Pharm Quiz 1 Flashcards
what is biochemistry?
study of the molecular basis of life
what is an ion?
electrically charged atom formed by the addition or loss of electrons
what is a molecule?
smallest unit of a pure substance (2+ atoms linked with a bond)
ex: H2O
Number of protons = atomic number on the periodic table (Z)
what is a radical ?
unstable atom that is very reactive
uncharged atom with equal protons and electrons
Radicals are released from chemical reactions in the body, and too many of them causes damage to other molecules
what are compounds?
more than 2 elements with a chemical union that is able to reproduce
can be broken back down into singular elements
Ex: adding heat to water
what is a mixture?
more than 2 different elements or compounds
can be separated into its components
Retains the properties of its components
Ex: sugar dissolved in water
what is a non-uniform mixture?
more than 2 substances that DONT bond or have fixed proportions
each substance keeps its own properties
Ex: mixing oil and water
what is the biological hierarchy?
atom, molecule, cell, tissue, organ, organism, population, ecosystem
usually a higher level structure has many copies of the lower level structure (ex: tissue contains many types of cells)
what is chemistry?
identifying substances, properties of those substances, the way it interacts and changes with other substances, and the use of these processes to make new substances
what is structural formula (chemistry) ?
graphical representation of the molecular structure (shows how atoms are arranged in that substance)
what is protein structure (chemistry)?
bio molecular structure of a protein molecule
Proteins are polypeptides formed from the building blocks of amino acid
what are chemical bonds?
attraction between atoms to form chemical substances
118 known elements that can combine to form different substances
what are the types of bonds?
covalent
non-covalent (hydrogen and ionic, van der waals bonds)
what is a covalent bond?
bonding between nonmetals (sharing a pair of electrons, and binding to each other with those shared electrons)
Hold together proteins, carbohydrates, and lipids
Strongest and most stable bonds
*** not involved in drug receptor interactions because so hard to break down
what are the types of non covalent bonds?
electrostatics (ionic), hydrogen, hydrophobic, and van der Waals
what are hydrogen bonds?
combination of a positive hydrogen atom and electronegative atom (ex: oxygen, nitrogen, sulfur)
Weaker than a covalent bond alone, but multiple hydrogen bonds together can build strength (3rd strongest)
ANY molecule with a hydrogen atom directly attached to a oxygen or nitrogen atom is capable of hydrogen bonding
Has higher boiling points, and more heat is necessary to separate them (it’s stickier)
Critical functions: holds the double helix together, helps polypeptides bond, helps enzymes bind, antibodies bind, transcription factors bind to each other and to DNA
what are ionic bonds?
bonding between metal and nonmetal
Transfer a electron from a metal onto a nonmetal (they should have opposite charges)
Ex: sodium(+) and chloride(-) together to form NaCl salt
Stronger than hydrogen, weaker than covalent bonds
*** MOST EFFECTIVE in attracting drug molecules to a receptor site
what are van der waals bonds?
an attract at moderate distance and repel in close range, bigger atom = bigger force
Most common bond between atoms
Weaker than the other types of bonds
Operate only in close proximity
Sometimes can participate in drug reception
what are redox reactions?
(combination of oxidation and reduction): reactions that transfer electrons
Reactions are a matched set, with only one, it’s called a half-reaction
Oxidation: loss of electrons
Reduction: gain of electrons
All metal atoms can be oxidized (lose electrons), which forms a cation (positively charged ion). The electrons released are then reduced onto a non-metal (which is then an anion)
what is oxidative stress
disturbance/imbalance between the production of reactive oxygen species (ROS)
ROS: free radicals and peroxides
Disturbances in the redox environment results in too much ROS —> can damage cell components like proteins, lipids, and DNA
Antioxidants can combat excess ROS
Oxidative stress and inflammation go hand in hand, resulting in: Aging, neurodegeneration, and diseases (diabetes, cancers, atherosclerosis, Parkinson’s, and Alzheimer’s)
Severe oxidative stress results in cell death (necrosis)
Moderate oxidative stress results in apoptosis (cell “popping” and dying)
ROS can be beneficial: kills pathogens and helps cells signal
Overproduction of ROS causes cell death, so we use antioxidants to prevent this (through natural body processes or nutrition)
what is inflammation?
part of the immune response of vascular tissues to stimuli such as: pathogens, physical, and chemical trauma
It is a necessary response that allows us to destroy invaders and repair itself (wound healing)
In some disorders, the immune system can’t repair itself and it can result in a chronic inflammatory disease
what are antioxidants?
