Pharmacokinetics and Pharmacodynamics Quiz
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Questions and Answers

What are the two primary phases of drug action?

Pharmacokinetics and pharmacodynamics

What are the four main processes involved in pharmacokinetics?

  • Distribution, metabolism, elimination, excretion
  • Absorption, distribution, elimination, excretion
  • Absorption, distribution, metabolism, excretion (correct)
  • Absorption, digestion, metabolism, excretion

What is the primary site of drug metabolism?

Liver

Enteric-coated tablets should always be crushed for faster absorption.

<p>False (B)</p> Signup and view all the answers

What is the definition of bioavailability?

<p>The percentage of an administered drug that reaches systemic circulation and is available to exert its therapeutic effect.</p> Signup and view all the answers

Which of the following routes of administration has the highest bioavailability?

<p>Intravenous (B)</p> Signup and view all the answers

What term describes the process of a drug moving from the bloodstream into body tissues?

<p>Distribution</p> Signup and view all the answers

What is the definition of protein binding?

<p>The extent to which a drug binds to plasma proteins, primarily albumin.</p> Signup and view all the answers

What is the definition of half-life?

<p>The time it takes for the concentration of a drug in the body to decrease by 50%.</p> Signup and view all the answers

What is a loading dose?

<p>An initial larger dose of a drug given to rapidly achieve therapeutic levels.</p> Signup and view all the answers

What is the definition of steady state?

<p>A state where the rate of drug administration equals the rate of drug elimination.</p> Signup and view all the answers

What is a pro-drug compound?

<p>A drug that is inactive when administered but is metabolized into an active form.</p> Signup and view all the answers

What are the primary routes of drug excretion?

<p>Kidneys, liver (bile), feces, lungs, saliva, sweat, and breast milk.</p> Signup and view all the answers

What is the therapeutic index?

<p>The ratio of a drug's toxic dose to its therapeutic dose.</p> Signup and view all the answers

What is potency?

<p>The amount of drug required to produce a specific effect.</p> Signup and view all the answers

What is maximal efficacy?

<p>The maximum therapeutic effect that a drug can produce.</p> Signup and view all the answers

What is onset?

<p>The time it takes for a drug to reach its minimum effective concentration and begin exerting its therapeutic effect.</p> Signup and view all the answers

What is duration?

<p>The length of time a drug's therapeutic effect lasts.</p> Signup and view all the answers

What is the approximate onset of action for oral medications?

<p>2-3 hours</p> Signup and view all the answers

What are peak and trough drug levels?

<p>Measurements of a drug's concentration in the blood at its highest point (peak) and lowest point (trough) during a dosing interval.</p> Signup and view all the answers

What is the site called where drugs bind to receptors?

<p>Ligand binding domain</p> Signup and view all the answers

What are the possible effects of drugs binding to receptors?

<p>All of the above (D)</p> Signup and view all the answers

What are agonists?

<p>Drugs that activate receptors and produce a desired response.</p> Signup and view all the answers

What are partial agonists?

<p>Drugs that interact with receptors to stimulate a response but also inhibit other responses by preventing receptor activation.</p> Signup and view all the answers

What are non-specific drugs?

<p>Drugs that affect various receptor sites throughout the body.</p> Signup and view all the answers

What are non-selective drugs?

<p>Drugs that affect more than one type of receptor.</p> Signup and view all the answers

What are the main mechanisms of drug action?

<p>Stimulation, depression, irritation, replacement, cytotoxic action, antimicrobial action, modification of immune status (C)</p> Signup and view all the answers

What is the definition of a side effect?

<p>A predictable, unintended, and often unavoidable effect of a drug.</p> Signup and view all the answers

What is an adverse reaction?

<p>An unintended and undesirable effect of a drug that is more severe than a side effect.</p> Signup and view all the answers

What is drug toxicity?

<p>A state where the drug level in the body exceeds the therapeutic range and produces harmful effects.</p> Signup and view all the answers

What are drug interactions?

<p>The altered effect of a drug due to interaction with another drug, food, nutrient, or disease state.</p> Signup and view all the answers

What is an additive drug interaction?

<p>The combined effect of two drugs is equal to the sum of their individual effects.</p> Signup and view all the answers

What is a synergistic drug interaction?

