Drug absorption, distribution, metabolism and excretion

Why is it important to know about ADME of a drug?

How can knowing the distribution of a drug in the body be useful?

Once an IV bolus dose is given, where does it go?

Most drugs obey first-order kinetics. What does this mean?

What is zero-order kinetics?

What is an example of a drug following zero-order kinetics and why is this clinically undesirable?

How do you work out apparent volume of distribution (Vd)?

What does this tell you, and how is it limiting?

What affects Vd and why is it clinically important?

What is plasma clearance of a drug?

How can you calculate clearance?

What will the CL for drugs following 1st order kinetics be?

What is F a measure of?

How is F calculated?

What is F for all IV doses and why?

How is calculating F useful?

What causes low bioavailability? (3)

Why are multiple doses of drugs given?

What influences the [drug] over time? (2)

What is a steady state?

What is Css?

How do you calculate dosing rate?

How long does it take to reach a steady state?

What factors determine how much drug will be in the circulation?

If the drug is not given IV what is the first step?

How is the route of delivery of a drug chosen? (4)

What does absorption require drugs to do and how does it mainly do it?

How does absorption occur? (3)

What determines the rate of diffusion?

What are most drugs?

What factors determine their extent of ionisation? (2)

What equation can be used to predict the extent of ionisation?

In order for drugs to diffuse across membranes, what must they be?

For acidic drugs, where are they best absorbed and why?

Where are basic drugs best absorbed and why?

What compensates for the fact that basic drugs are absorbed less efficiently?

What set of rules is there for oral drugs?

How are drugs and their metabolites modified to ensure they are excreted?

Why is it important to understand the metabolism and excretion pathways of drugs? (2)

What are 'prodrugs' and one example?

What is the first phase of drug metabolism?

What is phase 2 of drug metabolism?

Why is paracetamol an exception to the drug metabolism rule?

Why is paracetamol more dangerous for alcoholics?

Why is it important for drugs/their metabolites to be water soluble?

How else can drugs/their metabolites be excreted through the kidney?

How can net excretion be calculated?

What is 'renal clearance' of a drug?

How can plasma CL be calculated from that?

Why do neonates need to have lower doses of drugs?

Why would a higher body fat % affect drug metabolism and excretion?

Why would liver or renal disease be a problem for people taking medicines?

Why might you monitor drug concentration in a patient as they are taking a course of a drug? (6)

What are type A adverse reactions?

What are some causes of type A reactions? (5)

How can type A reactions be avoided? (2)

What are type B adverse reactions?

What causes type B reactions?

Give 2 examples of hypersensitivity reactions

What are 'yellow cards'?

What is the 'Black Triangle' scheme?

What is the current 'Green Form' system?

What is it important to remember when studying adverse reactions?

Considering aspirin specifically, where is the majority of aspirin going to be absorbed and why?

Why does it not diffuse back into the stomach?

Through which 3 methods can the salicylate be excreted from the kidney?

How does urinary pH affect the excretion of acid/basic drugs?

When can this be useful in clinical practice?