TERM 2-MY NOTES CORE CONCEPTS OF PHARMACOLOGY CH.4 "what Happens After A Drug Has Been Adminstered" Flashcards Preview

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Flashcards in TERM 2-MY NOTES CORE CONCEPTS OF PHARMACOLOGY CH.4 "what Happens After A Drug Has Been Adminstered" Deck (61):
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"what Happens After A Drug Has Been Adminstered"

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pharmacokinetics focuses on how drugs move within the body. Drug movement involves four processes: absorption, distribution, metabolism, and excretion.
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B)false

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The four processes of pharmacokinetics (drug movement) are absorption, metabolism, distribution, and excretion.
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B)false

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Absorption is the first step in how the body handles a drug.
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B)false

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Absorption is a process involving the movement of a substance from its site of administration across one or more body membranes. A drug may be absorbed locally and produce a biologic effect at a remote site.
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B)false

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Absorption may occur across the skin and associated mucous membranes, or drugs may move across membranes that line blood vessels. Ultimately most drugs move across many membranes to reach their target cells
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The presence of food in the digestive tract slows the absorption of drugs administered orally.
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B)false

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plasma proteins, already present in the bloodstream. When a drug binds with a plasma protein such as albumin, the drug is held by the plasma protein in the bloodstream, where it is unable to reach its target cells. Often, a second drug will interfere with the binding by displacing the first drug from the plasma protein. In this case, the first drug· activity is intensified
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B)false

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The term bioavailability is often used to describe how much of a drug will be available after administration to produce a biological effect.
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their cellular barriers only a llow fat- soluble substances to cross.These special barriers are called the blood-brain barrier; blood- placemal barrier; and blood-testicular barrier:
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Some drugs are able to cross the blood-brain barrier without difficulty. These include antianxiety drugs,sedatives (sleep-inducing), and psychoactive (or mind-altering) drugs.
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B)false

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Other medication . such as many antibiotics and anticancer medications, are absorbed easily from the intestinal tract. but they do not easily cross into the brain .
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B)false

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The blood-placental barrier serves an important protective function because it regulates which substances pass from the mother's bloodstream to the fetus. However, many potentially damaging agents such as cocaine and alcohol, and even some prescription or OTC medications, are not prevented from crossing this barrier.
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In males, the blood-testicular barrier prevents many drugs from reaching the testes, making it diffic ult to treat testicular disorders.
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Metabolism is the next step in pharmacokinetics. It is often described as the total of all chemical reactions in the body.
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Metabolism occurs in almost every cell and organ-including the intestinal tract and kidneys- but the liver is the primary site.
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biotransformation reactions: They are the chemical conversion of drugs from one form to another that may result in increased or decreased activity.
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Calcium needs muscle contraction.
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prodrugs require metabolism to make them active. In these cases, as the drug is broken down by chemical reactions of metabolism, the products formed by the breakdown produce a more intense response than does the original drug.
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An example of such a prodrug is sulfasalazine, which is not active in its original form taken by mouth . It is broken down by bacteria in the colon into two products that become active
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Another important mechanism that affects metabolism and drug action is the first-pass effect. Substances absorbed across the intestinal walI enter blood vessels known as the hepatic portal circulation, which carries blood directly to the liver
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Drugs administered orally are absorbed into the hepatic portal circulation and are taken directly to the liver for metabolism.
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The liver may then metabolize the drug to a less active form before it is distributed to the rest of the body and target organs. In some cases, this first-pass effect can inactivate more than 90% of an orally administered drug before it can reach the general circulation
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Age, kidney and liver disease, genetics, and other factors can dramatically affect metabolism.
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First-pass effect: Drugs given orally are absorbed through the intestinal wall and enter the hepatic portal circulation. Absorbed drugs are taken directly to the liver for metabolism before reaching the heart and circulating throughout the rest of the body.
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The last step of pharmacokinetics is excretion. Most substances that enter the body are removed by urination. exhalation, defecation, and/or sweating.
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Drugs are normally removed from the body by the kidneys. the respiratory tract, bile, or glandular activity.
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The main organ of excretion is the kidney.
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Drugs that are easily changed into a gaseous form are especially suited for excretion by the respiratory system. The rate of respiratory excretion is dependent on the many factors that affect gas exchange, including diffusion, gas solubility, and blood flow. The greater the blood flow into lung capillaries, the greater the excretion.
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enterohepatic recirculation. Recirculating drugs are then metabolized by the liver and excreted by the kidneys. The fraction of drug that is not recirculated continues on its way to the feces. Elimination of drugs through bile may continue for several weeks after therapy has stopped and results in prolonged drug action.
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In the process of enterohepatic recirculation, bile is circulated back to the liver, where contained drugs are metabolized and then excreted by the kidneys. Elimination of drugs through the bile may result in prolonged drug action.
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In general, metabolic enzyme activity is reduced in very young and in elderly patients. Therefore, pediatric and geriatric patients are usually more sensitive to medications than are other patients. Drug doses to the youngest and oldest age groups are often reduced to compensate for these differences.
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Elimination, which is another term for excretion, is often measured so that dosages of drugs can be determined more accurately.
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The term rate of elimination refers to the amount of drug removed per unit of time from the body by normal physiologic processes.
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The rate of elimination is helpful in determining how long a particular drug will remain in the bloodstream and is thus an indicator of how long a drug will produce its effect
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The half-life of a drug is a related measurement used to ensure that maximum therapeutic dosages are administered.
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Half-life is the length of time required for a drug's concentration in the plasma to decrease by one half. It is an indicator of how long a drug will produce its effect in the body.
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The larger the half-life value, the longer it takes for a drug to be eliminated. For example, a drug with a half-life of 10 hours will take longer to be eliminated from the body than a drug with a half- life of 5 hours. Drugs with longer ha lf- lives may be given less frequently-for example, once per day.
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When a patient has a renal or hepatic disease, the plasma half-life of a drug increases. This reflects the important relationship of half-life to metabol ism and excretion. Some drugs have a half-life of just a few minutes, whereas others have a half-life of several hours or days.
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Successful pharmacotherapy depends on these variables as well as how effectively the body responds to drugs at specific target locations. This leads to another important core area of pharmacology: the field of pharmacodynamics.
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Pharmacodynamics deals with the mechanisms of drug action, or how the drug exerts its effects. As the root words suggest, drugs have a powerful influence on body processes.
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The receptor theory is a classic theory referring to the cellular mechanism by which most drugs can change body processes. A receptor is any structural component of a cell to which a drug binds in a dose- related manner.The drug or natural body substance attaches to its receptor much like a lock a nd key
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The terms agonist and antagonist are often used to describe drug action at the receptor level.
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Agonists are drugs capable of binding with receptors and causing a cellular response; these are facilitators of cellular action. When they are present in the bloodstream, agonists cause the tissue to respond, resulting in a therapeutic action.
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Antagonists are drugs that inhibit or block the responses of agonists. Antagonists are called blockers.
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Potency refers to a drug's strength at a certain concentration or dose...
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If drug A has a higher potency than drug B, it means that drug A will produce a more intense effect than drug B if both drugs are given at the same dose.
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B)false