<p>The combined effect of two drugs is greater than the sum of their individual effects.</p> Signup and view all the answers

What is an antagonistic drug interaction?

<p>One drug blocks or reduces the effect of another drug.</p> Signup and view all the answers

What is pharmacogenetics?

<p>The study of how genetic variations influence individual responses to drugs.</p> Signup and view all the answers

What is tachyphylaxis?

<p>A rapid decrease in response to a drug after repeated administration.</p> Signup and view all the answers

Creatinine clearance is typically decreased in older adults and those with renal dysfunction.

<p>True (A)</p> Signup and view all the answers

Which phase of pharmacodynamics would be most influenced by fluid overload and fluid shift, such as in a patient with burns?

<p>Absorption</p> Signup and view all the answers

What nursing action is most important for medications with a narrow therapeutic index?

<p>Monitoring peak and trough drug levels</p> Signup and view all the answers

What are the three main categories of complementary and alternative medicine (CAM)?

<p>Botanicals, nutrients, and herbs</p> Signup and view all the answers

What is the definition of botanicals?

<p>Substances derived from plants used for medicinal purposes.</p> Signup and view all the answers

What is the definition of herbs?

<p>Plants used for medicinal purposes, often in their whole or dried form.</p> Signup and view all the answers

What is phytomedicine?

<p>The study of the therapeutic effects of plants on human health.</p> Signup and view all the answers

According to the Dietary Supplement Health and Education Act (DSHEA), what are the requirements for labeling dietary supplements?

<p>Products must be labeled as dietary supplements, intended to supplement the diet, contain one or more dietary ingredients, intended for oral ingestion, and have a nutrition facts label.</p> Signup and view all the answers

What must be included on the label of dietary supplements?

<p>Product name, name and address of manufacturer, amount of product in the package, ingredients, nutrition facts label (C)</p> Signup and view all the answers

What is Current Good Manufacturing Practice (CGMP) for dietary supplements?

<p>A set of guidelines that ensure the quality, purity, and consistency of dietary supplements.</p> Signup and view all the answers

What are some potential hazards associated with the use of herbs?

<p>Patients may not disclose herb use, potential for interactions with other medications, not all compounds are safe in all routes, interference with surgical procedures.</p> Signup and view all the answers

What did the Pediatric Research Equity Act of 2012 mandate?

<p>The requirement for studies involving pediatric drugs.</p> Signup and view all the answers

Why is there limited research on pediatric pharmacology?

<p>Research risks, challenges in obtaining informed consent, and limited resources.</p> Signup and view all the answers

How does drug absorption in children differ from adults?

<p>Absorption is influenced by age, weight, health, and route of administration.</p> Signup and view all the answers

What factors influence drug distribution in children?

<p>Children have more body fluid, less tissue mass, greater permeability of the blood-brain barrier, and lower protein levels.</p> Signup and view all the answers

How does drug metabolism differ in children compared to adults?

<p>Children have less developed hepatic blood flow and enzyme activity.</p> Signup and view all the answers

How does drug excretion differ in children compared to adults?

<p>Infants have a decreased glomerular filtration rate, leading to slower drug elimination.</p> Signup and view all the answers

What factors are considered when determining pediatric drug doses?

<p>Age, weight, route, health status, and organ function.</p> Signup and view all the answers

Medication errors are more common in pediatric patients.

<p>True (A)</p> Signup and view all the answers

What are some reasons why medication errors are more likely to occur in children?

<p>Difficulties in confirming identity, allergies, and medications, inaccurate dosage calculations, and challenges in communicating adverse reactions.</p> Signup and view all the answers

When teaching caregivers about drug administration, what information should be emphasized?

<p>The importance of accurate measurements and the use of appropriate syringes for medication administration.</p> Signup and view all the answers

What is the importance of assessing developmental age in addition to chronological age in pediatrics?

<p>Developmental age influences a child's understanding, comprehension, and ability to cooperate with medication administration.</p> Signup and view all the answers

How may toddlers react to medication administration?

<p>They may exhibit negative emotions and behavior due to a lack of understanding and limited communication skills.</p> Signup and view all the answers

How may preschool children typically react to medication administration?

<p>They may be receptive to medication explanations and cooperate more willingly if given age-appropriate explanations and involvement in the process.</p> Signup and view all the answers

How may school-age children typically react to medication administration?

