Intro to Pharm Flashcards
1
Q
drug def
A
something put in body for intended effect
2
Q
drugs that are almost exclusively harmful
A
poison
3
Q
FDA def drug
A
substance intended for:
- dx
- cure
- mitigation
- treatment
- prevention (prophylaxis) of disease
4
Q
natural sources of drugs
A
- botanical (plant)
- mineral/ earth (metalic vs. non-metallic)
- animal
- microbiological (bacteria/fungi) (penicilin, gentimyocin, streptomyocin)
5
Q
when nucleas of drug from natural source and chemical structure is altered
A
synthetic drug–most drugs nowadays
6
Q
when nucleus of drug from natural source is retained but chem structure altered
A
semi-synthetic drug
7
Q
desired gene spliced into rapidly repicating DNA (viral)–allowing vast production
A
recombinant DNA technology
8
Q
mineral drugs
A
iron, mercury salts, zinc, iodine, selenium
9
Q
advantages to recombinant DNA technology
A
- huge amount can be produced
- drugs can be obtained in pure form
- it is less antigenic
10
Q
Jenner–smallpox vaccine
A
contact with cowpox (milder disease in humans) –> immunity
11
Q
vaccine
A
agent that resembles a pathogenic microorganism but does no cause the disease–immunity to wild-type microbe
12
Q
study of all aspects of drugs–history–>therapeutics
A
pharmacology
13
Q
clinical def of pharm
A
study of those specific aspect of drugs which have relevance in their use in treatment, prevention, or dx of human disease.
14
Q
branch of pharmacology dealing with harmful effects of chemicals
A
toxicology
15
Q
Paracelsus
A
the dose makes the poinson
16
Q
clinical toxicology def
A
study of the adverse effects of drugs on humans when these drugs are used in disease dx, prevention, treatment, or in cases of accidental poinsoning
17
Q
ability of chemical to kill microb w/out harming host
A
selective toxicity
18
Q
side-effects aka
A
adverse drug reaction
19
Q
what drug does to the body
A
pharmacodynamics
20
Q
pharmacodynamics
A
what drug does to the body
21
Q
what body does to the drug
A
pharmacokinetics
22
Q
pharmacokinetics
A
what body does to the drug
23
Q
pharmacokinetics- what body does to drug
A
- absorption
- distribution
- metabolism
- elimination
24
Q
liver’s goal in metabolizing drugs
A
make water soluble
25
best drugs
lipid soluble
26
2 important considerations in pharmacodynamics
1. mechanism of therapeutic and toxic rxns (mechanism of action)
2. Dose-response relationships--therapeutic window or index
27
dosage range where there is benefit while minimizing toxicity risk
therapeutic window or index
28
How the drug moves through the body
pharmacokinetics--most active forms of drugs have been chemically changed
29
passage of drug from aministration site to general circulation
drug absorption
30
movement of drug from general circulation to target tissue
drug distribution
31
biotransformation--often necessary for proper activity or excretion
drug metabolism--may make multiple passes
32
removal of drug or metabolite from body
elimination--may be changed or unchanged
33
elimination pathways
urine, feces, perspiration, respiration, milk, tears, asaliva
34
main organ for elimination
kidneys--
35
time required to eliminate 50% of absorbed dose of drug
half-life
36
most common use for drugs
therapeutic--treatment of disease
37
guard against disease--preventive
phrophylactic use--i.e. asparin for MI
38
drugs to identify or establish cause for disease
diagnostic use of drug
39
drugs that carry the "federal law prohibits dispensing w/out a prescription" label
legend drugs
40
SAFETY + EFFICACY of drug, but not specifically made for problem
appropriate off-label use
41
does the FDA regulate the practice of medicine?
No
42
must show safety and efficacy of treatment if using drugs_____-_____
off-label
43
drug interactions may ______ or _______ effect of drug; interactions can be ________ or ________
increased or decreased
| positive (wanted by doc) or negative (not wanted by doc)
44
positive drug interactions may be ______ or ________
additive or synergistic
45
Predispositions for drug interactions
1. old age (organ and tissue decrease in function)
2. polypharmacy (lots of drugs)
3. genetics
4. hepatic or renal disease (higher levels of drugs in body)
5. use of drugs with narrow therapeutic index
46
Types of Drug interactions-- may be wanted or unwanted
1. drug-drug
2. drug-food
3. drug-disease
4. drug-receptor (mechanism of action for drug)
47
notorious drug-food interaciton
grapefruit
48
name for drug used during research
chemical name
49
the common or nonproprietary name of active drug--forever attached to drug compound or chemical
generic name
50
prescribing should be done using the
generic name i.e. acetaminophen
51
generic drug contrasted from
generic name
52
generic drugs must be ________ to a brand name drug
bioequivalent or identical
53
nutritional supplements and herbs covered under
DSHEA
54
average time before drug hits marked from Investigational New Drug IND application
6 years
55
considerations in choosing route of admin
1. speed--closest to target
2. characteristics of drug--absorbable?
