Pharma

  1. is the process by which the body inactivates or biotransforms drugs.
    Metabolism, or Biotransformation
  2. Drugs can be metabolized in several organs; however, the_____ is the primary site of metabolism.
    liver
  3. Most drugs are inactivated by_____ and are then converted or transformed by_____ to inactive metabolites or _____
    liver enzymes; hepatic enzymes; water-soluble substances for excretion.
  4. a large percentage of drugs are_____
    lipid soluble
  5. When the drug metabolism rate is decreased, excess drug accumulation can occur and lead to_____
    toxicity
  6. The _____ of a drug is the time it takes for one half of the drug concentration to be eliminated.
    half-life (t 1/2 )
  7. ___&___ affect the half-life of a drug.
    Metabolism and elimination
  8. A drug goes through several half-lives before more than_____ of the drug is eliminated.
    90%
  9. The main route of drug elimination is through the_____
    kidneys (urine)
  10. Other routes for excretion include:
    • ✓Bile
    • ✓Feces
    • ✓Lungs
    • ✓Saliva
    • ✓Sweat
    • ✓breast milk
  11. The_____ filter free unbound drugs, water- soluble drugs, and drugs that are unchanged.
    Kidneys
  12. The kidneys filter?
    • free unbound drugs
    • water- soluble drugs
    • drugs that are unchanged
  13. The____ eliminate volatile drug substances and products metabolized to carbon dioxide (CO2) and water (H2O).
    lungs
  14. The lungs eliminate volatile drug substances and products metabolized to___&___
    carbon dioxide (CO2) and water (H2O)
  15. The_____ influences drug excretion
    urine pH
  16. Urine pH varies from___
    4.5 to 8
  17. ___urine promotes elimination of weak base drugs
    Acidic urine
  18. ___urine promotes elimination of weak acid drugs
    alkaline urine
  19. A decrease in GFR results in an increase in _____and a decrease in___
    serum creatinine level; urine creatinine clearance
  20. ___is a waste product that your kidneys remove from your blood.
    Urea nitrogen
  21. A_____ can help uncover kidney problems at an early stage when treatment can be more effective
    BUN test
  22. Common tests used to determine renal function are___&___
    creatinine clearance (CLcr) and blood urea nitrogen (BUN)
  23. ___is a metabolic by-product of muscle that is excreted by the kidneys.
    Creatinine
  24. The___ compares the level of creatinine in the urine with the level of creatinine in the blood.
    creatinine clearance test
  25. Creatinine clearance varies with___&___
    age and gender
  26. is the study of the way drugs affect the body.
    PHARMACODYNAMIC PHASE
  27. Drug response can cause a?
    primary or secondary physiologic effect or both
  28. An example of a drug with a primary and secondary effect is?
    diphenhydramine (Benadryl), an antihistamine.
  29. The primary effect of diphenhydramine is to?
    treat the symptoms of allergy
  30. the secondary effect of diphenhydramine is a?
    central nervous system depression that causes drowsiness
  31. ___ is the time it takes to reach the minimum effective concentration (MEC) after a drug is administered.
    Onset of action
  32. ___occurs when the drug reaches its highest blood or plasma concentration.
    Peak action
  33. ___is the length of time the drug has a pharmacologic effect.
    Duration of action
  34. Drugs act through receptors by?
    binding to the receptor to produce (initiate) a response or to block (prevent) a response.
  35. The activity of many drugs is determined by the?
    ability of the drug to bind to a specific receptor
  36. Most receptors, which are___ in nature, are found in ___.
    protein; cell membranes
  37. Drug-binding sites are primarily on:
    • ❖Proteins
    • ❖Glycoproteins
    • ❖Proteolipids
    • ❖enzymes
  38. There are four receptor families:
    • a) kinase-linked receptors
    • b) ligand-gated ion channels
    • c) G protein–coupled receptor systems
    • d) nuclear receptors
  39. The ___ is the site on the receptor at which drugs bind.
    ligand-binding domain
  40. The ligand-binding domain for drug binding is on the cell surface. The drug activates the enzyme (inside the cell), and a response is initiated.
    Kinase-linked receptors
  41. The channel spans the cell membrane and, with this type of receptor, the channel opens, allowing for the flow of ions into and out of the cells. The ions are primarily ___&___
    • Ligand-gated ion channels
    • sodium and calcium
  42. There are three components to this receptor response: (1) the receptor, (2) the G protein that binds with guanosine triphosphate (GTP), and (3) the effector that is either an enzyme or an ion channel.
    G protein–coupled receptor systems
  43. There are three components to G protein–coupled receptor systems response:
    • (1) the receptor
    • (2) the G protein that binds with guanosine triphosphate (GTP)
    • (3) the effector that is either an enzyme or an ion channel
  44. Found in the cell nucleus (not on the surface) of the cell membrane. Activation of receptors through the transcription factors is prolonged. first three receptor groups, activation of the receptors is rapid.
