D1- General & Ocular Pharmacology Flashcards
1
Q
Study of substances that interact with living systems through clinical processes
A
Pharmacology
2
Q
Any chemical substance that brings about a change in biologic function through its chemical actions
A
Drug
3
Q
Activator of a specific molecule
A
Agonist
4
Q
Inhibitor of a specific molecule
A
Antagonist
5
Q
The target molecule for a drug
A
Receptor
6
Q
Is the study of how the body absorbs, distributes, metabolizes, and excrete drug
A
Pharmacokinetics
7
Q
What the body does to the drug
A
Pharmacokinetics
8
Q
Describes the action of drugs to the body
A
Pharmacodynamics
9
Q
The study of the use of drugs to treat diseases
A
Pharmacotherapeutics
10
Q
Is the study of the relationship of genetic factors to variation in drug response
A
Pharmacogenetics
11
Q
Is the study of the cost effectiveness of drug treatments
A
Pharmacoeconomics
12
Q
Is the study of the effect of drugs on population
A
Pharmacoepidemiology
13
Q
What is the use of drug treatment?
A
Cure a disease
Delay disease progression
Alleviate the signs and symptoms of disease
Facilitate nonpharmacologic therapeutic intervention
14
Q
Study of drugs adverse effects
A
Toxicology
15
Q
Study of doses
A
Posology
16
Q
Study of drug’s manufacture, preparation and dispensing of drugs
A
Pharmacy
17
Q
Is the study of the identification and preparation of crude drugs from natural resources
A
Pharmacognosy
18
Q
Drugs that are used to kill or inhibit the growth of cells that are considered foreign in the body
A
Chemotherapy
19
Q
Major routes of administration
A
Enteral
Parenteral
Topical
20
Q
Administering a drug by mouth or by rectum
A
Enteral Administration
21
Q
Drug administration by mouth is called
A
Peroral administration
22
Q
Drug administration under the tongue
A
Sublingual administration
23
Q
Drug administration cheeks and gums
A
Buccal administration
24
Q
Administering drugs directly into the systemic circulation
A
Parenteral administration
25
Is also used if patient is unable to take oral medications and in circumstances that require a rapid onset of action
Parenteral administration
26
Main type of parenteral administration
IV
IM
SC
27
Type of administration where the drug is injected into the surface area of skin
Intradermal injection
28
Type of administration used in chemotherapy to target drug to organ
Intra-arterial injection
29
Type of administration where the drug is directly injected into cerebrospinal fluid for uptake into brain
Intracathecal injection
30
Type of administration commonly used in laboratory animals
Intraperitoneal injection
31
Is the transfer of a drug from the site of administration to the bloodstream
Absorption
32
Factors influencing absorption
Effect of pH on drug absorption
Blood flow to the absorption site
Total surface area available for absorption
Contact time at the absorption surface
Expression of P-glycoprotein
33
Is the rate and extent to which an administered drug reaches the systemic circulation
Bioavailability
34
Factors that affect bioavailability
First-pass hepatic metabolism
Solubility of the drug
Chemical instability
Nature of the drug formulation
35
The process by which a drug reversibly leaves the bloodstream and enters the interstitium and the tissues
Drug administration
36
Factors influencing distribution
Blood flow
Capillary permeability
Binding of drugs to plasma proteins and tissues
Lipophicility
Volume of distribution
37
Is described in terms of clearance from a hypothetical well-stirred compartment containing uniform drug distribution
Drug elimination
38
Defined as the volume of fluid removed of the drug from the body per unit of time
Clearance
39
First-order kinetics is also referred to as
Linear kinetics
40
Order of elimination where the rate of change of drug concentration is directly proportional to the drug concentration remaining to undertake that process
First-order kinetics
41
Order of elimination where the amount of drug eliminated does not change with the amount or concentration in the body, but the fraction removed varies
Zero-order elimination
42
Also called nonlinear or saturation kinetics
Zero-order elimination
43
The removal of the intact drug
Drug excretion
44
Optimization of dose
Half life, maintenance dose, loading dose
45
Type of drug actions where drugs may increase or enhance the function of an organ or a system
Stimulation
46
Type of drug actions where drug inhibit or decrease the function of an organ or the system
Depression
47
Type of drug actions where there is an action attributed to the local effects of the drug on a tissue or cell
Irritation
48
Type of drug effects where it is usually the desired effect that leads to its therapeutic use
Primary drug effect
49
