Chapter 5 (using drugs therapeutically)

Question 1

local effects

Answer 1

largely limited to the site of administration and surrounding tissues
Organs of body have limited exposure to drug so side effects and toxicity is much less than normal
(like nasal sprays and topical creams)

Question 2

Latisse

Answer 2

local effect drug for eye lashes that can have local side effects of skin darkening, irritation, dryness, and redness

Question 3

systemic effects

Answer 3

occur from oral, inhaled, and parenteral absorption in which drug is ‘felt’ throughout the body

Question 4

oral prednisone

Answer 4

systemic corticosteroid; used to treat poison ivy case but would expose organs to drug along with all skin

Question 5

drugs are formulated to take advantage of particular effects

Answer 5

local vs systemic is decided based on the desired effect, possible side effects, and distribution

Question 6

some drugs are meant to have local effects, but are absorbed to some degree systemically

Answer 6

leads to systemic effects even though local was desired

Bronchodilators can do this and cause nervous ‘jitters’

Question 7

therapeutic effect

Answer 7

effect for which the drug is intended

Question 8

ADRs

Answer 8

adverse drug reactions; side effects; unintended consequences of giving a drug; every drug has them even if they are minor

Question 9

use of side effects

Answer 9

some drugs are reformulated to take advantage of a side effect which now becomes the therapeutic effect; eg using 1 gen antihistamines as sleep aids

Question 10

adverse effects

Answer 10

severe side effects that may so severe that they outweigh the overall benefit and the drug will be banned; occur in all drugs at high levels

Question 11

Accutane

Answer 11

very dangerous cystic acne drug still on the market despite being a teratogen and increasing suicidal ideation. Treats acne that can be scarring and disfiguring on faces for life and reducing self-esteem maybe leading to suicide in kids (hence why it is still on the market)

Question 12

TI

Answer 12

therapeutic index: Toxic dose 50 / Effective dose 50

avoid drugs like Accutane and Digoxin that have low TIs

Question 13

Good TI

Answer 13

about 20 is good because a person could take a lot of the drug without killing themselves
Low TI means there is very little room for dosing error

Question 14

Idiosyncratic reactions

Answer 14

those which do not involve any of the known pharmacological effects of a drug and do not occur in most humans or animals (very personable)
Unpredictable, atypical, and do not involve immune mechanisms
Effect not predicted by the normal action of the drug
Not side effects

Question 15

allergic reactions

Answer 15

antigen/antibody immune system reaction usually accompanied by release of histamine
Often pt. will develop rash, bronchoconstriction, and have a drop in BP
Not a side effect

Question 16

anaphylactic reaction

Answer 16

worst kind of allergic reactions in which there is edema and impaired breathing; can even lead to shock and death

Question 17

5 rights of medication safety

Answer 17

Right person
Right medication
Right dose
Right time
Right route

Question 18

Accutane

Answer 18

isotretinoin; used to treat cystic acne

Question 19

Vd

Answer 19

theoretical volume that would be necessary to contain the total amount of administered drug at the same concentration that is observed in the blood plasma

Question 20

enterohepatic circulation of a drug is about…

Answer 20

recycling of certain drugs and molecules from liver to bile and then back to liver again through resorption of the bile in the small intestine that contained the drug that was secreted into the SI through bile

Question 21

drug-drug interactions

Answer 21

may lead to ADR worse than either drug by themselves

Question 22

adverse reactions occur with what drugs

Answer 22

all drugs have adverse reactions at high levels

Question 23

volume of distribution is (formula)

Answer 23

distribution of drug in tissues vs plasma

dose in body/serum

Question 24

protein binding of drug

Answer 24

the percent of drug not free to act

Question 25

1/2 life

Answer 25

estimates duration of action of drug

Question 26

local effects may be intended, but…

Answer 26

unintended systemic effects may occur

eg. using a bronchoconstrictor by inhalation but it leaks into systemic circulation and there are nervous jitters

Question 27

topical drug admin and systemic effects

Answer 27

gives lowest systemic toxicity

Question 28

biotransformation

Answer 28

same as metabolism

Question 29

drug entering blood leads to

Answer 29

systemic effects