Pharm Chp 2

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  1. What are the three routes of drug administration
    • Enteral
    • Parental
    • Topical
  2. What is the enteral route of administration and what are some examples
    • drug is absorbed from the gastrointestinal (GI) tract
    • Includes oral, sublingual, Buccal and rectal
  3. What is the prescription abbreviation for "take by mouth"
  4. How is the sublingual administration absorbed
    through the oral mucosa
  5. Buccal administration is placed
    between the gums and the inner lining of the cheek
  6. When is rectal administration advised
    When the drug is too irritating for the stomach, the patient is vomiting or can't swallow or local effect on the colon
  7. What is the abbreviation for rectal admininstration
    PR- per rectum
  8. What is parental administration and what are the five routes
    • delivers drugs via a needle
    • intravenous, intramuscular, subcutaneous, intradermal, and intrathecal
  9. What is the fastest route of administration
    Intravenous- directly in the vein
  10. What is an example of Intramuscular administration
    Hep B vaccine
  11. Describe the Subcutaneous administration and what are some examples
    • into connective tissue under the skin.
    • Drug cannot be irritating. Small volumes only
    • Ex. dental anesthetics, Insulin
  12. Describe the Intradermal administration and what are some examples
    • directly into dermis (layer beneath the epidermis).
    • Ex. Allergen testing, tuberculin skin test
  13. Describe the Intrathecal administration
    delivered into spinal fluid, used for spinal anesthesia
  14. Describe Topical Administration and what are the routes
    • administered directly to surface of body where action is desired. Includes skin, mucous membranes of the gingiva, eyes, ears, gingival crevice of teeth, mouth and throat
    • Subgingival, Inhalation, Opthalmic, Otic, Intranasal, Transdermal, Epicutaneous
  15. Explain the inhalation method of administration and what are some examples
    • inhaled through mouth or nose
    • inhaler for asthma, rhinitis, diabetes (inhaled insulin), general anesthesia, and moderate sedation with nitrous oxide/oxygen
  16. Describe otic admininstration
    drops and irrigations for local conditions of the ear
  17. Describe Intranasal administration
    nose sprays and drops for local and systemic effects
  18. Describe Epicutaneous administration and an example
    • directly on the skin
    • Dental topical anesthetic
  19. Pharmacokinetics is the
    study of drug movement throughout the body, including how a drug gets to the site of action, and how the body handles medications
  20. Pharmacokinetics is determined by what four processes
    • Absorption
    • Distribution
    • Metabolism (biotransformation)
    • Elimination
  21. Absorption and Distribution is
    how a drug gets to the site of action
  22. Metabolism (biotransformation) is
    what the body does to the drug
  23. Elimination or Excretion is
    how drugs move through and exits the body
  24. The Ultimate goal of pharmacokinetics is
    for the drug to reach the site of action (through the bloodstream) in an adequate concentration to produce desired effect prior to elimination
  25. Drugs are Better absorbed in the small intestine than the stomach due to
    the larger surface area
  26. Absorption is getting the drug ___________ in order to get the drug to the _______ where it will have its effect
    • into the blood
    • organ or tissue
  27. To get into the blood, a drug must pass through many _______
    cell membranes or tissue barriers
  28. Cell membranes are composed of two layers of lipids called the __________
    biphospholipid layer
  29. _______ is one of the most important determinants of the pharmacokinetic characteristics of a drug
    Lipid solubility
  30. Lipophilic drugs pass through the cell membrane by ________
  31. Hydrophilic drugs either pass through the _________ or are ________
    • aqueous pores of the membrane
    • kept outside
  32. What are the types of cell membranes to get into the blood and what drugs uses which
    • Intestinal mucosa–blood barrier: orally administered drugs
    • Oral mucosa–blood barrier: sublingually or buccally administered drugs
    • Placental barrier: acts as filter to some substances getting into the blood of the fetus
  33. What are the Types of cell membranes in the body from the blood to the site of action
    • Blood-tissue barrier: the membrane between the blood and the organ/tissue of the site of action
    • Blood-brain barrier: cell membrane of the brain is very lipid which allows lipid-soluble drugs (ex. general anesthetics, alcohol, anti-anxiety drugs) to go through, but keeps out water soluble drugs
  34. What are the four processes of absorption
    • 1.Passive diffusion
    • 2.Facilitated diffusion
    • 3.Active transport
    • 4.Pinocytosis
  35. Explain passive diffusion
    • -Most drugs follow this route
    • –Moves from the higher concentration outside the cell to lower concentration inside the cell
    • –No energy is used in passive diffusion
  36. Explain active transport
    • involves the use of carrier proteins against the concentration gradient.