    Nuclear receptors
  45. Drugs that produce a response are called
    agonists
  46. Drugs that block a response are called
    antagonists
  47. ___are located in the bladder, heart, blood vessels, stomach, bronchi, and eyes.
    Cholinergic receptors
  48. Drugs that affect various sites are
    nonspecific drugs
  49. Drugs that affect various receptors are
    nonselective drugs
  50. Four Categories of Drug Action
    • Stimulation
    • Replacement
    • Inhibition or killing of organisms
    • Irritation
  51. the rate of cell activity or the secretion from a gland increases
    Stimulation
  52. cell activity and function of a specific organ are reduced
    depression
  53. drugs such as insulin replace essential body compounds
    Replacement
  54. estimates the margin of safety of a drug through the use of a ratio that measures the effective (therapeutic) dose (ED) in 50% of people (ED50) and the lethal dose (LD) in 50% of people (LD50).
    The therapeutic index (TI)
  55. The closer the ratio is to_, the greater the danger of toxicity.
    1
  56. Drugs with a ___ have a wide margin of safety and less danger of producing toxic effects
    high therapeutic index
  57. ___of a drug concentration in plasma is the level of drug between the minimum effective concentration in the plasma for obtaining desired drug action and the minimum toxic concentration (the toxic effect).
    The therapeutic range (therapeutic window)
  58. ___is the highest plasma concentration of drug at a specific time. Peak drug levels indicate the rate of absorption.
    Peak drug level
  59. These indicate the rate of absorption.
    Peak drug levels
  60. If the drug is given orally, the peak time might be ___after drug administration.
    1 to 3 hours
  61. If the drug is given IV, the peak time might occur in?
    10 minutes
  62. ___is the lowest plasma concentration of a drug, and it measures the rate at which the drug is eliminated.
    The trough drug level
  63. ___are drawn immediately before the next dose of drug is given, regardless of route of administration.
    Trough levels
  64. When immediate drug response is desired, a large initial dose, known as the ___, of drug is given to achieve a rapid minimum effective concentration in the plasma.
    loading dose
  65. ___ is the process by which the minimum effective concentration level for digoxin is achieved in the plasma within a short time.
    Digitalization
  66. The therapeutic goal is achieved. The drug does what is supposed to do.
    Desired Effect
  67. Are mild but annoying response to medication. Ex nausea and drowsiness.
    Side Effect
  68. Are more severe symptoms or problems that arise because of the medication. Ex gastric bleeding or edema
    Adverse Effect
  69. Are strange, unique, or unpredicted reactions. Ex blood in the urine a rare case for taking aspirin.
    Idiosyncratic Response
  70. Are reactions that are opposite of what would be expected.
    Paradoxical Reaction
  71. Is an antigen-antibody reaction. The body develops hives, rashes, itching, or swelling of the skin. A rash or shortness of breath is occasionally seen in patients allergic to aspirin.
    Allergic Response
  72. Is a severe form of allergic reaction that is life threatening. The patient develops severe shortness of breath, may stop breathing, or may have cardiac collapse.
    Anaphylactic Response
  73. When two drugs are given together, the combined effect of the drugs is equal to that of the single more active component of the mixture or to the sum of the effects of the individual drugs.
    Additive Effect
  74. Effect takes place when one drug interferes with the action of another drug.
    Antagonistic Effect
  75. Takes place when one drug replaces another at the drug receptor site, increasing the effect of the first drug.
    Displacement
  76. Occurs when two drugs mixed together in a syringe produce a chemical reaction, so they cannot be given.
    Incompatibility
  77. Occurs when one drug promotes the rapid excretion of another, thus reducing its activity.
    Interference
  78. identified by monitoring the plasma (serum) therapeutic range of the drug. However, for drugs that have a wide therapeutic index, the therapeutic ranges are seldom given.
    Toxic effects, or toxicity
  79. is the scientific discipline studying how the effect of a drug action varies from a predicted drug response because of genetic factors or hereditary influence. Because people have different genetic makeup, they do not always respond identically to a drug dosage or planned drug therapy.
    Pharmacogenetics
  80. refers to a decreased responsiveness over the course of therapy.
    Tolerance
  81. refers to a rapid decrease in response to the drug.
    tachyphylaxis
  82. is an “acute tolerance.”
    tachyphylaxis
  83. Drug categories that can cause tachyphylaxis include
    narcotics, barbiturates, laxatives, and psychotropic agents.
  84. is a psychological benefit from a compound that may not have the chemical structure of a drug effect.
    placebo effect
  85. Determinants that affect drug therapy
    • Clinical Factors
    • Administration
    • Pharmacokinetics
    • Pharmacodynamics
  86. Through____ the public is protected from drugs that are impure, toxic, ineffective, or not tested before public sale.
    Federal legislation
  87. Negligence; giving the wrong drug or drug dose that results in the patient’s death
    Misfeasance
  88. Omission; omitting a drug dose that results in the patient’s death
    Nonfeasance
  89. Giving the correct drug but by the wrong route that results in the patient’s death
    Malfeasance
Author
Lynx
ID
362861
Card Set
Pharma
Description
Updated