Basic and Clinical Pharmacology

Basic and Clinical Pharmacology Questions with answers already graded! Why is bioavailability for enteral administration (oral, rectal) usually much less than parenteral route of administration? - Answer First-pass metabolism by liver Why is the concept of absorption not particularly relevant in the field of anesthesia? - Answer Drugs instantly reach systemic circulation (have 100% bioavailability) When does first-pass metabolism occur? - Answer Before drug reaches systemic circulation or target site First pass metabolism significantly reduces the bioavailability of drugs, especially when ________ administered - Answer Orally Site of very significant first-pass metabolism for enteral administration - Answer Liver Which drug technically undergoes first-pass metabolism in the lungs before reaching arterial circulation/target site? - Answer Fentanyl Which drug is partially metabolized in the serum before reaching neuromuscular junction? - Answer Succinylcholine First-pass metabolism can be caused by what 4 things? - Answer Liver, lungs, plasma esterase, psuedocholinesterase What the body does to the drug - Answer Pharmacokinetics 4 processes of pharmacokinetics - Answer Absorption, distribution, metabolism, excretion Systemic absorption into circulation depends on what 3 things? - Answer Drug solubility, blood flow to site of absorption, area of absorbing surface available Relative amount of drug that reaches systemic circulation - Answer Bioavailability Bioavailability for parenteral route of administration (IV or IM) - Answer 1 (or 100%) Which tissue group gets the most cardiac output despite being a small percentage of body weight? - Answer Vessel rich group (brain, heart, liver, kidney, endocrine glands) Which tissue group get almost no cardiac output? - Answer Vessel-poor group (bone, ligaments, cartilage) After an injection, where does a drug initially go due to CO distribution? - Answer Vessel rich group tissues Following an injection, which type of drugs will rapidly equilibrium into CNS tissue? - Answer Lipophilic drugs Following an injection of a lipophilic drug, fat will gradually absorb more and more of the drug over time. This is an example of ________ - Answer Redistribution What is the effect of administering multiple doses of a lipophilic drug on peripheral tissue concentration (specifically fat)? - Answer Concentration increases (fat will gradually absorb more and more of drug) Most drugs are ________ acids or bases - Answer Weak Most drugs are weak acids/bases present in which form - ionized or unionized? - Answer Both Nonionized molecules are usually ________ soluble - Answer Lipid Ionized molecules are more ________ soluble - Answer Water soluble Which type of molecules can easily cross cell membranes, blood-brain barrier, renal tubular epithelium (therefore much more reabsorption), GI epithelium, placenta, and hepatocytes? - Answer Nonionized/lipid soluble Which type of molecules are less able to cross cell membranes, impair absorption in GI tract, limits access to the metabolizing enzymes in hepatocytes, and are much easier to be excreted renally? - Answer Ionized/water soluble Eventually, plasma concentration decreases begin to depend on ________ of the drug, rather than Redistribution as it did when the drug was initially administered. - Answer Elimination Most drugs are ________ to plasma proteins, making them unavailable or uptake and excretion - Answer Bound Protein that binds most acidic/neutral drugs - Answer Albumin