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PHARMACOLOGY > Module 02: Basic Principles of Pharmacology > Flashcards

Module 02: Basic Principles of Pharmacology Flashcards

1
Q

This is cited as a science dedicated to the study of rate processes such as absorption, distribution, metabolism, and excretion of a drug and the multiple interrelationships affecting same, such as incomplete absorption, saturability in transport, biotransformation, or binding.

A

Pharmacokinetics

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2
Q

What are the different routes for medications?

A

(A) Oral (PO)
(B) Sublingual route (SL)
(C) Buccal route (Bu)
(D) Intravenous route (IV)
(E) Intramuscular route (IM)
(F) Subcutaneous route (SC or SQ)
(E) Inhalation route (INH)

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3
Q

What are the different kinds of medications administered?

A

(A) Nasal Spray
(B) Rectal (tablets or suppositories)
(C) Vaginal (Tablets or suppositories)
(D) Cutaneous Route
(E) Otic (Ointments or drops)
(F) Ocular or Ophthalmic
(G) Transdermal patches

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4
Q

What are the different biochemical paths of drug administration?

A

(A) Passive diffusion
(B) Facilitated passive diffusion
(C) Active Transport
(D) Pinocytosis

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5
Q

This is known as the movement against a concentrated gradient using energy (ATP).

A

Active Transport

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6
Q

This is characterized as the movement along the concentration gradient without energy.

A

Passive Transport

(1) Simple Diffusion
(2) Facilitated Diffusion

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7
Q

This movement involves the transport of extracellular fluids along with its contents of small dissolved molecules (solutes).

A

Pinocytosis (pino which means to drink and kytos which pertains to the word cell)

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8
Q

What are the requirements of pinocytosis in order for it to transpire or occur?

A

Requires a considerable amount of cellular energy in the form of ATP to run.

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9
Q

These are known to activate the process of pinocytosis when they make contact to the plasma membrane.

A

Ions sugars or amino acids

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10
Q

What are the steps of pinocytosis?

A

(A) Solutes bind to the cell membrane.
(B) The cell membrane starts to fold inwards and the cell membrane continues to fold.
(C) Both ends of the fold meet, producing a pinosome.

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11
Q

This pertains to the fraction of administered drug that reaches the systemic circulation intact.

A

Bioavailability

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12
Q

Bioavailability is characterized to be a determiner of what?

A

It determines the dosage required for each drug via each route of administration.

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13
Q

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is known as the location of the curve along the dose axis.

A

Potency

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14
Q

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is characterized as the greatest attainable response.

A

Maximal efficacy or ceiling effect

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15
Q

Based on the hypothetical dose-response curve (relationship) in pharmacodynamics, this is characterized as the change in response per unit dose.

A

Slope

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16
Q

What are the factors causing low bioavailability?

A

(A) Insufficient time for absorption in the GIT (poorly dissolved drugs)
(B) Chemical reactions that reduce absorption can decrease bioavailability (drug interactions, gastric acids or enzymes, etc.)
(C) Age, sex, physical activity, genetic phenotype, stress disorders (malabsorption syndromes) or previous GI surgery (bariatric surgery) can also affect drug bioavailability

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17
Q

Enumerate drug administrations depending on their bioavailability.

A

(A) Intravenous
(B) Intramuscular
(C) Oral tablet
(D) Sublingual or buccal (powder)
(E) Oral capsule

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18
Q

What are the different factors affecting distribution?

A

(A) Volume distribution
(B) Protein binding
(C) Blood brain barrier

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19
Q

This is defined as the theoretical volume of fluid into which the total drug administered would have to be diluted to produce the concentration in plasma.

A

Volume Distribution

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20
Q

What are some drugs that can bind with plasma proteins?

A

(1) Albumin lipoproteins, a-1acid glycoprotein (AGP)

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21
Q

This factor affecting drug distribution is characterized to either enhance or detract from a drug’s performance.

A

Protein binding

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22
Q

Explain the difference between drugs that are minimally-protein bound to those that are highly protein bound drugs?

A

Drugs that are minimally protein bound penetrate tissue better than those that are highly protein bound drugs, but they are excreted much faster.

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23
Q

Why do highly protein-bound drugs increase the risk for toxicity?

A

Because when administered together they will compete for protein binding sites, thus increasing the risk for toxicity (eg 95% vs 90% protein binding)

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24
Q

What are the characteristics of highly protein bound drugs?

