Flashcards
Pharma 2
Cards in this deck (65)
- 1What are the essentials for effective drug therapy?Right diagnosis, drug, dose, route, administration and end point i.e therapeutic instead of adverse drug reaction
- 2How do we determine the route for a drug?By the properties of the drug and the therapeutic objective i.e rapid response, continual dose
- 3What are the factors that make up a dosage regimen?Route, amount or dose, frequency, duration
- 4What controls the factors of a dosage regimen?Pharmacokinetics
- 5What are the major routes for delivery of drugs into the bloodstream?IV, IM, SC, orally, across the skin, rectally
- 6What are the major routes for local drug delivery?Pulmonary, oral for action in gut, nasal, skin, rectally
- 7What are Parenteral routes?IV and IV infusion - no absorption straight into blood
IM - intramuscular tissue slow absorption
Sub-cut
Intra-arterial
Intrathecal
Epidural
Intraarticular - 8What are some disadvantages of parenteral routes?IV access requires trained personnel, potential for infection, rapid injection can high peak concentrations and cause adverse effects, unsuitable for chronic or home administration
- 9What are enteral routes?Oral meds
- 10What are advantages of enteral routes?Convenient, painless, suitable for home use
- 11What are disadvantages of enteral routes?GI adverse affects common (nausea vomiting), unsuitable if patient is vomiting, can be slow acting
- 12define absorptionProcess of drug moving from site of administration to site of measurement (blood stream) in body
- 13How are drugs absorbed?Via passive diffusion across enterocytes and carrier mediated uptake transport
- 14Do lipophilic Drugs have a high or low passive diffusion rate?High
- 15Do lipophobic drugs have a high or low passive diffusion rate?Low
- 16Which factors affect the absorption rate in the GIT?Blood flow, surface area, gastric emptying
- 17Define distributionProcess of drug moving from blood to organs/tissues, site of drug action
- 18In distribution which kinds of drugs cross cell membranes?lipid soluble drugs
- 19What effects the rate of blood flow?blood flow
- 20Define eliminationIrreversible loss of drug from blood
- 21What are the 2 processes of elimination?Metabolic elimination (drug is converted to another chemical) and excretion (unchanged drug is eliminated)
- 22Describe metabolic eliminationliver metabolises lipid soluble drugs by lowering the lipid solubility so they can be excreted
- 23Describe excretion as a form of eliminationWater soluble drugs are broken down by the kidney via mechanisms in the nephron at glomerulus, proximal tubule and distal tubule/ collecting duct
- 24Describe the 3 mechanisms for renal clearance?1. Glomerulus: blood filtered as plasma water @ 120 ml/min (any drug in plasma water is filtered)
2. Proximal tubule: Secretion - active pumps that pump drug to lumen of kidney (most penicillin antibiotics)
3. Distal Tubule/ collecting duct: Reabsorption - diffusion from lumen back into blood to be excreted through kidney - 25Where are enteric coated tablets absorbed?In upper intestine
- 26What are the 4 main pharmacokinetic parameters to achieve the right drug concentrations?Clearance, volume of distribution, bioavailability and half life
- 27Give an example of pharmacokinetic parameters of a drug with associated numerical valuescaffeine
bio-availability - 100%
Clearance - 100 ml/min
Half life - 5 hours
volume distribution - 45 litres - 28What is bio-availability?how much of the dose enters the blood stream i.e IV 100% or oral 0-100%
Oral is always compared to IV - 29What are the differences between single and chronic dose in relation to steady state?Single drug - drug absorbed, distributed and eliminated
Chronic dose - fixed dose, fixed time interval, steady state achieved when plasma concentration doesn't increase with successive doses i.e rate in = rate out/ clearance rate - 30How is bio-availability calculated?Symbol, F = area (oral)/ area (IV)
Determined by liver first pass, high first pass lower F value - 31What is clearance?Clearance describes the efficiency of irreversible elimination of the drug from the body
- 32Which is the most important of the 4 parameters of pharmacokinetics?Clearance
- 33What does clearance determine?The steady state concentration when a drug is given chronically
- 34How do you calculate concentration (css) with clearance?concentration = dose rate over clearance (L/hr or Ml/min)
