Pharm Final Flashcards
The study of cost and benefits/detriments of drugs used clinically:
Pharmacoeconomics
Which of the following is NOT an action of the BODY on a DRUG?
a) absorption
b) distribution
c) metabolism
d) excretion
e) adverse effects
E
-Pharmacokinetics– BODY on drug (ADME)
The study of drug effects between individuals in a population & between populations:
Pharmacoepiddemiology
What phase can be used for humans but is still in the post-marketing surveillance phase?
Phase 4 (only one with post-marketing)
What phase is the investigative new drug phase?
After preclinical testing & before phase 1
What is the new drug application phase?
After phase 3 before phase 4
Which of these drug:target interactions is an example of covalent bonding?
Aspirin & cyclooxyrgenase (irreversible bond)
(another example is Omeprazole & proton pump)
What determines the degree of movement of a drug between body compartments?
a) size
b) pH
c) degree of ionization
d) protein binding
e) all of the above
E
(distribution)
Aspirin readily donates a proton in aqueous solutions. Pyrimethamine readily accepts a proton in aqueous solution. Thus aspirin is a _____ & pyrimethamine is a _____
acid; base
For a dose/response chart, what will you need to do to the dose if you add a competitive inhibitor?
Increase dose to get same effect as agonist alone
Following the agonist activation of a single GCPR, amplification of the downstream signal occurs because:
duration of activation of G-protein is longer than agonist activation of receptor
What allows histamine to get a variety of different effects in different receptors?
Heterogeneity of G-protein coupled receptors
What superfamily has a DNA binding domain?
Nuclear
What keeps the nuclear receptor ligands stable?
Heat shock protein
What receptor takes the longest and requires hours to days to take an effect?
Nuclear receptor
What receptors can be involved in rapid responses (seconds to minutes)?
GPCR (Beta-adrenergic)
Ligand-gated (Nicotinic-acetylcholine)
Acidic drugs bind primarily to which of the following plasma proteins?
Albumin
Basic drugs bind primarily to which of the following plasma proteins?
Alpha-1 glycoprotein
Cp= plasma concentration
Our goal is to get a plasma concentration within a therapeutic window in order to elicit an appropriate response without reaching toxicity
Parameters of this include:
1. clearance
2. Volume of distribution
3. Half-life
Determines the maintenance dose rate:
Clearance
Determines the loading rate:
Volume of distribution
Determines the time to reach steady state & determines dosing intervals:
Half life
For therapeutic response of a drug to occur the drug must be:
unbound to plasma protein
The free or unbound fraction of a drug is usually the portion that:
exerts a pharmacologic effect
(If protein binding is reduced, greater free drug concentration is available which may lead to increased drug activity)
If a drug is 80% bound to blood elements or plasma proteins, what part is considered the free form?
20%
What is the average availability of a drug following IV administration?
100%
What organ is responsible for metabolism in the FIRST PASS EFFECT?
Liver
Which of the following would receive a drug slowly?
adipose
Bactrim is a 2c9 inhibitor and warfarin is a 2c9 substrate. What happens when the two are taken together?
Increased warfarin effect
Pharmacokinetics is the effect of the ______
Pharmacodynamics is the effect of the ____
K: Body on drug
D: Drug on body
Which of the following is NOT a pharmacokinetic process?
the drug causes dilation of coronary vessels
(Kinetics = BODIES effect on drug)
Which of the following describes MINIMAL effective concentration (MEC):
The minimal drug PLASMA concentration to produce an effect
What refers to your body “tank”
Volume of distribution
(VD determines loading rate as well)
For first-order drug elimination, half-life is T1/2 is _____ at two places on the curve and a constant ____ is lost per unit time
Equal; percentage
What happens to insulin once its bound to the receptor?
Phosphate group to tyrosine kinase protein
Phyisochemical property of drugs :
-Racemic mixture regarding chirality
equation for loading dose for an IV drug?
