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Pharmacolocy 2 > Exam 3 Toxicology > Flashcards

Exam 3 Toxicology Flashcards

1
Q

Defined as the range of response per dose?

A

biological variation

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2
Q

Defined as a greater-than-normal reaction to a drug?

A

hypersusceptibility

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3
Q

Defined as a response of the patient to the drug is qualitatively different from the usual or expected response?

A

drug idiosyncracy

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4
Q

Age - Pediatrics: dosing is based on the ___ of the child?

A

weight

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5
Q

Age - Geriatrics: what’s the rule for geriatric dosing?

A

give lower dose

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6
Q

Pathological State: liver disease: in most cases, drug metabolism is reduced due to diminished function of ____ system, dosing must be _____

A

cytochrome P-450

reduced

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7
Q

Pathological State: renal disease: results in renal impairment of drug excretion; dosing must be modified on the basis of _____ values of the drug

A

renal clearance

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8
Q

Defined as increasing amounts of drugs are required to produce a consistent effect?

A

drug tolerance

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9
Q

Defined as a rapid development of tolerance?

A

tachyphylaxis

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10
Q

Defined as a quantitative measure of the therapeutic window?

A

therapeutic index

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11
Q

What is therapeutic index?

A

a single number that quantifies the relative margin of safety of a drug in a population of people OR how selective the drug is in producing the desired effects.

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12
Q

Do dentists want to see a large TI or small TI?

A

large TI, because a small TI is a small window requiring monitoring

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13
Q

What is TD50?

A

dose of the drug that causes a toxic response in 50% of the population

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14
Q

What is ED50?

A

does of the drug that is therapeutically effective in 50% of the population

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15
Q

Defined as a result of a single, large exposure to the toxic agent; seen within minutes/hours, and MAYBE weeks to months following initial exposure?

A

acute toxicity

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16
Q

Defines as the effect of a toxic insult that occurs over a prolonged period of time; seen after years of exposure and long after Pt is no longer exposed to the toxin?

A

chronic toxicity

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17
Q

Toxins must cross an _____ to be absorbed systemically

A

epithelial layer

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18
Q

Name the 3 primary sites of absorption into the body?

A

GI tract
Respiratory tract
Skin

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19
Q

Rate of distribution to a particular tissue is related to ___?

A

the amount of blood flow to the tissue

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20
Q

Organs with a lot of blood flow?

A

brain
liver
kidney

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21
Q

Organs with less blood flow?

A

fat

bone

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22
Q

Concentration of the toxin in each tissue is determined by ____?

A

the affinity of the toxin for the tissue

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23
Q

Defined as a being metabolized to inert products in the liver (active to inactive)?

A

detoxication

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24
Q

Detoxification uses ____ liver enzyme system to create ____ molecules to allow for elimination.

A

P450

water soluble

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25
Q

Defined as nontoxic materials converted into toxic materials after undergoing metabolism in the liver (inactive to active)?

A

toxication

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26
Q

Name 2 elimination pathways?

A

1) renal excretion of water-soluble molecules

2) respiratory excretion of gases and volatile compounds

27
Q

Defined as altering structure of proteins, lipids, carbohydrates, and nucleic acids so severely that cellular integrity is lost?

A

macromolecular damage

28
Q

Tissue-damaging agents are ____ and most commonly affect what systems exposed to the environment?

A

non-specific

skin, eyes, respiratory system

29
Q

Defined as reacting chemically with biologic macromolecules and other chemicals?

A

reactive species

30
Q

Reactive species are more ____ in their site of action

A

specific

31
Q

Reactive species cause damage where?

A

in the tissues in which they are generated

32
Q

Name a reactive species example?

A

carbon tetrachloride

33
Q

How does carbon tetrachloride become reactive?

A

metabolized by liver with oxygen to form toxic organic free radicals that can then attack kidney, liver and cause liver cancer

34
Q

The immune response can be triggered by toxins in what 2 ways?

