Term
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Definition
| volume of fluid clearing out of the body. same as excretion |
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Term
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Definition
| How long the drug will work |
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Term
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Definition
| how long it takes to get rid of 1/2 the drug |
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Term
| ED 50/EC 50 (effective dose/effective concentration) |
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Definition
| the does of a drug which induced a specific clinical effect in 50% of subjects |
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Term
| What is LD 50 (lethal dose) |
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Definition
| dose of a drug that induces death or toxicity in 50% of subjects |
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Term
| What is Therapeutic Index? |
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Definition
| a measure of the safety of a drug |
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Term
| What is the Margin of Safety? |
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Definition
| the margin between therapeutic and lethal dose |
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Term
| What is a Single-Dose Time Course? |
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Definition
| duration of effects determined by the combination of metabolism and excretion |
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Term
| how many half lives does it usually take for a drug to plateau? |
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Definition
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Term
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Definition
| where the graph of half-lives dips slightly before it plateaus |
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Term
| What is Maximum Efficacy/Effectiveness? |
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Definition
| the largest effect that a drug can produce |
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Term
| What is Relative Potency? |
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Definition
| Hiw much a drug must be given to achieve the desired response |
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Term
| If you need less mg of a drug to get a response is that drug less or more potent? |
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Definition
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Term
| What is the Steady State? |
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Definition
| The amount of drug in is equal to the drug that comes out. |
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Term
| What are therapeutic drug levels? |
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Definition
| Dose large enough to lock onto enough receptors to get the desired results |
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Term
| What is Toxic Concentration? |
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Definition
| the Plasma level at which toxic effects begin |
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Term
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Definition
| protien found in the blood |
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Term
| If you have less Albumin (protien) in your blood, is the drug more or less active? |
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Definition
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Term
| Is an unbound drug active or inactive? |
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Definition
|
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Term
| Is a bound drug active or inactive? |
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Definition
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Term
|
Definition
| The movement of drugs throughout the body |
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Term
| What is Creatinine Clearance? |
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Definition
| How well the kidneys work and will clear a drug. |
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Term
| Glomerular Filtration Rate (GFR) |
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Definition
| affected by blood pressure |
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Term
|
Definition
| removing the drug from the body. |
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Term
| Where does excretion take place? |
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Definition
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Term
| What are special considerations (5) in patients that you should consider in drug metabolism? |
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Definition
- Age
- Induction of drug metabolizing enzymes
- First pass effect
- Nutrition
- Drug competition |
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Term
| What is a drug inhibitor? |
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Definition
| Decreases enzyme activity |
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Term
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Definition
| Increases enzyme activity |
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Term
|
Definition
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Term
| Where does most drug metabolism take place in the body? |
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Definition
|
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Term
|
Definition
| the way the body alters the drug |
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Term
| What is a competative antagonist? |
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Definition
| Reduces the amount of agonist required to produce any given intensity of response |
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Term
| What is a noncompetitive antagonist? |
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Definition
| Decreases maximal response achieveavke with an agonist |
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Term
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Definition
| prevents receptor activation |
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Term
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Definition
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Term
| What are 8 patient factors affecting pharmocokinetics? |
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Definition
- weight and body composition
- age
- pregnancy
- smoking
- alcohol
- liver function
- kidney function
- psychosocial factors |
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Term
| 94% of the drug in the body will be eliminated in how many half-lives? |
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Definition
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Term
| What is the peak of a drug? |
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Definition
| The amount of time to maximize the efficiancy of drug |
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Term
| What is the Onset of the drug? |
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Definition
| amount of time needed for the drug to start working |
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Term
| What is the timing of a drug? |
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Definition
| Giving the drug at the right time so it can start working but not expire while you are giving treatment |
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Term
| What 4 factors affect Plasma Drug Levels? |
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Definition
- Loading dose
- Maintenance dose
- timing
- special considerations |
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Term
| What is toxic concentration? |
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Definition
| Plasma level at which toxic effects begin (too many receptors were activted) |
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Term
| What is the Minimum Effective Concentration? |
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Definition
| plasma drug level which below, therapeutic effects will not occur. |
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Term
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Definition
| the initial dose of a drug that is higher than a normal dose to achieve therapeutic levels quickly |
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Term
| Where does most drug metabolism take place? |
