[1] General Principles of PT Pharmacology (CH1) Flashcards

1
Q

contrast pharmacology to pharmacy

A

pharmacology is the STUDY of drugs

pharmacy is the DISPENSING of drugs

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2
Q

pharmacology can be divided into what 2 categories?

A

pharmacodynamics and pharmacokinetics

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3
Q

define pharmacodynamics and provide examples

A

pharmacodynamics is what the drug does to the body

- ie. MOA, effects

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4
Q

define pharmacokinetics and give an example

A

pharmacokinetics is what the body does to the drug

- ie. ADME (absorption, distribution, metabolism, excretion)

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5
Q

when under the topic of drug nomenclature, compare the “generic name” of a drug to the “trade (brand) name” of a drug

A

generic names of drugs are nonproprietary when compared to the trade/brand name, which is proprietary and is assigned by the pharmaceutical manufacturer

  • generic name: diazepam
  • trade/brand name: Valium (TM)
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6
Q

who monitors the development and approval of a drug?

A

the FDA is who monitors it, a branch specifically in the FDA called the CDER is charged with this.

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7
Q

preclinical trials are conducted in ….

A

animals (small –> big)

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8
Q

what is an IND? what is its purpose?

A

Investigational New Drug Application

- after preclinical trials, the IND application is submitted to the FDA for administration of the drug in humans

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9
Q

clinical trials are conducted in…

A

humans

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10
Q

describe how clinical trials in humans works

A

4 phases ( I, II, III, IV )

  • you progressively work your way up in subjects/patient population
  • priority shifts from safety –> effectiveness for disease state –> adverse effects

NDA comes after Phase III
- you conduct Phase IV

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11
Q

in Phase 1 of clinical trials, describe the population you are working with and what you are looking for

A
  • in phase 1 you are working with < 80 HEALTHY volunteer subjects
  • safety is the biggest concern
  • other factors you are acknowledging are the pharmacokinetic profile & dose
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12
Q

in Phase 2 of clinical trials, describe the population you are working with and what you are looking for

A
  • in phase 2 your patient population grows but is still < 300
  • the patient population shifts from HEALTHY volunteers in phase 1 to a slightly larger patient population that POSSESSES the disease
  • you are monitoring the effectiveness for disease state in the phase, as well as safety
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13
Q

in Phase 3 of clinical trials, describe the population you are working with and what you are looking for

A
  • in phase 3 your patient population grows but is still < 5000
  • larger patient population that POSSESSES the disease
  • still addressing the effectiveness for disease state and safety, but you are now taking into account ADVERSE EFFECTS due to a larger patient population
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14
Q

you have finished conducting Phase 3 of clinical trials, what happens next?

A

new drug application (NDA) occurs after Phase 3, now its Phase 4

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15
Q

in Phase 4 of clinical trials, describe the population you are working with and what you are looking for

A

also called “post-marketing surveillance,” your population grows even more, pretty much to see if there are any adverse effects or reactions in a patient population that provides more subjects than phase 3
- you look for effectiveness comparisons, safety, rare adverse rxns

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16
Q

what is the purpose of Phase IV?

A

the purpose is to monitor safety in the general population
- going off Phase 3 ( x > 5000), Phase 4 is able to potentially detect very rare adverse effects that otherwise wouldn’t have been caught in a smaller patient population

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17
Q

human testing (phase 1-3) may take how long?

A

6-9 years

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18
Q

only about 1 in every ___ drugs synthesized by a MFR will ever be released as a new drug

A

1 of every 1000 drugs

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19
Q

drugs receive FDA approval for specific indication… what does this mean?

A

this means a specific sign, symptom, or medical condition that leads to the recommendation of a treatment, test, or procedure.

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20
Q

what does the term “off-label” mean?

A

“off-label” use refers to the ability of a physician to prescribe drug(s) for
other “off-label indications”

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21
Q

drug companies are really competitive…so what would be fair to assume that when a new medicine is discovered early in the timeline?

