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Pharm Damelio
Pharm ppt Damelio
| Question | Answer |
|---|---|
| Define pharmacokinetics | Focuses on what the body does to drugs after they are administered |
| Define pharmacodynamics | How the drug affects the body |
| Pharmaco means ____________ | medicines |
| Kinetics means ____________ | movement |
| 2 broad classifications of drugs | 1. therapeutic 2. pharmacologic |
| Therapeutic describes_____________ | what is being treated by the drug (WHAT). Often uses the prefix anti. I.E. anti-coagulant |
| pharmacologic classification describes _______ | how the drug acts (HOW) lowers plasma volume - diuretic |
| prototype drug | drug is the agent to which all other drugs in that class are compared. |
| chemical names are assigned using | standard nomenclature. Sometimes called by part of their nomen such as Xanax |
| generic names | assigned by Unites States Adopted Name Council |
| trade names are assigned by ______ | the originating pharmaceutical company |
| typical length of exclusivity is ____ | 5 years. Orphan drugs get 7 years. |
| combination drugs | drugs with more than one active generic ingredient. |
| appropriate way to refer to drug.... | generic name in lower case first followed by the trade name in parentheses with the first letter capitalized. i.e. alprazolam (Xanax) |
| Bioavailability | rate and extent to which the active ingredient is absorbed and becomes available at the site of drug action to produce its effect. |
| 4 Barriers a drug must cross before interacting with target cell. Starting from the Stomach --> | --> Portal Vein--> Liver--> Systemic Circulation--> Target Tissue--> Target Cell |
| 3 Factors that affect crossing the plasma membrane | Size, Lipid solubility, & Ionization |
| Molecules that can cross the plasma membrane are ________ in size, have ___________ electrical charge, and are ___________philic. | small, no, lipid |
| The process of moving a drug from the site of administration to the bloodstream is called | Absorption |
| 3 types of drugs that do not have to be absorbed are | Intravenous, some GI anti-infectives, and some radiological contrast medias |
| 5 factors affecting absorption | Blood flow, acids absorbed in acids, bases absorbed in bases, drig interactions and surface area |
| _________________ describes how drugs are transported throughout the body | Distribution |
| Blood flow to tissues Drug solubility Tissue storage Drug protein binding | Factors affecting distribution |
| Blood brain barrier is least developed in ____________. When BBB is inflamed, ______________ is increased. The BBB does not contain __________ which helps it to protect the brain against _____________ and ___________. | Neonates. permeability pores pathogens and toxins |
| ______________ is a process that takes place in the _______________ where it converts the drug into a more water soluable form for the kidneys | Metabolism Liver |
| This particular enzyme is responsible for breaking drugs down into smaller molecules accelerating its metabolism and drug to drug interactions. | CYP Enzyme |
| The life of a drug (4 phases) | Absorption, Distribution, Metabolism, & Excretion |
| Name 6 barriers the drug must pass before it hits the site | 1.Portal Vein 2.Liver 3.Systematic Circulation 4.Target tissue 5.Target cell 6.Nucleus |
| How do drugs cross over the membranes to reach their target cells? | 1. diffusion 2.Active transport |
| What is parenteral administration? | Injections (actually, it means not orally or topically. Shots are the most common) |
| Most dangerous route of drugs? | IV. Enters bloodstream immediately. |
| 4 processes of pharmokinetics | 1. Absorption 2.Distribution 3.metabolism 4.excretion. |
| what is simple diffusion? | passive transport. Moving from a higher to a lower concentration. |
| Can all drugs diffuse easily? Why not? | No. Drugs that have large molecules, ionized drugs, or water soluble agents have a hard time getting across the membrane. They then have to use carriers or transport proteins. |
| What is facilitated diffusion? | Moving into a cell along it's concentration gradient, utilizing a membrane carrier protein. No energy required. But requires specific carriers. |
| What is active transport? | When drugs cross against the gradient. Requires energy. Carrier proteins are sometimes called pumps. |
| What is absorption? | Absorption is the process of moving a drug from the site of administration to the bloodstream |
| Are all drugs absorbed? | Most drugs must be absorbed, except: Intravenous or intra-arterial Some GI anti-infectives Some radiologic contrast medias |
| Factors Affecting Absorption | Oral meds must undergo dissolution Topical drugs can have slow or rapid absorption. Blood flow to site. Drug concentration/dose Physical and chemical condition of GI tract Motility Presence of food/fat in stomach |
| Acid/Base considerations for absorption | Acids absorbed in acids, bases in bases. |
| Distribution | Distribution describes how drugs are transported throughout the body |
| Factors affecting Distribution | Blood flow to tissues - Drug solubility - tissue storage - drug protein binding |
