Drug Delivery Flashcards Preview

PA30326 > Drug Delivery > Flashcards

Flashcards in Drug Delivery Deck (20)
Loading flashcards...
1

What are the 4 main reasons to change the route of administration for a pain medication?

If different drug profiles are needed (eg, quick acting or prolonged acting)

 

To avoid the 1st pass effect

 

To have efficient, non-invasive delivery

 

Patient factors (eg, age/dexterity/support)

2

What is an Abuse-Deterent Formulation (ADFs) of opioids?

A formulation in which the opioid is rendered useless if the tablet/capsule has been tampered with

 

 

3

How much more potent than morphine is fentanyl?

50-100x

4

Name 4 ways that a Abuse-Deterent Formulation can be made

Physcial Barrier (gel) --> Solids that become viscous when alcohol is added to extract the drug

 

Aversion --> Utilizes a noxious powder in the formulation to act as a deterrent

 

Agonist/Antagonist --> Naltrexone is added to morphine, which if chewed will be released, reducing the euphoria that is gained from the morphine

 

Pro-Drug --> The active drug is only avaliable once consumed

5

What type of fentanyl patch is Duragesic?

 

And what type are the newer generics?

Duragesic --> Reserviour System

 

Generics --> Simple adhesive-type

6

How can patches be abused?

Removal of the gel and boiling --> Allows the opioid to be injected or drunk

 

Chewing of the patch --> Released all 3 days worth via the mucosa

7

What is the benefit of Fentanyl Citrate?

The most lipophillic IR opioid --> so has a rapid onset of action as can pass through membranes rapidly

 

Can be used submucoasally as Oral Transmucosal Fentanyl Citrate (OTFC) for BTcP

 

8

What is a Copy-Number Variation (CNV)?

Either a gene deletion (loss of function) or gene duplication (increase expression and hyperactivity)

9

Explain the following..

 

Halpotype

 

Germline Genetic Variation

 

Somatic Genetic Variation

Halpotype --> A group of allelles across several genes on the same chromosome that are close together and so tend to be inherited together 

 

Germline --> Variation of DNA that is present at conception, and so is passed down to offspiring

 

Somatic --> Changes in DNA that occur spontaneously after conception, and so aren't passed down to offspring

10

What's the difference between pharmacogenetics and pharmacogenomics?

Pharmacogenetics --> Study of the variability in drug response due to hereditary factors, with focus on a single gene or several genes

 

Pharmacogenomics --> Whole-genome application of pharmacogenetics

- Genome-wide analysis of the genetic determinants of drug efficacy and toxicity

11

Define Actionable Genetics

Where we could change therapy due to the genetic variability of patients (18% of US prescriptions)

12

What are the effects on being either a Poor Metaboliser (PM) or a Ultra Metaboliser (UM)?

PM --> ADRs at normal doses

- No/poor response to drugs that require activation (eg, pro-drugs)

 

UM --> No/poor repsonse to usual doses (eg, antidepressents)

- Toxicity after pro-drugs (eg, codeine)

13

What's the difference between a Genotype and a Phenotype?

Genotype --> An individuals full hereditary information ("Born with it")

- Eg, A pair of alleles regarding the CYP2D6 genotype

 

Phenotype --> The individuals actually expressed properties/oberservable characteristcs (eg, metabolism of tamoxifen)

14

Why do Poor Metabolisers (PM) get less of a benefit from tamoxifen?

 

Which class of drugs would be better for them?

As tamoxifen is broken down to more active metabolites....which is a slower process in PMs

 

They would get better outcomes by taking aromatase inhibitors

15

Why is genetic testing useful before giving treatment with 6-MP?

As if people have inactive forms of TPMT they cannot break down 6-MP, so the cancer therapy is toxic

 

Slow metabolisers will therefore need to have lower doses and shorter durations of treatment

16

What are the 3 criteria needed for a Pharmacogenomic (PGX) test to be done in hospitals?

Analytical Validity --> Ability of a test to measure accuratly and reliably the genotype of interest

 

Clinical Validity --> The accuracy with which the test can detect the prescence of the target phenotype/disease

 

Clinical Utility --> Whether use of the test will improve health outcomes, due to the potential risks of the test itself (often money based)

17

What are the 3 ways that the FDA and EMA support the integration of PGX tests?

Include PGX data in drug labelling

 

Use PGX data to choose dose regime and identify patients at risk

 

Use of a PGX label when PGX data is of high importance for treatment outcomes

18

When can the Cockroft and Gault equation not be used?

When the patient is not in steady state (eg, renal function must be fairly stable)

 

Extreme muscle mass

 

Obesity or ascites

19

When should TBW be used instead of IBW?

In obese patients to ensure they're not under-dosed!

20

What is the Calvert Equation?