Glutathione is an antioxidant produced naturally and protects cells from free radicals. Found in plants, animals, fungi, and bacteria. Important protector in aud/vestib system
what is chronic inflammation?
continued active inflammation and tissue destruction
Is a predisposition to cancers and aging diseases (ex: diabetes, cardiovascular, and autoimmune diseases)
what are enzymes?
speed up chemical reactions in cells (most are proteins)
In an enzymes reaction: molecules at the beginning are substrates (ex: lactose is a substrate), then the enzyme unites with one of them and changes it to a product (ex: changes it to lactase)
The enzyme determines which metabolic process will occur in the reaction
All enzymes end in “-ASE”
what is an enzyme-substrate complex?
if the shapers don’t match, a react might not occur… unless the enzyme changes it shape to accommodate the substrate cell
Enzyme activity: can be affected by other molecules (inhibitors and activators). Also affected by chemical environment, substrate concentration, and temperature. Some are used commercially:
Laundry detergent, meat tenderizers, antibiotic synthesis, etc.
what are receptors?
a protein molecule in the cell surface that fosters communication on behalf of the cell and allows extracellular molecules (ligands) in and out of the cell
what are hormones?
a chemical substance that elicits physiological activity and sends chemical messages from one cell to another.
Only a small amount of a hormone is required to elicit change in the cell metabolism
All multicellular organisms produces hormones
what are neurotransmitters?
a chemical messenger that carries, boosts, and modulates signals from the neurons and other cells
Affected by disease and drugs
what are the types of neurotransmitters?
Excitatory- increase likelihood that a neuron will fire an AP (epinephrine (adrenaline for fight or flight) and norepinephrine)
Inhibitory- decrease likelihood of a neuron firing an AP (GABA and serotonin)
Some NT’s are both excitatory and inhibitory, and depending on which receptor they bind to, can do either (ex: acetylcholine and dopamine)
what is the function of acetylcholine (neurotransmitter)?
voluntary movement of skeletal muscles (sympathetic path)
what is the function of norepinephrine (neurotransmitter)?
wakefulness/arousal (sympathetic path)
what is the function of dopamine (neurotransmitter)?
voluntary movement and motivation, pleasure, addiction
what is the function of serotonin (neurotransmitter)?
memory, emotion, wakefulness, sleep, temp regulation (depression)
what is the function of GABA (neurotransmitter)?
inhibit of motor neurons, in the CNS
what is the function of glycine (neurotransmitter)?
spinal reflexes and motor behavior
what is the function of glutamate (neurotransmitter)?
excitatory
what are neuromodulators?
a substance released by a neuron that alters activity of the NT’s
Sensory transmission role, ex: pain
what are local chemicals?
not released into the systemic circulation, but work closely with the organs that release them (local processes)
histamine: allergic responses in the immune system)
prostaglandins: hormone like lipid that deals with injury and illness that controls inflammation, blood flow, and induction of labor
Why study Pharmacology in AuD?
Drugs and side effects are very prevalent in audiology
Adverse drug reactions can cause HL, tinnitus, vestib. dysfunction, cognitive dysfunction, and a combination of any of these
Helps us get an accurate case Hx to avoid misdiagnosis
Can help us be a valuable part of the healthcare team, resource to patient, prevent/manage ototoxic effects, and explain test discrepancies
audiologic case hx
what meds are you taking, what condition are you taking them for, how long have you been taking them, etc.
OTC and herbal meds can also affect auditory system, ask about those too as well as neurological side effects
what is pharmacology?
science that deals with what drugs do to/in the body (fate and actions)
combination of the words “pharmakon” (poison) + “logos” (study)
what are drugs?
substance used for diagnosing, preventing, or treating disease
what is quinine?
Quinine from tree bark treats malaria (banned in the US)
1st specific drug to treat an infectious disease!
what are synthesizing arsenicals (1910)?
attaching a carbon atom to a arsenic atom to treat syphilis
what is digitalis?
is served in a tea to treat congestive heart failure, and is still the preferred treatment today
expensive to make so we still get it from the digitalis plant family
what is morphine?
solated from opium (pain treatment) which was used since prehistoric times
Opium is from the poppy plant, which is highly regulated in the US
Isolation of morphine led to caffeine, atropine, and strychnine
what is caffeine?
originated in East Africa (Ethiopia), extracted from the plant coffea arabica
Stimulates the CNS, heart, and muscles
Relieves mental and physical fatigue, increases mental awareness
what are the Devil’s Cherries (atropa belladonna)?
