Podcast
Questions and Answers
What is one of the primary reasons for switching a patient's medication form?
What is one of the primary reasons for switching a patient's medication form?
- To improve patient adherence and ease of use (correct)
- To match the brand name with the generic name
- To reduce the cost of the medication
- To increase the dosing frequency
Which of the following statements is true about modified or extended-release drugs?
Which of the following statements is true about modified or extended-release drugs?
- They should always be taken with food to improve absorption.
- They can be crushed for easier administration.
- They have a higher risk of causing adverse effects than immediate-release drugs.
- They allow for a more constant drug level in the bloodstream. (correct)
What must be considered when assessing renal dosing for a drug?
What must be considered when assessing renal dosing for a drug?
- The type of oral solution the patient prefers
- The patient’s age only
- The patient's body mass index (BMI)
- The patient's creatinine clearance (CrCl) or estimated glomerular filtration rate (eGFR) (correct)
What is a key counseling point for patients using transdermal medications?
What is a key counseling point for patients using transdermal medications?
What lab test result is most relevant for calculating a Child-Pugh score?
What lab test result is most relevant for calculating a Child-Pugh score?
Which term defines the process of how a drug is absorbed, distributed, metabolized, and excreted in the body?
Which term defines the process of how a drug is absorbed, distributed, metabolized, and excreted in the body?
In the context of drug distribution, which factor is most likely to affect the distribution of a drug within the body?
In the context of drug distribution, which factor is most likely to affect the distribution of a drug within the body?
What is the term used to describe a drug that becomes active only after metabolization?
What is the term used to describe a drug that becomes active only after metabolization?
Which concept describes the difference in therapeutic effect between two drugs that are chemically identical?
Which concept describes the difference in therapeutic effect between two drugs that are chemically identical?
What process primarily occurs in the liver and alters drug structure?
What process primarily occurs in the liver and alters drug structure?
Which of the following is a common factor affecting drug absorption?
Which of the following is a common factor affecting drug absorption?
In terms of pharmacokinetics, which parameter is best described as the time taken for the concentration of a drug in the blood to decrease by half?
In terms of pharmacokinetics, which parameter is best described as the time taken for the concentration of a drug in the blood to decrease by half?
What is the primary factor that facilitates drug absorption in the gastrointestinal tract?
What is the primary factor that facilitates drug absorption in the gastrointestinal tract?
Which of the following is NOT a factor that can affect drug elimination in the body?
Which of the following is NOT a factor that can affect drug elimination in the body?
What is the primary concern when prescribing an extended-release medication to a patient?
What is the primary concern when prescribing an extended-release medication to a patient?
Which of the following is NOT a characteristic of a 'do not crush' medication?
Which of the following is NOT a characteristic of a 'do not crush' medication?
A patient with a Child-Pugh score of 8 is being considered for a new medication. What is the appropriate clinical action?
A patient with a Child-Pugh score of 8 is being considered for a new medication. What is the appropriate clinical action?
Which of the following is NOT a key counseling point for patients using transdermal medications?
Which of the following is NOT a key counseling point for patients using transdermal medications?
Which of these statements accurately describes the impact of the first-pass effect on drug bioavailability?
Which of these statements accurately describes the impact of the first-pass effect on drug bioavailability?
What factor plays a significant role in determining the rate and extent of drug distribution throughout the body?
What factor plays a significant role in determining the rate and extent of drug distribution throughout the body?
Consider a drug with a narrow therapeutic index. What is a key implication of this characteristic?
Consider a drug with a narrow therapeutic index. What is a key implication of this characteristic?
Which of the following routes of administration is associated with the fastest onset of action?
Which of the following routes of administration is associated with the fastest onset of action?
Which of the following factors is most likely to increase the bioavailability of an orally administered drug?
Which of the following factors is most likely to increase the bioavailability of an orally administered drug?
What is the primary function of Phase II metabolism reactions?
What is the primary function of Phase II metabolism reactions?
Which of these statements accurately describes the concept of bioequivalence?
Which of these statements accurately describes the concept of bioequivalence?
What is the relationship between a drug's half-life and its steady-state concentration?
