multiple illness
  2. multiple medications
  3. altered homeostasis
  4. altered immunity
  5. altered pharmacokinetics
  6. altered pharmacodynamics
  7. sensitivity to sedatives
  8. compliance problems
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

why are people with liver disease more at risk for ADRs? (5)

A
  1. encephalopathy risk (sedatives/diuretics)
  2. clotting factor synthesis not normal -> bleeding
  3. low protein affects drug binding and fluid balance
  4. metabolism abnormal -> potential for toxicity
  5. shunting affects bioavailability
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

why are people with renal disease more at risk for ADRs? (5)

A
  1. failure to excrete drugs
  2. failure to excrete metabolites
  3. increased sensitivity to drugs
  4. side-effects are poorly tolerated
  5. some drugs may be ineffective
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the main groups of drugs used to treat hypertension?

A

A - ACE inhibitors & angiotensin receptor blockers (under 55 and not pregnant)
B - beta blockers
C - calcium channel blockers (over 55 or african american)
D - diuretics

23
Q

what are the mechanisms and side-effects of ACE inhibitors?

A

they block formation of angiotensin II and inhibit aldosterone release and blocks breakdown of bradykinin
Cough
Angioedema
Proteinuria
Taste changes
Orthostatic hypotension
Pregnancy fetal renal failure
Rash
Increases renin and decreases angiotensin II
Lytes - hyperkalemia due to decreased aldosterone release
-drop in BP
-fatigue
-headache
-liver damage
-renal failure

24
Q

what are the mechanisms and side-effects of angiotensin receptor blockers?

A

they bind to the angiotensin receptor and block vasoconstriction
-fatigue
-hyperkalemia
-renal failure
-syncope

25
what are the mechanisms and side-effects of beta blockers?
they lower cardiac output, heartrate and renin secretion B1- bradycardia - conduction -heart failure B2 - bronchospasm - vasoconstriction
26
what are the indications for beta blockers?
- angina - tremour -dysrhymias - hypertension - myocardial infarction - thyrotoxicosis labetalol used for malignant hypertension Propranolol used for anxiety SYMPTOMS (sweating, shaking, reduce adrenaline, lower HR)
27
what are the mechanisms and indications for calcium channel blockers?
they lower calcium available to contractile proteins, lower BP, lower cardiac contractility, lower vascular smooth muscle - angina (prevention) - dysrhythmias - hypertension
28
what are the side-effects of calcium channel blockers? (dihydropyridine and non-dihydropyridine)
dihydropyridine: hypertension - headache - oedema - flushing non-dihydropyridine: not first course treatment for hypertension -> used for arrythmias - bradycardia - heart failure
29
what are the mechanisms and side-effects (8) of diuretics?
they inhibit sodium transport in the distal tubule and have a vasodilator effect e.g thiazide like drugs such as xipamide - hypercalcemia - hyperglycemia - hyperuricemia - hypochloremia - hypokalemia - hypomagnesemia - hyponatremia - blood disorders
30
what do loop diuretics do? give an example and what are the side-effects?
inhibit sodium and potassium transport in the loop of Henley, side-effects same as diuretics e.g. furosemide
31
what do potassium sparing diuretics do? give an example and side-effects
increase excretion of sodium, water, chloride and calcium decrease excretion of potassium and hydrogen ions side- effects - ▪ dizziness, orthostatic hypotension ▪ dry mouth ▪ nausea, vomiting, diarrhea e.g. amiloride
32
what drugs are used to treat myocardial infarction?
anti-coagulants, A, B and C drugs
33
name 2 anti-coagulants
warfarin and heparin
34
warfarin
decreases the biological activity of clotting factors II, VII, IX, and X and anticoagulant proteins C and S teratogen, vitamin K antagonist, warfarin metabolism affected by several drugs and food, monitored using INR - 2.5
35
heparin
binds to antithrombin III which catalysts inactivation of factors IIa, Xa, IXa and XIIa monitored using aPTT
36
what are the side-effects of heparin? (4)
- alopecia - hyperkalemia - hemorrhage/thrombocytopenia - osteoporosis
37
name an anti-platelet drug
aspirin
38
aspirin
inhibits cyclooxygenase, preventing formation of thromboxane A2
39
what are the indications for aspirin?
- acute coronary syndrome - acute stroke - prevention of cardiovascular disease - alternative to anti-coagulants in A.Fib
40
what are the main drug groups used in treating asthma?
bronchodilators (relievers) and anti-inflammatory (controllers)
41
give 3 examples of bronchodilators
B2 agonists, antimuscarinics and methylxanthines
42
give 3 examples of anti-inflammatories
corticosteroids, lukasts and chromones
43
what drugs are used to treat anaphylaxis and what do they do?
adrenaline - inhibits mast cell release of mediators corticosteroids - reduce inflammation
44
what do NSAIDs do?
they inhibit COX1 and COX2 which decreases prostaglandin synthesis - anti-inflammatory - analgesic - anti-pyretic - antiplatelet - anti-tumour
45
what are the side-effects of NSAIDs? (9)
headaches dizziness stomach pain bone marrow toxicity GI issues hypersensitivity liver damage renal impairment vascular disease
46
what are the side-effects of opioids?
tolerance, dependance and withdrawal
47
what are the consequences of alcohol use?
- depressant -> causes disinhibition and dependence neuro: depression, stroke, neuropathy cardio: cardiomyopathy, hypertension resp: TB, pneumonia gastro: gastritis, ulcers, liver disease, pancreatitis - infertility, osteoporosis, cancers
48
what are the consequences of cocaine use? (11)
- psychosis - seizures - dysphoria - mydriasis - stroke - hyperthermia - tachycardia - heart attack - hypertension - kidney failure - blood coagulation
49
what are the consequences of cannabis use?
- impaired short-term memory - impaired motor coordination - altered judgement - paranoia/psychosis - addiction - altered brain development - cognitive impairment - diminished life satisfaction - risk of chronic psychosis disorders
50
what are the principal drugs used in treating peptic ulcers?
- antacids: neutralize acid and pepsin - alginates: prevents reflux - H2 receptor antagonists: reduce acid release - chelates: coats ulcer - proton pump inhibitors: reduce acid release and pepsin activation
51
what are the principal drugs used in treating constipation?
- bulk: increase fecal mass, promotes peristalsis (methylcellulose) - osmotic: increases water in large bowel (lactulose) - stimulants: increase intestinal motility (senna) - stool softeners: emollients (glycerol)
52
what are the uses and action of nitrates?
- used to treat angina and heart failure - relaxation of smooth muscle of veins and arterioles causes reduction in venous return (preload) which reduces left ventricular work. Arterioles also relax (afterload) rapid symptomatic relief of angina.
53
what are the side effects of nitrates?
flushing, headache and postural hypotension