Module 9 Flashcards

1
Q

The variation in individual response to medication is due to what factors?

A

Environment, genetics and disease state

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

_______ ______ are an important first step in determining interpatient variability to drug response.

A

Clinical trials

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Phase 1 CT:

  • __-____ _______ volunteers
  • Evaluation of _________ and ___________
  • ________ studies guide dosing
A

20-100 healthy volunteers
Evaluation of pharmacokinetics and pharmacodynamics
Animal studies guide dosing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Phase 2 CT:

  • ____-______ patients with the _______
  • ____-term trial to determine ______ and _____-_______
  • ____-response is determined
A

300-500 patients with the disorder
Short term trial to determine efficacy and side effects
Dose-response is determined

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Phase 3 CT:

  • ____-_____ patients with the target disorder
  • ______ verified and ___-term _____-______ evaluated
A

500-5000 patients with the target disorder

Efficacy verified and long-term side effects evaluated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Phase 4 CT - most important part.

A

PMS - post-market surveillance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dose required to produce a response in 50% of the population

A

ED50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The ______ is often used as the initial dose for therapy.

A

ED50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do we dose drugs that have a narrow therapeutic range?

A

Dose should initially be titrated - i.e. start low and increase slowly until the desired response is achievved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is it okay to use the ED50 as a starting dose?

A

When the drug has a wide therapeutic range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tests for toxic or lethal doses are carried out on who?

A

Animals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Dose in which 50% of animals experience drug toxicity.

A

TD50 - average toxic dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dose in which 50% of animals die

A

LD50 - average lethal dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Indicator of a drug’s safety. How is it calculated?

A

Therapeutic index
LD50/ED50 = TI
or
TD50/ED50

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 7 factors that affect interpatient variation in response to drugs?

A
Body weight and composition
Genetics
Gender
Race
Kidney disease
Liver disease
Environment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Clinicians often adjust the dose of drugs by ______ because this partially accounts for body composition.

A

BSA - body surface area

17
Q

What is the normal BSA?

18
Q

Study of the effect of DNA sequence variation to the clinical response of drugs

A

Pharmacogenomics

19
Q

Single nucleotide changes in DNA

20
Q

Up until recently, the majority of drug research was conducted in ____.

21
Q

In what year did Health Canada and the FDA put pressure on drug companies to include women in trials of new drugs?

22
Q

What are a few differences between women and men that we know of in terms of variation to drug response?
1 - Alcohol
2 - Opiods
3 - Drugs for heartbeat

A

Alcohol metabolism is slower in females

Certain opioids are more effective in women, requiring lower doses

Certain drugs used to treat irregular heartbeat cause prolongation of the QT interval - more likely to cause a fatal cardiac dysrhythmia

23
Q

Although race is often hard to define, and even harder to generalize to drug effects, what are some instances where race plays a role in drug effects?

A

Rosuvastatin concentrations tend to be 2-3x higher in Asians vs. caucasians and thus dosing should be lowered for Asians

24
Q

Decreased renal function affects drug pharmacokinetics in what way?

A

Decreased drug excretion and therefore an increase in excretion half-life
Decreased hepatic and intestinal drug metabolism
Net: increased oral bioavailability and decreased drug excretion

25
Dosage is changed how in patients with kidney disease?
Dosage is decreased
26
How does liver disease affect drug pharmacokinetics?
Metabolism is impaired, thus drug half-life increases greatly
27
``` Describe the effects of each of the following environmental factors on pharmacology. Cigarette smoking Alcohol Exercise Pesticides ```
Cigarette smoking induces certain drug metabolizing enzymes Alcohol exacerbates the toxicity of some drugs Exercise improves insulin activity Some common pesticides induce CYPs