Podcast
Questions and Answers
Which medication should be avoided in combination with aliskiren due to the risk of hypotension and hyperkalemia?
Which medication should be avoided in combination with aliskiren due to the risk of hypotension and hyperkalemia?
Which medication class selectively blocks the vasoconstrictive effects of angiotensin II?
Which medication class selectively blocks the vasoconstrictive effects of angiotensin II?
A patient is prescribed olmesartan for hypertension. What potential adverse effect should be monitored?
A patient is prescribed olmesartan for hypertension. What potential adverse effect should be monitored?
Which of the following medications is classified as a direct renin inhibitor?
Which of the following medications is classified as a direct renin inhibitor?
Signup and view all the answers
What is the mechanism of action of ACE inhibitors in treating hypertension?
What is the mechanism of action of ACE inhibitors in treating hypertension?
Signup and view all the answers
Which of the following characteristics enables a drug to bypass Phase I metabolism?
Which of the following characteristics enables a drug to bypass Phase I metabolism?
Signup and view all the answers
Which of the following is NOT a typical outcome of Phase I drug metabolism?
Which of the following is NOT a typical outcome of Phase I drug metabolism?
Signup and view all the answers
What is the primary purpose of Phase II drug metabolism?
What is the primary purpose of Phase II drug metabolism?
Signup and view all the answers
Which of the following receptor types involves direct alteration of DNA transcription?
Which of the following receptor types involves direct alteration of DNA transcription?
Signup and view all the answers
Which best describes the function of an antagonist?
Which best describes the function of an antagonist?
Signup and view all the answers
The 'rebound phenomenon' associated with sudden drug discontinuation is most closely related to which receptor type?
The 'rebound phenomenon' associated with sudden drug discontinuation is most closely related to which receptor type?
Signup and view all the answers
What is a 'Quantal' dose-reponse?
What is a 'Quantal' dose-reponse?
Signup and view all the answers
How does a partial agonist behave in the presence of a full agonist?
How does a partial agonist behave in the presence of a full agonist?
Signup and view all the answers
What factor determines the time it takes to reach steady state for a drug?
What factor determines the time it takes to reach steady state for a drug?
Signup and view all the answers
A drug with a significant first-pass effect would likely require which of the following?
A drug with a significant first-pass effect would likely require which of the following?
Signup and view all the answers
Which route of administration is LEAST likely to be affected by first-pass metabolism?
Which route of administration is LEAST likely to be affected by first-pass metabolism?
Signup and view all the answers
A drug has a therapeutic index of 2:1. What does this suggest about its safety?
A drug has a therapeutic index of 2:1. What does this suggest about its safety?
Signup and view all the answers
If a drug's half-life is 8 hours, approximately how long will it take to reach steady state?
If a drug's half-life is 8 hours, approximately how long will it take to reach steady state?
Signup and view all the answers
A pro-drug is best described as:
A pro-drug is best described as:
Signup and view all the answers
What does bioavailability represent in pharmacokinetics?
What does bioavailability represent in pharmacokinetics?
Signup and view all the answers
During which phase of drug metabolism do oxidation, reduction, and hydrolysis reactions typically occur?
During which phase of drug metabolism do oxidation, reduction, and hydrolysis reactions typically occur?
Signup and view all the answers
An infant (older than 28 days but less than 12 months) receives a topical medication. What physiological factor increases the risk of toxicity compared to an adult?
An infant (older than 28 days but less than 12 months) receives a topical medication. What physiological factor increases the risk of toxicity compared to an adult?
Signup and view all the answers
A neonate (0-28 days) requires medication. What is the primary concern regarding renal clearance in this age group?
A neonate (0-28 days) requires medication. What is the primary concern regarding renal clearance in this age group?
Signup and view all the answers
A 6-month-old infant needs a hydrophilic drug. What dosage adjustment should be considered due to the infant's body composition?