<p>They may feel scared of harm and need clear explanations and reassurance, but can participate actively in the medication routine.</p> Signup and view all the answers

What is the principle of atraumatic care?

<p>Providing care in a way that minimizes stress and anxiety for children and their families.</p> Signup and view all the answers

What are the general medication guidelines for neonates?

<p>Medication choices are dependent on the specific clinical indication.</p> Signup and view all the answers

What general medication form is typically preferred for infants?

<p>Liquids</p> Signup and view all the answers

What are the typical medication forms suitable for children aged 2-5 years?

<p>Liquids, tablets dissolved in liquids, or sprinkles.</p> Signup and view all the answers

Flashcards

Pharmacokinetics

The study of what the body does to the drug.

Pharmacodynamics

The study of what the drug does to the body.

Enteric-coated tablet

A tablet with a coating that dissolves in the intestines, not the stomach. It's designed for slower absorption.

Drug absorption

The process of a drug moving from the GI tract into the bloodstream.

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Enteral

Administration through the GI tract, like taking pills or swallowing liquids.

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Parenteral

Administration that bypasses the GI tract, like injections or IV.

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Disintegration

Breaking down the oral drug into smaller particles.

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Dissolution

Combining small drug particles with liquid to form a solution.

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Bioavailability

The percentage of a drug administered that is actually available to produce an effect in the body.

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Drug distribution

The movement of a drug from the bloodstream to body tissues.

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Drug metabolism/ biotransformation

The process of the body chemically changing a drug so it can be excreted.

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Half-life

The time it takes for the amount of drug in the body to be reduced by half.

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Loading dose

The first dose given to reach a therapeutic effect quickly, followed by lower doses.

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Steady state

A plateau drug state where the amount of drug entering the body equals the amount being excreted.

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Potency

The amount of drug needed to elicit a certain response.

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Maximal efficacy

The point at which increasing a drug's dosage no longer increases the desired therapeutic response.

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Onset

The time it takes for a drug to reach its minimum effective concentration.

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Peak

The highest concentration of a drug in the blood.

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Duration

The length of time a drug exerts a therapeutic effect.

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Agonist

A drug that activates a receptor and produces the desired response.

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Antagonist

A drug that prevents a receptor from being activated, blocking the response.

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Partial agonist

A drug that interacts with a receptor to stimulate a response but also inhibits other responses by preventing receptor activation of other drugs.

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Non-specific drug

A drug that affects various receptor sites.

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Non-selective

A drug that affects more than one receptor.

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Pharmacogenetics

The study of how genetic variation affects an individual's response to drugs.

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Biologic variations

The science of understanding how genetic factors influence a person's response to drugs.

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Tachyphylaxis

A rapid decrease in response to a drug.

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Study Notes

Pharmacokinetics and Pharmacodynamics

  • Two drug phases are pharmacokinetics and pharmacodynamics.
  • Pharmacokinetics describes what the body does to a drug. It includes absorption, metabolism, distribution, and excretion.
  • Pharmacodynamics describes what a drug does to the body. It includes receptor binding, post-receptor effects, and chemical reactions.

Drug Absorption

  • Absorption is the drug's movement from the GI tract into the bloodstream.
  • Oral meds use the GI tract. IV meds bypass the GI tract.
  • Disintegration is the breakdown of the oral drug into small particles.
  • Dissolution is combining small drug particles with liquid to form a solution.
  • PO liquids bypass disintegration and dissolution phases.
  • Low pH (acidic environment) helps with breakdown, increasing absorption rate.
  • Methods of absorption: passive transport, active transport, pinocytosis.

Factors Affecting Drug Absorption

  • Blood circulation
  • Pain and stress
  • Food texture (e.g., fast absorption with acid-rich meals)
  • Fat content of food (e.g., milk slows absorption).
  • Temperature of food
  • Stomach pH
  • Route of administration
  • Slowed gastric emptying (e.g., after exercise)
  • Drug half-life

Drug Distribution

  • Drug distribution is the movement of the drug from the bloodstream into body tissues.
  • Factors include the drug's ability to bind, vascular permeability, cell membrane permeability, blood flow, tissue perfusion, and lipid solubility.
  • Protein binding: a portion of the drug binds to protein, which is inactive.
  • Free drug: the portion of the drug not bound to protein.
  • Monitor albumin and protein levels to ensure sufficient binding sites for the drug.
  • The blood-brain barrier (BBB): water-soluble drugs cannot cross; lipid-soluble drugs with low molecular weights can. The placenta also allows passage of lipid-soluble drugs.