    • Energy is used.
    • Not common
  37. Explain pinocytosis
    • involves the engulfment of fluids or particles by a cell.
    • Cell membrane traps the substance, forms a vesicle that detaches and moves into the cell.
    • Involves energy use
  38. Only the ________ form of the drug is usually ______ soluble and readily crosses the cell membrane (absorbed).
    • nonionized
    • lipid
  39. Pka is the
    pH that produces 50% ionized and 50% nonionized molecules of the drug
  40. How much of the drug is in the ionized or the nonionized form depends on the _______ and _________
    pKa of the drug AND the pH of the solution that the drug is in
  41. What does it mean for a drug to be ionized
    charged/water soluble (not going to be absorbed by the cell membrane)
  42. So most nonionized drugs (including the weak acids) are transported to the ________ where they are absorbed
    small intestine
  43. What are the four factors that influence the rate of absorption
    • 1.Blood flow to the organ– more blood flow equals more absorption
    • 2.Surface area – larger surface area of the small intestine equals more absorption
    • 3.Salt form of the drug – salt form of the drug enhances absorption and stability. Ex. – local anesthetics are combined with an acid to form a salt, allowing them to be combine with sterile water
    • 4.Route of drug administration – enteral vs. parenteral. With enteral, food can be a factor
  44. Local anesthetics are _______ but all anesthetics are ______ prior to injection
    • weak bases
    • acidic
  45. The _____________ determines whether the anesthetic will be charged or uncharged
    pH of the surrounding environment
  46. From the bloodstream drugs taken orally goes into the _______ where it is _________ which is called ________
    • liver
    • partially or totally biotransformed
    • first-pass effect
  47. What is the Distribution Phase
    the time from when a drug is absorbed from the GI tract into the bloodstream, and is distributed (transferred) throughout the body fluids to tissues and organs
  48. While in the bloodstream, drugs have the opportunity to either exist in _________ or ________
    • the free form
    • Be reversibly bound to the many proteins, primarily albumin, which is referred to as plasma protein binding
