Ch1-3 Lehne
benefit, harm
This can inhibit CYP3A4 and cause drug toxicity.
Grapefruit juice
Side Question: Where are CYP enzymes located? Which part of pharmacokinetics do they influence?
They can activate prodrugs (e.g., codeine → morphine by CYP2D6)
Or inactivate active drugs (e.g., midazolam by CYP3A4)
They influence drug half-life, bioavailability, and clearance
This route bypasses the GI tract and liver, allowing 100% bioavailability.
IV (intravenous)
There are many measures taken to minimize adverse reactions. Name 2.
avoiding particular drugs that are likely to cause harm, monitoring for signs and symptoms of ADR, educating patients about possible ADRs, monitoring organs vulnerable to the drug.
This cellular adaptation has the greatest risk for cancer development
Dysplasia
The impact of the body on the drug is known as ___.
Pharmacokinetics
Generic Names: a drug that ends in -cillin is most likely used for ____. A drug that ends in -statin is most likely used for ____.
bacterial infection, lowering cholesterol.
Plateau stage is reached when ____.
The amount of drug eliminated between doses equals the dose administered, whereas drug levels remain consistent in the body.
Side Question: How many half-lives does it take to reach the plateau stage?
This is the range between the minimum effective concentration and the toxic level of a drug.
Therapeutic Range
Define coagulative necrosis and provide an example.
a type of cell death typically caused by ischemia (loss of blood supply) or infarction (tissue death due to lack of oxygen) Ex: Heart attack, renal infarction
Side Question: Name 2 other types of necrosis and give examples if you can!
Name 4 examples of sources of individual variation:
age, gender, weight, diminished functions (pathological), genetic variability, etc
Side Question: What are some specific pathological changes that influence variation?
A patient receives a single 200 mg dose of a drug with a half-life of 4 hours.
Assuming no additional doses are given and normal drug elimination, how much of the drug remains in the body after 12 hours?
After each half-life (every 4 hours), the amount of drug is reduced by 50%:
0 hours: 200 mg
4 hours: 100 mg
8 hours: 50 mg
12 hours: 25 mg
Correct answer: 25 mg remains after 12 hours.
These are the “5 rights” of medication administration.
What are the right patient, right drug, right dose, right route, and right time?
As a result of taking Vancomycin, an antibiotic, Denise has developed C. diff (GI infection that causes severe diarrhea). This is considered a(n) _____ disease.
Iatrogenic
Side Question: What is a disease referred to as when it has unknown origin?
Differentiate between hypertrophy and hyperplasia. Provide an example of each.
Hypertrophy: increase in cell SIZE; ie cardiac hypertrophy
Hyperplasia: Increase in cell NUMBER; ie BPH or endometrial hyperplasia
Drug schedules categorize drugs with -----. Provide an example of a Schedule I and a Schedule V medication.
Risk for abuse/dependency; heroin/ecstasy/LSD/cannabis, cough medications including >200 mg of codeine per 100mL
There are several nonrenal routes of excretion. Name 3.
Breast milk, sweat, saliva, lungs (volatile anesthetics), bile
Drugs that bind to receptors and mimic the actions of the body's own regulatory molecules.
Agonists
Side Question: What is the opposite of an agonist?
In a patient with kidney failure, drug-half life ____
increases (struggle to excrete it from the body!)
Side question: What is the role of the kidneys in pharmacokinetics?
Explain the process of metaplasia in smoker's lung. Is it reversible?
As cells are damaged, a hardier version replaces the normal strata of cells.
Side Question: In patient education, how might you explain how to reverse the metaplasia?
Name 3 factors that influence the intensity of a drug response:
administration, pharmacokinetics, pharmacodynamics, sources of individual variation
Drugs can reversibly bind to various proteins in the body. Of all of the plasma proteins ___ is the most important.
plasma albumin (page 34)
A large therapeutic index indicates that a drug is ____.
safe; low risk for toxicity
A reduction in drug responsiveness brought on by repeated dosing over a short time (hours).
Tachyphylaxis
Name 3 differences between apoptosis and necrosis:
1. apoptosis is programmed cell death, necrosis is a result of irreversible cellular injury
2. in apoptosis, cells are killed via cascade and not directly
3. apoptosis is not always pathological
4. there is no inflammation with apoptosis