Chapter 21
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| Many drugs treated with a weak () or weak (), and are a () of the () drug is what? | acid; base; salt; original; drug salt
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| "Drug salt" is not normally indicated on the prescription unless a particular () is a () or is the best choice. | form; necessity
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| Drug salts may end in...? | 1) Mesylate, Tartrate, Citrate 2)Hydrochloride (HCl) 3)Sodium or potassium
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| How does hydrochloride affect absorption rate? | Increases rate
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| Drug () is a drug name that may indicate drug () or use. | nomenclature; class
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| Brand names may take part of the () name as the () name. | generic; trade
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| Example of brand name taking part of the generic name as the trade name? | Amoxil is amoxilcillin
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| What does MOA stand for? | Mechanism of Action
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| What is the MOA/mechanism of action? | How the drug works
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| MOA is classified by the different () or () changes within the body. | biological; biochemical
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| Drugs within the same class have similar...? | 1) Mechanisms of actions 2) Adverse effects 3) Contradictions
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| What does DOC stand for? | Drug of choice
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| A drug or drug () that is () in () certain conditions is the DOC. | class; superior; treating
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| DOC is the most frequently (). | prescribed
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| Examples of most frequently prescribed DOC's? | Diabetes, first sign of infection
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| The () drugs have an acceptable () profile. | first line drugs; adverse effect
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| If the DOC doesn't work, the () is prescribed, then () and (), etc. | second line, third, fourth
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| Second, third, and fourth line drugs are () or have more (). | less active; adverse effects
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| () is the study of the () and () in the drug within the (). | Pharmacokinetics; movement; changes; body
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| What are the four parts of pharmacokinetics? | Absorption, Distribution, Metabolism, Elimination
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| What is absorption? | How the drug gets into the blood
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| IV drugs (are/are not) absorbed. Why? | Not; directly into the bloodstream
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| Drug absorption factors include? | pH of compartment, lipid solubility, vascularity of administration site
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| Drug reacts with the () of the () it enters. | environment; body compartment
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| Examples of body compartments? | stomach, floor of tongue
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| If acidity of the drug and the body environment are (), the drug remains (). | similar; intact
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| If the drug remains intact, is that good or bad? Why? | Bad; drug needs to be broken down and absorbed
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| If the acidity of the drug and the body environment are dissimilar, the drug (). | ionizes
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| Drugs are only absorbed as (), not as () or (). | intact molecules; dissolved salts; ionized particles
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| Drugs are better absorbed in "()". | like environments
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| If the body cavity () is altered, so will the (). Example? | pH; drug uptake; aspirin and antacid
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| () drugs pass easily through the cell membrane. | Lipid soluble
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| Lipid soluble (do/do not) tend to remain in the (), as it is (). | do not; plasma; water soluble
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| Highly lipid soluble drugs include? | Most CNS drugs; anesthetics
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| The more () at the absorption site, the () the drug is absorbed. Example? | blood vessels; faster; sublingual tablets
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| Once the drug enters the bloodstream, it () throughout the body. | disseminates
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| After the drug disseminates throughout the body, part of the drug remains (). | free in the plasma
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| 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
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| Highly lipid soluble drugs stored in fatty tissue include? | Liver, spleen, CNS, stored fat
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| Highly lipid soluble drugs can also be stored as (). | Protein-drug complexes
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| Protein-drug complexes are bound to...? | Tissue proteins, plasma proteins
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| Example of tissue proteins? | Trypsin, keratin
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| Example of plasma proteins? | Blood plasma
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| Drugs bound to proteins exist in () between () and () in the (). It is not necessarily a (). | bound drug, free drug, 1:1 ratio
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| What is a free drug? | An active drug that is not bound to a carrier protein
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| Only the () has a () effect and can be () from the body. | free; therapeutic; eliminated
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| What is Vd? | Volume of distribution
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| What is volume of distribution? | the volume of space the drug occupies in the body
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| What is a large Vd? | Drug distributed throughout different body compartments
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| What is a small Vd? | drug that is concentrated mainly in one place
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| What is a loading dose? | The large initial dosage utilized to help the drug quickly reach therapeutic levels
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| Drug () occurs when the drug undergoes () in the body, can be in any (), however mainly occurs in the () | changes; organ; liver
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| Drug is metabolized by (). | enzymes
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| Certain enzymes may differ with () and (). | age, gender
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| Cytochrome P450-() system | Cytochrome mixed function oxidase
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| What is Cytochrome 450? | A main group of enzymes that break down drugs
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| Cytochrome 450 is involved in the metabolism of most drugs in the (). | liver
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| 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.
