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therapeutic drug mon
| Question | Answer |
|---|---|
| the range that exists between the minimum effective concentration and the minimum toxic concentration | therapeutic window |
| minimum effective concetration | MEC |
| Minimum toxic concentration | MTC |
| subtherapeutic | drug has no measurable effect on patient |
| toxic | 100% effective but to an extent that causes injury to the patient |
| What does LADME system do | describes change of drug concentration with time in your body |
| what are the three types of dosage forms | tablets and capsules, ointment, suppository |
| What does L stand for in the LADME | liberation |
| What does liberation mean | process by which a drug is released from a dosage form thus passing into solution |
| in this dosage form, gastric fluid dissolves covering immediately | tablets and capsules |
| this form of dosage is liberated when water from sweat mixes with the dosage and reabsorbs through sweat glands | ointment |
| this dosage liberation method is via rectal fluids dissolving and then absorbing through blood vessels | suppository |
| this dosage form is normally in a package that part is readily disolved while the other is dissolved after the stomach | controlled release |
| what does A stand for in LADME | absorbance |
| when the drug molecule is taken up into circulation or plasma compartment is known as | absorbance |
| What are the three mechanisms of absorbance | passive diffusion, active transport, facilitated transport |
| this mechanism of absorbance is most predominant and works by concentration gradient and membrane potential (large to small) | passive diffusion |
| this mechanism of absorbance involves the transport against concentration gradient with carrier molecule and ATP | active transport |
| this mechanism of absorbance involves a carrier molecule with concentration gradient | facilitated transport |
| What does the D stand for in the LADME system | distribution |
| the active drug absorbed into blood vessels and distributed to the tissues is known as what | distribution |
| What is the average distribution time | 30 min to 2 hours |
| What does the M in the LADME system stand for | metabolism |
| this is the conversion of the parent drug (active) into one or more metabolites | biotransformation |
| What two organs are involved with the metabolism of drugs | liver and kidney |
| which is less toxic-the metabolite or parent drug | metabolite, there are exceptions |
| What does the E stand for in the LADME system | Elimination |
| this means excreted from the body either in the form of the parent drug or as a metabolite | elimination |
| what are the major routes for elimination | liver and kidney |
| how is a drug excreted via the liver | in bile and comes out in feces |
| how is a drug excreted via the kidney | parent or metabolite in urine |
| This is the time required to reduce blood concentration of the drug to half of the dosage given | half-life |
| high-performance liquid chromatography | 1. liquid phase is perculated through the column 2. these beads within the column will interact with the drug 3. drugs exit at different times 4. each drug is detected and recorded |
| what does felbamate treat | epilepsy |
| another name for felbamate is | felbatol |
| used for primary therapy of partial seizures used when all other drug treatment fails | felbamate |
| this drug carries the risk of aplastic anemia and liver failure | felbamate |
| Another name for neurontin is | gabapentin |
| this medication is used for the effective treatment of drug resistant partial seizures and also back surgery | gabapentin |
| this drug promotes the release of gamma aminobutyric acid (GABA) | gabapentin |
| this is a potent inhibitor of presynaptic discharges | GABA |
| what is another mane for lamictal | lamotrigine |
| this medication binds to GABA receptors and is an agonist | lamotrigine |
| this medication can be anti-folate and is associated with severe rashes | lamictal |
| what is another name for levetiracetam | keppra |
| this medication is used for adjunctive therapy and treatment of partial onset seizures | levetiracetam |
| this medication has no pharmacokinetic interaction between levetiracetam and other antiepileptic drugs | levetiracetam |
| another name for oxcarbazepine is | trileptal |
| this medication is used for therapy of partial seizurs with and without secondary generalized seizures | oxcarbazepine |
| this medication is used in the control of all seizures except for petite mal | phenobarbital |
| phenobarbital is metabolized where | liver |
| this medication reduces synaptic transmission, via increasing seizure thresholds so more neurotrasmitter is needed to precipitated a seizure and also inhibits synaptic discharge | phenobarbital |
| phenobarbital is known for it's | long half-life |
| what is another name for dilantin | phenytoin |
| this medication is used for the control of all seizures | phenytoin |
| this medication modulates sodium and potassium atpase that results in the blockage on neurotransmitter release | dilantin |
| where is phenytoin metabolized | liver |
| what is another name for tiagabine | gabitril |
| this medication is used as an adjuctive therapty for the treatment of partial seizures given along with at least one other antiepileptic drug | tiagabine |
| what is another name for topiramate | topamax |
| this medication is a broad spectrum antiepileptic drug | topiramate |
| this medication blocks seizure spread rather than raising seizure potential | topiramate |
| what is another name for valproic acid | depakote |
| this medication is used for treatment of absent seizures | volproic acid |
| this medication inhibits the nonrenal clearance of phenobarbital resulting in elevated plasma phenobarbital | valproic acid |
