raines 1 straightforward

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raines 1 straightforward
2010-12-04 17:34:45
pharm micro

easy-ish memorization
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  1. how drugs interact with receptors. drugs go through the whole body, but
    only receptors, when targeted, do the action.
  2. 2 examples of zero-order reactions
    • alcohol
    • aspirin

    constant amount of drug is metabolized per unit time. nothing to do with concentration. the graph drops down in a straight line, no half life or curve.
  3. what a drug is called when it goes in the body in an inactive form, changes (biotransforms) within the body and THEN becomes the active drug
  4. first-order kinetics: concentration dependent
    constant FRACTION of drug metabolized per unit time (curve, half-lives)
  5. explain what it means to have a half life of one hour
    half the drug is metabolized in one hour. after another hour, half of what was left is metabolized. etc. larger volume distribution (Vd) takes longer to be broken down.
  6. pharmacokinetics: where the drug goes in your body
    • distribution
    • "the process by which a drug reversibly leaves the bloodstream and enters the extracellular fluid and/or cells"
  7. 3 factors that affect distribution (pharmacokinetics)
    • blood flow
    • capillary (blood brain barrier)
    • binding of drugs to proteins (albumin)
  8. pharmacokinetics: how a drug is converted in your body
  9. 2 drugs are therapeutically equivalent if
    they have comparable efficacy and safety (same effect)
  10. 2 drugs are bioequivalent if
    **not sure about this**

    they show comparable bioavailability and similar times to achieve peak blood concentration
  11. pharmacokinetics: how a drug gets out of your body
  12. oral penicillin is 10% bioavailable. your options are:
    give 10x the dose orally, or give I.V.
  13. without blood flow to the site, you won't get
    drug flow to that site.
  14. what is the concept of 'contact time' in terms of absorption?
    with diarrhea, the drug will come right out. with gastroparesis, it will stay in too long.
  15. relevance of surface area to amount of drug
    if you decrease surface area, you must increase the amount of drug. example: gastric bypass surgery, missing some stomach and some intestine. need more meds.
  16. pH in the context of absorption
    the pH of the site is very important!
  17. transport: most drugs go by [passive diffusion or active transport]
    passive diffusion. sometimes they need active transport, which requires ATP. but usually passive diffusion.
  18. route of administration: intrathecal
    • directly into spine.
    • good for anesthesia.
    • rare.
  19. 3 parenteral modes of administration (most predictable to least predictable)
    • IV
    • IM
    • SC
  20. is direct IV access predictable?
    yes, and fast. it hits the brain first.
  21. pharmacokinetics: how the drug gets in
  22. this is made by coagulase-negative staph in order to protect itself from antibiotics
    biofilm. catheters just need to COME OUT.
  23. 4 problematic sites of infection for antibiotic delivery
    • CNS/eye/blood brain barrier
    • Abscess
    • poorly vascularized areas
    • bone
  24. a diplococcus (in 2's), major cause of lobar pneumonia. the magic is in its capsule: without the capsule it's powerless
    • streptococcus pneumoniae
    • aka pneumococcus
    • aka strep pneumo
  25. normal flora in oropharynx, GI and GU tracts. dental caries, subacute bacterial endocarditis
    viridans streptococci
  26. streptococcus makes these. they activate the immune system and make it go haywire. massive cytokine storm. necrotizing fasciitis is in there.
  27. 2 routes of non-renal clearance
    bile (i.e. ceftriaxone)

    intestine (i.e. azithromycin)
  28. infection in the biliary tree
    ascending cholangitis
  29. if a drug is excreted in the bile, you don't want to use it to treat a
  30. most common mechanism of clearance for antibiotics
    renal clearance
  31. destroys muscle, destroys fat. starts off as cellulitis
    necrotizing fasciitis
  32. disproportionate amount of pain; blood-filled bulla: assume this until proven otherwise
    necrotizing fasciitis
  33. unique superficial form of cellulitis (cellulitis proper is deeper). red, swelling, on the face
  34. impetigo: treat for strep or staph?
  35. 4 centor criteria
    • 1. heart rate 100+
    • 2. temp above 38C (104F)
    • 3. no cough
    • 4. positive sore throat

    3 of 4? treat for strep A.
  36. this comes from strep. pyogenes. it breaks down blood clots and RBCs. we use it for strokes.
  37. the most important virulence factor for strep pneumo
  38. who gets vaccinated for strep pneumo?
    • kids
    • 65+
  39. kind of hemolysis: green plate. RBCs intact. hemoglobin turns to biliVERDin
    alpha hemolysis (this is not "true" hemolysis like beta)
  40. gamma hemolysis
    is a misnomer. no actual hemolysis at all.
  41. true hemolysis. lysed blood cells! plate becomes clear where cells have been lysed.
    beta hemolysis
  42. same family as strep but lives in the gut
  43. amoxicillin is given this way
  44. ampicillin is given this way
    • IV
    • you can give it orally but it must be dosed very frequently
  45. MIC
    minimum/mean inhibitory concentration. the concentration needed to inhibit growth. note: this doesn't assure safety, it might inhibit life, too.
  46. 2 aminopenicillins are
    • ampicillin
    • amoxicillin
  47. percentage of drug that reaches the systemic circulation, of the total amount given
    • bioavailability
    • IV is 100% bioavailable because all the drug enters the bloodstream
  48. "Drugs absorbed form the small intestine can be affected by metabolism from the liver as the venous circulation of the intestine drains into the portal circulation"
    first pass effect
  49. drug goes from portal vein into liver, metabolized and THEN spreads out into the body
    first pass effect