Type of drug effects where it commonly leads to undesired effects
Secondary drug effect
50
Major mechanism of drug that alter the cell environment by physical or chemical processes
Structural nonspecific
51
Major mechanism of drug that alter the cell by drug-receptor interactions
Structural specific
52
4 levels of drug action
Molecular, cellular, tissue, system
53
Any molecule which attaches selectively to particular receptor or sites
Ligands
54
It is the ability of drug to trigger the pharmacological response after making the drug-receptor complex
Intrinsic activity or efficacy
54
Is the capacity of a drug to form the complex with its receptor
Affinity
55
Type of drug ligands that activates a receptor to produce an effect similar to the physiologic signal molecule
Agonist
56
Type of drug ligands that activates a receptor to produce a submaximal effect but antagonizes the actions of a full agonist
Partial agonist
57
Type of drug ligands that decreases the number of activated receptors to below that observed in the absence of drug
Inverse agonist
58
Type of drug ligands that prevents the action of an agonist on a receptor but doesn't have any effect of its own
Antagonist
59
So-called receptor because their ligands are presently unknown, which may prove to be useful targets for the development of new drugs
"Orphan" receptor
60
The best-characterized receptors; modify the actions of endogenous chemical signals
Regulatory proteins
61
Proteins identified as drug receptors
enzymes, transport proteins, and structural proteins
62
Also known as channel-linked and ionotropic receptors
Type 1 receptors
63
Are initiated when excitatory neurotransmitter activates Na+ or Ca+2 channels
Excitatory post synaptic potentials
64
Are initiated when an inhibitory neurotransmitter open Cl- and K+ channels and membrane becomes hyperpolarized
Inhibitory post synaptic potentials
65
Activated when a drug or an endogenous substance binds with a specific receptor
Receptor operated ion channel
66
Activated when a drug or an endogenous substance do not bind directly but are activated by membrane potential
Voltage gated ion channel
67
Also known as G-protein coupled, "seven-transmembrane" or "serpentine"
Type 2 receptors
68
Are systems that allow signals from cell surface receptors to be converted and amplified into a cellular response
Second messenger systems
69
cAMP is produced by
adenylyl cyclase
70
cGMP is produced by
guanylyl cyclase
71
IP3, DAG is produced by
phospholipase C
72
Biological actions of cAMP
Stimulates cAMP-dependent protein kinase A
Mobilization of stored energy
Conservation of water by the kidney
Calcium homeostasis
Increased rate and contractile force of heart muscle
73
Biological actions of IP3
To facilitate the entry Ca2+ into different cellular compartments
Smooth muscle contraction
Increased rate of contraction and relaxation of cardiac myocytes
Hormone release
Cytotoxicity
74
Biological action of DAG
Influences the activity of membrane-bound protein kinase C
Inflammation
Ion transport
Tumor promotion
75
Biological action of cGMP
Acts by stimulating a cGMP-dependent protein kinase
76
Also known as enzyme-linked receptors
Type 3 receptors
77
Also known as nuclear or intracellular receptors
Type 4 receptors
78
The primary targets of these ligand-receptor complexes are transcription factors in the cell nucleus
Type 4 receptors
79
Example of type 4 receptors
Hormonal receptors
80
Antagonist neutralizes the effect of agonist
Chemical antagonism
81
Antagonist may act at a completely separate receptor, inititiating effects that are functionally opposite those of the agonist
Physiologic antagonism
82
Antagonist acts at a similar receptor causing competitive antagonism
Pharmacologic antagonism
83
Both agonist and antagonist compete with the same active site in the receptor causing prevention of an agonist from binding to its receptor
Competitive antagonism
84
Antagonist act at a site beyond the active site of the agonist's receptor
Non-competitive antagonism
85
Forms non-covalent bond specifically intermolecular forces of interaction
Reversible antagonism
86
Binds covalently to the active site of the receptor, thereby reducing the number of receptors available to the agonist
Irreversible antagonism
87
The response elicited by combined drugs is EQUAL to the combined responses of the individual drugs
Addition
88
The response elicited by combined drugs is GREATER than the combined responses of the individual drugs
Synergism
89
A drug which has no effect on the system enhances the effect of the other
Potentiation
90
It plots the magnitude of response against increasing doses a drug
Graded dose-response relationship
91
