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Exam 1 Flashcards

1
Q

Pharmacokinetics definition

A

what the body does to a drug involves ADME

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2
Q

Pharmacodynamics definition

A

how a drug affects a body

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3
Q

T/F: pharmacy and pharmacology mean the same thing?

A

False

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4
Q

Pharmacotherapeutics definition

A

study of the therapeutic use and effects of drugs in the treatment or prevention of disease

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5
Q

what does ADME stand for?

A

absorption distribution metabolism excretion

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6
Q

what are the 3 steps in the FDA drug approval process?

A

identify new drug need FDA IND Clinical trials

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7
Q

what are the 4 phases of clinical trials?

A
  1. safety 2. efficacy 3. larger and longer RCT 4. post marketing surveillance
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8
Q

Off-label and Off-patent difference?

A

off-patent = not paying original develop, anyone can make it;

off-label = not original/FDA approved use for drug

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9
Q

is off-label use illegal?

A

no (unless unethical) illegal to market off-label use though

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10
Q

3 ways drugs are named

A

chemical, generic, brand/trade names

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11
Q

define brand/trade name for drugs

A

drug marketed under a proprietary, trademark-protected name

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12
Q

how are controlled substances classified?

A

into 5 schedules, schedule 1 has the highest abuse and dependence level and no medical purpose

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13
Q

what are the 2 ways drugs are absorbed?

A

via enteral (GI tract) or parenteral route

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14
Q

what are 3 drug types that are absorbed via enteral route?

A

oral,

sublingual,

rectal

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15
Q

what are 5 drug types that are absorbed via parenteral route?

A

inhalation, injection, topical, transdermal, implant

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16
Q

what are the 3 main pathways a drug gets to a target?

A
  1. passive diff thru lipid membrane 2. passive diff thru aqueous channel 3. carrier-mediated
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17
Q

define bioavailability

A

% of drug that makes it into systemic circulation

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18
Q

what is the first-pass effect/metabolim/elimination?

A

Oral medications that are taken will exit the stomach and can be absorbed up to the liver via the portal vein which can result in a large percentage of the drug being broken down and thus resulting in a decreased bioavailability of that drug.

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19
Q

What does volume of distribution tell us?

A

how extensively a drug is distributed to the rest of the body compared to the plasma

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20
Q

what does a higher Vd mean?

A

there is more drug in tissue than the blood

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21
Q

what are CYP enzymes?

A

enzymes that catalyze reactions to break down drugs, mainly in the liver

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22
Q

how are CYPs affected by drug-drug interactions?

A

some drugs induce or inhibit CYP which affects the bioavailability of other drugs

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23
Q

what is the difference between first-order and zero order elimination?

A

first-order has a constant half-life zero order has a constant elimination rate

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24
Q

how many half-lives before a drug is considered “cleared”?

