Midterm Flashcards
3 different types of drug names
Chemical
Trade (brand)
Generic
Generic name starts with a
Lowercase letter
Before any drug is marketed it is given a ____ that becomes the “official” name for the drug
Generic name
Brand name starts with a
Upper case letter
acetaminophen is a trade name, what is an example of its generic name
Tylenol
FDA requires the active ingredient of the generic product to ____ at the same rate as the trade name product
Enter the bloodstream at the same rate
Generic name is generally ___ than brand name items
Cheaper
What does chemically equivalent mean
2 formulations of a drug meet the chemical and physical standards established by regulatory agencies
What does biologically equivalent mean
2 formulations of a drug produce similar concentrations of the drug in the blood and tissues
Therapeutically equivalent means
2 formulations of a drug have an equal therapeutic effect
For medications to be FDA approved it needs to be
Biologically equivalent and therapeutically equivalent
FDA determines?
Which drugs can be sold by prescriptions and OTC
Who regulates the labelling and advertising of prescription drugs
FDA
How long does it take for a new drug to be available on pharmacy shelves
12 years
Animal studies usually begin by measuring what?
Acute and chronic toxicity
Phase I clinical trials refers to small and then increasing doses administered to?
A limited number of healthy human volunteers
Phase I of clinical studies determines ?
Biologic effects
Metabolism
Safe dose range in humans
Toxic effects of the drigs
In phase II of clinical studies a larger group of humans are given the drug. What is reported by the FDA during this phase?
Adverse reactions
Phase 3 of clinical trials involves a large number of patients who have?
The condition for which the drug is indicated for
In phase III of clinical studies what must be demonstrated?
What is determined?
Safety and efficacy must be demonstrated
Dosage is determined
Phase 4 of clinical studies involves?
(Drug is now approved at this point)
Post marketing surveillance
-toxicity that occurs in pts taking the drug after it is released is recorded
Schedule II-IV drugs require a
Prescription
What schedule of drugs must be types or written in one or indelible ink
Schedule II
What schedule of drug prescriptions CANNOT be phoned to pharmacist
Schedule II
Schedule II prescriptions require what for refill
A new written prescription for refill
Schedule III-IV drugs may not be refilled more than how many times in what time frame?
May not be refilled more than 5 times in a 6 month period
Which schedule drug has the highest potential for abuse?
What are some examples
Schedule I
Ex. Herion. LSD. Hallucinogens
Examples of schedule II drugs
Oxycodone
Morphine
Amphetamine
Hydrocodone
Examples of schedule III drugs
Codeine mixtures (Tylenol 3)
Schedule V drugs do not need a prescription because
They can be purchased OTC
Package inserts should include what?
Chemical makeup of the drug
FDA approved indications for use
Warnings
Contraindications
Side effects
Drug interactions
Dose and administration
How supplied
What is the purpose of a black box warning
To draw attention to safety concerns associated with the drug
Orphan drugs are
Developed to treat rare medical conditions
(Funded by government assistance)
pc abbreviation means
After meals
ac abbreviation Means
Before meals
PO abbreviation means
By mouth / orally
ud abbreviation means
As directed
What part of the prescription includes prescribers name, address and phone #, patients name address age phone number and date of prescriptions
Heading
Body of prescriptions contains what
Rx symbol
Drug name / dose size / concentration
Directions to pt
Sig
Closing at the bottom of the prescription contains what
Prescribers sig
Refill instructions
Pharmokinetics is based off the principles of ADME which stands for
Absorption
Distribution
Metabolism
Excretion
Biologically active substance that can modify cellular function
Drug
What is potency
Amount of drug required to produce an effect
Efficacy is the
Maximum intensity of effect or response that can be produced by a drug
Will administering more of a drug increase the efficacy?
No
*increases the probability of an adverse rxn
Will administering more of a drug increase the efficacy?
No
*increases probability of an adverse rxn
Are efficacy and potency related?
No unrelated
The effects seen on cells organs and systems is the
Pharmacological effect
What is therapeutic effect
Desired effect of the drug
Unwanted effects of a drug is the
Adverse effect
Whether a drug will produce a pharmacological effect depends on the drug binding to its
Target
*concentration of the drug at the receptor site influences the drugs effect
Has affinity for a receptor
Combines with receptor
Produces an effect
Agonist
Counteracts action of agonist
Antagonist
What are the 3 types of antagonists
Competitive
Non competitive
Physiologic
Mechanisms of drug transfer
Passive transfer
Simple diffusion
Specialized transport of drugs in drug absorption
Active transport
Facilitated diffusion
Distribution of a drug refers to the passage of drugs into various body fluid compartments such as
Plasma
Interstitial fluid
Intracellular fluid
Metabolism or biotransformation is the body’s way of changing a drug so that
It can be more easily excreted by the kidney
First pass metabolism pathway
Stomach
GI tract
Liver (pumps out good stuff)
Blood stream
Liver can pump out the drug in what 3 states
Inactive metabolite
Active drug
Active metabolite
Prodrug which is not active gets metabolized in liver and gets pumped out as
Active drug
What are some factors that influence rate of drug absorption
Lipid solubility
Degree of ionization
Molecular shape and size
Site of absorption