Refers to the concentration or dose of a drug required to produce 50% of that drug's maximal response
Potency
91
The relationship between receptor occupancy and its ability to initiate a response
Efficacy
92
The observable response can be described only in terms of an all or none event
Quantal response
93
Graphically plots the precent of the population that responds to a drug versus the drug dose
Quantal dose response relationship
94
The dose at which 50% of the individual exhibit the specified quantal effect
Median effective dose
95
The dose required to produce a particular toxic effect in 50% of animals
Median toxic dose
96
The dose with which the toxic effect is death to 50% of the population
Median lethal dose
97
The ratio of the dose that produces toxicity in half the population to the dose that produces a clinically desired or effective response in half of population
Therapeutic index
98
Pharmacological response which a drug produces usual effect at unexpected low dosage
Hyperactive
99
Pharmacological response which a drug produces increased sensitivity as a result of denervation
Supersensitivity
100
Pharmacological response which a drug produces usual effect at unexpected high dosage
Hyporeactive
101
Pharmacological response where there is a decrease in the sensitivity acquired as a result of prior exposure to the drug
Tolerance
102
Pharmacological response where there is a rapid development of tolerance after administration of few doses of drug
Desensitization
103
Pharmacological response which is a result of patient's immune system, which identifies the drug as foreign substance that must be neutralized or destroyed
Immunologic
104
Pharmacological response which is a genetically-determined reaction that results to unwanted effect that is beyond the drug's pharmacology
Idiosyneractic reactions
105
A psychologic reaction from taking a substance with no intrinsic pharmacologic activity but may yield therapeutic outcome
Placebo reactions
106
It represents a summary of diagnosis, prognosis, and treatment of patient's illness
Prescription
107
An order for medication written by a physician, dentist or other licensed medical practitioner
Prescription
108
Doctrine where the patient must be aware of the procedures to perform, other alternatives, pros and cons of procedure and benefits they will receive
Doctrine of informed consent
109
Doctrine where the superior is responsible for actions committed by subordinates
Doctrine of respondeat superior
110
Minors and incompetent are required the informed consent of a parent or guardian when agreeing to any care, treatment, or procedure to be done
Minors and incompetent in medical decision making
111
It usually contains the name of the physician or dentist, his specialty, clinic address, contact number and clinic hours
Prescriber's information
112
It contains pertinent information about the patient such as the name, address, sex, age and weight and sometimes BSA
Patient's information
113
The medication prescribed
Inscription
114
It is the body or principal part of the prescription order
Inscription
115
Dispensing directions to the pharmacist
Subscription
116
It contains directions to the pharmacist for preparing and labeling the prescription
Subscription
117
It usually contains the quantity of the medication to be dispensed
Subscription
118
Directions for the patients
Transcription
119
It contains the signature of the prescriber as well as the doctor's license number to practice his profession, PTR number, and sometime S2 number
Prescriber's signature and license numbers
120
aa.
of each
121
ad
up to; to make
122
disp.
dispense
123
div.
divide
124
d.t.d.
give of such doses
125
No.
number
126
Sig.
write (directions on label)
127
a.c.
before meals
128
ad lib.
freely
129
admin
administer
130
A.M.
morning
131
aq.
water
132
ATC
around the clock
133
b.i.d.
twice a day
134
dil.
dilute
135
h.s.
at bedtime
136
i.c.
between meals
137
p.r.n.
as needed
138
q.i.d
four times a day
139
s.i.d
once a day
140
t.i.d.
three times a day
141
ut dict.
as directed
142
Are pharmaceutical products or drug preparations that can be dispensed even without the written order
Nonprescription drugs
143
Are pharmaceutical products or drug preparations that are to be dispensed only upon written order
Prescription drugs
144
Are pharmaceutical products referring to either prohibited or regulated drugs which require a special prescription form
Dangerous drugs
145
Compounds with known chemical structure, MOA, functional groups responsible for the biologic activity
Lead compounds
146
Is the government agency that mandates the conditions under which drugs intended for medical use are developed and tested
Food and Drug Administration
147
What FDA category of pregnancy?