A

patent protections are quickly filled

  • US patent application and issue
  • foreign patent applications filed and issued
22
Q

the generic substitution for a brand name drug may be approved when…

A

brand name MFR patent expires

23
Q

a generic drug must undergo tests to establish bioequivalence when substituting for a brand name drug, why?

how is this done?

A
  • bioequivalence means that the generic form of the drug contains the same type and amount of active ingredient as the brand name
  • generic drug MFR files an abbreviated NDA with the FDA
24
Q
A

TRUE

25
Q

the classification of prescription vs non-prescription drugs is decided by who?

A

FDA

26
Q

[T/F] OTC can be purchased without a prescription

[T/F] OTC is generally safer, lower dose, used for minor conditions + short time

A

True

True

27
Q

OTC is typically less expensive, but often not covered by insurance…what could this imply for the patient?

A

the cost of the OTC drug may be actually be greater (complex $)

28
Q

what is something to acknowledge with OTC drugs & PT?

A

OTC may interact with PT and prescription drugs

29
Q

[controlled substances]

how many schedules are there..?

A

5 in total: Schedule I … II … III … IV … V

30
Q

how are Schedule I, II, III, IV, V all related on a spectrum?

A

Schedule I possesses the highest potential for abuse & addiction
- as you progress down the schedule spectrum, the potential for abuse and addiction DECREASES

31
Q

Example of a Schedule I drug

A

LSD, Heroin, Marijuana

32
Q

Example of a Schedule II drug

A

Morphine

33
Q

Example of a Schedule III drug

A

Codeine in Tylenol #3

34
Q

Example of a Schedule IV drug

A

Diazepam

35
Q

Example of a Schedule V drug

A

Diphenoxylate, Atropine, Lomotil

36
Q

what does the “threshold does” represent?

A

the point on the Dose Response Curve at which a response begins to occur

37
Q

what does the “maximal efficacy” or “ceiling effect” mean?

A

the point on the Dose Response Curve where increasing the dose does NOT increase the response to the drug (plateau)

38
Q

the shape of the Dose Response Curve and presence of a plateau can be used to obtain …?

A

can be used to obtain information about specific drugs and interactions with body components such as “receptors” which may bind to the drug

39
Q

what does “graded response” mean?

A

describes a drug effect which increases in proportion to increasing drug dose

40
Q

define potency

A

dose that produces a given response in a specific amplitude

41
Q

when comparing 2 drugs, how do you determine which is more potent?

A

the more potent drug is the drug that requires the lower dose to produce the same effect

42
Q

is potency the same as efficacy?

A

No. Potency is NOT efficacy

  • potency: dose that produces a given response in a specific amplitude
  • efficacy: max response achieved with said drug
43
Q

what does ED50 stand for?

A

Median Effective Dose

44
Q

what does the Median Effective Dose (ED50) represent?

A

represent the dose at which 50% of population respond in a specified BENEFICIAL way

  • ie. “Did this drug dose relieve your headache?” (Y or N)
45
Q

what does TD50 stand for?

A

Median Toxic Dose

46
Q

what does Median Toxic Dose (TD50) represent?

A

represents the dose at which 50% of population exhibits a specified ADVERSE effect

  • ie. “Did this drug dose cause you to be constipated?” (Y or N)
47
Q

in animal studies, what does LD50 stand for?

why is LD50 useful?

A
  • LD50 stands for the Median Lethal Dose
  • LD50 means the dose at which it causes 50% death of the animals studies
  • LD50 provides useful information on preclinical trials
48
Q

what does TI stand for?
what does TI represent?
how would we define TI?
how would we define TI in an equation?

A
  • TI stands for Therapeutic Index
  • TI is an indication of a drugs relative safety
  • Could be defined in many ways, but is sometimes considered the ration of the TD50 and ED50
  • TI = TD50/ED50
49
Q

when we are presented with the equation “TI = TD50/ED50” what do we want?

A

we want that number (TI) to be really high

50
Q
A

True

51
Q
A

True, anti-cancer drugs have a low TI.