D= VD x Css / F
Dry = very dry x cause / fuck
Which of the following drugs would most likely need a loading dose to help reach therapeutic levels:
Whichever drug has the greatest half life
Which of the following is the amount of drug absorbed per the amount administered
Bioavailability
The lipid soluble form of a base is ____ and the lipid soluble form of an acid is ____
unprotonated
protonated
What prohibited full FDA review of supplements and botanicals as drugs?
Dietary supplemental health and education act
Who is in charge of safety regarding drug development?
Manufacturers
What did Paul Ehlrich say about drugs?
A drug will NOT work unless bound
What happens to the curve when naloxone is bound to morphine:
Right shift
What superfamily receptor is a SINGLE transmembrane spanning domain?
Kinase linked & related receptors
What drug is used for patients with TNF-alpha to decrease symptoms?
Infliximab
What does verapamil block?
Calcium
T/F: The first order elimination of a drug half life is constant
True
What needs to occur for a drug to be useful?
Must show a high degree of binding site specificity
What drug interaction still allows binding of the agonist but binds to the same receptor?
allosteric antagonist
HMG-CoA reductase inhibitors
Statins
What doe HMG-CoA reductase inhibitors do?
Competitively inhibit rate limiting step in cholesterol biosynthesis in the liver (lovastatin)
Anti-epileptic with cognitive impairment, gingival hyperplasia and drug interactions of cyp450 3A4 enzyme induction:
Phenytoin
Drugs that cause gingival hyperplasia include:
- anticonvulsants
- calcium channel blockers
- cyclosporine (antifungal)
Antianginal medication that works by blocking beta-adrenoreceptor:
Atenolol
What are three endogenous catecholamines;
- epinephrine
- norepinephrine
- dopamine
Cardiac output is a function of:
SV x HR
Myocardial oxygen demand is determined by:
- heart rate
- myocardial contractility
- myocardial wall stress
Which of the following is true regarding the EXTRINSIC pathway of the coagulation cascade?
results in formation of activated factor VIIa
Which of the following is true regarding the INTRINSIC pathway?
all components are present in the blood
Predictable dose related reaction NOT part of the therapeutic effect:
Side effect
Levofloxacin is a 2c9 inhibitor, warfarin is a 2c9 substrate, what happens when taken together?
Increased warfarin effect
What results from covalent modification and alteration of DNA?
Mutagenesis
What will dissolve in H2O:
must be ionized
T/F: An ionized drug more readily crosses the plasma membrane
False
-small uncharged molecules can cross
After FDA approval how long is left of patent lie?
5-10 years
Beta-2 agonist for short term control in asthma:
Albuterol
Vaughn Williams classification for potassium channel blocker:
Class IV
What happens to EC50 when competitive agonist is added?
Shifts to right
What is a high intensity dose?
Rosuvastatin at 20 mg
What is a high intensity dose?
Atorvastatin (Lipitor) 80 mg
What has the most perfusion?
Central organs (heart, brain, liver, kidney)
HDL should be:
greater than 60
LDL should be:
less than 100
What competitively inhibits conversion of plasminogen to plasmin by TPA?
tranexamic acid
What drug is associated with anaphylactic shock?
PCN
Dries secretion and increases heart rate in nerve agent exposure:
Atropine
Patient using albuterol for asthma, which medication is most likely to result in pharmacodynamic interaction & negate use?
Propranolol
Class of lipid lowering agents most potent lowering LDL cholesterol and also very expensive
PCSK-9 inhibitors
Study of genetic basis of ADME and receptor target interactions:
Pharmacogenomics
Enzyme responsible for breaking down acetylcholine in serum:
acetylcholinesterase
Clot that occurs in arterial circulation & consists of platelets:
White thrombus
Taking APAP with codeine, how will it affect other meds they take?
SLOWED absorption
What should you avoid in asthma patients?
- Aspirins
- NSAIDs
- Opiates
- Barbiturates
- Antihistamines
Noncovalent type of interaction:
Formation of hydrogen peroxide
Antianginal medication with gingival hyperplasia:
Dilitazem
DIRECT thrombin inhibitor:
Pradaxa
Which would you NOT expect with acute cholinergic toxicity?
Dry mouth
Drug for chronic dry mouth, avoid adverse effects while maximizing stimulation of saliva:
M3 receptors