Drugs in solution are ____absorbed than drugs in tablet or capsule form
More rapidly
What is half life
Time it takes for the concentration of drug to fall to 50% of its original blood level
Takes approximately how many half life’s for drug to be completely eliminated from body
4-5 half lifes
If drig is ionized it means it has a
Charge
What tends to happen when drug is ionized (has a charge); it will not
Enter our cell (too bulky to pass membrane)
Ionized drug is
Water soluble
Non ionized drug is
Lipid soluble
Local anesthetic is generally basic, if we inject into an area of infection (which is more acidic) what will be the effects of the LA
Effects will be reduced because when broken down becomes ionized and they can’t pass membrane to have effects
Adverse drug reaction occurs at usual
Therapeutic doses
Toxic reaction is
Exaggeration of the desired response (drug overdose)
Idiosyncratic reaction
Genetically related abnormal drug response
Interference with natural defense mechanisms
Certain drugs can interfere with body’s ability to fight infection
Pans
Parasympathetic
Rest and digest
Sans
Sympathetic
Fight or flight
Cholinergic drug
Calms people down
Cholinergic PANS agents direct acting
Acts like acetylcholine at receptor sites
Cholinergic PANS agents: indirect acting
Causes increase in amount of acetylcholine indirectly
-inhibits acetylcholinesterase
Cholinergic agents PANS adverse effect
SLUD
Contraindications for Cholinergic agents pans
Bronchial asthma
Hyperthyroidism
GI or urinary tract obstruction
Severe cardiac disease
Myasthenia gravis
Peptic ulcer
Anticholinergic agents pans
(Will not make you relax)
Cholinergic blocking agents
Prevent acetylcholine action at postganglionic pans nerve endings
Anticholinergics on CNS
Cans produce stimulation or depression
Anticholinergics on exocrine glands
Reduce flow and volume of secretions
*cause Xerostomia
Anticholinergics on smooth muscle
Relax GI smooth muscle (stops digestion)
Major transmitters in SANS
Norepinephrine
Epinephrine
Two types of adrenergic receptors in SANS
Alpha and beta
If neurotransmitter in sans bind to alpha-1 what will be effected
Veins
If neurotransmitter in sans binds to beta-1 what will be affected
Heart
If neurotransmitter binds to beta-2 it will affect the
Lungs
Sans drugs are
adrenergic agents
Adrenergic agents on sans
Eyes dilating
Increased bp and heart rate
Lungs open up
Dry mouth
Adrenergic agents contraindications to taking the meds
Uncontrolled hypertension
Angina
Hyperthyroidism
Epinephrine uses
Vasoconstriction
-prolonged action
-Hemostasis
-decongestion
Adrenergic agents can be used to treat
Shock
Cardiac arrest
Examples of adrenergic agents
*hint usually end in “rine”
Epinephrine
Phenylephrine
Dopamine
Levonordefrin
Analgesics are
Pain relievers
Non opioid aka
Non addictive
Non narcotic
Perception is the
Physical component of pain
Reaction is the
Psychological / emotional component of pain
-I.e do you enjoy the pain or do you dislike the pain
Acetylsalicylic acid is aka
Aspirin
Where do nonopioid analgesics act
Primarily at peripheral nerve endings
(Antipyretic effect is mediated centrally)
Where do opioids primarily act
CNS
Nonopioid analgesics inhibit
Prostaglandin synthesis
Opioids affect the response to pain by
Depressing the CNS
What “turns on the switch” or activates prostaglandins
Cox 1 and cox 2
When prostaglandin is activated it causes
Pain fever and inflammation
Acetylsalicylic acid inhibits
Prostaglandin synthesis
Acetylsalicylic acid will tell cox 1 and 2 enzymes to stop releasing prostaglandin what is the effect of this
Pain goes away
Fever reduced
Acetylsalicylic acid is absorbed from the
Stomach and small intestine
Acetylsalicylic acid (aspirin) properties
Analgesic (stops pain)
Antipyretic (stops fever)
Anti inflammatory
Anti platelet (stops clotting/ is a blood thinner)
Acetylsalicylic acid adverse reactions
GI effects (upset stomach)
Bleeding
Reye’s syndrome
Hepatic and renal effects
Reyes syndrome
DO NOT give aspirin to kids. They may develop Reye’s syndrome which is liver and brain swelling in kids
Overdose of aspirin effects
Tinnitus
Headache
Dizziness
Nausea
Vomiting
Lethal dose of aspirin to children
4 g
Warfarin plus aspirin
DO NOT
could cause severe bleeding
NSAIDs are
Non steroidal anti inflammatory drugs
NSAIDs are similar to aspirin. They inhibit
Enzymes cox 1 and 2
Taking NSAIDs results in
Reduction in formation of prostaglandin precursors and thromboxanes from arachidonic acid
Are NSAIDS able to easily pass through cell membrane?
No
Most NSAIDs peak in how many hours
1-2 hours
NSAIDs useful in treatment of
Gout
Adverse rxns of NSAIDs
Could cause blood clotting
Myocardial infarction or stroke
GI upset (but more common with aspirin)
Renal problems
Who should NOT take NSAIDs
Ppl with asthma, cardiovascular disease, renal disease
NSAIDs examples
Naproxen (aleve)
Acetaminophen is aka
Tylenol
Acetaminophen works as a
Analgesic and antipyretic
Adverse reactions of acetaminophen
Hepatic necrosis (liver damage)
Nephrotoxicity (toxic to kidney)
Alcoholics should avoid
Ibuprofen examples
Motrin
Advil
Aspirin ibuprofen and naproxen should not be
Taken together
Acetaminophen can be taken with
NSAIDs
Endogenous substances in our body with opioid like substances
Enkephalins
Endorphins
Dynorphins
3 important receptors in regard to opioids
Mu
Kappa
Delta
What do opioids do
Analgesia
Sedation and euphoria
Cough suppression
GI effects (increase constipation)
Adverse reactions
Naloxone is used for
An opioid overdose
Naltrexone and methadone are used for
Treatment of opioid addiction
Adverse effects of opioids
Respiratory depression (can’t breathe)
Nausea
Constipation
Miosis (pinpoint pupils)
Urinary retention and antidiuretic effects
Drug of choice for dental pain
Ibuprofen