What is the relationship between a drug's half-life and its steady-state concentration?
What is the primary reason the FDA allows generic drugs to differ from brand-name drugs?
What is the primary reason the FDA allows generic drugs to differ from brand-name drugs?
A patient with hepatic impairment and a Child-Pugh score of 10 needs a medication dosage adjustment. What general recommendation is most appropriate?
A patient with hepatic impairment and a Child-Pugh score of 10 needs a medication dosage adjustment. What general recommendation is most appropriate?
Which of the following is a typical pharmacokinetic change observed in geriatric patients that influences medication dosing?
Which of the following is a typical pharmacokinetic change observed in geriatric patients that influences medication dosing?
What process is least likely involved in drug elimination from the body?
What process is least likely involved in drug elimination from the body?
A physician is considering prescribing a modified-release drug to a patient. What is a primary concern that should be considered?
A physician is considering prescribing a modified-release drug to a patient. What is a primary concern that should be considered?
Which process best describes the movement of a drug from the bloodstream into tissue?
Which process best describes the movement of a drug from the bloodstream into tissue?
What primary effect does a drug's first pass metabolism have on its bioavailability?
What primary effect does a drug's first pass metabolism have on its bioavailability?
What does a steep slope on a dose-response curve of a drug indicate?
What does a steep slope on a dose-response curve of a drug indicate?
What is the main benefit of administering a drug through the intravenous route?
What is the main benefit of administering a drug through the intravenous route?
What would be the most likely effect on the absorption of an acidic drug (such as aspirin) when administered with an antacid?
What would be the most likely effect on the absorption of an acidic drug (such as aspirin) when administered with an antacid?
Which phase of drug metabolism primarily involves oxidation, reduction, or hydrolysis?
Which phase of drug metabolism primarily involves oxidation, reduction, or hydrolysis?
Which process is most likely to cause a drug to be reabsorbed from the renal tubules back into the bloodstream?
Which process is most likely to cause a drug to be reabsorbed from the renal tubules back into the bloodstream?
If a drug has a half-life of 4 hours, how long will it take for the drug concentration to reach 25% of the original concentration?
If a drug has a half-life of 4 hours, how long will it take for the drug concentration to reach 25% of the original concentration?
What factor may cause a need to switch a medication from an oral form to a transdermal form?
What factor may cause a need to switch a medication from an oral form to a transdermal form?
When considering a medication that should not be crushed, which of the following is a potential reason?
When considering a medication that should not be crushed, which of the following is a potential reason?
What change in drug elimination might be expected in a patient with renal impairment?
What change in drug elimination might be expected in a patient with renal impairment?
Which aspect should be considered for prescribing medications to the geriatric population?
Which aspect should be considered for prescribing medications to the geriatric population?
Which of the following is a downside of using modified or extended-release formulations?
Which of the following is a downside of using modified or extended-release formulations?
What is meant by the term 'therapeutic window' in pharmacology?
What is meant by the term 'therapeutic window' in pharmacology?
Which factor is likely to have the least effect on drug absorption?
Which factor is likely to have the least effect on drug absorption?
Which process best describes the movement of a drug from its site of administration into the bloodstream?
Which process best describes the movement of a drug from its site of administration into the bloodstream?
What is the primary role of drug metabolism in pharmacokinetics?
What is the primary role of drug metabolism in pharmacokinetics?
Which of the following statements is true regarding 'first-pass effect'?
Which of the following statements is true regarding 'first-pass effect'?
What does a steep slope on a dose-response curve indicate?
What does a steep slope on a dose-response curve indicate?
Which is NOT a characteristic of pharmaceutical equivalence?
Which is NOT a characteristic of pharmaceutical equivalence?
How does ionization of a drug molecule affect its distribution in the body?
How does ionization of a drug molecule affect its distribution in the body?
A patient presents with severe nausea and vomiting, making oral medications difficult. Which of the following dosage forms would be most appropriate in this situation?
A patient presents with severe nausea and vomiting, making oral medications difficult. Which of the following dosage forms would be most appropriate in this situation?