A 6-month-old infant needs a hydrophilic drug. What dosage adjustment should be considered due to the infant's body composition?
Signup and view all the answers
A physician is attempting to determine the correct dosage of a highly lipophilic drug for a 9-month-old infant. What consideration regarding the infant's body composition is most important?
A physician is attempting to determine the correct dosage of a highly lipophilic drug for a 9-month-old infant. What consideration regarding the infant's body composition is most important?
Signup and view all the answers
Compared to adults, how does the rate of drug metabolism generally differ in children older than 1 year?
Compared to adults, how does the rate of drug metabolism generally differ in children older than 1 year?
Signup and view all the answers
An infant (older than 28 days but less than 12 months) is prescribed a medication that is primarily metabolized through Phase II metabolism. What should the prescriber consider?
An infant (older than 28 days but less than 12 months) is prescribed a medication that is primarily metabolized through Phase II metabolism. What should the prescriber consider?
Signup and view all the answers
What ethical principle emphasizes the importance of equitable distribution of benefits and consequences in healthcare decisions, ensuring that patient needs are prioritized?
What ethical principle emphasizes the importance of equitable distribution of benefits and consequences in healthcare decisions, ensuring that patient needs are prioritized?
Signup and view all the answers
According to the provided content, Which of the following is a true consideration regarding intramuscular (IM) absorption in neonates (0-28 days old)?
According to the provided content, Which of the following is a true consideration regarding intramuscular (IM) absorption in neonates (0-28 days old)?
Signup and view all the answers
According to the content, what is the major concern when there are adverse drug effects due to immature organs?
According to the content, what is the major concern when there are adverse drug effects due to immature organs?
Signup and view all the answers
What ethical principle stresses that the patient be informed about decisions, and gives consent?
What ethical principle stresses that the patient be informed about decisions, and gives consent?
Signup and view all the answers
What is the primary goal of antibiotic stewardship programs?
What is the primary goal of antibiotic stewardship programs?
Signup and view all the answers
Which of the following best describes a time-dependent antibiotic?
Which of the following best describes a time-dependent antibiotic?
Signup and view all the answers
Oseltamivir (Tamiflu) is most effective when administered within what timeframe of influenza symptom onset?
Oseltamivir (Tamiflu) is most effective when administered within what timeframe of influenza symptom onset?
Signup and view all the answers
Which of the following is a common mechanism of action for inhaled medications used in asthma and COPD?
Which of the following is a common mechanism of action for inhaled medications used in asthma and COPD?
Signup and view all the answers
Why is combination therapy required for the treatment of tuberculosis (TB)?
Why is combination therapy required for the treatment of tuberculosis (TB)?
Signup and view all the answers
Which of the following directly describes the mechanism of action of corticosteroids in asthma and COPD treatment?
Which of the following directly describes the mechanism of action of corticosteroids in asthma and COPD treatment?
Signup and view all the answers
Which of the following describes the function of pyrazinamide in the treatment of tuberculosis?
Which of the following describes the function of pyrazinamide in the treatment of tuberculosis?
Signup and view all the answers
Which of the following properties describes concentration dependent antibiotics?
Which of the following properties describes concentration dependent antibiotics?
Signup and view all the answers
What is the function of Ethambutol in TB treatment?
What is the function of Ethambutol in TB treatment?
Signup and view all the answers
What is the therapeutic goal of Beta 2 agonists?
What is the therapeutic goal of Beta 2 agonists?
Signup and view all the answers
Which medication is typically considered first-line for managing hypertension in patients with heart failure?
Which medication is typically considered first-line for managing hypertension in patients with heart failure?
Signup and view all the answers
A patient with heart failure and a history of angioedema should be monitored for which of the following adverse drug reactions when taking ACE inhibitors?
A patient with heart failure and a history of angioedema should be monitored for which of the following adverse drug reactions when taking ACE inhibitors?
Signup and view all the answers
Which of the following antihypertensive medications is LEAST likely to be used in the treatment of heart failure?