| Digoxin, lidocaine, quinidine, procainamide, and amiodarone are all what kind of drugs | cardiac meds |
| What is another name for digoxin | lanoxin |
| This medication is derived from the digitalis plant | digoxin |
| What dosage form is digoxin in | powdered form as tablets or capsules |
| this drug reduces the concentration gradient between sodium and potassium thus allowing calcium to move into the muscle, cells increase the refractory period of the AV node of the heard | digoxin |
| this medication allows the heard to pump more blood giving an increased cardiac output | digoxin |
| this medication is used in the management of tachycardia, atrial fibrillation, and congestive heart failure | digoxing |
| digoxin is concentrated where | tissue |
| how are therapeutic ranges determined for digoxin | peak tissue concentrations |
| where is digoxin metabolized | in liver excreted in urin |
| how is digoxin monitored | immunoassay |
| what is another name for lidocaine | xylocaine |
| this is the drug of choice for initial therapy of PVC and may prevent atrial fibrillation of the heart After AMI | lidocaine |
| this medication shortens the action potential refractory period in Purkinje fibers of the heart | lidocaine |
| lidocain can be administered how | inner ventral or muscular-heart |
| this medication is used in the treatment of tachycardia and fibrillation, it increases the threshold membrane potential | quinidine |
| this medication has a very similar action as quinidine | procainamide |
| this medication produces a metabolite-N-acetylprocainamide (NAPA that has a similar effect as it's parent drug | procainamide |
| what is N-acetylprocainamide parent drug | procainamide |
| this medication is used to control supraventricular and ventricular tachyarrhythmias | amiodarone |
| amiodarone has what kind of half life | long |
| this medication can interact with thyroid hormone receptors to cause toxicity | amiodarone |
| When amiodarone interacts with thyroid hormone receptors to cause toxicity what condition is associated with this | grave's disease |
| theophyllines is what type of medication | bronchodilator |
| this medication relaxes bronchial smooth muscle to relieve or prevent asthma | theophyllines |
| this medication's metabolite is caffeine | theophyllines |
| theophyllines have what as it's metabolite | caffeine |
| this medication is given to newborns when suffering from sleep apnea | theophyllines |
| aminoglycosides are what kind of medication | antibiotics |
| this medication binds to ribosomal subunites to prevent protein synthesis | aminoglycosides |
| the goal of this drug is to kill bacteria | aminoglycosides |
| lithium is what kind of medication | antipsychotic med |
| this medication is used for the treatment of the manic phase of manic depressive illness | lithium |
| what is the method of determination for lithium | ISE |
| this medication enhances the reuptake of catecholamines producing a sedating affect | lithium |
| what is another name for imiprimine | tofranil |
| imiprimine is what kind of drug | antidepressant |
| this medication is used to elevate moods | imiprimine |
| what medication is an antimetabolite | methotrexate |
| this medication is used in the management of ALL in children and carcinoma of the breast, tongue and testes | methotrexate |
| methotrexate does what to dna synthesis | inhibits |
| this medication inhibits dna synthesis by preventing pyrimidine from being formed, ultimately slowing down cell division | methotrexate |
| methotrexate is what kind of drug in terms of cells it affets | nonspecific |
| methothrexate can lead to what due to its lack in specificity | myelosupression |
| what is the method of determination for methotrexat | immunoassay |
| cyclo sporine is what kind of medication | immunosuppressant |
| cyclosporin is isolated from what fungus | trichoderma polysporum |
| this medication is used to suppress host vs graft rejection in organ transplants | cyclosporine |
| this medication prevents the poliferation of lymphocytes ultimately decreasing immunity | cyclosporine |
| what is the method of determination for cyclosporine | HPLC |
| mycophenolate mofetil has another name as | cellcept |
| what type of medication is mycophenolate mofetil | immunosuppressant |
| this medication is the fermentative product of several penicillium species | mycophenolate mofetil |
| this medication inhibits the enzyme inosine monophosphate dehydrogenase (IMPDH) that is utilized by poliferating lymphocytes | mycophenolate mofetil |
| What cell type does mycophenolate mofetil arrest the poliferation of | t-cells |
| what is the method of determination for mycophenolate mofetil | immunoassay |
| What are the five important parameters that must be determined on patients with toxic reactions | amount of agent, route of administration, number of doses, time period of administration, lethal dosage |
| What does amount of agent introduced into a person mean | what has been taken |
| how a toxin has been introduced to the body is what | route of administration |
| number of doses can be either | acute or chronic |
| this helps determine if a toxic reaction is an acute or chronic | time period of administration |
| this is the amount of a substance to cause death | lethal dosage |
| what are the five ways a toxic agent may effect the body | interference with the action of enzymes, blockage of Hb/O2 transport, interference with cell function, interference with dna and rna synthesis, hypersensitivity reaction |
| two types of interference with the action of enzyme systems in the body are | irreversible enzyme inhibition and inhibition of oxygen transfer |