A

5

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25
how many half-lives does it take to reach "steady state"?
4-5
26
define steady state as it pertains to dosing
amount of drug excreted in specific time frame = amount of drug administered often equal to time to reach therapeutic effect
27
define volume of distribution (Vd)
the ratio of the amount of drug in the total body to the concentration of drug in the plasma
28
define drug
articles intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease in man or other animals
29
what is toxicology?
the study of the harmful effects of chemicals, side effects or adverse effects
30
Schedule I substance
regarded as having the highest potential for abuse and addiction (THC, LSD, heroin, ecstasy)
31
Schedule II substance
approved for specific uses but still have a high potential for addiction (opioids/narcotics)
32
Schedule III substance
lower abuse potential but still might lead to dependence
33
Schedule IV substance
still lower potential for abuse
34
Schedule V substance
lowest relative abuse potential
35
define dose
the amount of drug given at any one time
36
define dosage
the frequency with which a drug dose is to be given
37
What are the 4 drug receptor types?
1. ligand-gated ion channels 2. G-protein-coupled receptors 3. Kinase-linked receptors 4. Nuclear receptors (DNA coupled)
38
what is pharmacodynamics?
the study of the biochemical and physiological effects of drugs on the body and underlying pathologies
39
receptor info for ligand-gated ion channels?
nicotinic ACh receptors very quick (milliseconds)
40
receptor info for G-protein-coupled receptors?
Muscarinic ACh receptors quick (seconds)
41
receptor info for Kinase-linked receptors?
Cytokine receptors longer (hours)
42
receptor info for nuclear receptors?
estrogen receptors longer (hours)
43
what are 2 other drug targets?
enzyme non-human cells
44
define specificity
drug binds to only one type of receptor
45
define selectivity
can bind to a multiple subtypes of a receptor but it prefers one
46
what are the potential consequences of decreased specificity or selectivity?
less spec-selc = more AE less targeted approach
47
what is an agonist?
drugs that occupy receptors and activate them
48
what is an antagonist?
drugs that occupy receptors but don't activate them block activation by agonist
49
what is competitive antagonist?
agonist vs antagonist higher concentration wins
50
what is noncompetitive antagonist?
antagonist binds to secondary receptor, cannot leave, shuts down/blocks agonist effects
51
what is a partial agonist?
similar to agonist but not a perfect fit lower dose leads to some agonist effect higher dose blocks agonist, leads to diminished effect
52
what is a partial agonist?
similar to agonist but not a perfect fit lower dose leads to some agonist effect higher dose blocks agonist, leads to diminished effect
53
what is Emax?
maximal response receptors are saturated may cause toxicity
54
what is ED50?
effective dose to get 50% of expected response
55
how does ED50 relate to potency?
lower ED50 = more potent less drug required for effect
56
Other forms of antagonism?
chemical, physiologic, pharmacokinetic receptor changes
57
What is a quantal-dose response curve?
used to compare safety of a drug tracks % or # of population who has a particular reponse at a given dose
58
what can a quantal-dose response curve help us find?
the smallest effective dose among a population of people.
59
what is TD50?
dose that is toxic for 50% of people
60
What is the Therapeutic Index?
a ratio of TD50 to ED50
61
which is safer: Narrow or Wide therapeutic index?
wide therapeutic index
62
define adverse drug reaction (ADR)
response to a medicine which is noxious and unintended
63
side effect
any unintended effect of a pharmaceutical product occurring at doses normally used by a patient which is related to the pharmacological properties of the drug
64
medication error
any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care pro, pt, or consumer
65
define side effect
any unintended effect of a pharmaceutical product occurring at doses normally used by a patient which is related to the pharmacological properties of the drug
66
define medication error
any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care pro, pt, or consumer
67
define adverse event/experience
any untoward medical occurrence that may present during treatment with a medicine but which does not necessarily have a causal relationship with this treatment
68
serious adverse event is any event that is:
1) . fatal/life threatening 2) .permanently/sig disabling 3) . requires/prolongs hospitalization 4) . causes congenital anomaly 5) . requires intervention
69
what are boxed warnings?
FDA designation added to labels, calls attention to serious/life threatening risk
70
What is the Naranjo Scale/
a questionnaire that helps to determine if a pt is suffering from AE
71
What could cause ADRs?
1) . patient specific factors 2) . drug-drug interactions 3) . HCP error 4) . Nonadherence
72
how to prevent ADRs
simplify med regimens assess adherence evaluate changes in pt health avoid polypharmacy use ISMP recomendations
73
define synergistic interaction
produces a response \> sum of responses to both drugs
74
define antagonists interaction
produce effect \< response produced by each drug alone
75
What is pain?
an experience based on complex interactions of physical and psychological processes
76
what are the 3 types of pain?
nociceptive neuropathic psychogenic
77
What neural structures are involved with ascending pain pathways?
periphery sensory neurons, dorsal horn of spinal cord, brain stem, thalamus, somatosensory cortex
78
where would you find 1st order neurons in ascending pathways?
going from the injury site to the dorsal horn of the spinal cord
79
where would you find 2nd order neurons in ascending pathways?
going from the dorsal horn of the spinal cord, crossing over then ascending up to the thalamus
80
where would you find 3rd order neurons in ascending pathways?
going from the thalamus to the somatosensory cortex of the brain
81
Where does interpretation of pain occur?
somatosensory cortex (cerebral cortex)
82
What does the descending pathway do?
modulate/suppression pain signals
83
where does the descending pathway originate?
periaqueductal gray matter of the mid-brain
84
Name some neurotransmitters in the nociceptive pathways
GABA, glutamate, serotonin, norepinephrine, adenosin
85
what is the MOA for opioids?
bind to opioid receptor in CNS to inhibit ascending pain pathways
86
What are the 3 main opioid receptors?
mu delta kappa
87
AE of opioids on CNS
sedation, nausea, respiratory depression, cough suppression, miosis (pinpoint pupil), truncal rigidity
88
AE peripheral effects of opioids
constipation urinary retention bronchospasm reduced GI motility Pruritus (itching)
89
what to notice for respiratory depression
labored breathing and decreased respiration rate
90
T/F: respiratory depression from opioid can occur even at usual doses
TRUE
91
most opioid drugs bind to which receptor?
mu
92
effects associated with Mu opioid receptors
analgesia, euphoria, respiratory depression, bradycardia, emesis, slowed GI motility, pruritis, high abuse/dependence potential
93
what is nociceptive pain?
produced by injury stabbing, aching, well-localized (exceptions)
94
when is nociceptive pain not localized?
when it originates from visera
95
what is neuropathic pain?
typically indicates nerve involvement burning, tingling sensation
96
what is psychogenic pain?
origin or relationship to pscyh d/o
97
T/F: the 3 types of pain are mutually exclusive and cannot have overlap?
FALSE
98
what are the 2 primary nociceptive afferent neurons?
unmyelinated C fibers finely myelinated A delta fibers
99
in the dorsal horn, what neurotransmitters inhibit pain signal propagation?
NMDA blocker substance P antagonists inhibition of NO synthesis
100
what is the substantia gelatinosa?
a collection of gray cells (in dorsal horn) act like gate keeper to regulate pain signals from nociceptive fibers
101
what type of pain is usually created by unmyelinated C fibers?
diffuse pain sensation
102
what type of pain is usually created by finely myelinated A delta fibers?
localized, defined pain sensation

Pharmacology (10 decks)

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