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Pharmacology > intro to clinical drug action > Flashcards

intro to clinical drug action Flashcards

1
Q

What is a drug

A

Chemical substance (other than food) that when administered to a living organism produces a biological effect on the structure or function of the body.

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2
Q

What are non-medicinal drugs

A

Caffeine, nicotine, alcohol, cannabis etc

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3
Q

What are the different effects of drugs

A

Therapuetic (beneficial)
Side (known/predictable)
Adverse (unpredictable, can hinder treatment)

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4
Q

What drugs are used in dentistry

A

Local anaesthetic e.g. Lidocaine, Articaine​
Prevent pain during procedures

Antimicrobials e.g. Penicillin, Fluconazole​
Treat and prevent infections

Anxiolytics e.g. Diazepam, Midazolam
Reduce anxiety

Analgesics e.g. Paracetamol, Ibuprofen
Reduce postoperative pain

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5
Q

What is pharmacodynamics

A

The effects of the drug on the body and mechanism of action​

What the drug does to the body​

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6
Q

What is pharmacokinetics

A

Term to describe the 4 stages of absorption, distribution, metabolism, excretion of drugs​

What the body does to the drug

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7
Q

What can drugs do

A

Simulate normal body communications​

​

Interrupt normal body communications​

​

Act on non-host organisms to aid body defences

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8
Q

What is the difference between hormone and neural messages

A

Hormone - general to ALL
Neural - targetted to SPECIFIC

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9
Q

What do adrenal gland hormones do

A

Regulate stress response, blood pressure, immune system

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10
Q

What are symptoms of hyperthyroidism

A

Rapid metabolism, High pulse rate, Sweating & Heat intolerance, Anxiety and agitation, Weight loss

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11
Q

What are the symptoms of Hypothyroidism

A

Cold intolerance, Coarse Skin, Memory loss, Slow pulse, Low metabolism

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12
Q

What is the neurotransmitter mainly responsible for the effects of the sympathetic/parasympathetic nvs

A

Sympathetic (Adrenaline)​

Parasympathetic (Acetylcholine)​

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13
Q

What is pilocarpine

A

Increases salivia production
Cholinergic agonist, enhances the function of the sympathetic NS

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14
Q

What is atropine

A

A drug which decreases saliva production
(PSNS inhibitter) cholinergic blocker

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15
Q

What drug has the opposing effect of adrenaline

A

Atenolol

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16
Q

What is topical administration

A

Drug applied to the tissue where it acts

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17
Q

What is the name for when a drug is applied to the whole organism

A

Systemic administration

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18
Q

Injection administration is also called?

A

Parenteral

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19
Q

What is the differece between transdermal and subcutaneous administration

A

Transdermal Drug applied to the skin for adsorption​

Subcutaneous Drug injected into the tissues of the skin

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20
Q

What is intramuscular and intravenous administration

A

injected into the muscle or vein

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21
Q

What is transmucosal administration

A

Drug is applied to the mucosea for adsorption

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22
Q

What are the 4 main modes of action of drugs

A

Activation or blocking of Receptors​

​

Activating or blocking Enzyme function​

​

Opening or blocking Ion Channels​

​

Facilitation or blocking Transport systems

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23
Q

What is efficacy

A

How effective the drug is at producing a response from the receptor​

24
Q

What determines efficacy

A

​

Affinity – how avidly the drug binds to the receptor​

Occupancy – how much time the drug spends on the receptor

25
Q

What is a partial agonist

A

Binds to receptor but only partially activates the receptor. Less efficacy in comparison to agonist i.e. produces less than maximal effect. ​

Increase partial agonist concentration will improve efficacy for some but not for others ​

26
Q

What is an example of an irreversible antagonist

A

Penoxybenzamine (alpha 1 blocker)

27
Q

What is a reversible agonist

A

Atenolol (beta 1 blocker)