| insecticides-acetylchoinesterase which cause loss of neuromuscular control is an example of what thy pof interference of enzymes | irreversible enzyme inhibition |
| cyanide-cytochrome oxidase which decreases ATP production (cell dies due to no energy) is an example of what kind of interference of enzymes | inhibition of oxygen transfer |
| what is an example of the blockage of Hb/O2 transport | Hb has a higher affinity to carbon monoxide |
| what is an example of interference with cell function | anesthetics- affecting membrane potential |
| what is an example of interference of DNA and RNA synthesis | mustard gas |
| What is an example of hypersensitivity reaction | toxic shock, anaphylactic shock |
| barbiturates, benzodiazepine, and methaqualine are what kind of drugs | depressants |
| phenobarbital, pentobarbital, secobartital are all under what type of drug | barbiturates |
| valium and librium are under what type of drug | benzodiazepine |
| this type of medication is a used to reduce pain without causing loss of consciousness | analgesics |
| this medication can lower body temperature and are anti inflammatory | analgesics |
| morphine, heroin, codeine, and methadone are all what kind of medications | narcotics-analgesics |
| salicylates and acetaminophen are both what kind of medication | nonperscription analgesics |
| acetaminophen in combination with this drug can cause the liver to shutdown | alcohol |
| imipramine is an example of what kind of medication | tricyclics |
| tricyclics do what? | elevate mood |
| these drugs have no medical usage | hallucinogens |
| LCD and mescaline are what kind of drugs | hallucinogens |
| amphetamine and cocaine are what kind of drugs | stimulants |
| these medications are no long used therapeutically and are very potent CNS stimulants | stimulants |
| marijuana, THC, and hashish are what types of drug | cannabis |
| this type of drug has very minimal medicinal use | cannabis |
| how long is the half life of THC | 1 day, chronic users 3-5 |
| serum levels decrease what percent after you have smoked a joint (about an hour) | 10% |
| what toxic agents cause cellular hypoxia | carbon monoxide and cyanide |
| this is the most common of the caseous poisons | carbon monoxide |
| what specimen should be used for carbon monoxide | whole blood |
| % saturation of Hg by CO is how what is determined | carbon monoxide |
| this is a colorless gase with the odor of almonds | cyanide |
| when inhaled this drug is rapidly bound to the heme of hemoglobin causing hypoxia | cyanide |
| how are levels of cyanide measured | ISE or GC-MS |
| this drug has the highest blood levels than any other toxic agent | alchohol |
| where is the specimen for an alcohol test collected from | venipuncture without cleaning via alcohol |
| what are the two main alcohols | ethanol and methanol |
| methanol can form what metabolite | formaldehyde |
| how is methanol poisoning treated | with ethanol |
| where is arsenic found | herbicides and fungicides |
| this toxic substance tends to mimic other disorders | arsenic |
| when considering acute arsenic poisoning what sample should be collected | urine |
| when considering chronic arsenic poisoning what sample should be collected | hair or nails |
| arsenic has and affinity to bind with what protein | keratin |
| this type of poisoning is one of the most serious metallic poisons | lead |
| how are adults normally exposed to lead | industrial setting |
| how are children normally exposed to lead | dirt, paint chips, soil, toy recalls |
| lead inhibits what production | heme |
| why is analysis hard for lead | lower levels |
| What are four drug screening techniques | TLC, Immunoassay, urine |
| what is the purpose of doing a drug screening test | separate negatives from positives |
| this kind of test must be rapid and accurately identify the drug | screening test |
| when should a conformation drug test be used | on a positive screen |
| this test must specifically identify the drug | conformation test |
| What is TLC | thin layer chromatography |
| what are the five steps in TLC | sample prep, drug isolation and extraction, development, visualization, interpretation |
| two strengths to TLC | can be used for a wide range of drugs, no measure instrumentation |
| what are the two weaknesses of TLC | least sensitive, reliable, and precise, and no permanent record |
| this is the best method for screening drugs | immunoassay |
| what types of labels can be used in an immunoassay | radioactive, enzyme, and fluorescent |
| what is the principal immunoassay uses | competitive binding |
| what are the strengths of immunoassay | sensitive and accurate, precision may vary though |
| what is a drug confirmation technology | gas chromatography and mass spectrometry |
| what is the best method for confirmation of drug abuse | gas chromatography and mass spec |
| what does gas chromatography do | separates different drugs present in blood |
| mass spec does what to the drug | fragment it via bombardment of electrons |
| mass spec looks for this of a drug | molecular fingerprint |
| what are the strengths of gas chromatography and mass spec | accurate, sensitive, precise and specific |
| What are some weaknesses of mass spec and gas chromatography | labor intensive, special training, data interpretation, time consuming, very expensive |
| What does a negative drug screening test mean | drug is not present or below at the sensitivity of the test |
| a positive drug screen means | confirmatory test is needed and or drug or metabolite may be present |
| a positive drug confirmation means what | drug is present and has been used recently |
| what does a drug confirmation not imply | that there was intoxication |
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jnwells03
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