A

(1) Poorer tissue penetration
(2) Decreased access to privileged sites
(3) Slower excretion
(4) Longer plasma half life

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25
Q

What are the characteristics of minimally protein bound drugs?

A

(1) Better tissue penetration
(2) Enhanced access to privileged sites
(3) Faster excretion
(4) Shorter plasma half life

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26
Q

What happens to protein binding occurring outside the bloodstream?

A

Compounds can bind with macromolecules in skin, breast milk, tissues and organs including the placenta. They become stuck and are thus prevented from reaching the site of their intended action.

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27
Q

This is known as an endothelial lining in the blood vessels in the brain where cells are tightly pressed together creative a selective semi-permeable membrane between blood and the interstitium of the bran (tight junction proteins).

A

Blood brain barrier

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28
Q

What is the role of the blood brain barrier?

A

To protect the brain from foreign substances including 98% of available drugs in the market

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29
Q

What drugs are known to have the capacity to cross the Blood Brain Barrier by diffusion and others via transport proteins?

A

Highly lipid soluble drugs and those with low molecular weight (benzodiazepine and enoxaparin)

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30
Q

What drugs that cannot cross the Blood Brain Barrier by diffusion and others via transport proteins?

A

Water soluble drugs (penicillin and atenolol) and drugs not bound with transport proteins (free drugs)

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31
Q

This refers to the fraction of a drug that is not bound to serum proteins and is immediately available to distribute in the body, interact with biological membranes, and bind to receptors.

A

Free drugs

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32
Q

What are other biological barriers?

A

(A) Placental barrier
(B) Skin barrier
(C) Breastmilk

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33
Q

The goal of this process in pharmacokinetics is to make the drug easier to excrete.

A

Drug metabolism

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34
Q

What are some processes that fall under drug metabolism?

A

Oxidation, reduction, hydrolysis, hydration, conjugation, condensation or isomerization

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35
Q

How does drug metabolism work?

A

It typically inactivates drugs, some drug metabolites are pharmacologically active- sometimes even more so than the parent compound.

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36
Q

This is characterized as the principal site of drug metabolism within the human body.

A

Liver

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37
Q

This is known as a drug that requires activation in order to have its therapeutic effect. This is also characterized as an inactive or weakly active substance metabolized into an active pharmacologic substance.

A

Prodrug

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38
Q

Prodrugs are often designed to what?

A

Improve a drug’s bioavailability

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39
Q

How do prodrugs work?

A

Prodrug’s parent compounds that contain regions or additional chemical groups that mask the drugs’ active zone and or alters drug solubility (promoiety), but can be enzymatically or chemically cleaved or altered by site specific enzymes, exposing the drug’s active zone and allowing the drug to activate it’s receptor resulting in a therapeutic effect.

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40
Q

What is the active drug of codeine?

A

Morphine

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41
Q

What is the active drug of clopidogrel?

A

Thiol-derivative

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42
Q

What is the active drug of enalapril?

A

Enalaprilat

43
Q

What is the active drug of L-dopamine?

A

Dopamine

44
Q

What is the active drug of prednisone?

A

Prednisolone

45
Q

This is known as an estimate of the time it takes for the concentration or amount in the body of that drug to be reducted by exactly one half (50%).

A

Drug half life (t 1/2)

46
Q

What are some patient specific variables affecting half-life?

A

(A) Age or gender
(B) Blood circulation
(C) Diet and fluid excess (CHF)
(D) History of previous drug use
(E) Kidney and liver function
(F) Obesity and pre existing conditions
(G) Drugs competing for binding sites
(H) Race or ethnicity (can influence the metabolism of certain drugs)
(I) smoking
(J) Medical procedures (Hemodialysis)

47
Q

What are some drug specific variables affecting half life?

A

(A) Drug formulation (MR or controlled release preparations extend half life)
(B) Drug administration
(C) How the drug is cleared from the body (kidneys, liver or lungs)
(D) Protein binding
(E) Drug interactions
(F) Properties of drugs (molecular size or charge)
(G) Volume of distribution

48
Q

This type of half life is characterized to be fast but short acting and is usually needed to be taken several times a day.

A

Short half life

49
Q

This type of half life is characterized to take longer before it starts to work, effects persist longer (long acting) and is dosed either once a day, once a week, once a month or even less.

A

Long half life

50
Q

This pertains to the act of giving a large initial dose that is significantly higher than the maintenance dose.