- 35True or false: clearance changes over a dosing interval?False
- 36True or false: clearance differs from patient to patient?True
- 37What is Css?The dose rate required to maintain target plasma concentration/ clearance
- 38Define half life?The time it takes for blood concentration to fall by 50 percent after a single dose (can be minutes, hours, days)
- 39How any half lives does it take for Css t be achieved?5
- 40What does half life (T 1/2) determine?the time to achieve steady state and the time taken to eliminate drug after dosing has stopped
- 41How do you determine half life (t1/2)?0.69 x volume over clearance
- 42Define volume of distribution?The amount of drug in the body vs the concentration of the drug in the blood
- 43What is volume of distribution used to determine?the loading dose to get the Css quickly
- 44What is the equation to determine loading dose?Css x volume
- 45What are the principles of individualisation of drug therapy?Disease, Age, Pregnancy and pharmacogenetics, other medicines: interactions, diet and environment
- 46What is the motto for administering drugs to the elderly?start low, go slow but dont stay too low
- 47What are the Australian Drug Pregnancy Categories?Category A: Drugs taken by a large number of prego women with no issues
Category B1 -3: Drugs taken by limited number of prego women with more risk of issues as a result - 48What is enzyme induction?Drug A stimulates enzymes of Drug B resulting in lowered concentration of drug B due to more rapid elimination
- 49What is enzyme inhibition?Drug A blocks the enzyme of drug B resulting in slower elimination which increases the concentration of drug B and can result in toxicity
- 50What are the prescription requirements for s8 controlled drugs?Full name and address of patients, date of birth, name, strength and form of drug, dose, quantity to be dispensed (words and numerical)
if any of the quantity (words or numerals) are missing you cannot proceed - 51Who can prescribe?GPs, specialists, optometrists, vets, nurse prescribers, podiatrists
- 52What is the difference between dose and dosage?Dose: total amount patient is exposed to
Dosage: amount in relation to patient factor i.e body weight - 53In regards to concentration what is meant by molarity?the number of moles of drug per L of volume e.g 1M solution = 1 mole of drug per L
- 54Define the term adverse drug reaction?Patient reaction caused by a medicine taken in therapeutic doses
- 55What is a side effect?A predicted effect of the drug e.g nausea or vomitting
- 56What are the 4 times of adverse drug reaction?Type A - exaggerated response based on pharmacodynamics
Type B - non-pharmacological response, often allergic (uncommon)
Type C - continuous, long term use
Type D - delayed - 57What are some clinical signs of an adverse drug reaction?Difficulty breathing, lethargy, changes in colour, rashes, nausea/ vomiting, changes in heart rate or blood pressure, neurological changes
- 58Which patients are more susceptible to adverse drug reactions?Elderly, female, people with concurrent diseases, people with previous drug reactions, immuno - compromised
- 59What is an adverse drug event?patient reaction during treatment but not related to the drug i.e overdose and other medication errors
- 60What are the 6 biological hazards?Airborne - in air and dust
Alimentary - eating route
droplet - close proximity, coughing sneezing
Direct - physical contact
Indirect - transfer from infected object eg bed linen
Vehicle - contaminated blood, food, water, equipment - 61When should medication management ve reviewed?at all stages - in patient, out patient and every health visit
- 62What are 4 steps to medication management review?Assess patient, check meds, optimise meds, follow up with action
- 63What are medication errors?Preventable events that cause inappropriate drug use or patient harm while taking medicine
- 64What are the 6 rights?Right person, right drug, right dose, right time, right route and right documentation
- 65What should you do if a medication error occurs?Check patient and reassure, notify senior staff or medical officers, know reversing agents, report event according to policy: when, what happened, what outcome, preventable?
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- Pharmacology 1 Flashcards on Pharma 2, created by Shannon Austen on 07/11/2016.
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- Shannon Austen
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