Controlled studies in women fail to demonstrate a risk to the fetus in the first trimester and the possibility of fetal harm appears remote
Pregnancy category A
148
What FDA category of pregnancy?
Either animal reproduction studies have not demonstrated a fetal risk but there are no controlled studies in pregnant women or animal reproduction have shown adverse effect
Pregnancy category B
149
What FDA category of pregnancy?
Drugs should be given only when the potential benefit justifies the potential risk to the fetus
Pregnancy category C
150
What FDA category of pregnancy?
There is positive evidence of human fetal risk, but the benefits from use in pregnant women may be acceptable despite the risk
Pregnancy category D
151
What FDA category of pregnancy?
The drug is contraindicated in women who are or may become pregnant
Pregnancy category X
152
The government agency tasked in creating policies in dealing with dangerous drugs, controlled substances and illegal drugs
Dangerous drug board
153
The lead anti-drug law enforcement agency
Philippine drug enforcement agency
154
Complete description of chemical structure of drug
Chemical name
155
Shortened scientific name based on active ingredient
Generic name
156
Name given by pharmaceutical company to distinguish their drug products from other competitors
Brand
157
A substance of compound that is intended to be used in the manufacture of a pharmaceutical product as a therapeutically active compound
Active pharmaceutical ingredient
158
The drug product type that contains a drug substance generally, but not necessarily, in association with excipient
Dosage form
159
The concentration or potency of the known API
Dosage strength
160
An ingredient, added intentionally to the drug substance which should not have pharmacological properties in the quantity used
Excipient
161
Catecholamines that is clinically used to treat anaphylaxis, cardiac arrest, heart failure and shock
Epinephrine
Norepinephrine
Isoproterenol
Dobutamine
Dopamine
162
Non-catecholamines marketed as nasal and ophthalmic decongestants
Phenylephrine and methoxamine
163
Bronchodilators
Metaproterenol, albuterol, bitolterol, terbutaline, salbutamol
164
Major a and b direct-acting agonists
Epinephrine, norepinephrine, dopamine
165
Alpha 1-selective direct-acting agonist
Phenylephrine
Methoxamine
Midodrine
166
Alpha 2-selective direct-acting agonist
Clonidine
Methyldopa
Apraclonidine
Brimonidine
167
Beta-non selective direct-acting agonist
Isoproterenol
168
Beta 1-selective direct-acting agonist
Dobutamine
169
Beta 2-selective direct-acting agonist
Albuterol
Metaprotenerol
Terbutaline
Ritrodine
170
Delta 1-selective direct-acting agonist
Fenoldopam
171
Delta 2-selective direct-acting agonist
Bromocriptine
172
These agents may block the reuptake of norepinephrine or cause the release of norepinephrine from the cytoplasmic pools
Amphetamine, methamphetamine, tyramine
173
Clinically used to treat narcolepsy, nasal congestion
Ephedrine
174
Treatment of hypotension
Mephentermine
175
Decongestant in oral OTC drugs
Phenylpropanolamine
176
Non-selective B-adrenergic antagonists
Nadolol
Timolol
Propranolol
Pindolol
177
Beta 1-selective blockers
Betaxolol
Bisoprolol
Esmolol
Metoprolol
Acebutolol
178
Beta blockers with intrinsic sympathomimetic activity
Carteolol
Labetalol
Acebutalol
Pindolol
179
Beta blockers with membrane stabilizing action
Acebutolol
Pindolol
Propranolol
Metoprolol
180
Clinical uses of beta adrenergic receptor blockers
Managment of chronic hypertension, ischemic heart dse., arrythmias, chronic glaucoma, hyperthyroidism
181
Side effects of beta adrenergic receptor blockers
Hypotension
Bradycardia
Drowsiness
Bronchoconstriction
184
What complication has been reported as a result of topical steroid therapy?