A

Loading dose (therapeutic effects can be achieve while the drug reaches a steady state)

51
Q

This condition affecting drug excretion pertains to the decreased blood flow to the kidneys leading to decreased GFR.

A

Prerenal

52
Q

How are pre-renal conditions affecting drug excretion manifested?

A

(A) Dehydration
(B) Hemorrhage

53
Q

This condition affecting drug excretion is characterized to affect GFR, tubular secretion and reabsorption.

A

Intrarenal

54
Q

This condition affecting drug excretion is characterized to obstruct urine flow and affects filtration.

A

Postrenal

54
Q

How are intrarenal conditions affecting drug excretion manifested?

A

(A) CKD
(B) Glomerulonephritis

55
Q

How are post renal conditions affecting drug excretion manifested?

A

(A) BPH
(B) Stones
(C) Neurogenic bladder

Drug accumulation may occur resulting to adverse drug reactions.

56
Q

What is the function of the lungs in terms of drug excretion?

A

(A) Excretion of volatile drug substances (anesthetics i.e Nitrous oxide, butane and propane)
(B) Metabolizing drugs to carbon dioxide and water (saliva and sweat)

57
Q

This is characterized to use the tools of nanotechnology. This must be closely evaluated to optimize drug delivery to the target site while minimizing adverse effects.

A

Nanomedicine

58
Q

These are designed to be long lasting with minimal excretion within organs.

A

Nanoparticles

59
Q

This is the study of a drug’s molecular, biochemical, and physiologic effects or actions. It comes from the Greek words “pharmakon,” meaning “drug,” and “dynamikos,” meaning “power.”

A

Pharmacodynamics (what the drug does to the body)

60
Q

Under the process of pharmacodynamics, the pharmacologic response depends on what>

A

On the drug binding to its target

61
Q

Under the process of pharmacodynamics, this is known to influence the drugs’s effects.

A

The concentration of the drug at the receptor sites.

62
Q

The process of pharmacodynamics can be affected by physiologic changes due to:

A

(A) A disorder or disease (eg insulin-resistant DM, malnutrition)
(B) Aging process (eg changes in metabolism, alteration in receptor binding)
(C) Other drugs (eg drug-drug interactions resulting to competition in receptor binding sites

63
Q

Site some examples wherein some drugs produce effects without altering cellular function and without binding to a receptor:

A

(A) Some antacids through simple chemical reaction neutralizes gastric acid
(B) Alka Seltzer (NaHCO3)
(C) Gaviscon (Magnesium trisilicate)
(D) TUMS (CaCO3)
(E) Sucralfate (Iselpin) (aluminum complex of sucrose octasulfate; soluble in strong acids and alkali but not in water and alcohol)

64
Q

Explain the dose response relationships.

A

The concentration of the drug at the site of action controls the effect (regardless of the effect through binding or chemical reaction, etc.

65
Q

Regardless of the route administration, explain the relationship between the drug dose and the drug concentration.

A

At the cellular level their relationship is complex (Pharmacokinetics)

66
Q

Based on dose response relationships (hypothetical dose response curve), this is known as the location of the curve along the dose axis.

A

Potency

67
Q

Based on dose response relationships (hypothetical dose response curve), this is known as the greatest attainable response.

A

Maximal efficacy or ceiling effect

68
Q

Based on dose response relationships (hypothetical dose response curve), this is known as the change in response per unit dose.

A

Slope

69
Q

This is essential to understanding drug action and states that drugs act as agonists, antagonists, or inverse agonists of physiologic receptors and thus can only mimic, intensify, inhibit, or block normal physiologic responses.

A

Receptor Theory (Drug -receptor interaction)

70
Q

Based on the Receptor Theory (Drug -receptor interaction), these are known to activate receptors and produce a desired response.

A

Agonist

71
Q

Receptor Theory (Drug -receptor interaction), these are known to prevent receptor activation and block a specific response.

A

Antagonist

72
Q

Receptor Theory (Drug -receptor interaction), these are characterized to affect multiple receptor sites.

A

Non specific drugs

73
Q

Receptor Theory (Drug -receptor interaction), these are characterized to affect multiple receptors.

A

Non-selective drugs

74
Q

This type of mechanism of drug action is characterized to enhance intrinsic activity.

A

Stimulation

75
Q

This type of mechanism of drug action is characterized to decrease neural activity and bodily functions.

A

Depression

76
Q

This type of mechanism of drug action is characterized to have noxious affects.

