Week Two

Question 1

the movement of how a drug moves throughout the body

Answer 1

pharmacokinetics

Question 2

what are the two main points regarding pharmacokinetics

Answer 2

• trying to achieve maximum benefit of medication without causing harm
• intensity of medication

Question 3

what questions should come to mind when dealing with pharmacokinetics

Answer 3

how does drug get into body and where does it go?
what does the body do with the drug?
how does the body get rid of the drug

Question 4

what is the process of pharmacokinetics through the body

Answer 4

absorption
distribution
metabolism
excretion

Question 5

going into blood stream=

Answer 5

absorption

Question 6

going to tissue and cells=

Answer 6

distribution

Question 7

metabolized in liver by enzymes=

Answer 7

metabolism

Question 8

taken out of the body=

Answer 8

excretion

Question 9

what is determined with the process of pharmacokinetics in the body

Answer 9

intensity of the drug to its intended site of action

Question 10

what is the objective of pharmacokinetics

Answer 10

we want the highest level of intensity to create maximum benefit without harm

Question 11

what is the biggest organs to excrete medication

Answer 11

through kidneys, bowel and air we breathe

Question 12

what are the three passages of drugs across membranes

Answer 12

• channels and pores
• transport system
• direct penetration of the membrane

Question 13

what is the definition of transport system

Answer 13

one side of cell membrane to the other

Question 14

what is one of the larger transports and multi drug transporter protein,

Answer 14

P-glycoprotein

Question 15

what 5 places is the P-glycoprotein found in

Answer 15

• liver
• kidney
• intestines
• placenta
• capillaries of brain

Question 16

why is P-glycoprotein important for excretion

Answer 16

because it reduces chance of toxicity in medication

Question 17

movement of drug from site of administration into the blood

Answer 17

absorption

Question 18

what does the medication have to do in order to be absorbed

Answer 18

dissolved

Question 19

what factors can affect process of absorption

Answer 19

• rates of dissolve and absorption
• surface area
• blood flow
• lipid solubility
• pH levels

Question 20

the _______ the surface area the _______ medication can be absorbed

Answer 20

larger;faster

Question 21

what are most drugs

Answer 21

lipid soluble

Question 22

what routes can affect drug absorption

Answer 22

IV, IM, Oral

Question 23

what are the advantages/barriers of IV route

Answer 23

advantage: directly into blood stream
barrier: no barrier, absorption is immediate

Question 24

what are the advantages/barriers of IM route

Answer 24

advantage: food for poorly soluble medication, deposited into certain parts of body
barrier: capillary walls and muscle are, won’t get to the body as fast as IV

Question 25

what are the advantages/barriers of oral route

Answer 25

advantages: simple to administer, convenient, less expensive, pt compliance barrier: stomach, intestines, competing with other meds

Question 26

what is the fastest route to get meds where needed

Answer 26

IV

Question 27

drug distribution is determined by what 3 factors

Answer 27

- blood flow to tissues - exiting the vascular system - entering the cells

Question 28

for best distribution process what does the meds need

Answer 28

need to be lipid soluble and need transport system

Question 29

when is medication delayed

Answer 29

when having to get through blockage such as a tumor

Question 30

what drugs can cross the blood brain barrier (BBB) to a significant degree

Answer 30

drugs that are lipid soluble or have a transport system

Question 31

why is BBB important

Answer 31

this protects brain from medications

Question 32

what is the mixed blessing of BBB

Answer 32

protects brain from toxic substances but also blocks certain meds needing to treat CNS disorders

Question 33

where is BBB not really developed

Answer 33

at birth

Question 34

what are characteristics of placenta membranes

Answer 34

- lipid soluble meds pass readily | - P-glycoprotein bound meds are largely excluded

Question 35

what are the risks with placenta drug factors

Answer 35

could cause defects, dependency and respiratory issues in baby

Question 36

if mother needs surgery or given meds such as analgesic what are the risk factors in baby

Answer 36

respiratory depression

Question 37

membranes of the placenta ___ ____ constitute an absolute barrier to the passage of drugs

