Pharmacology 2

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  • Created by: evepoag
  • Created on: 18-10-22 15:35
What are the functions of the GI system?
1. Ingestion
2. Secretion
3. Digestion/Absorption
4. Elimination
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What factors affect drug absorption?
- route of administration
- blood flow to absorbing site
- total surface area for absorbing site
- contact time at absorbing site
- chemical makeup of the drug
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What are the advantages and disadvantages or oral drug absorption?
Advantages:
- convenient
- non-sterile
- good absorption for most drugs
Disadvantages:
- GI irritation
- potential for interactions
- first-pass destruction
- inactivated by acids
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Describe first class metabolism bioavailability
When the medicine enters the gut, a portion of the dose is not absorbed. The other portion enters the portal vein, into the liver for metabolism. After metabolism, it enters the systemic bloodstream
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So what is meant by bioavailability?
It is part of the absorption process, and is the % of drug that reaches the systemic circulaiton
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What is peptic ulcer disease and what is a common cause?
Ulceration due to a breach in the gastric/duodenal mucosa,
usually caused by the use of NSAIDS
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What are PPIs?
Proton pump inhibitors
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What do PPIs do?
They irreversibly block an enzyme involved in the final stage of acid production. They block the receptors on the cells of the stomach that produce acid, causing reduce acid secretion
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Where are PPIs best absorbed and how do they reach there untouched?
Bets absorbed in the small intestine. They have a coating that prevents breakdown of drug in the stomach
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What do stimulant laxatives do?
eg: Bisacodyl
The laxative is metabolised by an intestinal enzyme and colon bacteria, producing a metabolite. This metabolite and the drug act on the colonic mucosal cells, which increases peristalsis (digestion contractions)
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Which blood vessel brings blood from the gastrointestinal tract to the liver?
Hepatic portal vein
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Can drugs be excreted in breast milk?
Yes
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What are the main routes of drug elimination?
Sweat, urine, faeces
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Should coated tablets be crushed prior to administration?
No
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Production of what protects the gastric mucosa by increasing mucus production and decreasing acid secretion?
Prostaglandins in the stomach
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If a patient is experiencing constipation, what laxative should be prescribed?
Lactulose
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What can ulcerative colitis be characterised by?
Acute and chronic inflammation of the colon which damages mucosal and submucosal layers of the large bowel
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What type of drugs are used in inflammatory bowel diseases?
(IBD)
Aminosalicylates
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What do aminosalicylates do?
They reduce inflammation of the bowel
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Why is it important that most aminosalicylates have a modified release?
Formulated to be released when it reaches the colon, where it is needed
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What are the two types of immunity?
Acquired and innate
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What are the 4 types of antimicrobials?
1. Antibiotics
2. Antivirals
3. Antiparasitic agents
4. Antifungals
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What do antibiotics fight against?
Bacteria
eg: bacterial pneumonia
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What do antivirals fight against and what do they aim to do?
Viruses, eg: HIV

They aim to minimise symptoms and infectiousness, and shorten the illness duration. They do not KILL the virus, but interfere with the replication of the virus
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Viruses need a human host to support multiplication. Why does this make antiviral medication treatment difficult?
The drug must be able to treat and stop the virus without serious affecting the host's cells
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What do anti-parasitic agents fight against?
Parasites
eg: malaria
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What do antifungals or antimycotics fights against?
Fungi
eg: yeast infections
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How are antifungals usually administered?
Topically
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What is it called when an antibiotic stops the growth/replication of bacterial pathogens?
Bacteriostatic
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What is it called when an antibiotics kill the bacterial and destroy bacterial cells?
Bactericidal
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When bacteria pathogens grow in chains, what is this called?
Strepto growth
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When bacteria pathogens grow in pairs, what is this called?
Diplo growth
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When bacteria pathogens grow in clusters, what is this called?
Staphlo
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What are aerobic and anaerobic bacterias?
Aerobic - requires an oxygenated environment

Anaerobic - does not require an oxygenated environment (some even die in oxygen)
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Gram stain is a bacterial stain, the ability of the cell wall of bacteria to take up the stain.

When bacteria takes up stain, what is this called?
Gram positive (it has a cell wall)
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When a bacteria cell has no cell wall and does not retain this stain, what is it called?
Gram negative
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Describe broad-spectrum and narrow-spectrum antibiotics to treat bacteria?
A broad-spectrum antibiotics will treat both Gram positive and Gram negative bacteria

Narrow-spectrum antibiotics will treat either Gram positive OR negative bacteria
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What happens if a patient who is Gram negative is given a Gram positive antibiotic?
They will not improve
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What are the 5 possible mechanisms or action/ targets of antibiotics?
1. Bacterial cell wall, eg: beta lactums, vancomycin
2. Bacterial cell membrane
3. Protein synthesis inside bacterial cell
4. Inhibiting DNA/RNA synthesis required to make proteins, eg: quinolone
5. Folic acid/folate synthesis
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What is the mechanism of action for the beta lactum antibiotic Penicillin?
Inhibits cell wall synthesis on Gram positive bacteria
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What is a common antibiotic-induced secondary infection?
Thrush due to the disruption of intestinal flora
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Penicillins all have a B lactam ring as part of their structure. Some bacteria produce an enzyme against it.
What is this enzyme called?
B-lactamase
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Amoxicillin is penicillin and cavulanic acid. Why is Cluvulanic acid important?
It is a B-lactamase inhibitor
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How does a B-lactamase inhibitor work?
It blocks the enzyme made by the bacteria so that the antibiotic is effective
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Infections are caused by microorganisms. What sample can you send to test for microorganisms?
Microbiology for O+S (organisms and sensitivities)
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What do penicillins target?
Bacterial cell walls
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Describe antibiotic resistance
Resistance happens when the safe dose of the antibiotic becomes ineffective.

Bacteria mutates and changes their genetic structure which allows resistance to occur. If the change results in better survival under the antibiotic, they will reproduce those m
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Give a specific example of antibiotic resistance
Bacteria that produces beta lactamase attack the antibiotic penicillin, making it ineffective
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What is the appropriate use of antibiotics to prevent antibiotic resistance called?
Antibiotic stewardship
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What should be avoided to prevent antibiotic resistance?
Using broad-spectrum antibiotics where possible
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Gentamicin is an antibiotic with a narrow therapeutic range. What should be carried out as a result of this?
Blood levels should be monitored regularly
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Co- amoxiclav is bactericidal when used to treat bacteria that it is active against. Describe the action of bactericidal drugs
Bactericidal drugs kill the bacteria present
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Why is it difficult to develop effective drug treatments for viruses?
Viruses reproduce in our cells
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Other cards in this set

Card 2

Front

What factors affect drug absorption?

Back

- route of administration
- blood flow to absorbing site
- total surface area for absorbing site
- contact time at absorbing site
- chemical makeup of the drug

Card 3

Front

What are the advantages and disadvantages or oral drug absorption?

Back

Preview of the front of card 3

Card 4

Front

Describe first class metabolism bioavailability

Back

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Card 5

Front

So what is meant by bioavailability?

Back

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