A patient with severe renal impairment is prescribed a medication that is primarily eliminated by the kidneys. What pharmacokinetic parameter would be most important to consider when determining a safe and effective dosage for this patient?
A patient with severe renal impairment is prescribed a medication that is primarily eliminated by the kidneys. What pharmacokinetic parameter would be most important to consider when determining a safe and effective dosage for this patient?
Which of the following scenarios is most likely to necessitate a change in the dosage form of a medication being used?
Which of the following scenarios is most likely to necessitate a change in the dosage form of a medication being used?
A patient presents with hepatic impairment and a Child-Pugh score of 7. What general recommendation for dosage adjustments should be considered for medications that are primarily metabolized by the liver?
A patient presents with hepatic impairment and a Child-Pugh score of 7. What general recommendation for dosage adjustments should be considered for medications that are primarily metabolized by the liver?
Which of the following is a potential disadvantage of using modified or extended-release formulations?
Which of the following is a potential disadvantage of using modified or extended-release formulations?
What does the term 'bioavailability' refer to in pharmacology?
What does the term 'bioavailability' refer to in pharmacology?
Which statement best describes the first-pass effect?
Which statement best describes the first-pass effect?
What is a primary consequence of a drug possessing a narrow therapeutic index?
What is a primary consequence of a drug possessing a narrow therapeutic index?
Which factors primarily influence drug absorption in the gastrointestinal tract?
Which factors primarily influence drug absorption in the gastrointestinal tract?
What is the significance of the angle of the slope in a dose-response curve?
What is the significance of the angle of the slope in a dose-response curve?
Which of the following best defines pharmacodynamics?
Which of the following best defines pharmacodynamics?
In the context of drug metabolism, what is primarily involved in Phase II reactions?
In the context of drug metabolism, what is primarily involved in Phase II reactions?
What does the term 'therapeutic window' imply about a drug?
What does the term 'therapeutic window' imply about a drug?
Which characteristic is associated with passive transport across a cell membrane?
Which characteristic is associated with passive transport across a cell membrane?
What primary factor determines the rate of absorption across cell membranes?
What primary factor determines the rate of absorption across cell membranes?
The ratio of ionized to unionized drug molecules at a specific site is most likely to impact which pharmacokinetic process?
The ratio of ionized to unionized drug molecules at a specific site is most likely to impact which pharmacokinetic process?
A drug that relies on a protein carrier for transport is most likely using which process?
A drug that relies on a protein carrier for transport is most likely using which process?
Which of these is a distinguishing characteristic of active transport compared to facilitated diffusion?
Which of these is a distinguishing characteristic of active transport compared to facilitated diffusion?
Which of the following best describes how a vasodilator could alter drug absorption?
Which of the following best describes how a vasodilator could alter drug absorption?
A drug administered intravenously has a bioavailability of 100%. What does this mean in the context of drug absorption?
A drug administered intravenously has a bioavailability of 100%. What does this mean in the context of drug absorption?
How does the first-pass effect primarily influence a drug's bioavailability?
How does the first-pass effect primarily influence a drug's bioavailability?
If a drug has 80% bioavailability when administered transdermally, what percentage of a 100mg dose will reach systemic circulation?
If a drug has 80% bioavailability when administered transdermally, what percentage of a 100mg dose will reach systemic circulation?
Which of the following medications is MOST likely to be affected by chelation with calcium?
Which of the following medications is MOST likely to be affected by chelation with calcium?
What is the most accurate definition of the 'first-pass effect'?
What is the most accurate definition of the 'first-pass effect'?
What does the therapeutic index of a drug reflect?
What does the therapeutic index of a drug reflect?
Which of the following best describes the term 'drug distribution' in pharmacology?
Which of the following best describes the term 'drug distribution' in pharmacology?
Which route of drug administration bypasses the gastrointestinal tract?
Which route of drug administration bypasses the gastrointestinal tract?
What is the primary function of plasma proteins in drug distribution?
What is the primary function of plasma proteins in drug distribution?
Which of the following factors is most likely to decrease the percentage of a drug bound to plasma proteins?