  49. Drugs that are plasma protein bound are in ______
    an inactive state
  50. Excretion is elimination through the ________ and out of the body in the _____.
    • kidneys
    • urine
  51. Drugs are eliminated either as the original parent compound or as a _____
    drug metabolite
  52. _________drugs are easily excreted by the kidneys
    Water-soluble (hydrophilic)
  53. To be readily eliminated from the body, a drug must be in a _________ form and the ______ is the primary site of drug biotransformation
    • water-soluble/polar (ionic)
    • liver
  54. After the drug is biotransformed, it is referred to as a
  55. What are PRODRUGS
    • defined as oral drugs that are inactive and become active only after metabolism in the liver
    • Ex. codeine
  56. Describe Phase I of Biotransformation
    The liver uses enzymes (called cytochrome P450 enzymes) to make lipid soluble drugs more water soluble (so they can be excreted). Some drugs may get excreted after Phase I, some will get reabsorbed from the kidneys back into the blood and go to Phase II
  57. Describe Phase II of Biotransformation
    The drug or metabolite from phase I is conjugated or linked with highly water soluble compounds such as glucuronic acid to make it more water-soluble so that it can be excreted
  58. _______ is the most common enzyme that metabolizes many drugs in dentistry
  59. Substrate
    The drug being metabolized
  60. Factors that may influence an individual’s ability to metabolize drugs include
    • Genetics
    • Age
    • Disease
  61. Most drugs follow _________ of elimination
    first-order kinetics
  62. Explain First-order kinetics
    As the drug is eliminated from the body, the concentration of the drug in the plasma will decrease equally over time
  63. Zero-order kinetics
    Elimination of a drug is at a constant rate that is not dependent upon its concentration
    Time it takes for the concentration of the drug in the blood to fall to half (50%) of its original value
  65. The larger the t½ value, the longer it takes for
    a drug to be eliminated from the body
  66. Drug delivered intravenously has _______ bioavailability
  67. Loading dose
    A high dose of a drug is given initially to rapidly establish a therapeutic plasma drug concentration
  68. Maintenance dose
    Lower doses used to maintain a desired drug level at a steady state plasma concentration
  69. Therapeutic range
    Concentration of the drug in the plasma between the MEC (minimum effective concentration) and the toxic concentration
  70. Drug clearance
    Capacity of the body to remove a drug
  71. The site where such drug attachment takes place is termed the
  72. Receptors are usually a ________. Drugs attach by ______ to the receptor site
    • protein
    • Van der Waal’s forces (ionic bonds)
  73. An agonist is
    a drug that rapidly combines with a receptor to initiate a response and rapidly dissociates or releases from the receptor
  74. An antagonist is
    a drug that binds to the receptor but does not dissociate and has no positive response and no efficacy. It blocks the reaction of an agonist.
  75. A partial agonist is
    a drug that slowly binds to the receptor and produces a mild therapeutic response (slight efficacy) when administered alone but may inhibit the action of an agonist when given concurrently, acting like an antagonist
  76. Graded dose
    –Observing and measuring the patient’s response obtained at different doses of the drug
  77. Threshold dose
    minimum dose of a drug needed to produce a therapeutic/measurable response
  78. Efficacy
    Ability to produce a therapeutic effect
  79. Ceiling effect is reached when
    the therapeutic response cannot be increased with a higher dose of the drug
  80. Therapeutic effect
    • Desirable/beneficial pharmaceutical effect of that a drug exerts at the target site of action
    • Ex. the therapeutic effect of aspirin is pain relief and fever reduction
  81. Therapeutic index is the
    ratio of a drug’s toxic dose to its therapeutic dose
  82. The effective dose or _____ is the _______
    • (ED50)
    • the drug dose that produces 50% of the maximum possible response
  83. Adverse drug event (ADE)
    Injury resulting from medical intervention related to a drug
  84. What are some examples of Type A adverse drug events
    • –Providing the correct drug but the wrong route
    • –Drug interactions
    • –Predictable and preventable
  85. What are some factors of Type B adverse drug events
    • –Dose independent
    • –Individual’s response and genetic differences
  86. Adverse drug reactions (ADR)
    Undesirable drug effects
  87. Generally, adverse effects are
    dose related
  88. Toxic Effect
    • Defined as harmful effects associated with drug overdose
    • dose dependent and predictable
    • Nontarget organs involved
  89. Idiosyncrasy
    the unexplained, uncharacteristic response to a drug caused by hereditary factors or genetic differences
  90. Allergic response is
    when a foreign substance, an antigen (drug) causes the body to produce antibodies in response to that antigen
  91. Mutagenic Reaction
    Caused by drug-induced damage to DNA
  92. Teratogenic Reaction
    Refers to the drug-induced damage that develops in the fetus
  93. Tachyphylaxis
    very rapid development of tolerance
Card Set:
Pharm Chp 2
2017-01-23 13:24:47
Pharm Chp
Pharm Chp 2
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