Chapter 3

Question 1

What is the first-pass effect?

Answer 1

When a drug is metabolized in the liver before it reaches systemic circulation.

Question 2

The first pass effect happens with what kind of drugs?

Answer 2

Oral

Question 3

Explain the process of the first pass effect (where it starts and eventually ends up)

Answer 3

Mouth
Stomach
Small Intestine
Portal vein
Liver
Systemic Circulation

Question 4

What does the first pass effect reduce?

Answer 4

Bioavailability

Question 5

What are 2 things that drugs with the first pass effect may need?

Answer 5

Higher oral doses
Non-oral routes like IV, sublingual, transdermal

Question 6

Where to protein bound drugs bind to?

Answer 6

Plasma proteins, mainly albumin

Question 7

______ is a highly protein bound drug

Answer 7

Warfarin

Question 8

If another drug displaces a warfarin, what is there a risk for?

Answer 8

Bleeding

Question 9

Should 2 highly protein-bound drugs be given together?

Answer 9

No

Question 10

_____ activates receptors, producing a biological response and mimicking the body’s natural responses

Answer 10

Agonists

Question 11

_______ binds to receptors, but does not activate them, blocking the agonist’s actions

Answer 11

Antagonists

Question 12

What do partial agonists do?

Answer 12

Activates the receptor, but has a weaker effect

Question 13

What do competitive antagonists do?

Answer 13

competes for same receptor site, as an agonist, but doesn’t turn on the receptor

Question 14

A _________ happens when one drug changes the effect of another drug.

Answer 14

drug interaction

Question 15

What are the pharmacokinetic interactions?

Answer 15

Absorption
Distribution
Metabolism
Excretion

Question 16

If Drug A prevents absorption, what happens to drug B

Answer 16

It’s effectiveness is reduced

Question 17

What liver enzymes are involved in metabolism of drug interactions?

Answer 17

CYP450

Question 18

If Drug A and B are administered at the same time, but Drug A induces the metabolism of Drug B, what needs to be done?

Answer 18

Drug B amount needs to be increased

Question 19

If Drug A and B are administered at the same time, but Drug A inhibits the metabolism of Drug B, what needs to be done?

Answer 19

Drug B amount needs to be decreased