Which of the following factors is most likely to decrease the percentage of a drug bound to plasma proteins?
What is a significant factor influencing the absorption of a drug?
What is a significant factor influencing the absorption of a drug?
According to the information provided, if two drugs have the same efficacy, which characteristic of a dose response curve would indicate one drug may be safer than another?
According to the information provided, if two drugs have the same efficacy, which characteristic of a dose response curve would indicate one drug may be safer than another?
If a drug has a high apparent volume of distribution (Vd), what does that indicate?
If a drug has a high apparent volume of distribution (Vd), what does that indicate?
Which of these options is a factor which affects the extent of a drug's distribution?
Which of these options is a factor which affects the extent of a drug's distribution?
What does the term 'variability' refer to in the context of dose-response relationships?
What does the term 'variability' refer to in the context of dose-response relationships?
What effect does drug binding to plasma proteins have on the drug's activity?
What effect does drug binding to plasma proteins have on the drug's activity?
Which of the following is a key factor affecting the rate of drug distribution after absorption?
Which of the following is a key factor affecting the rate of drug distribution after absorption?
If a drug is administered via the sublingual route, what characteristic makes it a suitable method of administration?
If a drug is administered via the sublingual route, what characteristic makes it a suitable method of administration?
What is the clinical relevance of the 'apparent volume of distribution'?
What is the clinical relevance of the 'apparent volume of distribution'?
Which of the following is an example of 'enteral' administration of a drug?
Which of the following is an example of 'enteral' administration of a drug?
What is the primary function of metabolic reactions in the body regarding a drug?
What is the primary function of metabolic reactions in the body regarding a drug?
What is a key characteristic of a Phase II metabolic reaction?
What is a key characteristic of a Phase II metabolic reaction?
If a drug is metabolized into an active form with affinity for the parent drug receptor, what is this metabolite best described as?
If a drug is metabolized into an active form with affinity for the parent drug receptor, what is this metabolite best described as?
In terms of drug metabolism, what is the most important effect of chemical reactions in the liver?
In terms of drug metabolism, what is the most important effect of chemical reactions in the liver?
A patient has a polymorphism that causes them to be a poor metabolizer of a particular drug; how would this most likely affect its concentration-time curve (AUC)?
A patient has a polymorphism that causes them to be a poor metabolizer of a particular drug; how would this most likely affect its concentration-time curve (AUC)?
What is the most likely outcome of enzyme induction on a drug's effect?
What is the most likely outcome of enzyme induction on a drug's effect?
If a drug is an enzyme inhibitor, what is the most likely effect this will have on a drug metabolized by that enzyme?
If a drug is an enzyme inhibitor, what is the most likely effect this will have on a drug metabolized by that enzyme?
Consider a patient with extremely functional CYP2D6 when considering codeine, a prodrug requiring this enzyme for activation. What would be the appropriate adjustment for a dose of codeine in this patient?
Consider a patient with extremely functional CYP2D6 when considering codeine, a prodrug requiring this enzyme for activation. What would be the appropriate adjustment for a dose of codeine in this patient?
What is a characteristic of competitive inhibitors?
What is a characteristic of competitive inhibitors?
Which of the following describes a consequence of P450 enzyme inhibition?
Which of the following describes a consequence of P450 enzyme inhibition?
What role does drug metabolism play in excretion?
What role does drug metabolism play in excretion?
Which mechanism is NOT involved in renal drug excretion?
Which mechanism is NOT involved in renal drug excretion?
What condition primarily affects glomerular filtration?
What condition primarily affects glomerular filtration?
What type of excretion involves the bile instead of urine?
What type of excretion involves the bile instead of urine?
Which statement correctly describes noncompetitive inhibitors?
Which statement correctly describes noncompetitive inhibitors?
Which factor does NOT influence the renal excretion process?
Which factor does NOT influence the renal excretion process?
Flashcards
Pharmacology
Pharmacology
The study of how drugs interact with living organisms, including their absorption, distribution, metabolism, excretion, and effects.
Drug
Drug
Any substance that can alter a biological function when administered to a living organism.
