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BMS 311 - Pharmacology > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Chemicals that affect living processes.

A

drugs

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2
Q

study of drugs and their interactions with living systems

A

pharmacology

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3
Q

study of drugs in humans

A

clinical pharmacology

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4
Q

medical use of drugs to diagnose, treat, or prevent disease

A

therapeutics/pharmacotherapeutics

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5
Q

Name the three most important properties of the ideal drug.

A

effectiveness, safety, selectivity

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6
Q

Name some of the additional properties of an effective drug

A

reversible action, predictability, ease of administration, freedom from interactions, low cost, chemical stability, simple generic name

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7
Q

What is the therapeutic objective of drug therapy?

A

to provide the maximum benefit with the minimum harm

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8
Q

What are the 6 rights?

A

right drug, right patient, right dose, right route, right time, right documentation

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9
Q

Why is it important for nurses to know pharm?

A

minimize adverse effects, patient education, proper dosage and administration, prn decisions, manage toxicity

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10
Q

This legislation required drugs to be free of adulterants, did nothing for safety or effectiveness.

A

Federal Pure Food and Drug Act of 1906

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11
Q

Required that all new drugs undergo testing for toxicity and that the FDA reviewed these tests for safety before drug hits the market.

A

Food, Drug, and Cosmetic Act (1938)

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12
Q

Required that all drugs be tested for effectiveness before hitting the market, also set rigorous procedure for testing new drugs before FDA approval.

A

Harris-Kefauver Amendments to the Food, Drug, and Cosmetic Act (1962)

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13
Q

Set rules for the manufacture and distribution of drugs considered to have the potential for abuse. Schedule 1 most abuse, Schedule 5 the least.

A

Controlled Substances Act (1970)

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14
Q

FDA takes too long to review drug applications, for $500k the process is sped up with additional reviewers and a stricter timetable.

A

Prescription Drug User Fee Act (1992) PDUFA

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15
Q

Includes drugs for other serious life threatening illnesses in the accelerated program, must notify patients 6 mos. in advance if stop manufacturing drug, clinical trial database will be established for drugs treating serious life threatening illnesses, drug companies can provide info for off label use of drugs, research must include women

A

Food and Drug Administration and Modernization Act (FDAMA) (1997)

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16
Q

Offers a 6 month patent extension for drug companies who evaluate a drug already on the market for its safety, efficacy, and dosage in children.

A

Best Pharmaceuticals for Children Act (BPCA) (2002)

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17
Q

The FDA can require drug companies to conduct pediatric clinical trials on meds that might be used on children.

A

Pediatric Research Equity Act (PREA) (2003)

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18
Q

FDA can require postmarketing safety studies, changes in a drugs label to include new safety info, and restrict distribution of drugs based on safety concerns. FDA also created an active postmarketing risk surveillance system.

A

FDA Amendments Act (FDAAA) (2007)

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19
Q

Legislation resulted from Tragedy where >100 ppl died d/t new med that contained an antibiotic (sulfanilimide) and a solvent (diethylene glycol) aka antifreeze.

A

Food, Drug, and Cosmetic Act (1938)

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20
Q

Legislation resulted from the European thalidomide tragedy where moms took the drug that didn’t absolutely need it. Babies born with defects - phocomelia - malformation/absence of limbs.

A

Harris-Kefauver Amendments to the Food, Drug, and Cosmetic Act (1962)

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21
Q

This legislation Came about due to the rise of cancer and AIDs and the need for meds to treat them. The drug risks are much less known this way.

A

Prescription Drug User Fee Act (1992) PDUFA

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22
Q

a substance given to a group to compare to an experimental group, could be a placebo with no effect or an already existing drug.

A

control

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23
Q
  • subjects are assigned randomly to the control or experimental group to prevent allocation bias.
A

random

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24
Q

study in which the subjects don’t know if they are in the control group or the experimental group.

A

single blind study

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25
Q

study in which neither the researchers nor the subjects know who is in the control or experimental group.

A

double blind study

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26
Q

What does preclinical testing do during drug development?