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| What is drug elimination? |
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| Drug clearance is usually by the () or (). | kidney, liver
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| () by kidney, the drug must not be () or () | Filtration, lipid soluble, protein-bound
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| Drug is () by the liver to () to (). | secreted; bile; feces
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| Careful consideration must be given to drugs filtered by the (). Examples? | kidney; age groups; one kidney; weak kidney
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| Contraindicate | To make a treatment or procedure inadvisable because of a particular condition or circumstance; "against"
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| Mechanism of action | specific biochemical interaction through which a drug substance produces its pharmacological effect
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| 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
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| 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.
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| Pharmacokinetics | The process by which a drug is absorbed, distributed, metabolized, and eliminated by the body.
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| Volume of distribution | the calculated body space available for distribution of a drug.
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| Cytochrome P450 | A superfamily of enzymes
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| 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.
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| The amount of time it take for () of the () to clear the body is the (). | half; drug dosage; drug half-life
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| Drug half-life is influenced by () and how () a drug might be () in the body by (). | rate of elimination; quickly, inactivated, enzymes
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| What alters drug half-lives? | 1) altering the clearance rate 2) pH 3) altering the elimination rate
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| () or () dysfunction can () the elimination rate. | Renal, liver, decrease
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| Example of decreasing elimination rate through renal or liver dysfunction? | Acetylcholines or enterohepatic recycling
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| () effects can range from () to (). | Adverse; uncomfortable; life-threatening
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| Adverse effects advises us to understand the () with () to determine the possible effects. | mechanism of the drug's action; physiology background
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| Drug-drug interactions most likely occur during...? | 1) Absorption 2) Distribution (protein-binding) 3) Clearance
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| Drug must be () in the () for drug-drug interactions at absorption to work | free; plasma
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| If the drug is not absorbed into the (), the drug will not have an effect. | bloodstream
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| List absorption level drug-drug interactions. | 1) binding interactions 2) change of pH in the environment 3) Change in local blood flow
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| During drug distribution interactions, many drugs bind to the same (). | plasma proteins
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| If drug A binds to all (), drug B is left in the () at (). | available proteins; plasma; high levels
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| Drug distribution interactions can be (). | toxic
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| Most drugs bind to the protein (). | Albumin
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| An example of a drug that binds to proteins is (). | Coumadin
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| During drug interactions at clearance, the body () the drug through the (). | expels; lungs, urine, bile
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| Some drugs "()" for the same enzyme, or (). | compete; limit enzyme activity
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| Example of interactions at clearance? | Tagamet or alcohol
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| Interactions at clearance lead to...? | increased levels of a drug in the blood
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| Define agonist. | Endogenous (mimics actions)
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| How does an agonist work? | 1) stimulate cellular/biochemical activity 2) inhibiting BD (indirect agonisms)
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| Example of endogenous drug? | Drug edrophonium
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| What is the effect of the antagonist? | decreases/prevents/does not stimulate
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| The antagonist may () the () to agents that may stimulate, which prevents the function of the (). | block, receptor (2)
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| A receptor is only ___ at the (). It ()/() for continued stimulation. Examples? | moment of contact; detach/reattach; Prazosin
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| Partial agonists are also known as? | Weak agonists
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| Weak/partial agonists act as (), unless (), then acts as (). | agonists, stronger agonist is present, antagonist
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| Partial agonists () activity | normalize
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| Example of partial agonist. | morphine
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| 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
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| 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
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| () and () have a dangerous synergistic effect. | CNS depressants, alcohol
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