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Pharmacology > LO 5-6 > Flashcards

LO 5-6 Flashcards

1
Q

Describe the possible effect types of drugs

A
  1. Local - at the site of administration and absorption
  2. Systemic - widespread, in areas of the body distant to the site of administration and absorption
  3. Therapeutic effect - the desired effect on targeted organ
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2
Q

Describe adverse reactions to drugs

A
  1. Drugs act on an organism and produce a certain effect.
  2. Drugs lack absolute specificity; can act on many different organs and tissues and this is how adverse drug reactions (undesirable) happen alongside the therapeutic effect (desirable).
  3. No drug is free from producing some adverse effects in a certain number of patients.
  4. The main objective in drug selection is to pick a drug that will give max. therapeutic effects with minimum adverse reactions.
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3
Q

List the possible types of adverse drug reactions

A
  1. Toxic reactions
  2. Side effect
  3. Idiosyncratic reaction
  4. Drug allergy
  5. Interference with natural defense mechanism
  6. Teratogenic
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4
Q

Describe toxic reactions to drugs

A
  1. exaggerated effect on the target organs
  2. Typically occurs with excessive drug administered
  3. Predictable
  4. Dose-related
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5
Q

Describe side-effects

A
  1. non-target organs=> non therapeutic effect
  2. Predictable.
  3. Referred to generally as “adverse reaction”.
  4. dose-sensitive - usually occurs at higher doses
  5. dose decrease will reduce adverse reaction.
  6. one drug can have different side effects at different doses.
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6
Q

Describe idiosyncratic reactions

A
  1. abnormal drug reaction.
  2. genetically related
  3. specific to certain populations/individuals (deficiency in certain enzymes - lack the enzymes to metabolize drug properly)
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7
Q

Describe drug allergy reactions

A
  1. immune system response.
  2. range: local rash to anaphylactic shock.
  3. Not dose related
  4. unpredictable.
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8
Q

What are the 4 types of allergic reactions to drugs?

A
  1. Immediate reaction - occurs within minutes; histamines is released causing inflammation (atopic); anaphylactic (acute/life threatening)
  2. Cytotoxic reaction - Cell lysis; e.g. Penicillin induced hemolytic anemia
  3. Immune complex
  4. Delayed hypersensitivity or Cell mediated reactions - Takes place 24-48 hrs after administration; e.g. topical anesthetics/benzocaine
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9
Q

Describe the result of drugs interference with natural defense mechanisms

A
  1. may reduce immunity
  2. susceptible to developing infections/ difficulty fighting the infections.
  3. E.g. corticosteroids, chemotherapy agents, immunosuppressants

*Use cases for these drugs include transplants

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10
Q

Describe teratogenic effects of drugs

A
  1. terato=monster, genic=producing
  2. The effect drugs have on fetal development
  3. Many drugs cross the placenta and will influence fetal development.
  4. No safe drug during pregnancy.
  5. only given if absolutely necessary.
  6. first trimester carries the greatest risk.
  7. must ask women of child bearing age if pregnant
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11
Q

What dental drugs are safer to take during pregnancy?

A
  1. Antibiotics - penicillin, Clindamycin
  2. Analgesics - acetaminophen(Tylenol)
  3. L.A. - lidocaine
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12
Q

What dental drugs are NOT safe to take during pregnancy?

A
  1. Antibiotics - tetracyclines, metronidazole
  2. Analgesics - Aspirin, NSAIDs(Advil, Motrin)
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13
Q

How do adverse drug reactions impact dental treatment plan?

A
  1. One drug can produce several adverse reactions
  2. Must record in chart
  3. Treatment / future clinical management modification
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14
Q

Describe drug tolerance

A

Same dose produces less effect for some people, or for others, a larger dose is required to obtain the same effect. (occurs after approx. 17 days)

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15
Q

Describe drug half-life (t1/2)

A

Time required for the serum concentration of a drug to be halved after absorption is completed. If t1/2 of a drug is 2 hrs., then after 2 hrs. the blood levels of the drug will decrease to ½ of what was absorbed.

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16
Q

Describe toxicologic evaluation of drugs

A
  1. The goal of drug therapy => to select a therapeutic (range) dose and avoid toxic dosages .
  2. Therapeutic range - range of drug levels/serum concentration within which most patients will experience significant therapeutic effect without an undesirable degree of adverse reactions
  3. The known ranges should be used as a guide only - patients may have differences in drug distribution/ transport which alter drug bioavailability (low-high end of range)
17
Q

What is ED50?

A

median effective dose, dose required to produce a specified intensity of effect in 50%of the animals studied

18
Q

What is LD50?

A

lethal dose, dose that kills 50% of animals studied

19
Q

How is the therapeutic index (TI) calculated?

A

TI=LD50/ED50

  1. Narrow TI(small value)=> the toxicity is more likely to happen - be careful !
  2. Wide TI(large value): drug is safer!
  3. A therapeutically useful drug has a TI >10
20
Q

Describe drug interactions

A
  1. The effect of one drug is altered by the presence of another drug
  2. can have undesirable or beneficial results.
21
Q

What are the 4 types of drug interactions?

A
  1. Additive
  2. Antagonism
  3. Summation
  4. Synergism
22
Q

Describe additive drug effects

A

Combined effect of two drugs that produce the same biological response, and the same mechanisms of action is equal to sum of their individual effects.

23
Q

Describe antagonism drug effects

A

combined effect is less than sum of their individual effects.

24
Q

Describe summation drug effects

A

Combined effect of two drugs that produce the same biological response but by different mechanisms of action is equal to the sum of individual effects

25
Q

Describe synergism drug effects

A

The combined effect is greater than the sum of their individual effects

26
Q

List examples of drugs used in dentistry that interact

A
  1. Aspirin and oral anticoagulants (warfarin)
  2. Antibiotics and oral contraceptives
  3. Metronidazole and alcohol
  4. Opioids and alcohol
  5. Epinephrine and TCA meds
  6. Epinephrine and oral hypoglycemic (decreasing efficacy, increasing blood glucose levels)

Pharmacology (15 decks)

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