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A higher potency also means that a much smaller dose of the medication will be needed to produce the same effect as another drug.
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Efficacy refers to the ability of a drug to produce a more intense response as its concentration is increased.
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B)false

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Patients with liver disorders would most likely have problems with which pharmacokinetic phase?
A)Absorption
B)Distribution
C)Metabolism
D)Excretion

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The patient asks the nurse why she must take her medication twice a day instead of just once. The nurse's best response would be:

1.Taking it once a day is fine as long as it is taken at the same time every day."
2. " Taking the medication twice a day ensures that maxi- mum concentrations are ma inta ined within the body."

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Which of the fo llowing princ iples is true?
I. For a drug to be e ffective, it must be potent.
2. For drug efficacy to occur, a lower dose must be admi n- istered.
3. Antagonists bind to receptors and prod uce responses to block agon ists.
4 . The drug-receptor interaction must occ ur at its target tissue.

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Drugs that bind with a receptor to produce a therapeutic response are called:
I. Antagonists
2. Facilitators
3. Blocker
4. Agonists.

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If a pati ent takes a medication on a full stomach, the nurse is aware that the medication will be:
I. Absorbed more rapidly
2. Absorbed more slowly
3. NeUlralized by gastric enzymes
4. Activated by gastric enzymes

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Potency relates to the concentration or amount of drug required to produce a maximum response.
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B)false

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Efficacy refers to how great the maximal response of a drug will be
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B)false

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Which of the following factors does not influence the effectiveness of drug therapy?

1.Temperature
2. Food-drug interactions
3.Route of administration
4.Time of administration with in the day

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An antibiotic has been ordered for the brain abscess. The nurse understands that:

1.Antibiotics are not effective to treat brain abscesses.
2. Only fat-soluble substances will pass the blood-brain barrier.
3. The half- life of the antibiotic will be decreased.
4. The intestinal tract will prevent absorption from occurring.

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When orally admini stered drugs are extensively metabolized by the liver, with only part of the drug close reach ing target organs, this is known as:

1.Half- life
2.Potency
3.First-pass effect
4.Rate of elimination

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Which of these drugs inhibit cell function by preventing other d rugs from binding with receptor sites and blocking cellular response?
1.Agonists
2.Antagonists
3.Facilitators
4.Anesthetics

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Drug dosing in pediatric and elderly patients is most often decreased due to:

1.Reduced metabolic enzyme activity 2.Enhanced metabolic enzyme activity 3.Decreased metabolic kidney function 4.Increased metabolic kidney function

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