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Stack #1000556

Chapter 21

Many drugs treated with a weak () or weak (), and are a () of the () drug is what? acid; base; salt; original; drug salt
"Drug salt" is not normally indicated on the prescription unless a particular () is a () or is the best choice. form; necessity
Drug salts may end in...? 1) Mesylate, Tartrate, Citrate 2)Hydrochloride (HCl) 3)Sodium or potassium
How does hydrochloride affect absorption rate? Increases rate
Drug () is a drug name that may indicate drug () or use. nomenclature; class
Brand names may take part of the () name as the () name. generic; trade
Example of brand name taking part of the generic name as the trade name? Amoxil is amoxilcillin
What does MOA stand for? Mechanism of Action
What is the MOA/mechanism of action? How the drug works
MOA is classified by the different () or () changes within the body. biological; biochemical
Drugs within the same class have similar...? 1) Mechanisms of actions 2) Adverse effects 3) Contradictions
What does DOC stand for? Drug of choice
A drug or drug () that is () in () certain conditions is the DOC. class; superior; treating
DOC is the most frequently (). prescribed
Examples of most frequently prescribed DOC's? Diabetes, first sign of infection
The () drugs have an acceptable () profile. first line drugs; adverse effect
If the DOC doesn't work, the () is prescribed, then () and (), etc. second line, third, fourth
Second, third, and fourth line drugs are () or have more (). less active; adverse effects
() is the study of the () and () in the drug within the (). Pharmacokinetics; movement; changes; body
What are the four parts of pharmacokinetics? Absorption, Distribution, Metabolism, Elimination
What is absorption? How the drug gets into the blood
IV drugs (are/are not) absorbed. Why? Not; directly into the bloodstream
Drug absorption factors include? pH of compartment, lipid solubility, vascularity of administration site
Drug reacts with the () of the () it enters. environment; body compartment
Examples of body compartments? stomach, floor of tongue
If acidity of the drug and the body environment are (), the drug remains (). similar; intact
If the drug remains intact, is that good or bad? Why? Bad; drug needs to be broken down and absorbed
If the acidity of the drug and the body environment are dissimilar, the drug (). ionizes
Drugs are only absorbed as (), not as () or (). intact molecules; dissolved salts; ionized particles
Drugs are better absorbed in "()". like environments
If the body cavity () is altered, so will the (). Example? pH; drug uptake; aspirin and antacid
() drugs pass easily through the cell membrane. Lipid soluble
Lipid soluble (do/do not) tend to remain in the (), as it is (). do not; plasma; water soluble
Highly lipid soluble drugs include? Most CNS drugs; anesthetics
The more () at the absorption site, the () the drug is absorbed. Example? blood vessels; faster; sublingual tablets
Once the drug enters the bloodstream, it () throughout the body. disseminates
After the drug disseminates throughout the body, part of the drug remains (). free in the plasma
If part of the drug remains free in the plasma, the other part of the drug may be (), either () or in (). stored; bound to plasma proteins; fat
Highly lipid soluble drugs stored in fatty tissue include? Liver, spleen, CNS, stored fat
Highly lipid soluble drugs can also be stored as (). Protein-drug complexes
Protein-drug complexes are bound to...? Tissue proteins, plasma proteins
Example of tissue proteins? Trypsin, keratin
Example of plasma proteins? Blood plasma
Drugs bound to proteins exist in () between () and () in the (). It is not necessarily a (). bound drug, free drug, 1:1 ratio
What is a free drug? An active drug that is not bound to a carrier protein
Only the () has a () effect and can be () from the body. free; therapeutic; eliminated
What is Vd? Volume of distribution
What is volume of distribution? the volume of space the drug occupies in the body
What is a large Vd? Drug distributed throughout different body compartments
What is a small Vd? drug that is concentrated mainly in one place
What is a loading dose? The large initial dosage utilized to help the drug quickly reach therapeutic levels
Drug () occurs when the drug undergoes () in the body, can be in any (), however mainly occurs in the () changes; organ; liver
Drug is metabolized by (). enzymes
Certain enzymes may differ with () and (). age, gender
Cytochrome P450-() system Cytochrome mixed function oxidase
What is Cytochrome 450? A main group of enzymes that break down drugs
Cytochrome 450 is involved in the metabolism of most drugs in the (). liver
What is drug clearance? Drugs are excreted primarily by the kidneys into the urine, but other routes for elimination include bile, sweat, saliva, breast milk, and expired air.