Which of the following antihypertensive medications is LEAST likely to be used in the treatment of heart failure?
Signup and view all the answers
Which of the following adverse effects is specifically associated with nitroprusside use, especially in patients with renal failure?
Which of the following adverse effects is specifically associated with nitroprusside use, especially in patients with renal failure?
Signup and view all the answers
Which of the following is an example of an angiotensin II receptor blocker (ARB)?
Which of the following is an example of an angiotensin II receptor blocker (ARB)?
Signup and view all the answers
A patient is prescribed amoxicillin-clavulanate (Augmentin) for a bacterial infection. What is the role of clavulanic acid in this combination?
A patient is prescribed amoxicillin-clavulanate (Augmentin) for a bacterial infection. What is the role of clavulanic acid in this combination?
Signup and view all the answers
What is the most appropriate route of administration for vancomycin to treat a systemic infection?
What is the most appropriate route of administration for vancomycin to treat a systemic infection?
Signup and view all the answers
A patient receiving vancomycin develops flushing, itching, and a rash. What is the MOST likely cause of these symptoms?
A patient receiving vancomycin develops flushing, itching, and a rash. What is the MOST likely cause of these symptoms?
Signup and view all the answers
Which of the following beta-lactam antibiotics has the lowest risk of cross-reactivity in patients with a penicillin allergy?
Which of the following beta-lactam antibiotics has the lowest risk of cross-reactivity in patients with a penicillin allergy?
Signup and view all the answers
Which of these medications is a direct renin inhibitor?
Which of these medications is a direct renin inhibitor?
Signup and view all the answers
Which of the following antibiotics is typically used as a single-dose oral treatment for uncomplicated urinary tract infections (UTIs)?
Which of the following antibiotics is typically used as a single-dose oral treatment for uncomplicated urinary tract infections (UTIs)?
Signup and view all the answers
Which of the following antibiotics is LEAST likely to cause a Clostridium difficile infection?
Which of the following antibiotics is LEAST likely to cause a Clostridium difficile infection?
Signup and view all the answers
What condition would warrant the use of bacitracin?
What condition would warrant the use of bacitracin?
Signup and view all the answers
Which beta-lactamase inhibitor is combined with piperacillin to form the antibiotic Zosyn?
Which beta-lactamase inhibitor is combined with piperacillin to form the antibiotic Zosyn?
Signup and view all the answers
Which of the following classes of antibiotics is generally considered safe to use during pregnancy and breastfeeding?
Which of the following classes of antibiotics is generally considered safe to use during pregnancy and breastfeeding?
Signup and view all the answers
Flashcards
Pro-drug
Pro-drug
An inactive drug that must be metabolized into its active form.
First pass metabolism
First pass metabolism
Metabolism of a drug in the liver before it reaches systemic circulation.
Half-life
Half-life
The time required for half of a drug to be eliminated from the body.
