1. Pharmacology

Question 1

Definition of a pre-drug
Definition of a drug
Function of a drug
Types of dental drugs (4)
Action of ion channels

Answer 1

Inactive form of a drug activated in first-pass metabolism
Substance that acts on living tissues, via receptors, enzymes or ion channels, to produce a measurable change in tissue function
Simulate/interrupt normal communication and act on non-host organisms to aid body defences
LA, anxiolytics, antimicrobials, analgesics
Ion channels (LA, anti-diabetic drugs) disrupt cell ion balance

Question 2

Types of autonomic drugs (4)

Autonomic nerve control of HR

Answer 2

B-agonist, B-antagonist, cholinergic agonist, cholinergic antagonist
SyNS increases HR via B-receptors; PSyNS decreases HR via cholinergic receptors

Question 3

Drug receptor interactions (2) and response (1)

Answer 3

Affinity, occupancy and efficacy

Question 4

Methods of drug administration (2)
Examples of drug administration
Advantages (1) and disadvantages (4) of oral administration
When is oral route not preferred (3)
Advantages (2) and disadvantages (3) of parenteral route
Definition of first-pass metabolism

Answer 4

Enteral and parenteral
Oral, IV, IM, SC, TD, inhalation
Socially acceptable; slow onset, variable absorption, affected by first-pass metabolism, drug formulation
Emesis, absorption irregularities, destruction by digestive enzymes/gastric acid
No first-pass metabolism, predictable plasma levels, higher cost, more severe allergic reactions, access difficulties
Enterally administered drugs pass through liver once before entering circulation - activation or inactivation

Question 5

Definition of bioavailability

What is bioavailability modified by

Answer 5

Proportion of ingested drug available for clinical effect

Dosage form, poor absorption, first=pass metabolism

Question 6

Phases of drug metabolism (2)
Phase 1 description
Phase 1 reactions (3)
Phase 2 description
Phase 2 reactions (2)
Methods of drug excretion (5)

Answer 6

Phase 1 and phase 2 
Drug inactivation 
Reduction, oxidation, hydrolysis
Preparing drug for removal
Conjugation - methylation, sulphanation 
Renal (urine), liver, lung, sweat, saliva

Question 7

Definition of volume of distribution
Types of drug distribution (2)
What is drug distribution affected by (2)

Answer 7

Body compartments the drug is diluted in (usually uneven)
Single (evenly distributed around body), two compartments (equilibrium with different body tissues)
Lipid binding and binding to plasma proteins

Question 8

Drug clearance components (2)
Features of first-order kinetics (3)
Features of zero-order kinetics (3)

Answer 8

Plasma half-life and kinetics
Elimination/absorption is passive. T0.5 is constant. Removal is proportional to concentration
Elimination is active and can be saturated. Maximum rate of elimination is constant regardless of concentration. Predictable

Question 9

Definition of drug accumulation
Features of drug scheduling (2)
What is drug efficiency effected by
What controls access of endogenous substances and xenobiotics (2)

Answer 9

Measure of how plasma concentration builds due to repeated doses
Too much - toxic plasma levels. Too little - no clinical effect
Degree bound - less bound (free drug), less predictable
Blood-brain barrier and blood-CSF barrier

Question 10

Features of aspirin (what it is, what it does)
How is aspirin eliminated from the body
Side effects of aspirin (4)

Answer 10

Blood thinner/antiplatelet drug - reduces MI/bowel cancer risk
By first-order kinetics
Gastric irritation, inhibits platelets (increased bleeding), bronchospasm, allergic reaction

Question 11

Action of NSAIDs (2)
Side effects of ibuprofen vs aspirin
Features of diclofenac
Features of COX II inhibitors (side effects, action)

Answer 11

Reduce inflammatory mediators, inhibit prostaglandin synthesis
Ibuprofen less than aspirin
Diclofenac more potent (lower doses)
Less gastric irritation. Better long-term (arthritis) but cause cardiac death

Question 12

Action of corticosteroids (4)
What do corticosteroids not do
Side effects (7)

Answer 12

Reduce inflammation by inhibiting WBC migration, bradykinin formation and capillary permeability. Reduce eicosanoid synthesis
Do not treat cause/underlying problem
HTN, weight gain, fat distribution change (buffalo hump, moonface), adrenal suppression, risk of osteoporosis, diabetes, gastric ulcers

Question 13

Dental medical emergency drugs (8)

Answer 13

Adrenaline injection, glucagon injection, oral glucose, oxygen cylinder, midazolam, salbutamol inhaler, aspirin dispersible tablet, GTN spray

Question 14

What are pharmacodynamic interactions

What are pharmacokinetic interactions

Answer 14

Between drugs with similar/antagonistic effects/side effects

When one drug alters the absorption, distribution, metabolism or excretion of another