FFM2 - Mini I Flashcards
Pharmacology
Study of substances that will interact with living systems via chemical processes
Drug
Molecule that will bind to target to exert effect
Prototype drug
First form of a drug/medication
Is used to formulate alternative forms
Pharmacokinetics
What body does to drug
Pharmacodynamics
What drug does to body
Toxicology
Science of adverse effects of chemicals on body
Pharmacogenetics
Relationship between persons genetic makeup and response to specific drugs
What is main item that NBME tests on for medication names?
Generic names of medications
Mechanism of action
How drug works to produce change in body
Pharmacologic drug action
Consequences of drug-receptor combination
Pharmacologic effect
Results of drug action
Consequences of drugs own actions
Precaution
Used when medication use should be used with care and careful monitoring of patient
Contraindication
Specific circumstance where medication should NOT be used
Relative Contraindication
Caution needs to be used when 2 meds used together
Benefits outweigh risks
Absolute contraindication
Substance can cause life-threatening and should be avoided
Black box warning
Serious/life threatening risks associated with
Most serious medication warning from FDA
Therapeutic effect
Beneficial consequence of treatment
Adverse event
Harmful/abnormal result form medication
Pregnancy Risk Catagories
A
B
C
D
X
Which pregnancy risk catagories are adverse?
C
D
X
Affinity
Strength of interaction between drug and target
Potency
Amount of drug necessary to produce effect
EC50
Concentration drug needed to produce 50% of max effect
Efficacy
Largest effect achieved with drug, regardless of dosage
Agonist
Bind to receptor
Produce normal response
Antagonist
Bind to receptor
Compete and prevent binding by other molecules
Will block actions OF agonist
Full Agonist
Complete 100% activation of receptor
Partial agonist
Binding to receptor results in >0% but < 100% of activation even with high concentrations
Inverse agonist
Bind to receptor and will produce a response BELOW baseline response
Decreased concentration of drug
Competitive antagonist
Bind to same site
Lowers efficacy of medication
Decreases EC50 of medication
Noncompetitive anatgonist
Bind covalently to receptor
Permanent reduction of # of receptors
Irreversible
EC50 remains same; efficacy decreases
Selectivity
Degree to which drug acts on given site relative to other sites
Nonselective drug
Affects many different tissues producing range of effects
Selective drug
Affects single organ/system
Local effects of medication
Application to site of action
Systemic effects
Drug enters circulation and transported to cellular site of action
Routes of Administration:
Enteral
Oral, sublingual/buccal, rectal
Routes of Administration:
Paraenteral
IV/IA
IM
SubQ
Intradermal
Routes of Administration:
Other types
Oral inhalation
Intrathecal/intraventricular
Topical
Transdermal
Vaginal
Urethral
Absorption
Entering blood stream from site of administration
Distribution
Process which drug reversibly leave bloodstream and enters ECF and tissues
Metabolism
Biochemical changes to medication to facilitate elimination from body
Elimination
Irreversible removal of medication from body
Renal most common
Bioavailability
Extent to which medication reaches systemic circulation
Factors affecting Absorption
ph changes
Blood low
Presence/absence of transporters
First pass effect (Liver/GI metabolism)
Drug formulation
Factors affecting Distribution
CO and Blood flow
Permeability of capillaries
Degree of binding of drug to proteins in blood/tissue
Lipophilicity of medication
MW
Central compartment of body
Highly perfused organs
Heart/Liver/Kidneys
Peripheral compartment of body
Fat tissues
Muscle tissues
CSF
Instantaneous distribution within body
One-compartment
All fluids/tissues considered part of compartment
Delayed distribution within body
Some areas get medication faster than others…
Two-compartments
Distribution into high vascular organs then everywhere else more slowly
Metabolism of meds in 3 ways
1)
2)
3)
1) Active med to inactive med
2) Active med to active metabolite
3) Inactive med to active med
Volume of Distribution (Vd)
Fluid volume required to contain entire drug in body at same concentration as measured in plasma
Equation for Vd
Dose of drug/drug concentration
Factors affecting Vd
Drug MW
Lipophilic or hydrophilic
Ionization at pH
Protein binding
Disease states