A

1) hypersensitivity reactions (allergic)

2) autoimmune reactions

35
Q

Defined as altering importan metabolic pathways, signaling pathways or interacting with critical receptors?

A

enzyme and receptor-mediated toxicity

36
Q

Enzyme-mediated nerve gases and pesticides are ____ inhibitors

A

acetylcholinesterase

37
Q

Nerve gases and pesticides cause what?

A

excessive concentration of acetylcholine in synaptic cleft

38
Q

Excess acetylcholinesterase in synaptic cleft causes what symptoms?

A 
slowed heart rate
breathing difficulties
sweating
diarrhea
salivation
vomiting
weakness
convulsions
pinpoint pupils
39
Q

Describe the enzyme-mediated process that prevents the generation of ATP?

A

cyanide bindes heme iron to active site of cytochrome C oxidase

40
Q

Describe the receptor-mediated toxicity example?

A

carbon monoxide binds strongly to iron in active site of hemoglobin, preventing oxygen binding and reducing oxygen carrying capacity

41
Q

Defined as the transformation of a normal cell to a neoplastic cell?

A

carcinogenesis

42
Q

Defined as a chemical, physical or biological substance that can cause transformation?

A

carcinogen

43
Q

Describe a carcinogenesis example?

A

chronic consumption of alcohol lead to cirrhosis, which can lead to liver cancer

44
Q

Describe how carcinogenesis works?

A

initiator damages DNA, causes mutation, mutation replicated, if mutation affects genes that control cell cycle replication, cancer is initiated

45
Q

Defined as a substance that can induce a birth defect?

A

teratogen

46
Q

What are most teratogens?

A

reactive species or metabolic inhibitors

47
Q

What are potent teratogens?

A

substances that can inhibit intracellular signals

48
Q

Name some ways teratogens work?

A 
alter DNA/chromosomes
fetus exposure means mother exposure
functional deficit
growth retardation
death
49
Q

What organ may recover after toxic exposure?

A

liver

50
Q

What organs cannot recover after toxic exposure?

A

heart, neurons

51
Q

What prevents many toxins from entering the CNS?

A

blood brain barrier

52
Q

Name some ways cancer cells use selective toxicity to survive and replicate?

A 
PERMS
proteins
enzymes
receptors
metabolic pathways
structures
53
Q

Selective toxicity attack targets that are unique to the pathogen/cancer cell that are WHAT 3 things?

A

1) not present in the host
2) similar but not identical to those in the host
3) shared by the host, but that vary in importance between the pathogen and the host

54
Q

Drugs exhibit the least toxicity when they what?

A

target a unique difference

55
Q

Drugs exhibit the most toxicity when they what?

A

target common pathways

56
Q

Name a highly selective drug because of the large difference between the therapeutic and toxic concentrations?

A

penicillin

57
Q

Drugs that are less selective are what?

A

affect pathogenic and normal cells, are not as safe, have narrow therapeutic indext

58
Q

Give an example of a unique drug target?

A

antibiotics targeting cell wall

59
Q

Give an example of a bad unique drug target?

A

anti fungal drugs (can alter human cells as well); low therapeutic index; significant side effects

60
Q

Give an example of a bad unique DRUG and what is CAUSES?

A

amphoteracin = ototoxicity

61
Q

Name examples of selective inhibition of similar targets?

A

inhibiting protein synthesis = antibiotics
prevent emergence of protein from ribosome = macrolides
disrupt decoding of mRNA = aminoglycosides

62
Q

Defined as drugs that produce an effect on the cancer cell than the host and has a narrow therapeutic index?

A

common targets

63
Q

Name an example of common targets?

A

inhibiting cancer cell growth = mutated tumor cells using same machinery as normal cells

64
Q

Side effects of targeting cancer cell growth?

A 
chemotherapy side effects
loss of hair
mouth sores
skin problems
GI problems (diarrhea)
Sex cells (infertility)

Pharmacolocy 2 (15 decks)

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