Bioavailability
Bioavailability
Signup and view all the flashcards
Therapeutic index
Therapeutic index
Signup and view all the flashcards
Steady state
Steady state
Signup and view all the flashcards
Phase I reaction
Phase I reaction
Signup and view all the flashcards
Peaks and troughs
Peaks and troughs
Signup and view all the flashcards
Angiotensin II Receptor Blockers (ARBs)
Angiotensin II Receptor Blockers (ARBs)
Signup and view all the flashcards
Common ADRs of ARBs
Common ADRs of ARBs
Signup and view all the flashcards
Direct Renin Inhibitors
Direct Renin Inhibitors
Signup and view all the flashcards
ACE Inhibitors
ACE Inhibitors
Signup and view all the flashcards
Mechanism of Action (MOA) of ARBs
Mechanism of Action (MOA) of ARBs
Signup and view all the flashcards
Phase I Drug Metabolism
Phase I Drug Metabolism
Signup and view all the flashcards
Polar Molecule Groups
Polar Molecule Groups
Signup and view all the flashcards
Phase II Drug Metabolism
Phase II Drug Metabolism
Signup and view all the flashcards
Pharmacodynamics (PD)
Pharmacodynamics (PD)
Signup and view all the flashcards
Agonist
Agonist
Signup and view all the flashcards
Antagonist
Antagonist
Signup and view all the flashcards
Partial Agonist
Partial Agonist
Signup and view all the flashcards
Graded vs. Quantal Response
Graded vs. Quantal Response
Signup and view all the flashcards
Neonates
Neonates
Signup and view all the flashcards
Blood-Brain Barrier (BBB) in Neonates
Blood-Brain Barrier (BBB) in Neonates
Signup and view all the flashcards
Drug Absorption in Infants
Drug Absorption in Infants
Signup and view all the flashcards
Transdermal Absorption
Transdermal Absorption
Signup and view all the flashcards
Volume of Distribution (Vd)
Volume of Distribution (Vd)
Signup and view all the flashcards
Protein Binding in Infants
Protein Binding in Infants
Signup and view all the flashcards
Phase II Metabolism in Infants
Phase II Metabolism in Infants
Signup and view all the flashcards
Children 1 year and older
Children 1 year and older
Signup and view all the flashcards
Ethical Principle: Justice
Ethical Principle: Justice
Signup and view all the flashcards
Ethical Principle: Nonmaleficence
Ethical Principle: Nonmaleficence
Signup and view all the flashcards
Minimum Bactericidal Concentration (MBC)
Minimum Bactericidal Concentration (MBC)
Signup and view all the flashcards
Time Dependent Dosing
Time Dependent Dosing
Signup and view all the flashcards
Concentration Dependent Dosing
Concentration Dependent Dosing
Signup and view all the flashcards
Antibiotic Stewardship
Antibiotic Stewardship
Signup and view all the flashcards
Oseltamivir (Tamiflu)
Oseltamivir (Tamiflu)
Signup and view all the flashcards
First-Line TB Therapy
First-Line TB Therapy
Signup and view all the flashcards
Pyrazinamide in TB
Pyrazinamide in TB
Signup and view all the flashcards
Beta 2 Agonists
Beta 2 Agonists
Signup and view all the flashcards
Corticosteroids MOA
Corticosteroids MOA
Signup and view all the flashcards
ADRs of Inhaled Drugs
ADRs of Inhaled Drugs
Signup and view all the flashcards
Aldosterone antagonists
Aldosterone antagonists
Signup and view all the flashcards
First line diuretics for HF
First line diuretics for HF
Signup and view all the flashcards
Beta blockers
Beta blockers
Signup and view all the flashcards
SGLT2 inhibitors
SGLT2 inhibitors
Signup and view all the flashcards
Nitroprusside
Nitroprusside
Signup and view all the flashcards
Calcium channel blockers in HF
Calcium channel blockers in HF
Signup and view all the flashcards
Monitoring HF medications
Monitoring HF medications
Signup and view all the flashcards
Common ADRs of HF medications
Common ADRs of HF medications
Signup and view all the flashcards
Penicillins
Penicillins
Signup and view all the flashcards
Vancomycin
Vancomycin
Signup and view all the flashcards
Cephalosporins
Cephalosporins
Signup and view all the flashcards
Beta-lactamase inhibitors
Beta-lactamase inhibitors
Signup and view all the flashcards
Study Notes
Exam 1 Blueprint
-
Students have 75 minutes for the exam
-
The blueprint outlines the approximate distribution of questions across different content areas of pharmacology
-
Pharmacokinetics/Pharmacodynamics (PK/PD) covers 9 questions
-
Pharmacokinetics (PK): the body's interaction with a drug.
- Basic concepts include first-pass metabolism, half-life, bioavailability, and therapeutic index.
- Absorption: how well the body takes up a drug
- Distribution: how well the drug is transported to the site of action, including volume of distribution (Vd).