What is drug elimination?
Drug clearance is usually by the () or (). kidney, liver
() by kidney, the drug must not be () or () Filtration, lipid soluble, protein-bound
Drug is () by the liver to () to (). secreted; bile; feces
Careful consideration must be given to drugs filtered by the (). Examples? kidney; age groups; one kidney; weak kidney
Contraindicate To make a treatment or procedure inadvisable because of a particular condition or circumstance; "against"
Mechanism of action specific biochemical interaction through which a drug substance produces its pharmacological effect
First line drugs, second line drugs, etc Any therapeutic agent that is not the drug of choice, or the first normally used to treat a particular condition; 2nd-line agents are used when standard 'first-line' therapy fails
Drug of choice A therapeutic that is regarded as being the best agent or first agent to use when treating a particular condition; DOCs usually have the lowest toxicity and the widest therapeutic range of the available agents.
Pharmacokinetics The process by which a drug is absorbed, distributed, metabolized, and eliminated by the body.
Volume of distribution the calculated body space available for distribution of a drug.
Cytochrome P450 A superfamily of enzymes
Drug half-life The duration of action of a drug; period of time required for the concentration or amount of drug in the body to be reduced by one-half.
The amount of time it take for () of the () to clear the body is the (). half; drug dosage; drug half-life
Drug half-life is influenced by () and how () a drug might be () in the body by (). rate of elimination; quickly, inactivated, enzymes
What alters drug half-lives? 1) altering the clearance rate 2) pH 3) altering the elimination rate
() or () dysfunction can () the elimination rate. Renal, liver, decrease
Example of decreasing elimination rate through renal or liver dysfunction? Acetylcholines or enterohepatic recycling
() effects can range from () to (). Adverse; uncomfortable; life-threatening
Adverse effects advises us to understand the () with () to determine the possible effects. mechanism of the drug's action; physiology background
Drug-drug interactions most likely occur during...? 1) Absorption 2) Distribution (protein-binding) 3) Clearance
Drug must be () in the () for drug-drug interactions at absorption to work free; plasma
If the drug is not absorbed into the (), the drug will not have an effect. bloodstream
List absorption level drug-drug interactions. 1) binding interactions 2) change of pH in the environment 3) Change in local blood flow
During drug distribution interactions, many drugs bind to the same (). plasma proteins
If drug A binds to all (), drug B is left in the () at (). available proteins; plasma; high levels
Drug distribution interactions can be (). toxic
Most drugs bind to the protein (). Albumin
An example of a drug that binds to proteins is (). Coumadin
During drug interactions at clearance, the body () the drug through the (). expels; lungs, urine, bile
Some drugs "()" for the same enzyme, or (). compete; limit enzyme activity
Example of interactions at clearance? Tagamet or alcohol
Interactions at clearance lead to...? increased levels of a drug in the blood
Define agonist. Endogenous (mimics actions)
How does an agonist work? 1) stimulate cellular/biochemical activity 2) inhibiting BD (indirect agonisms)
Example of endogenous drug? Drug edrophonium
What is the effect of the antagonist? decreases/prevents/does not stimulate
The antagonist may () the () to agents that may stimulate, which prevents the function of the (). block, receptor (2)
A receptor is only ___ at the (). It ()/() for continued stimulation. Examples? moment of contact; detach/reattach; Prazosin
Partial agonists are also known as? Weak agonists
Weak/partial agonists act as (), unless (), then acts as (). agonists, stronger agonist is present, antagonist
Partial agonists () activity normalize
Example of partial agonist. morphine
When () drugs have the same effect, the effect of one will be () to the effect of the other is called an () effect. Example? two, added, additive, blood pressure meds
A () effect is when () drugs have the same () effect, but different (), and one () the effect of () such that the () effect is () than the () of both drug effects. synergistic; two; psycological, mechanisms, potentiates, the other, combined, greater, sums
() and () have a dangerous synergistic effect. CNS depressants, alcohol
Created by: yquyenvu