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Definition
|
|
Term
| What system, in the liver, is responsible for the metabolism of drugs? |
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Definition
| The hepatic microsomal enzyme system...or the P450 system. |
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Term
| How many enzyme systems does the P450 system have? |
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Definition
|
|
Term
| Which systems of the P450 system metabolize meds? |
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Definition
|
|
Term
| What do the other 9 families of the P450 system metabolize? |
|
Definition
| endogenous compounds...such as steroids and fatty acids |
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Term
| Do Hepatic microsomal enzymes ever make a larger molecule? |
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Definition
| yes, they can make a molecule larger than the parent drug. |
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Term
| What organ is the major player in drug excretion? |
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Definition
|
|
Term
| What does the kidneys have a hard time excreting? |
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Definition
|
|
Term
| Can the liver enzymes make a pharmaceutical drug inactive? |
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Definition
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|
Term
| Give an example of increased therapeutic action. |
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Definition
|
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Term
| Is a prodrug active, inactive, highly active, or subclinically active? |
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Definition
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|
Term
| At what age does the liver develop its full capacity to metabolize drugs? |
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Definition
| 1yr.....prior to this time, infants must be handled with extreme care since they are limited. |
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Term
| What is the process of induction? |
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Definition
| when the liver is stimulated to produce more drug-metabolizing enzymes. |
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Term
| What is the first-pass effect? |
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Definition
| Refers to the hepatic inactivation of certain oral drugs. If the capacity of the liver to metabolize a drug is extremely high, that drug can be completely inactivated on its first pass through the liver. |
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Term
| What is sometimes the outcome of first-pass? |
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Definition
| A drug could have no therapeutic effect |
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Term
| How do we bypass the first-pass effect? |
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Definition
| We administer parenterally....this permits the drug to bypass the liver, allowing it to reach therapeutic levels in the systemic blood. |
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Term
| What is the relationship to malnourishment and cofactors? |
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Definition
| Malnourishment can lead to a deficiency in cofactors, which cause drug metabolism to be compromised. |
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Term
| When drugs compete for the same metabolic pathway, what is the two main concerns? |
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Definition
| The rate at which both drugs are metabolized could be decreased....and secondly, dangerous levels could be accumulated if the metabolism is decreased too much. |
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Term
| What non-renal route of drug excretion can cause the most harm? |
|
Definition
| Breast milk....potential to expose a nursing infant to drugs. |
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Term
| Which drugs play a larger role in breast milk....protein bound, lipid-soluble,ionized, or polar? |
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Definition
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|
Term
| Which excretion routes have the least significance? |
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Definition
|
|
Term
| What is the issue with the bile route of excretion? |
|
Definition
| Some drugs can be reabsorbed into the blood through the intestine, which could substantially prolong a drug's sojourn in the body. |
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Term
| Experience has shown that, for most drugs.... |
|
Definition
| there is a direct correlation between therapeutic and toxic responses and the amount of drug present in the plasma. |
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Term
| Can we measure drug concentrations at the sites of action? |
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Definition
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|
Term
| What are the two plasma drug levels that are of special importance? |
|
Definition
| Minimum effective concentration and Toxic concentration |
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Term
| To be of benefit, a drug must be present at or above the what? |
|
Definition
| MEC...Minimum effective concentration |
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|
Term
| What is the objective of drug dosing? |
|
Definition
| To maintain plasma levels in the therapeutic range |
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Term
| Drugs that have a narrow therapeutic range are easy to administer? T or F |
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Definition
| False, the wider the range the safer the drug.....e.g. acetaminophen vs lithium....tylenol is much more safer than the lithium (bipolar drug) because lithium has a much narrower therapeutic range. |
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Term
| What are the two things responsible for how long drug effects persist? |
|
Definition
|
|
Term
|
Definition
| The amount of time it takes for a drug in the body to decrease by 50%. |
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Term
| Drugs with short half-lives leave the body very slowly? T or F |
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Definition
| False, since 50% of the drug is decreased in a short time, it only makes since that the rest of the drug will be following the same path and be excreted in a short time as well. |
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Term
| What are the three ways in which drugs can pass the membranes of the cells? |
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Definition
| Channels or pores, passage with the aid of a transport system, and direct penetration. |
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Term
| Most drugs use channels and pores as their means of travel? T or F |
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Definition
| False, most of the time they take the direct penetration route |
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|
Term
| Who's the biggest pimp of all transport system carriers? |
|
Definition
| P-Glycoproteins AKA multidrug transporter protein, because they help out in so many ways. |
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|
Term
| What makes a polar molecule polar? |
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Definition
| A neutral outcome....the positive and negative charges even each other out in these particular molecules. |
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|
Term
| What do we call a molecule that does have a net charge? |
|
Definition
|
|
Term
| If a particular drug is more lipid soluble than another, does this mean it will have a faster absorbing rate? |
|
Definition
|
|
Term
| If a particular drug has a large molecular weight, does this mean it will absorb faster? |
|
Definition
| no, it will be less absorbant |
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|
Term
| The amount of time needed to start working for a drug is called peak? T or F |
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Definition
|
|
Term
| What do you call the length of time a drug is therapeutic? |
|
Definition
|
|
Term
| How much of the drug will be out of the system within 3-4 half-lives? |
|
Definition
|
|
Term
| Does an agonist activate or unactivate receptors? |
|
Definition
|
|
Term
|
Definition
| A drug which has no effect that enhances the effect of a second drug.....0+1=2 |
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