Key Concepts:Kinetics and dynamics:- The big 3- Drug types: prescription, OTC, herbal- Clinical Trials - Phase 1,2,3, and post marketing surveillance phase 4- Controlled Substances - Schedules- Pregnancy classifications- Pharmacogenetics- Genetic polymorphisms in different ethnic groups- Drug names: generic, trade- Drug formulations - Kinetics versus dynamics- 4 pharmacokinetic processeso Absorption Bioavailability- extent of absorption Life-span considerations age and health status Routes of administration and rate of absorption by site Effect of food on absorption Enteric coated Time-release Solution/suspension Ionization vs non ionized form  Lipid solubility Effect of GI motility on absorptiono Distribution Breast milk/ Placenta- highways of drug transport Fat storage of drugs  Blood brain barrier Protein binding- Albumin- Affinity- Competition- Conditions causing low albumin- Hypo-albuminemia Se albumin<3.0o Metabolismo Goal of metabolismo Changing drug to metaboliteo Active or inactiveo Toxic or non - toxico Pro-drugso Need to be metabolized to active metabolite to work.- First pass effect- gut circulationEffect on oral doses- CYP450 inducers and inhibitors - Pharmacogenetics- Genetic polymorphisms- Food and substances and drug metabolism- Grapefruit Cranberry Juiceo Excretion- Renal- Other body systems that can excrete drugs- Clearance o Glomerular filtrationo Tubular secretiono Tubular reabsorption- Half-life and steady state- Loading dosePharmacodynamics- Drug action versus drug effect Receptors, enzymes, and miscellaneous- Receptor specificity- Receptor affinity- Agonist or antagonist- Effect -Systemic or local- Efficacy versus potency- Tolerance- Additive vs synergistic - Therapeutic index- Side effects versus adverse drug reactions- allergies reactions and idiosyncratic reaction- Toxicity- Hepatotoxicity- Ototoxicity- Nephrotoxicity- Adherence- Additive and synergistic