A

Irritation

77
Q

This type of mechanism of drug action is characterized to replace essential body compounds.

A

Replacement

78
Q

This type of mechanism of drug action is characterized to selectively kill invading parasites and cancers.

A

Cytotoxic action

79
Q

This type of mechanism of drug action is characterized to prevent, inhibit or kill infectious organisms.

A

Antimicrobial action

80
Q

This type of mechanism of drug action is characterized to modify, enhance or depress the immune system.

A

Modification of immune status

81
Q

What types of drugs are known to have the drug mechanism of stimulation?

A

Adrenergic drugs that increase heart rate, sweating and respiratory rate during fight or flight response

82
Q

What types of drugs are known to have the drug mechanism of depression?

A

Barbiturates and opiates

83
Q

What types of drugs are known to have the drug mechanism of irritation?

A

Astringents

84
Q

What types of drugs are known to have the drug mechanism of replacement?

A

Insulin, thyroid drugs and hormones

85
Q

What types of drugs are known to have the drug mechanism of cytotoxic action?

A

Chemotherapy

86
Q

What types of drugs are known to have the drug mechanism of antimicrobial action?

A

Antibiotics

87
Q

What types of drugs are known to have the drug mechanism of modification of immune status?

A

Interferons and methotrexate

88
Q

What are the different types of drug interactions?

A

(1) Drug to drug interaction
(2) Drug to herb interaction
(3) Drug to allergy interaction
(4) Drug to food interaction
(5) Drug to disease interaction
(6) Drug to gene interaction

89
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes calcium?

A

(A) Antibiotics
(B) Osteoporosis meds

90
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes green vegetables?

A

Anticoagulants

91
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes bitter oranges?

A

(A) Benzodiazepines
(B) Calcium chain blockers
(C) Statins

92
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes alcohol?

A

(A) Antibiotics
(B) Antidepressants
(C) Paracetamol
(D) Insulin

93
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes tyramine foods?

A

Antidepressants (MAOIs)

94
Q

Based on drug and food interactions, what are drugs that won’t work well the patient consumes any food?

A

(A) Bisphosphonates
(B) Hypothyroid drugs
(C) Hyperthyroid drugs
(D) Digoxin

95
Q

These are characterized as secondary effects that can be predictable (Nitrates for CAD), range from discomfort and annoying to severe or life threatening, and could be desirable (e.g. antihistamines taken at bedtime resulting to sleepiness or drowsiness).

A

Side effects

(One of the reasons why patients stop taking their prescribed medications)

96
Q

These drug reactions are characterized as unwanted effects of a drug of medication. This can be unintentional, unexpected reactions to drug therapy that occur at normal drug dosages.

A

Adverse drug reactions

96
Q

What are some of the side effects that range from discomfort and annoying to severe or life threatening?

A

(A) Rashes
(B) Fever
(C) Constriction of the airways and wheezing
(D) Swelling of tissues (such as the larynx and the opening between the vocal cords that closes to stop the flow of air to the lungs (glottis), which impairs breathing)
(E) Fall in blood pressure, sometimes to dangerously low levels (leading to anaphylactic shock)

96
Q

What are the different factors that might affect drug side effects?

A

Chronic illness, age, sex, weight and ethnicity

97
Q

Describe adverse drug reactions.

A

(A) Reactions range from mild to severe, including anaphylaxis
(B) They are always undesirable
(C) Must be reported immediately (variance to planned therapy)

98
Q

What are the risk factors for adverse drug reactions?

A

(1) Hereditary factors
(2) Certain preexisting diseases
(3) Simultaneous use of several medications
(4) Very young or old age
(5) Pregnancy and breastfeeding

99
Q

Why is taking several medications simultaneously considered as a risk factor for adverse drug reactions?

A

(A) Taking several medications, whether prescription or over the counter, contributes to the risk of having an adverse reaction. The number and severity of adverse drug reactions increase disproportionately as the number of drugs taken increases.
(B) The use of alcohol, which is also a drug, also increases the risk.

100
Q

This drug reaction refers to serious, often harmful, and sometimes fatal toxic reactions to an accidental overdose of a medication.

A

Overdose Toxicity

101
Q

Describe overdose toxicity.

A

(1) May result from drug accumulation
(2) Can be unintentional (because of an error on the part of the nurse, doctor, pharmacist or person taking the medication.
(3) Could be an intentional overdose (homicide or suicide)

PHARMACOLOGY (9 decks)

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