28
Q

What is the steps/routeof drugs through the body

A

Administration
Absorption
Transport
Clinical effect
Metabolism
Excretion

29
Q

What does enteral mean

A

Via the gut

30
Q

What is the name for administration not via the gut

A

Parenteral

31
Q

What pathways are enteral

A

Oral
Rectal
Nasogastric
Nasointestinal

32
Q

What are the advantages or oral administration

A

Can self administer
Non-invasive
Cost effective
Convenient

33
Q

What are the disadvantages of oral administration

A

Slow onset
Least reliable
Can be innefficient
variable absorptionn

34
Q

When does the drug reach systemic circulation

A

AFTER passing through the liver

35
Q

What drugs are inactivated by the liver

A

Glyceryl trinitrate (higher doses needed oraly)

36
Q

Name a drug activated by the liver

A

Valaciclovir (less taken oraly)

37
Q

ADV and DISADV or intravenous and intramuscular

A

Advantages​

Very rapid onset
Predictable plasma levels
No first pass metabolism​

Disadvantages​

Allergic reactions more severe
Short duration of action
Requires trained staff to administer
Drug cost higher
Painful

38
Q

Name 2 advantages and disadvantages of transdermal and subcutaneous administrations

A

Advantages​

No first pass metabolism
Allergic reactions often very localised
Prolonged action – can be days with transdermal patches
Can be self administered​

Disadvantages

Very slow onset
Drug cost higher
Effect will vary from person to person and site to site

39
Q

What is bioavailability

A

Proportion of an ingested drug that is available for clinical effect

40
Q

What factors might alter a drugs bioavailability

A

Modified by pharmaceutical factors​

Dosage
formulation
Route of administration
​

Affected by physiological factors​

Destruction in the gut
Poor absorption

41
Q

What is drug distribution

A

Drug distribution is the movement of a drug to and from the blood and various tissues

42
Q

What determines speed of diffusion into tissues from blood

A

Blood flow to area
Membrane characteristics

43
Q

What is the one and two compartment model

A

Single Compartment model​

Drug behaves as if it is evenly distributed throughout the body​

​

Two Compartment model​

Drug behaves as if it is in equilibrium with different tissues in the body

44
Q

Where does metabolism occur

A

Occurs in the liver but some processes occur in gut wall, kidneys, lungs, blood plasma​

45
Q

What are phase 1 metabolism reactions

A

Phase 1 reactions- Modification​

Examples - Oxidation, reduction, hydrolysis

46
Q

What are the enzymes involved in the matabolism of drugs

A

Cytochrome P450 mono-oxygenase system

47
Q

What are phase 2 metabolism reactions

A

Phase 2 reactions- Conjugation​

Examples - Glucuronidation, sulphation, methylation, acetylation,

48
Q

How does the most extensive excretion occur

A

Renal excretion of water soluble metabolites – urine​
​

Liver metabolism and excretion – bile​
​

Lungs – inhaled gases and volatile fractions of other drugs

49
Q

Does saliva and sweat excrete drugs

A

Yes in small proportions

50
Q

What are the 3 stages of renal excretion

A

Glomerular filtration​

Reabsorption​

Secretion

51
Q

What are the main excretory diseases

A

Renal disease
Liver disease

52
Q

What is the plasma half life

A

Time taken to eliminate half of the drug

53
Q

What is the first order kinetics

A

Essentially a proportional increase in elimination of drug as plasma conc increases

Drug elimination increases as drug concentration increases​

Excretion is by PASSIVE DIFFUSION only

54
Q

What is zero order kinetics

A

Constant amount of drug is elliminated per unit time irrespective of drug conc

Drug elimination is at a FIXED rate – ACTIVE process​

Irrespective of drug concentration​

Can lead to the drug accumulation if saturation exceeded

55
Q

What order of elimination is alcohol removed via

A

Alcohol begins as zero order kinetics but moves the first order at lower blood level conc

56
Q

What are the safe doses of paracetemol

A

The manufacturer recommended safe dose of 4g divided over a 24 hour period.

57
Q

Where does the main metabolism of paracetemol occur

A

Liver

Pharmacology (3 decks)

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