2013-08-20 Intro to Med Pharm

Question 1

This lecture was very intro. Included are just a few cool facts to maybe know.

Answer 1

Phew!

Question 2

Generic drug requirements

Answer 2

• can only be manufactured after brand name’s period of exclusivity has ended (up to 17 yrs!)
• contain identical dose of identical active ingredient
• demonstrates comparable kinetics (F, Tmax, Cmax, AUC) in healthy volunteers
• in total only ~20 healthy volunteers needed to demonstrate PK equivalence (not clinical efficacy)
• must meet all other USP requirements (e.g. purity)

Question 3

Dr. Nierenberg’s approach to therapy selection

Answer 3

1. define most likely dx
2. understand pathophys of’t
3. generate list of possible tx’s
4. select best tx for specific pt taking into account:
   - -efficacy
   - -safety
   - -cost/value
5. select endpoints to follow
6. form alliance w/ pt.

Question 4

conversion rxn vs. Münchausen syndrome vs. Malingering

Answer 4

1. Converstion Rxn: unconscious drug/medical attention seeking
2. Münchausen syndrome: “Münchausen syndrome is a psychiatric factitious disorder wherein those affected feign disease, illness, or psychological trauma to draw attention, sympathy, or reassurance to themselves. It is also sometimes known as hospital addiction syndrome, thick chart syndrome, or hospital hopper syndrome. […] The syndrome differs from malingering, in which a patient fabricates symptoms for an apparent purpose, such as financial compensation, absence from work, or access to drugs.”
3. “In medicine, malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of “secondary gain” motives, which may include financial compensation (often tied to fraud); avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences; or simply to attract attention or sympathy.”

source wiki

Question 5

Define pharmaceutical vs. pharmacokinetic vs. pharmacodynamic.

Answer 5

pharmaceutical properties have to do with synthesis, manufacturing and distribution of a drug

pharmacokinetics has to do with “what the pt does to the drug”; ADME: absorption, distribution, metabolism and elimination

pharmacodynamics has to do with “what the drug does to the pts” at the levels of receptor, cell, organ, system, organism, pt, society; intended, unintended, socioeconomic

Question 6

List pharmaceutical properties of drugs

Answer 6

salts
excipients
packaging
route of admin
purity
USP standards for purity, sterility, disintegration, etc.

Question 7

What are some routes of admin that bypass first pass metabolism in the liver?

Answer 7

intranasal, sublingual, IV, PR