Answer 37

do NOT

Question 38

plasma albumin is _______ and important for drugs to _____ to

Answer 38

abundant; bind

Question 39

why is it important for drugs to bind to albumin

Answer 39

since it is so large it remains in blood stream and plays role in healing

Question 40

how does albumin impact drug distribution

Answer 40

doesn't allow certain meds to reach intended site, cause for drug interaction because it is so big

Question 41

what happens when binding sites compete for drug distribution

Answer 41

intensity is increased then patient can become toxic

Question 42

what helps with drug metabolism

Answer 42

enzymes

Question 43

where does metabolism take place

Answer 43

liver

Question 44

what can enzymes activate

Answer 44

prodrug= medication that remains inactive until it has been affected by metabolism of one of these enzymes

Question 45

what are the special factors/considerations in drug metabolism

Answer 45

age first-pass effect nutritional status competing between drugs

Question 46

drugs and their metabolites can exit (excrete) the body through

Answer 46

- bile - urine/feces - sweat/saliva - breast milk - expired air

Question 47

what is the most important organ typically involved with excretion

Answer 47

kidneys and liver

Question 48

what is the importance of plasma drug levels

Answer 48

make sure that there is a correlation between therapeutic level and toxic level

Question 49

what are the two important levels of time course of drug responses

Answer 49

- MEC=drug level that falls below level of therapeutic action - Toxic concentration

Question 50

what is the therapeutic range purpose

Answer 50

make sure medication doing what its supposed to and is it given at a safe level

Question 51

what is drug half life

Answer 51

time required for amount of drug in body to be decreased by 50% (important because determines drug dosing interval)

Question 52

build up in body of repetitive dose

Answer 52

plateau

Question 53

how many days does it take to achieve plateau

Answer 53

5

Question 54

medication at its highest level in the body

Answer 54

peak (1-2 hrs after last dose)

Question 55

trough is right before the next dose is _____

Answer 55

scheduled (30 minutes)

Question 56

loading is when

Answer 56

prescriber tells you to start off with 2 medications or more at one time and then take less the next day

Question 57

when finished with medication why is it important to know the outcome

Answer 57

know results and how long the medication is going to last and what is equally important is what meds have been discontinued

Question 58

drugs typically take how long to leave the body

Answer 58

4-5 days

Question 59

study of what drugs do to the body and how they do it

Answer 59

pharmacodynamics

Question 60

what is the dose response relationship in pharmacodynamics

Answer 60

relationship between the size of the dose and intensity of the response produced determines relative potency and is minimum amount of drug needed to illicit drug response

Question 61

in pharmacodynamics we want maximal efficacy which is

Answer 61

maximum response at the smallest dose

Question 62

measures drug safety by using lab animals, the ratio of the drugs legal dose to its effective dose tested on lab rats

Answer 62

therapeutic index

Question 63

highest dose of therapeutic index=

Answer 63

safer the drug is

Question 64

smaller dose of therapeutic index=

Answer 64

less safe the drug is

Question 65

when patient takes more than one drug there will be some sort of interaction

Answer 65

drug-drug interaction

Question 66

consequences of drug-drug interactions

Answer 66

it can potentiate (increase therapeutic effect) or increase adverse effect or reduce adverse effects or therapeutic effects

Question 67

what is the drug to drug unique response

Answer 67

two drugs creates something that would not be seen if given individually

Question 68

who is at greater risk of drug to drug interactions

Answer 68

young, old, kidney and liver failure, multiple medications, pregnant women, chronic illnesses

Question 69

ways to minimize drug-drug interaction

Answer 69

knowing history ask about drug history and what is being taken be aware of the possible of toxicity adjust timing because it can affect with food monitor for early signs of narrow therapeutic index

Question 70

what juice greatly inhibits metabolism of certain drugs by raising blood level which makes pt toxic

Answer 70

grapefruit juice

Question 71

who long can grapefruit stay in persons system

Answer 71

3 days since last dose