3. patient state-- i.e. conscious/ child
4. Risk--some routes ^toxicity
5. positive correlation btwn risk of injection and by-pass of barriers to absorption--i.e. risk of infection for I.V.
6. Cost
56
Topical administration
1. Oral --sublingual (bipasses liver) / buccal (not for high dose drugs)
2. Skin--i.e. cream--local or systemic
3. eye--i.e. antibiotic drops
57
Respiratory administration
1. intranasal meds--topical
| 2. inhaled medications--drugs delivered to alveoli and bronchioles
58
enteral administration
drug somewhere along GI tract
1. oral
2. rectal
59
parenteral administration
1. bypass GI tract
| 2. ex. IV, IM, SC, ID, IO, epidural
60
topical administration
1. oral
2. classical topical route
3. transdermal
61
transdermal patches benefits
1. self administered
2. avoid first pass metabolism ("downstream from liver)
3. systemic
4. can be chewed
Many drugs moving this dirrection
62
Enteral admin
PO (by mouth)
63
enteral admin disadvantages
1. variable absorption
2. upset stomach
3. compliance
4. first pass metabolism
64
"absorption rate limiting" steps
pill coating
65
dissolving of drug happens in stomach--absorption happens in_______
small intestine (large surface area due to microvilli--pH effects degree of ionization of drugs therefor drug absorption--will dictate direction of movement through membranes
66
pH in stomach lower when
food present
67
pH of small intestine optimal for
enzymatic activity--digestion of protein, carbs, and lipids--enzymes secreted into duodenum
68
small intestine pH rises
as food moves toward terminal end
69
colon
1. lacks microvilli
2. semi solid contents
3. lower pH than small intestine
4. lubcricated with mucin
5. poor absorption but some drugs designed to be absorbed here (sustained release products)
70
rectal
1. pH 7
2. little fluid
3. variable absorption
4. MIGHT escape first-pass metabolism
5. good for peds
71
parenteral administration
w/ needle i.e.
1. IV
2. IM
3. SubQ
4. ID
72
advantages to parenteral admin
1. rapid delivery
2. rapid onset
3. good control
73
disadvantages to parenteral admin
1. skilled personel
2. expensive
3. hard to reverse adverse rxn
4. infection (infiltration or extravasation)
74
intraarterial
for injection of dx substances
75
IM admin
along with subQ--most common parenteral route
76
IM admin depends on
1. blood flow
2. lateral dispersion of drug
3. can be controlled by adding vaso constrictor/dilator
77
subcutaneous SC
same factors for absorption as IM
78
locations for SC
abdomen, upper back, hips, lat prox arms (thicker subQ)
79
Intradermal admin
same factors as IM--lower blood flow than muscles
| TB test
80
Intraosseous admin
large volumes of fluid able to be infused
81
Intraarticular (injection into joint capsule)
usu. steroids, antimicrobials, anesthetics
82
Intralesional admin
usu. before removal of lesion
83
Epidural admin
injection ABOVE dura mater typically at L3-L4 level
| usually for anesthetic
84
Intrathecal admin
injection through dura mater into spinal canal into CNS
| w/out going through BBB--rare
85
pumps can deliver meds
epidural, transdermal, subcutanious
86
in addition to drug approval, the FDA
reviews evidence for safety and efficacy of drug through postmarketing surveillance--
87
New drug application filed
for ordinary clincal use, after completion of phase III clincal trials
88
phase I drug trials
establish safety/ pharmacokinetics on healthies
89
Phase II drug trials
establish efficacy and dose on diseased ppl
90
Phase III drug trials
verify efficacy on large population of diseased ppl
91
Phase IV drug trials
postmarketing surveillance
92
generic drugs available
20 years after IND applicaiton
93
highest cause of liver failure
tylenol -- toxic metabolite builds up in liver
94
Pregnancy categoriy A drug
controlled studies show no risk
95
Pregnancy category B drugs
no evidence of risk in humnas; the chance of fetal harm is remote
96
Preg Cat C drugs
Risk not exclueded. Adequate studies lacking. chance of fetal harm but benefits outweigh risks.
97
Preg Cat D drugs
positive evidence or risk. studies in humans show fetal risk. potential benefit in pregnant women may outweigh risk.
98
Preg Cat X drugs
Contraindicated--shouldn't be used
99
controlled substance schedules from abuse potential -->low potential
C-I --> C-V
100
high abuse no clinical application
C-I
101
high abuse w/ clinical application
C-II
102
less potential for abuse w/ clinical application
C-III
103
low abuse potential as related to C-III
C-IV
104
lowest abuse potential w/ clinical appliaction
C-V -- some OTC, but not all
105
will be a test Q on conversion in metric
1 kg = 2.2 lbs -- for pt weight
| 1 tsp = 5 mL
106
kg --> g --> mg --> mcg
*
107
3 part solution =
3% of X in solution
108
1 mg =
1000 mcg
