Pharmacokinetics( Week 2)

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week 2
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1

what is biotransformation?

metabolism

2

pharmacokinetics involves the study of these 4 things:

absorption, distribution, metabolism, excretion

3

this is where a larger amount of a drug is given to reach effects more quickly, then is given at a maintenance dose at following doses.

loading dose

4

this is the amount of drug needed to cause a therapeutic effect:

critical concentration

5

this is the actual concentration of a drug that reaches the body and results from this:

dynamic equilibrium

6

absorption from the liver,

distribution to active site,

biotransformation in the liver,

excretion from the body are all components of this:

dynamic equilibrium

7

this is the process that occurs from the time the drug enters the body to the time it enters the bloodstream to be circulated:

absorption

8

the onset of action during absorption is determined these 5 things:

dosage form,

route of administration,

blood flow to the site of administration,

GI function,

Presence of food or other drugs

9

These class drugs are virtually 100% bioavailable:

schedule IV

10

Distribution is this by definition:

movement of a drug to the body

11

distribution of a drug is largely dependant on this:

the adequacy of blood circulation

12

protein binding is when when:

drug molecules that bind to plasma proteins are pharmacologically inactive.

13

only ____ or ___ portion of the drug acts on body cells:

free or unbound

14

protein binding allows for part of the drug to be used now, and part to be:

stored and released as needed

15

what does the blood brain barrier do?

limits distribution of drugs to the CNS

16

Is the blood brain barrier selectively permeable?

yes

17

only these drugs can cross the blood brain barrier to achieve therapeutic concentrations in the brain:

lipid soluble drugs or drugs with a transport system

18

What is biotransformation/ metabolism?

method by which drugs are inactivated by the body

19

this is initially inactive and exert no pharmacologic effect until metabolized:

a prodrug

20

kidneys olny excrete ____ soluble drugs

water

21

this organ converts lipid soluble drugs into water soluble drugs so that the kidneys can excrete them:

liver

22

this influences the metabolism by producing different responses to drugs in ethnic groups or specific individuals:

genetic polymorphisms

23

this is and enzyme produced in the liver to metabolize drugs

cytochrome P450

24

What is first pass effect?

when drugs are given orally and are absorbed by the GI tract and carried directly to the liver where some metabolizing occurs, causing only part of the dose to reach systemic circulation and decreases bioavailability to the body

25

define excretion:

the elimination of a drug from the body

26

name 4 ways the body excretes drugs:

through skin, bowels, kidneys, lungs

27

drugs/ metabolites that are excreted in bile, reabsorbed in the small intestine and returned to the liver for further metabolism and excretion in urine is called this:

enterohepatic circulation

28

true or false.... some drugs given orally are never absorbed and go right to excretion:

true

29

this disease leads to the accumulation of numerous drugs and can cause severe adverse effects of dose is not reduced:

severe kidney disease

30

serums half life is also called:

elimination half life

31

serum half life is sefined as:

time required for serum concentration of a drug to decrease by 50%; determined by rates of metabolism and excretion

32

with a short half life, drugs need to be administered...

more frequently.

33

the amount of drug given must be equal to the amount eliminated. when dose is changed it will take an additional 4-5 half lives to reestablish equilibrium. this is called:

steady- state conditions

34

what is a serum drug level:

measurement of the amount of drug in the body at a specific time

35

this is when enough drug is present to exert its pharmacologic action on body cells:

MEC ( minimum effective concentration)

36

serum drug level and testing is especially useful when dealing with these drugs:

drugs with a narrow margin of safety

37

do most drugs like being taken with food? why?

no, because digestion of food often delays absorption and alters GI secretions and motility

38

treatment for warfarin is:

vitamin K

39

tyramine causes reaction with:

MAOI

40

do not take tetracyclines with ___, as it binds together into a non-absorbable compund

dairy

41

this food inhibits the metabolism of drugs normally by a certain enzyme:

grapefruit

42

this drug-drug interaction increases effects; occurs when 2 drugs with similar pharmacological actions are taken

additive effect

43

this drug- drug effect increases effects; 2 drugs with different sites/ mechanisms of action produce greater effects when taken together

synergism

44

this drug-drug interaction is where one drug causes the other drug to have intensified effects [such as cimetidine and benzodiazepine]

inference

45

this drug- drug interaction is where one drug pushes off the protein to cause increased effects of the displaced drug:

displacement

46

this drug-drug interaction decreases effects, is given to antagonize the toxic effect of another drug:

antidote drug

47

this drug-drug interaction decreases effect by the drug combining to make nonabsorbable compounds

decreased intestinal absorption

48

this drug-drug interaction increases metabolism causing a decreased effect:

activation of a drug metabolizing enzymes in the liver

49

these 5 variables are things can affect drugs and how well they work:

age, weight, genetics, gender, pregnancy

50

what is a psychological variable when it comes to drugs and how well they work for someone?

placebo response

51

why are infants at an increased risk for toxicity?

low plasma protein levels during first year of life

52

why are there so many variables to consider when giving infants/ young children drugs?

constant change and flux of immune system, total body water, fat stores, protein levels

53

absorption in particular is effected by 5 things:

1. age

2. gastric emptying

3. intestinal motility

4. route of admin

5. skin permeability

54

in pediatrics, distribution is affected depending on 3 things:

percent of body water, degree of protein binding, development of BBB

55

in pediatrics, metabolism is affected by this in the liver:

CYP450 enzyme

56

elimination is affected by this in pediatrics:

immature kidneys, a reduced GFR, and slower renal clearance

57

What is Beers Criteria?

dr. mark beers list of potentially inappropriate meds used by older adult population in 1997 ex. cimetidine causes confusion and others cause renal toxicity

58

this elevated blood value indicates that an older person is already at risk for renal/ drug toxicity

creatinine

59

cross tolerance is different to regular tolerance how?

cross tolerance is when the patient grows tolerant of pharmacologically related drugs. also creates issues such as alcoholics needing more anesthetics and sedatives

60

when therapeutic effect is not being seen with oral drug, what should the nurse consider why?

blood flow to muscle beds, food altering make up in gastric juices, weight of patient, temperature of peripheral environment

61

this is an adverse effect:

refers to any undesired response to drug administration

62

give a primary adverse affect:

simple overdose of desired effect

63

give a secondary adverse effect:

other effect in addition to desired drug effect, sometimes unavoidable [ex. antibiotics causing diarrhea

64

give an example of hypersensitivity adverse effect:

exaggerated adverse effect, sometimes due to underlying condition

65

give an example of adverse effect effect via drug allergy:

anaphylactic response, ex person allergic to amoxicillin

66

when giving atropine like drugs [anticholinergics] watch for these:

dry mouth, altered taste, and urinary retention

67

WHAT IS TERATOGENICITY?

many drugs reach the developing fetus and can cause damage or death