Biopharmaceutics
Biopharmaceutics
The study of how the physical and chemical properties of a drug affect its absorption, distribution, metabolism, and excretion. It focuses on how drugs are formulated and how they behave in the body.
Absorption
Absorption
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Distribution
Distribution
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Metabolism
Metabolism
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Excretion
Excretion
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Pharmacodynamics
Pharmacodynamics
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Generic vs. Brand-name Drugs: FDA Regulations
Generic vs. Brand-name Drugs: FDA Regulations
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Transdermal Drug Forms - Advantages & Disadvantages
Transdermal Drug Forms - Advantages & Disadvantages
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Liver Disease & Drug Metabolism
Liver Disease & Drug Metabolism
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Do Not Crush Medications
Do Not Crush Medications
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Prescribing Drugs for Geriatric Patients
Prescribing Drugs for Geriatric Patients
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Dose-Response Curve
Dose-Response Curve
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Therapeutic Index
Therapeutic Index
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Angle of the Slope (Dose-Response Curve)
Angle of the Slope (Dose-Response Curve)
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Drug Metabolism
Drug Metabolism
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Prodrug
Prodrug
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Half-Life
Half-Life
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Drug Excretion
Drug Excretion
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Steady-State Drug Concentration
Steady-State Drug Concentration
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Do Not Crush Medications: Why?
Do Not Crush Medications: Why?
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Transdermal Drug Forms: Pros and Cons
Transdermal Drug Forms: Pros and Cons
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Liver Disease and Drug Metabolism
Liver Disease and Drug Metabolism
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Prescribing for Geriatrics: Special Considerations
Prescribing for Geriatrics: Special Considerations
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Angle of the Slope in a Dose-Response Curve
Angle of the Slope in a Dose-Response Curve
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Drug Absorption
Drug Absorption
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Drug Distribution
Drug Distribution
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Pharmacokinetics
Pharmacokinetics
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Therapeutic window
Therapeutic window
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Therapeutic Index (TI)
Therapeutic Index (TI)
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Bioavailability
Bioavailability
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First-Pass Metabolism
First-Pass Metabolism
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Drug Absorption: How pH Affects It
Drug Absorption: How pH Affects It
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Drug Absorption: How Motility Affects It
Drug Absorption: How Motility Affects It
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Drug Absorption: How Perfusion Affects It
Drug Absorption: How Perfusion Affects It
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What is drug distribution?
What is drug distribution?
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What factors influence drug distribution?
What factors influence drug distribution?
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What are plasma proteins?
What are plasma proteins?
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What is the apparent volume of distribution (Vd)?
What is the apparent volume of distribution (Vd)?
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What does a high Vd mean?
What does a high Vd mean?
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What does a low Vd mean?
What does a low Vd mean?
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How does the binding of drugs to plasma proteins affect their activity?
How does the binding of drugs to plasma proteins affect their activity?
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How can the amount of bound drug change?
How can the amount of bound drug change?
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Competitive Inhibitor
Competitive Inhibitor
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Noncompetitive Inhibitor
Noncompetitive Inhibitor
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Renal Excretion
Renal Excretion
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Nephron
Nephron
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Glomerular Filtration
Glomerular Filtration
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Tubular Secretion
Tubular Secretion
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Phase I Metabolism
Phase I Metabolism
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Phase II Metabolism
Phase II Metabolism
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Polymorphisms
Polymorphisms
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Enzyme Induction
Enzyme Induction
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Enzyme Inhibition
Enzyme Inhibition
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Active Metabolite
Active Metabolite
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Study Notes
Definitions
- ADME: Absorption, Distribution, Metabolism, Excretion
- Pharmacokinetics: The study of how drugs are absorbed, distributed, metabolized, and excreted in the body.
- Pharmacodynamics: The study of the effects of drugs on the body and how the body responds to them.
- Therapeutic Window: The range of drug concentrations that produce the desired effect without causing significant adverse effects; a narrow window means a small difference between the therapeutic and toxic doses while a wide window indicates a larger range.
- Bioavailability: The fraction of administered drug that reaches the systemic circulation in an active form.