| Process that removes drugs from the body | Excretion |
| Drug-protein binding | These molecules are too large to cross. Drug is not available as long as it is trapped (bound).Drugs & other chemicals compete for these pr.binding sites. |
| Many drugs can enter the _______ ______ with ease | interstitial fluid |
| Blood-brain barrier | The brain has endothelial cells that are not loosely knit. They are tight junctions and present an anatomic barrier to drugs. crossing over. |
| Describe fetal-placental barrier | Not that effective. Lots can cross over. |
| What type of drugs can cross the blood-brain barrier? | lipid soluble drugs. Inflammation can increase permeability. |
| BBB | Blood brain barrier – BBB Does not contain pores Protects brain from pathogens and toxins Lipid soluble drugs able to cross Not fully developed in neonates Inflammation can increase permeability |
| Metabolism | Metabolism is a process that changes the activity of a drug and makes it more likely to be excreted |
| Metabolism Phase | Chemical changes which change drug molecules Primary site is liver Changes to drug structure allow for excretion Functional changes alter pharmacological activity Metabolites may be more toxic |
| Drug excretion is dependent upon _____________. | Urine pH. Acid absorbs acid so acid excretes base. Now there is some critical thinking for you.... |
| The rate of excretion determines ________ _______ ___________. | drug blood level |
| The therapeutic response of most drugs depends on their concentration in the plasma | Time- response Relationships |
| The goal of the nurse is to keep patient in the range where the drug produces its desired effect. | Therapeutic Range |
| estimates the duration of action for most medications | Drug Half-life |
| The __________ dose is given to "prime" bloodstream whereas the __________ dose is given to keep the concentration in the therapeutic range. | Loading maintenence |
| Primary site of metabolism | liver |
| Metabolite | The result of a drug being metabolized. Some are highly toxic (i.e.Tylenol) |
| Prodrugs | These are professional drugs. But I digress. These are drugs that don't have effect until they are metabolized. |
| Most metabolism in the liver is accomplished by ____ system | P-450 system (CYP). This system is an enzyme complex.(the Hepatic microsomal enzyme system) |
| Hepatic microsomal enzyme system | accomplishes most metabolism in the liver. Fondly known as the P450 (CYP) |
| isozymes | over 30 different forms of the CYP. Very important because they determine the speed at which a drug is metabolized |
| CYP contributes largely to _____ | drug-drug interactions |
| 3 major consequences of the CYP system that impact pharmacotherapy | Drugs as substrates /Drugs as enzyme inhibitors/ Drugs as enzyme inducers |
| Drug substrates | Drugs metabolized by a CYP enzyme |
| Drug enzyme inhibitors | drug inhibits action of the CYP isoenzymes; can contribute to toxic drug levels |
| Enzyme inducers | Accelerate metabolism of specific isoenzymes; drug level may decrease more rapidly. |
| First Pass Effect | Almost all drugs go through the hepatic portal and through the liver. A large # of drugs are rendered inactive by the hepatic metabolic reactions. |
| How can you use drugs that are destroyed by the hepatic enzymes? | Drugs that bypass the first pass effect: sublingual, rectal, parenteral, buccal. |
| What other factors affect metabolism of drugs? | 1.Individual variations 2.infants lack some enzymes 3. Enzyme activity reduced in elderly. 4.lowered metabolism with liver damage 5. Genetic variations of CYP enzymes. |
| Excretion Phase; Primary site | Kidney. |
| What determines drug blood levels? | Rate of excretion. Some drugs undergo reabsorption after renal filtration. |
| Drug excretion is dependent on _____ ____ | Urine ph. You can manipulate ph of kidney filtrate to retain drug. |
| If a patient has renal impairment, what does that indicate a need for? | Dose reduction |
| Other sites of excretion | Pulmonary/ glandular |
| Notes on pulmonary excretion | Pulmonary Gases and volatile liquids Most excreted unmetabolized Respiratory rate and blood flow affect excretion |
| Glandular excretion | Glandular Saliva, sweat, breast milk Taste and smell some drugs Excretion of some drugs in breast milk |
| Fecal and Biliary Excretion | Bile recirculated via enterohepatic path Prolongs drug activity |
| Minimum effective concentration | amount of drug required to produce a therapeutic effect. |
| Therapeutic range | The range where the drug produces its desired effect. After peaking, drug plasma level falls due to excretion. |
| Toxic concentration | level of drug that results in serious adverse effects. Goal is to keep drug within therapeutic range. |
| Drug 1/2 life | Presence in plasma is reduced by 50%. Approx. 4 half lives until excretion. |
| How do you reach a plateau drug plasma level? | Repeated dosing. |
| Drug Dosing | Multiple dosing results in drug accumulation Peak and trough levels Loading dose:Higher amount given to “prime” bloodstream Maintenance dose Keep concentration within therapeutic range |
Created by:
Marshall3
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