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52 Cards in this Set

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What are the three principles of pharmacology

1. Pharmaceutic


2. Pharmacokinetic


3. Pharmacodynamic

What is the pharmaceutic phase

- First phase of drug action


- dissolution of drug


- faster dissolution in acid


- slower absorption in alkaline

What is the pharmacokinetic phase and what are the four processes in the correct order

Process of drug movement to achieve drug action


AD.ME


1. Absorption


2. Distribution


3. Metabolism (biotransformation)


4. Excretion (elimination)

What is the absorption step in pharmacokinetic phase

Movement of drug particles from GI system to body fluids by passive and active transport and pinocytosis

What is passive diffusion of absorption in pharmacokinetic phase

Major process through which drugs are absorbed. Greater concentration of drug through membrane to lower concentration. Requires no energy

What is active transport of absorption in pharmacokinetic phase

Process uses energy to actively move molecules across the cell membrane. More common in drug excretion in the kidney than absorption of drug

What is pinocytosis of absorption in pharmacokinetic phase

Engulfing or ingestion of drug into cell by "budding" of cell membrane

What based drug are destroyed in the GI tract by digestive enzymes? What are two examples

Protein based drugs


1. Insulin


2. Growth hormone

What based drug is absorbed faster in the GI track and why

Lipid soluble drugs absorbs faster due to GI membrane being composed of lipids

Water soluble drugs need what to pass through what membrane

Water soluble drugs need a protein or enzyme carrier to pass through the GI membrane

What are some factors that affect absorption of a drug

1. Blood flow circulation


2. Ability of drug to dissolve


3. Route of administration


4. Body surface area


5. Lipid soluble


6. pH

What is the "first past effect" of absorption in pharmacokinetic phase

Phenomenon of drug metabolism whereby the concentration of a drug is greatly reduced by the liver before it reaches the systemic circulation

Taking into account the "first pass effect", what does this imply for oral drug dosing

Dosing for oral drugs can be considerably higher than recommended dose for Parental drugs

What is the bioavailability of absorption in pharmacokinetic phase

The amount of drug that reaches the systemic circulation to be absorption

In bioavailability, what can happen if there is a high availability or low availability of a drug

High availability - can lead to drug toxicity if absorbed fast



Low availability - can lead to less than therapeutic level if absorbed slowly

What is distribution in pharmacokinetic phase

Process where drugs become available to body fluids and body tissues

What influences distribution in pharmacokinetic phase

1. Blood flow


2. Permeability of tissue or membrane


3. Protein binding effect

What is the protein binding effect

When drugs bind to proteins for transportation. However, drug cannot pass through membranes with protein carrier. Drug must break away from protein to be available (free drug).

What issues will prevent a patient to have full success with drug distribution

1. Liver disease


2. Renal disease


3. Malnourished

Why would someone with liver or renal disease or malnourish have an issue with drug distribution

They may cause no or low albumin levels equating to less protein binding sites. This leads to more free-drug and possible drug toxicity

Where is the main site of biotransformation metabolism in pharmacokinetic phase and what does it do

Everything absorbed from GI tract first enters the liver. It detoxifies many chemicals and uses others to produce needed enzymes and structures

What is biotransformation in pharmacokinetic phase

Process by which drugs are changed into new, less active chemicals

What is half-life and where does it mostly occur?

Occuring mostly in the liver, half life is the time it takes for the amount of a drug in the body to decrease to one half the peak level it previously had.

What is the time of a drug that is considered short half-life or long half-life

Short half-life 4 - 8 hours


Long Half-Life 24+ hours

What is the point of knowing a drugs half life

To keep a steady state of the drug in the patient's system

Aspirin has a half life of 3 hours. 650 milligrams of aspirin was given to a patient. What is the life of aspirin after 3 hours?

162.5 mg



650 mg first past


325 mg return into circulation


162.5 mg after 3 hours

Every time drug goes through liver in half itself

What is excretion in pharmacokinetic phase

Removal of a drug from the body

What organ plays the most important role in drug excretion

Kidneys

What are the routes used to excrete drugs

1. Skin


2. Saliva


3. Bile


4. Lungs


5. Feces

What lab should be monitored to see how well a drug is excreted out of the body and why

Creatinine clearance because this is the test to see how well kidneys are performing.

What is pharmacodynamics

Study of drug concentration and its effect on the body

What is the primary effect of pharmacodynamic phase.

Desirable or therapeutic effect.



Ex: Benadryl for allergy,


Digoxin to slow heart rate

What is the secondary effect of pharmacodynamic phase

Desirable or undesirable effect



Ex: Benadryl causes sleepiness,


Digoxin causes diuresis

What is drug maximal efficacy

Amount of drug needed to produce the desired effect. All drugs have a maximal efficacy

In terms of maximal efficacy, what does the onset of a drug tell us

Minimum effective concentration after drug administration

In terms of maximal efficacy, what does the peak of a drug tell us

Highest blood or plasma concentration

In terms of maximal efficacy, what does the duration of a drug tell us

Length of time the drug has pharmacologic effect

What is the receptor site Theory

Receptor sites react with certain chemicals to cause and effect within the cell. In most situations, enzymes break down chemicals and open receptor site for further stimulation



"Right key in right lock"

Explain how agonist interaction with a receptor site on a cell works

Molecules of a drug react with specific receptor sites on cells of organs and change the cell's activity due to better chemical-cell linkage fitment

Explain how antagonist interaction with a receptor site on a cell works

Chemicals either compete for receptor sites on a cell or act on different receptor sites on a cell that inhibits other chemicals to bind to cell receptors

What does the therapeutic index measure

Estimates a drugs margin of safety

What is a low and high therapeutic index indicate

Low therapeutic index = narrow margin of safety, high danger of toxic effect



High therapeutic index = wide margin of safety, low danger of toxic effect

What does the therapeutic window or range measure

Measure drug concentration in the plasma

What should a drugs therapeutic window or range be between to obtain desired drug action

Minimum effective concentration and minimum toxic concentration

Define peak and trough

Peak - highest plasma concentration of a drug have a specific time (blood draw)



Trough - lowest plasma concentration of drug. Measures drug elimination rate

How is peak and trough to be obtained

Blood drawn for peak is right after dose is completed.


Blood drawn for trough is just before dose is to be administered

What is the purpose of peak and trough and what type of drug is it mostly performed on

To achieve therapeutic effect, mostly on antibiotics

Define loading dose

Use of a higher dose than what is usually used for treatment to allow drug to reach therapeutic concentration sooner

Define synergistic

When some drugs are given together to achieve greater effectiveness

What is drug incompatibility

An undesirable reaction between a drug and solution, material (Ex. IV lines), or another drug

What is medication reconciliation

The formal process of obtaining and verifying a complete and accurate list of each patient's current medication. Matching medications that should be prescribed to those that are actually prescribe

Define cumulative effect

Repeated administration of drug may produce effects that are more pronounced than those produced by first dose