- Bioequivalence: When two different formulations of the same drug have similar bioavailability and similar rates of absorption.
- Drug: A substance used to treat, prevent, or diagnose a disease or condition.
- Pharmacology: The study of drugs, their effects, and their uses.
- Drug Biopharmaceutics: The study of how the physical and chemical properties of a drug affect its rate and extent of absorption.
Drug Dosing
- Drug dosage forms/Drug Databases: Different ways a drug can be given (e.g., tablets, capsules, suspensions), and databases or websites used to look up drug information. This includes oral solutions, suspensions, elixirs and transdermal preparations.
- Drug Dosing in Special Populations: Dosage adjustments tailored to specific groups of patients (e.g., elderly, pregnant women), including those with renal or hepatic disease.
Absorption, Distribution, Metabolism, Excretion (ADME)
- Absorption: The process of taking in a drug. Factors affecting include:
- Site of absorption in the GI tract (primary site is the small intestine).
- Diffusion and transporter-mediated processes.
- Particle size and ionization.
- First-pass effect: The metabolism of a drug in the liver before it reaches the systemic circulation, reducing the bioavailability.
- OTC medications may affect absorption.
- Tissue permeability, and ionization.
- Distribution: The movement of a drug throughout the body. Factors affecting include:
- Tissue permeability, and ionization.
- Metabolism: The process of breaking down a drug. Major enzymatic reactions include Phase I (e.g., oxidation, reduction, hydrolysis) and Phase II (conjugation) processes. These processes occur primarily within the liver. This includes the formation of active or inactive metabolites.
- Excretion: The removal of a drug from the body. Important factors include renal excretion (filtration, secretion, reabsorption), biliary excretion, and other routes.
Dose-Response Relationships
- Dose-response curve: A graph showing the relationship between the dose of a drug and its effect.
- Therapeutic index: A measure of the safety of a drug. TI is quantified using ED50 and TD50 (effective dose and toxic dose).
- Slope of the dose-response curve: Represents the magnitude of effect change per dose change also indicating the slope sensitivity. The angle of the slope corresponds to the rate of effect change as the dose increases.
Administration Routes
- Various routes influence: onset, intensity, duration of a drug's effect. The comparison and contrast of different routes (e.g., oral, intravenous, intramuscular, subcutaneous, inhalational, transdermal) are crucial.
Other Key Concepts
- Half-life: The time it takes for the concentration of a drug in the body to be reduced by half.
- Drug interactions: The effects of one drug on another that alters drug metabolism or absorption.
- Pharmaceutical equivalence/bioequivalence: The relative similarity of different formulations of the same drug in terms of activity; Bioequivalence relates specifically to absorption.
- Therapeutic equivalence: When two different formulations of the same drug have the same therapeutic effect in a certain patient population.
- Generic drugs: Drugs that contain the same active ingredients as brand-name drugs, but are made by different companies. (FDA approval implies similar bioavailability and absorption)
- Adverse drug events (ADEs): Harmful effects of a drug.
- Prescribing cascades: The pattern of prescribing drugs in response to another drug's adverse events.
- Renal Disease and Hepatic Disease: These conditions can alter drug metabolism, elimination, and require dosage adjustments. This is relevant when considering dosages for special populations, such as those with hepatic disease or renal disease.
- Child-Pugh score: A clinical assessment to evaluate liver function and severity of liver disease.
- eGFR (estimated glomerular filtration rate): Estimate of kidney function.
- CrCl (creatinine clearance): A measure of kidney function.
Patient counseling and considerations
- Important factors to consider when counseling patients on dosage forms, routes of administration, and adverse effects of drugs.
- Identifying medications that might need modification or avoidance for patients based on clinical evaluation and characteristics (renal disease, hepatic disease, geriatrics).
- Consider conditions (e.g., geriatrics, hepatic/renal disease) and their impact on dosing and prescribing; this includes dosage and regimen adjustments for special populations.
- Pharmaceutical Equivalence/Bioequivalence and FDA: FDA approval for generic equivalents implies similarity to the active ingredients of brand-name drugs with respect to bioavailability and rate of absorption.
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