A

takes 1-5 years, test in animals, check toxicity, effectiveness, pharmacokinetics

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27
Q

How long does clinical testing of a drug take and what kind of subjects are used?

A

2-10 years and humans

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28
Q

What is done in phase 1 of clinical testing of drug development?

A

volunteers are tested on for a few months to check drug metabolism, pharmacokinetics, and effectiveness

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29
Q

What is done in phases 2 and 3 of clinical testing of drug development?

A

patients are tested for 3-6 months to learn about dosing, safety, and therapeutic effects

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30
Q

What is done in phase 4 of clinical testing of drug development?

A

This occurs after drug release and involves side effect reporting.

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31
Q

This name is a chemical description of the drug.

A

chemical name

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32
Q

this name is assigned by the US Adopted Names Council.

A

generic name

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33
Q

This is the proprietary name or brand name used for a drug.

A

trade name

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34
Q

List the 4 basic pharmacokinetic processes.

A

absorption, metabolism, distribution, excretion

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35
Q

What are the 3 routes that drugs can pass across membranes?

A

channels and pores for small ions (Na+, K+), transport system (p-glycoprotein), direct penetration of membrane by lipid soluble drugs.

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36
Q

Name 5 locations where p-glycoprotein is found.

A

liver, kidneys, intestine, placenta, brain capillaries

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37
Q

In what ways can drugs that are polar be administered effectively?

A

IV, subcutaneous, IM

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38
Q

Acid ionizes in what media?

A

basic or alkaline media

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39
Q

Base ionizes in what media?

A

acidic media

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40
Q

Name an example of both an acidic and basic medication that is subject to ion trapping.

A

aspirin is an acidic medication and is absorbed in the stomach but trapped in the SI, amphetamines are a base medication and are ionized in the stomach and trapped, but absorbed in the SI

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41
Q

Define absorption.

A

movement of the drug from its site of administration into the blood.

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42
Q

Name 5 factors that affect drug absorption.

A

rate of dissolution, surface area of where its being absorbed, faster bloodflow creates faster absorption, lipid solubility of the drug, pH partitioning.

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43
Q

what is the difference between enteral and parenteral absorption?

A

enteral is oral meds via GI tract, parenteral is via injection (IM IV subq)

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44
Q

Name some less common but still useable routes of administration.

A

topical, transdermal, inhaled, rectal, vaginal

45
Q

What are the perks of using IV meds?

A

rapid onset, control, can give large volumes of meds, can give meds that irritate stomach

46
Q

What are disadvanatages of using IV meds?

A

high cost, inconvenience, irreversible, infection, fluid overload, embolism

47
Q

What are the some advantages to administering meds IM or subq?

A

poorly soluble drugs can be administered, depot preparations can be used

48
Q

What are the some disadvantages to administering meds IM or subq?

A

discomfort, inconvenience, tissue injury, nerve damage.

49
Q

What are the some advantages to administering meds orally?

A

easy, convenient, cheap, safe

50
Q

What are the some disadvantages to administering meds orally?

A

variability, inactivation, patient adherence, irritability to GI tract

51
Q

Distribution is defined as what? What 3 factors determine it?

A

IT is defined as the movement of drugs thoughout the body and is determined by bloodflow to the tissues, the drug exiting the vascular system, and the drug entering cells.

52
Q

What prevents drugs from entering the brain easily?

A

tight junctions and P-glycoprotein that removes drugs

53
Q

What is the protein in the blood that many drugs bind to?

A

albumin

54
Q

Is there placental drug transfer?

A

Yes because there is no barrier, however p-glycoproteins pump drugs back into maternal circ.

55
Q

Where is most drug metabolism performed and how many enzymes specifically degrade drugs?

A

in the liver and there are 3 enzymes for drugs

56
Q

Name some things that might result from drug metabolism.

A

acclerated renal excretion of drug. drug inactivation, increased therapeutic action, activation of prodrugs, increased or decreased toxicity.

57
Q

How is phenobarbitol related to drug metabolism?