Posterior subcapsular cataract
185
What is the action of botulinum toxin on cholinergic transmission?
Inhibitor of acetylcholine release from the presynaptic membrane
186
What conditions have prostaglandin analogues been reported to cause?
Anterior uveitis and cystoid macular edema
187
Why is pilocarpine contraindicated in uveitis and secondary glaucoma?
Its miotic effect may predispose to posterior synechiae and pupillary occlusion
188
How does the mydriatic effect of alpha adrenergic agonists differ based on iris pigmentation?
Slower in onset on darkly pigmented irides compared to lightly pigmented irides
189
What are the reasons acetylcholine has no therapeutic application?
A. None of its actions are beneficial in any condition.
B. Its effects are transient.
C. It produces widespread actions affecting many organs.
D. Both B and C are correct.
190
What is a characteristic of apraclonidine?
Not used for long-term treatment due to allergic reactions.
191
Which of the following is a Non-Catecholamine sympathomimetic?
Ephedrine.
192
Define an 'orphan' drug.
A drug needed for treatment or prevention of a rare disease.
193
What feature of anticholinesterase poisoning does atropine not antagonize?
Muscle paralysis.
194
What is the purpose of administering 1% atropine in uveitis?
Cause mydriasis and prevent formation of posterior synechiae.
195
What is the action of acetazolamide?
Acts on the non-pigmented ciliary epithelium to inhibit aqueous production.
196
What effect does phenylephrine produce?
Mydriasis only.
197
What type of drug is pilocarpine?
Muscarinic agonist.
198
How does pilocarpine reduce intraocular tension in open angle glaucoma?
Increasing tone of ciliary muscle.
199
What is the longer-acting ocular Beta-blocker?
Levobunolol.
200
What type of neuromuscular blocker is succinylcholine?
Depolarizing neuromuscular blocker/nicotinic receptor agonist.
201
What is the duration of action of 1 drop of proparacaine?
20 minutes.
202
Which local anesthetic raises blood pressure instead of causing a fall?
Cocaine.
203
What is the most effective antidote for belladonna poisoning?
Physostigmine.
204
What is the action of miotics for therapeutic effect in angle closure glaucoma?
Sphincter pupillae muscle.
205
Why do glaucoma patients prefer Timolol eye drops over pilocarpine?
Timolol produces less ocular side effects.
206
Which anti-glaucoma drug acts by reducing aqueous humor production?
Beta-blockers.
207
What is the most important drug in the treatment of organophosphate poisoning?
Atropine sulfate.
208
What statement is true regarding pilocarpine?
May cause accommodative spasm.
209
What type of color blindness is noticed in ethambutol toxicity?
Red/green
210
What route of drug administration is most likely to be subjected to first-pass metabolism?
Oral
211
What drug causes iris cysts?
Echothiophate
212
What condition can ethambutol cause?
Optic Neuropathy
213
Isotretinoin, birth control pills, and diuretics can cause what type of refractive error?
Myopia
214
What is the most suitable mydriatic for a patient with a corneal ulcer?
Atropine sulfate
215
What is the pH stability of the ophthalmic preparation?
Neutral
216
What is the main organ for biotransformation of most medications?
Liver
217
What is the main organ for excretion of most medications?
Kidneys
218
What does Phase I biotransformation include?
Reduction, hydrolysis, oxidation
219
What polar moiety is used during phase 1 biotransformation?
Sulfhydryl
220
What is the safest diagnostic ophthalmic mydriatic medication for 10-year-old children?
0.5% Tropicamide
221
Which mydriatic and cycloplegic agent is the strongest?
0.5% Atropine
222
Which mydriatic and cycloplegic agent is the weakest?