Half Life (T1/2)
Time it takes to reduce plasma concentration by 1/2
Clearance (CL)
Volume of blood from which drug is cleared per unit of time
Equation of CL
CL(total) = CL(hepatic) + CL(renal) + CL (other)
Clearance is dependent on…
Half Life - t1/2
Volume of Distribution - Vd
Notable CYP-450 Interactions:
Inducers (8)
1) Carbamazepine
2) Chronic alcohol abuse
3) Modofinil
4) Nevirapine
5) Phenobarbital
6) Phenytoin
7) Rifampin
8) St Johns Wort
Notable CYP-450 Interactions:
Substrates (5)
1) Anto-epileptics
2) Oral contraceptives
3) Statins (EXCEPT FOR pravastatin)
4) Theophylline
5) Warfarin
Notable CYP-450 Interactions:
Inhibitors (16)
1) Acute alcohol overdose
2) Acetomenophen
3) Amniodarone
4) Chloramphenicol
5) Cimitidine
6) Clarithromycin
7) Erythromycin
8) Fluconazole
9) Grapefruit juice
10) Isoniazid
11) Ketoconazole
12) NSAID’s
13) Omeprazole
14) Ritonavir
15) Sulfonamides
16) Valporic Acid
Types of Tissues
Epithelial
Connective
Nervous
Muscular
Characteristics of Epithelium
Avascular
Packed cells with shape/arrangement associated with function
Cell characteristics of epithelium
Arranged as sheets or masses
Close to one another
Have intercellular junctions
Polarized
Rest on basal lamina
Polarization in epithelium
Distinct surface domains
Apical, Lateral and basal surfaces
Classification of cells:
1)
2)
Arrangement
Shape
Examples of Arrangement for cells
Simple
Stratified
Examples of Shape of cells
Squamous
Cuboidal
Columnar
Features of Simple Squamous cells
Width greater than height
One cell layer thick
Nucleus protrudes into lumen
Location of Simple Squamous cells
Lining of BV and Lymphatic vessels
Wall of Bowmans capsule
Covering of mesentery
Lining of respiratory spaces/alveoli in lungs
Function of Simple Squamous cells
Diffusion
Transportation in/out of lumen
Special terminology for certain simple squamous epithelia
Endothelium
Mesothelium
Endothelium
Simple Squamous cells lining blood vessels, lymph vessels, lining of heart (atria/ventricles)
Mesothelium
Simple Squamous cells lining walls and covering contents of body cavities (C/A/P)
Features of Simple Cuboidal cells
Width, depth and height all similar
One cell layer
Centrally located nuclei
Location of Simple Cuboidal cells
Wall of thyroid follicle
Walls of kidney tubules (DCT)
Surface of ovary (germinal epithelium)
Interior surface of tympanic membrane
Function of Simple Cuboidal cells
Absorption
Secretion
Conduction involving different metabolic processes
Features of Simple Columnar cells
Height greater than width
One cell layer
Nuclei seen near basement membrane
Location of Simple Columnar cells
Intestinal tract (stomach to rectum)
Gallbladder
Uterus/cervix
Kidney collecting ducts (lower portion of)
Inner ear
Larger glands and ducts
Function of Simple Columnar cells
Protection
Lubrication
Absorption
Secretion
Conduction involving different metabolic processes
Features of Stratified Squamous cells
Multilayered
Superficial layer is squamous
Can be keratinzied/nonkeratinized
Location of Stratified Squamous cells
Epidermis (K)
Lining of oral cavity (NK)
Lips
Lining of esophagus (NK)
Lining of vagina (NK)
Functions of Stratified Squamous cells
Barrier
Protection
Keratinized Stratified Squamous cells seen…
Dry environment
Non-keratinized Stratified Squamous cells seen…
Wet environment
Features of Stratified Cuboidal cells
Multilayered
Location of Stratified Cuboidal cells
Ducts of sweat glands
Larger ducts of exocrine glands
Anal canal
Functions of Stratified Cuboidal cells
Barrier
Conduit
Features of Stratified Columnar cells
Multilayered
Basal layer appears cuboidal
Superficial layer appears columnar
Location of Stratified Columnar cells
Largest ducts of exocrine glands
Anal canal
Conjunctiva of eye
Male urethra
Submandibular salivary gland
Function of Stratified Columnar cells
Barrier
Conduit
Features of Transitional Epithelium
Stratified
Upper cells domed shaped
Some cells are binucleated
Apical surface will stain more pink due to actin filaments
Location of Transitional Epithelium
Ureters
Urinary bladder
Renal calyces
Urethra
Function of Transitional Epithelium
Accommodation of distention
Another name for Transitional Epithelium
Urothelium
Features of Pseudostratified Epithelium
Appearance of being stratified but is NOT
Some cells do not reach free surface
Nuclei located at different distances from basal lamina
All cells rest on basement membrane