A

It in causes the liver to produce more metabolic enzymes which may increase the degradation of phenobarbitol or other drugs.

58
Q

Why is nitroglycerin given sublingually?

A

to avoid first pass metabolism from the liver which metabolizes the drug

59
Q

How does competition between drugs impact drug metabolism?

A

If the2 drugs are metabolized by the same enzyme then they might both be degraded less, if one has a higher affinity then that one will be degraded more and the other one will have a higher bloodlevel.

60
Q

Name the three processes of the kidney involved in drug excretion.

A

glomerular filtration, passive tubular reabsorption, active tubular secretion

61
Q

In this kidney process filtration moves drugs from blood to urine. Protein bound drugs are not filtered.

A

glomerular filtration

62
Q

In this kidney process lipid soluble drugs move back into the blood, meanwhile polar and ionized drugs remain in the urine.

A

passive tubular reabsorption

63
Q

In this kidney process tubular “pumps” for organic acids and bases move drugs from blood to urine.

A

active tubular secretion

64
Q

Name 3 factors that modify renal drug excretion.

A

pH-dependent ionization, competition for active tubular transport, and age

65
Q

Name two drugs that compete against each other for active tubular transport. Which drug gets excreted more and which one remains in the system?

A

Probenicid and Penicillin. Probenicid is excreted more and penicillin thus stays in your system longer.

66
Q

Name some other less common routes of excretion.

A

breast milk, bile (enterhepatic circulation - leaves in feces), feces, sweat and saliva

67
Q

This is defined as the minimum amount of drug needed for a therapeutic response.

A

minimum effective concentration (MEC)

68
Q

This is defined as the plasma level at which toxic effects begin.

A

toxic concentration

69
Q

This is defined as the range between the MEC and the TC.

A

Therapeutic range.

70
Q

This is defined as the time it takes for the amount of drug in the body to decrease by 50%.

A

half life

71
Q

In a single dose time course, what two things influence the duration of effects to a large extent?

A

metabolism and excretion. Effects are seen as long as the drug level remains above the MEC.

72
Q

With repeated doses of a drug how long does it take to build to a plateau level? What about declining from a plateau? (when using equal sized doses)

A

4 half lives

73
Q

What is the difference between loading doses and maintenance doses?

A

A loading dose is a large dose given right away to get a person in the therapeutic range, maintenance doses are much smaller and keep the person there.

74
Q

The study of biochemical and physiological effects of the drug and molecular mechanisms by which the effects are produced is the definition of what?

A

pharmacodynamics

75
Q

In terms of the dose-response curve, what is important about phase 1?

A

The dose is below the minimum amount needed for a response, the curve is flat at this point.

76
Q

In terms of the dose-response curve, what is important about phase 2?

A

There is a graded response, an increase in the dose corresponds with an increase in response.

77
Q

In terms of the dose-response curve, what is important about phase 3?

A

The receptors are saturated. The curves plateaus out because an increase in dose has no effect on the response.

78
Q

The largest effect that a drug can produce is the definition of what term?

A

maximal efficacy

79
Q

The amount of a drug that we must give to elicit an effect is defined as what?

A

potency

80
Q

Name the four primary receptor families.

A

cell membrane embedded enzymes, ligand gated ion channels, g-protein coupled receptors, transcription factors

81
Q

Which receptor family is being discussed and provide examples: endogenous compounds or agonist drug binds to and activates an enzyme. There is an increase in catalytic activity and a response occurs in seconds.

A

cell membrane embedded enzymes; insulin

82
Q

Which receptor family is being discussed and provide examples: an endogenous compound or agonist drugs binds to the receptor and it opens a channel. Ions then flow through based on the concentration gradient.

A

ligand gated ion channel, Ach, GABA

83
Q

Which receptor family is being discussed and provide examples: endogenous compounds or agonist drug activates receptor, which in turn activates the g-protein, which in turn activates the effector.

