Pharmacology - Week 1 - Introduction

Front 1

What are significant American Drug Laws?

Back 1

1, 1938 - Food, Drug, & cosmetic act = manufacture, distribution, labeling, advertising regulated by FDA. first set of standards of purity and strength.

2. 1952 - Durham Humphrey Amendment - some drugs must have a prescription. FDA enforces drug laws.

3. 1970 - Controlled Substances act - Narcotics have special regulations. DEA enforces laws for narcotics and other drugs that are abused.

Front 2

Differentiate between different areas of pharmacology.

Back 2

pharmaceutics = how dosage form affects rate and body. ie IV and IM faster that enteral.

pharmacokinetics - movement and metabolism of drug throughout body.

pharmacodynamics - how drug effects body

Front 3

What are the stages of pharmacokinetics?

Back 3

1. absorption = administration site to circulation

2. distribution = circulation to tissues

3. metabolism = biotransformation and breakdown

4. excretion

Front 4

Which routes of administration evades the first pass effect?

Back 4

IV - obvi

sublingual - bypassess gastric absorption

transdermal

Front 5

What is the first pass effect?

Back 5

usually, drugs entering the enteral route first encounters the liver before circ. - may reduce bioavailability

Front 6

What are the 5 rights of medication administration?

Back 6

drug
dose
time
route
patient

Front 7

What affects the distribution of drugs?

Back 7

distribution = systemic --> tissues

circulation
blood brain barrier
plasma protein binding
drug-drug interactions

Front 8

What role does circulation have in the distribution of drugs?

Back 8

places with high perfusion receive drug first - heart, kidneys, liver, brain

muscle, skin, fat is slower

Front 9

How might peripheral vasc or cardiovasc disease affect the effect of drugs?

Back 9

may cause disruption in circulation, thus affecting distribution of the drug ( to tissues)

Front 10

What kind of drugs can cross the blood brain barrier?

Back 10

lipid soluble drugs

Front 11

How do drugs travel throughout the circ system?

Back 11

mostly through binding to albumin

Front 12

What is the benefit to plasma-protein binding?

Back 12

only unbound drugs freely distribute to tissues.

albumin binding allows control over concentrations of free drugs in blood, thus avoiding toxicity.

Front 13

Why might two drugs cause antagonistic effects? how does that effect drug levels?

Back 13

competition for albumin. increases drug levels in blood.

Front 14

what is the metabolism of drugs called?

Back 14

biotransformation

Front 15

What are the effects of a decreased liver function for a person taking medication?

Back 15

accumulation of med and toxicity

Front 16

what are prodrugs? what are benefits?

Back 16

the inactive chemical form of drugs before it is metabolized and activated in the body.

increases selectivity for areas of action. (frequently used in chemotherapy)

Front 17

What effects the rate of metabolism of drugs?

Back 17

1. First pass effect
2. age - hepatic decline
3. Cytochrome P450 - enzyme
4. nutrtion - malnutrition -> impaired metabolism

Front 18

what is enzyme induction and enzyme inhibition?

Back 18

refers to cytochrome P450 enzymes

e. induction - a drug induces production of P450, inc metabolism, need higher doses for therapeutic effect

e. inhibition - often 2 drugs competing for p450. drug delays metabolism of drug, inc risk for accumulation and toxicity

Front 19

Where does the body excrete drugs?

Back 19

primarily kidneys, but also liver and bowel

Front 20

How can the effect of a drug be controlled?

Back 20

By monitoring and regulating serum drug levels

Front 21

what is minimum effective concentration?

Back 21

lowest therapeutic level of th drug

Front 22

What is the lowest therapeutic level of a drug called?

Back 22

minimum effective concentration

Front 23

What is the serum half life?

Back 23

= amt of TIME that it takes for serum drug concentration to decrease by 50%

Front 24

What is a "steady state"?

Back 24

= when absorption = excretion

Front 25

How long does it usually take for any drug to be effectively removed from the body?

Back 25

5 half lives

Front 26

how long does it take for a drug to achieve a steady state?

Back 26

after 4-5 half lives

Front 27

amt of time for drug to produce a therapeutic effect is called the?

Back 27

onset of action

Front 28

amt of time drug achieves maximum therapeutic response is called the

Back 28

peak effect

Front 29

the duration of action of a drug refers to

Back 29

length of time that a drug concentration produces a therapeutic effect

Front 30

What are the highest and lowest concentrations of drugs called? why are they measured?

Back 30

peak and trough

avoid toxicity, maximize therapeutic effects

Front 31

the mechanism of action of a drug refers to

Back 31

specific mechanism on which a drug affects the target cell

Front 32

What are different types of mechanisms of action a drug has?

Back 32

mech of action = affect on a target cell

can only enhance, or inhibit an already existing action of a cell

CANNOT produce a function not already in cell

Front 33

Differentiate the following:

agonist
antagonist
partial antagonist
agonist - antagonist

Back 33

these terms refer to action on cell receptors

agonists - produce response of receptor

antagonist - inhibits response of receptor

partial antag = agon-antag ==> produces response, but blocks another

Front 34

antagonist has multiple meanings in reference to different things. what are they?

Back 34

antagonist - a drug that inhibits response of receptor

antagonsit - relatinoship btwn drugs that decreases response of the other (sum of parts is less than whole)

Front 35

What are the different types of pharmacotherapy?

Back 35

acute
palliative

maintenance - prevent symp of chronic illnesses
suplementary - maintains normal function
supportive - maintain body while its recovering

Front 36

What is the problem with grapefruit juice and some drugs?

Back 36

a drug-diet interaction

grapefurit juice inhibits the metabolism of drugs that are metabolized by CYP-3A4

Front 37

Name kinds of drug-drug interactions

Back 37

additive effect - two similar drugs produce same effect

synergistic - two drugs, same effect, different mechanism - total effect is greater than sum of parts

antagonistic -total effect is less than sum of parts - (compeition)

incompatibility - chemical detioration - ppt produced, cloudy

Front 38

What does it mean when a drug has a black box warning?

Back 38

drug may have serious or deadly adverse effects

Front 39

What trimester is the fetus most vulnerable to teratogens?

Back 39

1st trimester

Front 40

What vaccinations are contraindicated for preganant women?

Back 40

live virus vaccines - mumps, measles, polio

Front 41

Can a mother take medication while breastfeeding?

Back 41

although medications are secreated in breastmilk, concentrations are usually too low to have effect

however, precautions can be taken, such as waiting to take meds after feeding