Drug Metabolism (Biotransformation)

  • Metabolism chemically changes the drug for excretion.
  • Primarily occurs in the liver.
  • Bioavailability: percentage of the administered drug usable for activity. IV has 100% bioavailability; PO has less than 100% due to the first-pass effect.

Drug Excretion

  • Primarily by kidneys (GFR, creatinine clearance, BUN are indicators of kidney function), liver (bile), feces, lungs (CO2, volatile drugs), saliva, sweat, breast milk.
  • The urine pH affects excretion: acidic urine promotes weak base drug excretion; alkaline urine promotes weak acid drug excretion.

Drug Action Effects

  • Primary effect: desirable response.
  • Secondary effect: desirable or undesirable depending on the context.

Drug Action Mechanisms

  • Stimulation: enhancement of existing activity.
  • Depression: a decrease in body function.
  • Irritation: noxious effect
  • Replacement: replacing a missing substance (e.g., insulin).
  • Cytotoxic action: invasion and killing of specific cells (e.g., chemotherapy).
  • Antimicrobial action: inhibiting/killing/preventing infectious organisms.
  • Modification of immune status: altering, enhancing, or depressing the immune system.

Drug Interactions and Effects

  • Drug-drug interactions: altered drug effect from interaction with another drug.
  • Additive effect: sum of the individual effects (e.g., diuretic and beta-blocker).
  • Synergistic effect: effect greater than the sum of individual effects.
  • Antagonistic effect: one drug blocks the effect of another (e.g., naloxone for opioid overdose).
  • Drug-nutrient interactions (e.g., grapefruit juice, spinach and Coumadin).
  • Drug-induced photosensitivity: skin reactions from sunlight exposure.

Drug Half-life, Tolerance, and Toxicity

  • Half-life: time for the drug concentration to decrease by half. Prolonged in kidney/liver disease.
  • Loading dose: large initial dose to quickly achieve a therapeutic effect, then lower doses afterward.
  • Steady state: the plateau when the amount of drug entering the body equals the amount excreted.
  • Tolerance: decreased response to a drug.
  • Drug toxicity: drug level surpasses the therapeutic range, influenced by age, genetics, disease (e.g., kidney disease).

Pediatric Pharmacology

  • Pediatric drug absorption, distribution, metabolism, and excretion differ from adults due to age-related physiological variations.
  • Infants, toddlers, preschoolers, and school-age children have different developmental stages that impact how drugs are absorbed, distributed, metabolized, and excreted.
  • Dose calculations must consider age and weight to avoid errors, and assessment should consider developmental and/or chronological age when dealing with potential drug reactions or side effects.
  • The principles of atraumatic care should be implemented.
  • Infants and toddlers may have faster gastric emptying caused by breastfeeding, and children may have altered GI function, pH, and enzyme levels that affect absorption. They may have less fully developed liver/kidney function.
  • Monitor I/O and lab values to assess kidney function.
  • More drug will cross the BBB than the adult.

Additional Concepts

  • Potency: amount of drug needed to elicit a response.
  • Maximal efficacy: point where increasing dosage doesn't increase response.
  • Onset: time to reach minimum effective concentration.
  • Peak: highest drug concentration.
  • Duration: length of time for drug to have effect.
  • Peak/trough levels: used to monitor drug absorption and elimination rates in patient's blood.
  • Complementary and Alternative Medicine (CAM): botanicals, nutrients, herbs.
  • DSHEA guidelines for dietary supplements.
  • Herbal interactions and hazards.
  • Pharmacogenetics: how genetics affect drug response.
  • Biologic variations: study of genetic factors influencing drug response.
  • Tachyphylaxis: rapid reduction in drug response.
  • CAM use can be missed (patients not reporting) and should be considered when working with patients.

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Test your knowledge on pharmacokinetics and pharmacodynamics, the fundamental concepts that explain how drugs interact with the body. This quiz covers drug absorption, factors affecting absorption, and the two phases of drug action. Challenge yourself and enhance your understanding of these critical pharmacological principles.

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