Location of Pseudostratified Epithelium
Upper Respiratory Tract
Epididymis
Ductus deferens
Middle Ear
Special features usually seen with Pseudostratified epithelium
Ciliated or Stereocilia
Goblet cells
Features of Basal Lamina
Acellular
Attachment site
Components synthesized and secreted by epithelial cells
Seen with PAS and Silver salts
Layers of Basal Lamina
1) Lamina Densa
2) Lamina Lucida
Features of Lamina Densa
Network of fine filaments
Features of Lamina Lucida
Clear space between base of cell and Lamina Densa
Cause by artifact
Functions of Basal Lamina
1)
2)
3)
Structure Attachement
Compartmentalization
Filtration
Function of Basal Lamina:
Attachement
Connection of epithelial cells to connective tissue
Function of Basal Lamina:
Compartmentalization
Separates connective tissue FROM nervous, epithelial, and muscular tissue
Function of Basal Lamina:
Filtration
Movement of blood filtrate within kidney
Negatively charged molecules in lamina lucida/collagen fibrils in lamina densa
Regulated via ion exchange and molecular sieve
Composition of Basal Lamina
Laminins
Collagens
Entactins/Nidogen
Proteoglycans
Functions of Laminins
Possess integrins
Link basal lamina to basal plasma membrane
Functions of Collagens
Type IV collagen
Short filaments
Structural integrity
Molecular sieve
Functions of Entactin/Nidogen
Link between laminins and Type IV collagen
Supports cell adhesion
Functions of Proteoglycans
Bulk of basal lamina
Protein cores
Attached to cores are negatively charges GAG’s
VERY EXTENSIVELY HYDRATED
Role in regulation of ions across basal lamina
Types of cell surface modifications
Microvilli
Cilia
Stereocilia
Lateral/Basal foldings
Features of Microvilli
Features of Stereocilia
Features of Lateral folds
Types of Junctional Complexes
Zonula Occludens
Zonula Adherens
Macula Adherens/Desmosomes
Gap Junctions
Features of Zonula Occludens
Features of Zonula Adherens
Features of Macula Adherens
Features of Gap Junctions
Features of Hemidesmosomes
Located on basal surface of plasma membrane
Connects basal PM to basal lamina
Locations with hemidesmosomes
Epithelia subjected to abrasion and mechanical shearing
Skin
Cornea
Mucosa of Oral cavity, Esophagus, and vagina
Composition of hemidesmosomes
Attachment plaque (plectin and BP230)
Plaque on cytoplasmic side
Intermediate filaments bind to attachment plaque
Integrins bind attachent plaque to ECM
Features of Focal Adhesions
Dynamic attachments
Link actin filaments to ECM proteins
Composition of Focal Adhesions
Actin filaments
Integrins
Laminin and Fibronectin
Role of Focal Adhesions
Attachment and migration of cells
CN-I
Name:
Sensory Function:
Motor Function:
Olfactory
Sensory Nerve - sense of smell
No motor function
CN-II
Name:
Sensory Function:
Motor Function:
Optic
Sensory Nerve - sense of sight
No motor function
CN-III
Name:
Sensory Function:
Motor Function:
Oculomotor
No sensory function
Motor function - controls 5/7 muscles of orbit/eye
CN-IV
Name:
Sensory Function:
Motor Function:
Trochlear
No sensory function
Downward internal rotation of eye (Superior Oblique)
CN-V
Name:
Sensory Function:
Motor Function:
Trigeminal
Sensory for facial sensations (pain, hot/cold)
Motor function for muscles of mastication
Motor function of myohyloid, anterior belly of digastric; tensor veli palantini; tensor tympani
Muscles of mastication
Temporalis muscle
Massetter muscle
Lateral/Medial Pterygoid
CN-VI
Name:
Sensory Function:
Motor Function:
Abducens
No sensory function
Motor function for lateral deviation of eye (Lateral Rectus)
CN-VII
Name:
Sensory Function:
Motor Function:
Facial
Sensory function of taste on anterior 2/3 of tongue and sensation of ear
Motor function of facial expressions (posterior belly of digastric; stapedius muscle)
CN-VIII
Name:
Sensory Function:
Motor Function:
Vestibulocochlear
Sensory function of hearing (cochlear) and balance (vestibular)
No motor function
CN-IX
Name:
Sensory Function:
Motor Function:
Glossopharyngeal
Sensory function of taste on posterior 1/3 of tongue
Sensory of pharynx, posterior portion of eardrum and ear canal
Motor function of the stylopharyngeus muscle
CN-X
Name:
Sensory Function:
Motor Function:
Vagus
Sensory function of pharynx and larynx
Motor function of pharynx, larynx, and palatal muscles
CN-XI
Name:
Sensory Function:
Motor Function:
Spinal Accessory
No sensory function
Motor function of SCM and trapezius
CN-XII
Name:
Sensory Function:
Motor Function:
Hypoglossal
