Pharm Test 1, Note Set 1

Front 1

Controlled Substances Act

Back 1

Restricts Rx refills
Track Rx, dispensing, purchase of listed substances
Substances listed by abuse potential I-V

Front 2

Schedule I

Back 2

High abuse potential, no med use approved

Front 3

Schedule II

Back 3

Written Rx ONLY, no refills (most opiods)
Locked in cabinets and "signed out" by LN; period counts to keep track of use; document and witness if wasted

Front 4

Schedule III/IV

Back 4

Oral/written Rx, refill X5 w/in 6 mo.
Locked in cabinets and "signed out" by LN; period counts to keep track of use; document and witness if wasted

Front 5

Schedule V

Back 5

dispensed w/o pharm Rx to adults w/ signature and address; may be limited by state law

Front 6

Pharmodynamics

Back 6

Study of biochemical/physiologic effects of drugs and their mechanisms of action = what the drug does to the body

Front 7

Pharmokinetics

Back 7

Absorption, distribution, biotransformation, and excretion of drugs combined w/ dosage determine concentration of drug at its site of action = intensity of its effects as a function of time

Front 8

Pharmacotherapeutics

Back 8

Use of drugs in the prevention and treatment of disease

Front 9

ADME

Back 9

Absportion, distribution, metabolism, excretion can explain variation among different persons' drug responses

Front 10

Passive diffusion

Back 10

Moves down concentration gradient until concentration is equal; most dominant method of drug transport

Front 11

Facilitated diffusion (carrier-mediated; carriers are selective and saturable)

Back 11

Carrier mediated by no E! required, important for endogenous substances that move at too slow of a rate

Front 12

Active transport

Back 12

Moves w/o regards to concentration gradient, needs E!

Front 13

Factors affecting drug transport

Back 13

Molecule size/shape
Solubulity
Degree of ionization (nonionized = lipid soluble)
Dissolution (pill/powder/liquid)
Circulation to site
Route of administration (IV - inhaled - IM/SQ - SL - oral = topical)

Front 14

First pass effect

Back 14

PO absorbed in small intestine, blood circulates to liver to be metabolized and/or inactivation; therefore PO doses must be higher

Front 15

Liposomes (topical)

Back 15

Spherical shells of fats in aqueous medium that can enhance per cutaneous absorption and penetrate epidermal barriers more efficiently

Front 16

Microgels (topical)

Back 16

Polymers that can enhance solubilization of certain drugs and enhancing penetration w/ less irritant

Front 17

Transfersomes (topical)

Back 17

Highly deformable, ultraflexible lipid vesicles that penetrate the skin when applied nonocclusively; pressure waves from laser radiation can permeabilize the stratum corneum for a system for transdermal drug delivery

Front 18

T/F: other drugs and food do not affect certain drugs

Back 18

F: TCN binds w/ calcium to form insoluble form; can affect bioavailability (amt of active drug in system)

Front 19

Target tissue

Back 19

Tissue the drug is supposed to affect

Front 20

Factors affecting distribution

Back 20

CO and regional blood flow
Drug storage in body tissues (drug has greater affinity to certain tissues)

Front 21

Compartments (drug storage sites)

Back 21

Plasma proteins (albumin)
Neutral body fat
Bone (mainly metals)

Front 22

Redistribution

Back 22

Happens when plasma concentrations drop and storage sites release to maintain concentration gradient (gamma)

Front 23

Blood-brain barrier

Back 23

Most drugs DO NOT cross but lipid-soluble pass more readily
Drugs may be formulated to be absorbed or not in CSF
In meningitis BBB isn't very effective

Front 24

Placenta

Back 24

POOR barrier
40 minutes for drug serum level in mom and baby to equalize
(fetus has poor liver metabolism and fetus is small = greater relative concentrations of drug in fetus)

Front 25

T/F: Drugs are made less lipid soluble

Back 25

T: more soluble in body fluids and therefore more likely to be excreted

Front 26

T/F: All drugs begin as active forms than be come inactive

Back 26

F: some drugs are inactive to active and must be absorbed to do so

Front 27

T/F: All drugs are broken down and excreted

Back 27

F: some drugs are excreted unchanged d/t lack of enzymes, hypersensitive people who don't metabolize as fast

Front 28

Which organ is primary organ of metabolism?

Back 28

Liver; the hepatic microsomal enzymes (nonspecific)

Front 29

Factors affecting metabolism

Back 29

Age (infants don't develop until 1-2, most active until teens, elderly are slower)
Genetics (fast acetylators vs slow; 50% of Caucasians are slow, 2% of NA are slow)
Disease states (especially hepatic)
Other drugs

Front 30

Induced hepatic enzymes:

Back 30

Sped up metabolism

Front 31

Inhibited hepatic enzymes:

Back 31

Slowed metabolism

Front 32

Which organ is the major excretion source?

Back 32

Kidney (some in GI, mammary glands, sweat glands, resp tract); designed to excrete H2O soluble substances b/c it is 25X more permeable than other membranes

Front 33

Tubular reabsorption

Back 33

can manipulate by manipulating urine pH or pH of drug to increase excretion

Front 34

Entero-hepatic recycling

Back 34

Drug is absorbed into bloodstream - through liver - excreted in bile - reabsorbed from GI - into blood
Neo-ionized/lipid soluble are more readily recycled

Front 35

Factors modifying excretion

Back 35

Urine pH
Age
Drug interactions
Renal disease