- Vd: the amount of circulating drug in the body
- Factors influencing distribution relate to the route of administration and blood flow
- Metabolism: transforming drugs into a more water-soluble form to be excreted
- usually involves the liver
- Parent drug: the initial drug form
- Pro-drug/inactive: Inactive form of drug that needs metabolism to become active
- Elimination: how a drug is cleared from the body.
- First-pass metabolism: hepatic metabolism before reaching the systemic circulation.
-
Half-life: time for half of the total drug to be eliminated from the body.
- Longer half-life = stays longer in the body
- Shorter half-life = quicker/more frequent dosing
-
Bioavailability: portion of the drug dose that reaches systemic circulation
-
Therapeutic index: ratio of dose causing undesirable effect to dose resulting in a desirable effect.
-
Steady state: amount of drug absorbed equals the amount eliminated. Reached at 3 to 5 half-lives.
Phase I and II Reactions
-
Phase I: non-synthetic reactions, involve oxidation, reduction, or hydrolysis (often via CYP enzymes) to create water-soluble/active metabolites
- Drugs may skip phase I; Phase I reactions can convert inactive drugs to active ones.
-
Phase II: synthetic/conjugation reactions, adds hydrophilic groups to parent drugs to create more water-soluble and easily excreted metabolites
- Usually involves glucuronidation.
- Phase II reactions usually make a drug inactive.
Pharmacodynamics (PD)
-
Drug response: the reaction of the body to the drug.
- Graded response: a continuous increase in response as dose increases
- Quantal response: either present or absent response in a given population
-
Drug action: the interaction between a drug and a receptor
- Agonist: elicits a response when binding to a receptor
- Antagonist: blocks receptor binding to prevent a response
- Partial agonist: partially activates a receptor, acting as an antagonist in the presence of a full agonist, thus reduces the response
Prescribing
- P-drugs = first-line drug, well-tolerated
- P-treatment: first-line, non-pharmacological approach: demonstrate calculation of correct pediatric doses, calculate initial dosages based on body surface area
Older Adults
- Physiologic changes in older adults: decreased kidney function, absorption, metabolism, and excretion.
Pediatrics
- Physiological variations (neonates, infants): permeability of the blood-brain barrier (BBB), intestinal and other absorption changes
- Neonates & Infants: Clearance & other metabolic differences
Pharmacokinetics/Pharmacogenetics and CYP Enzymes
- CYP enzymes: (Cytochrome P450) that metabolize many drugs.
- Poor metabolizers (PM), have diminished CYP, will have more pronounced adverse effects
- Extensive metabolizers (EM), have robust CYP, have more rapid metabolic reaction
- CYP1, CYP2, CYP3: important enzymes involved in drug metabolism
Adverse Drug Reactions (ADRs)
- Type I: Immediate, IgE-mediated (e.g., allergic reactions)
- Type II: Cytotoxic, antibody-mediated (e.g., hemolytic anemia)
- Type III: Immune complex-mediated (e.g., serum sickness)
- Type IV: Cell-mediated (e.g., contact dermatitis)
Drug-drug interactions
- Several factors influence this, including interactions between drugs through absorption, metabolism, distribution and excretion; interactions among medications.
Pharmacoeconomics
- Deals with the economic value of health care outcomes
- Factors involved include societal, insurance, healthcare organization, and the patient
Adherence
- Adherence = ratio of prescribed drugs taken to the number of prescribed doses, MPR (medication possession ratio.)
- Factors affecting adherence include personal beliefs, past history, economics, socioeconomic determinants of health
- Improving adherence involves lowest number of daily doses, the least expensive medications with fewest side effects, open communication and a shared decision-making model.
- Non-adherence can lead to negative health outcomes
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
Test your knowledge on hypertension medications and their mechanisms. This quiz covers topics such as drug interactions, side effects, and metabolic processes related to antihypertensive drugs. Perfect for students or professionals in pharmacology and medicine.