A

g-protein coupled receptor; NE, histamine, peptide hormones

84
Q

Which receptor family is being discussed and provide examples: this is much slower and make take hours or days to work, the drugs must be very lipid soluble…

A

transcription factors; thyroid and steroid hormones

85
Q

The intensity of the response to a drug is proportional to the number of receptors occupied by that drug and that a maximal response will occur when all available receptors have been occupied is what theory?

A

simple occupancy theory

86
Q

This theory talks about affinity and how it affects potency as well as the impact of intrinsic activity on drug response.

A

modified occupancy theory

87
Q

These type of drugs bind to receptors and mimic the effects of endogenous compounds.

A

agonists

88
Q

These drugs prevent receptor activation by endogenous compounds and other drugs.

A

antagonists

89
Q

Which type of antagonist drug can be overcome if there is enough agonist drug or endogenous compound is present?

A

competitive antagonists because their effects are reversible.

90
Q

How do noncompetetive antagonists work?

A

by reducing the max response of the agonist

91
Q

These compounds can act as both an agonist and antagonist.

A

partial agonists

92
Q

What do partial agonists do?

A

mimic the response of an endogenous compound but have less affinity than a full agonist or endogenous compound.

93
Q

Describe the relationship between two meds where one can act as a partial agonist.

A

meperidine and pentazocine. pentazocine is an agonist when given alone, but a partial agonist when given with meperidine because it blocks some sites so that the more powerful drug meperidine can’t work.

94
Q

Name some drugs that don’t use receptors for their effects and what do they use instead?

A

chemical and physical interactions. Some of these drugs would be antacids, antiseptics, saline laxatives, chelating agents like dimercaprol

95
Q

This term is defined as the dose required to produce a therapeutic response in 50% of the population.

A

ED50

96
Q

This term is defined as the does that is lethal to 50% of the animals treated.

A

LD50

97
Q

This term refers to a drug’s safety. LD50/ED50. The larger it is the safer the drug is.

A

therapeutic index

98
Q

Name two drugs that interact and have increased therapeutic effects.

A

Sublactam and ampicillin. sublactam inhibits bacterial enzymes that destroy ampiciilin. Ampicillin destroys bacteria, so when given together they work better.

99
Q

Name two drugs that interact and have increased adverse effects.

A

Warfarin and aspirin. These two drugs are both blood thinners. When both are taken the risk of excessive bleeding is much higher.

100
Q

Name two drugs that interact and have reduced therapeutic effects.

A

propanolol and albuterol. albuterol is a B2 agonist and propanolol is a nonspecific beta blocker. Propanolol blocks the functioning of albuterol.

101
Q

Name two drugs that interact and have reduced adverse effects.

A

morphine and naloxane. If overdose on morphine then take naloxane to block the effects of morphine.

102
Q

slowing the heart rate, increased gastric secretion, emptying the bladder and bowel, focusing the eye for near vision, constricting the pupil, contracting bronchial smooth muscle.

A

parasympathetic nervous system

103
Q

What are the three main functions of the sympathetic nervous system?

A

regulation of cardiovascular system, regulation of body temperature, implementation of fight or flight reaction.

104
Q

These adrenergic receptors are located in the arterioles and veins where they are responsible for vasoconstriction, in the eye where they are responsible for constriction of radial muscles, reproductive system where they control ejaculation, and they control contraction in the bladder neck and prostate.

A

Alpha1

105
Q

These adrenergic receptors are located in the presynaptic junction and inhibit release. They are of minimal clinical significance.

A

Alpha2

106
Q

These adrenergic receptors are located in the heart where they increase heart rate, force of contraction, and conduction velocity. They are also int he kidney and influence renin release.

A

Beta 1

107
Q

These adrenergic receptors are located in the bronchioles and relax them, as well as in the skeletal muscle where they are responsible for contraction, and they are responsible for vasodilation in the heart lung and skeletal muscle.

A

Beta 2

108
Q

These adrenergic receptors are located in the renal blood vessels and and are responsible for vasodilation.

A

dopamine receptors

BMS 311 - Pharmacology (5 decks)

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