0.5% Tropicamide
223
What mydriatic and cycloplegic agent has a rapid onset of action that can dilate pupils in 15-20 minutes?
2% Cyclopentolate
224
Where does 2.5% Phenylephrine belong?
Adrenomimetic Agent
225
What ocular effect does 2.5% Phenylephrine produce during refraction?
Produce mydriasis without cycloplegia
226
Which ocular structure is interacted upon by 2.5% Phenylephrine?
Radial muscles of the iris, conjunctival arteries, Mueller's muscles of the eyelids
227
What is the color cap of ophthalmic 2.5% Phenylephrine?
Red
228
What is the reversing agent to the mydriatic effect of Phenylephrine?
0.5% Dapiprazole
229
What is the color cap of the reversing agent of Phenylephrine?
Green
230
What is the diagnostic dye in strips used by licensed optometrists?
Fluorescein dye
231
What is an indication of using fluorescein dye in TBUT?
Determine if there is much deficiency that causes dry eye syndrome
232
What is an indication of using fluorescein dye during angiography?
Determine the pattern of retinal vessels for any obstruction or hemorrhages
233
What is an indication of using fluorescein dye in fluorescein dye test 1?
Determine the patency of lacrimal passage
234
What is the importance of a Seidel test using fluorescein dye?
Shows fishnet mosaic pattern of pre-corneal tear film
235
What is the importance of using fluorescein dye in Herpetic keratitis?
Shows corneal dendritic on cornea
236
A cell membrane consists of the following EXCEPT
A. hydrophobic layer
B. interspersed with protein
C. bilayer of lipid
D. hydrophilic layer
D. hydrophilic layer
237
All of these drugs can be used to decrease IOP in the treatment of glaucoma EXCEPT
A. Neostigmine
B. Pilocarpine
C. Timolol
D. Atropine
D. Atropine
238
A 20 year old female came to your clinic complaining of recent onset of blurring of vision at far. Which of the following medicines is MOST likely the cause of myopia?
A. Ibuprofen
B. Pilocarpine
C. Isotretinoin
D. Tylenol
C. Isotretinoin
239
Which of the following anesthetics also produces mydriasis?
A. Tetracaine
B. Cocaine
C. Proparacaine
D. Benoxinate
B. Cocaine
240
A patient with open angle glaucoma is also asthmatic and hypertensive. The anti-glaucoma drug of choice should be
A. Pilocarpine
B. Epinephrine
C. Levobunolol
D. Betaxolol
D. Betaxolol
244
What is the best way to prevent CNS side effects of Cyclopentolate in a 2 y/o child?
Use 0.5% Cyclopentolate
## Footnote
This option reduces the risk of CNS toxicity.
245
Which drug is often used concurrently with Pilocarpine for glaucoma treatment?
Echothiopate
## Footnote
This combination enhances the therapeutic effect for glaucoma.
246
What does a peak drug level indicate?
D. indicates the end of absorption
## Footnote
This is a critical point in pharmacokinetics.
247
Atropine sulphate is a classic example of what type of drug?
C. muscarinic antagonist drug
## Footnote
Derived from the belladonna plant, it inhibits muscarinic receptors.
248
Which test is used to determine if there is diabetes mellitus?
C. Hemoglobin test
## Footnote
This test is often used to assess blood glucose levels over time.
249
In the gastrointestinal tract, which phase occurs when drugs need to be in solution for absorption?
B. Pharmaceutic phase
## Footnote
This phase is crucial for the dissolution of drugs.
250
Which agent may be used for the prophylaxis of ophthalmia neonatorum instead of silver nitrate?
D. Erythromycin
## Footnote
Erythromycin is an alternative for preventing eye infections in newborns.
251
True or False: Anticholinergic drugs cause bradycardia.
False
## Footnote
Anticholinergic drugs typically increase heart rate.
252
What effect do anticholinergic drugs have on bowel activity?
B. increase body temperature in children
## Footnote
These drugs can affect thermoregulation.
253
Fill in the blank: The phase in the gastrointestinal tract where drugs must be in solution is the _______.
Pharmaceutic phase
## Footnote
Essential for the absorption of medications.