entire plant is poisonous, but two alkaloids are isolated from it:
Atropine: dilates the pupils, poison if ingested in large quantity
Scopolamine: motion sickness patch and sedative
what is Salicylic acid?
from willow tree bark (salicin)
Chemical precursor to Aspirin (anti inflammatory)
Increases risk of bleeding, ulcers, and TINNITUS
what is epinephrine?
adrenaline was the first neurotransmitter isolated
Discovered by the father of modern pharmacology
Produced in some neurons of the CNS + chromaffin cells of phenylalanine and tyrosine
Used in Epipens for allergic reactions
what is acetylcholine?
in the ANS, only NT in the motor division in the somatic system
Lowers heart rate in cardiac tissues
Also an excitatory NT in skeletal muscle tissues
what is sulfa?
first antibiotic used to treat strep infections in mice
Sulfanilamide: first effective treatment for pneumonia, meningitis, and other bacterial diseases
Predated use of penicillin
Carried in WW2 to combat infection
Used today to treat urinary tract
what is the FDA?
The FDA is a regulatory agency that regulates food supply and drug development
what is penicillin?
accidentally discovered in mold in a lab in 1928 that inhibited staph bacteria
wasn’t turned into a usable product til 1940, needed for war in the US
what are over the counter medications?
drugs sold without a prescription
the FDA regulates drugs for misbranding and adulteration, says which ones are safe, and can withdraw from the market too
They also test for purity, contaminants, and label matching contents
what is the Regulation of Controlled Substances?
drugs that have some potential for abuse or dependence
Controlled Substance Act of 1970: the DEA administers this act to regulate manufacturing and distribution of opioids, stimulants, and sedatives. Before these laws, mixtures with opium and cocaine were sold OTC
In 2016, the FDA required a black box label for addictive drugs (warning sign)
Opioids are a strong pain reliever (morphine, hydrocodone, codeine) and NOT meant for long term use
The modern FDA
very strict and most respected regulatory body… responsible for:
Protecting the public health by regulating human and vet drugs, biological products, medical devices, food supply, cosmetics, and radiation products
Advancing the public health by making meds more effective, safe, and affordable
Regulates manufacturing, marketing, and selling of tobacco products
Counterterrorism capabilities by ensuring food supply and responding to emerging public health threats
overseeing OTC & supplementals
Modern Drug Development:
the discovery and development of a new drugs takes about 12 years on average (also very high risk and complex)
Estimated cost is $1-2 Billion
Only 1 of 10 gets approved
what are the phases of drug development?
- Synthesis or discovery of new chemical
- Safety evaluation
- Effectiveness evaluation
- New drug application
- Post-marketing surveillance
what does it mean if a drug has a chemical name?
chemical name refers to its chemical structure
If structure is unknown, a combo of letters and numbers is used
what does it mean if a drug has a generic name?
FDA approved, now it is given a generic name for marketing purposes
There is only one generic name approved (but can have many brand names)
Not capitalized
what does it mean if a drug has a brand/trade name?
registered as a trademark under a company, and is their property (copyrighted name)
Ex: Tylenol (acetaminophen)
tell me about drug patents
when the patent expires after 20 years, other companies can market the generic drug under a trade name (ex: cola is generic, Coke and Pepsi are brand)
generic drugs are more affordable and have the same efficacy of the brand name drugs
Ex: ibuprofen is a generic name, but Advil, Genpril, Caldolor, Motrin, and Neoprofen are other brand names
Direct-to-Consumer Marketing:
now manufacturers are directly marketing to consumers instead of only to physicians
ex: tv ads, internet, radio, etc
Increases consumer interest and brand recognition
What influences drug cost?
manufacturing process, development and research, coverage/reimbursement from insurers, marketing before patent expires, exporting to foreign countries, etc.
what is pharmacodemiology?
study of drug outcomes
important to find side effects and what the drugs do to the body (ex: Vioxx causes heart attack and stroke)
Studied very similar to pharmacology, except: No true randomization, doctor or patient intervention, outcomes are shown as probabilities, millions of patients every year (much larger magnitude)
Look at the table on page 63 for comparison between the twoc
what are the cardinal signs of inflammation?
redness, swelling, heat (fever), pain, and loss of function
what is the doctrine of signatures?
in 1500’s thought that the shape/signature of the plant given from God should treat the part of the body that has the same shape (walnut for brain, beans for kidneys, etc, holes i the leaves of saint johns wort resemble pores of the skin so therefore if can treat the skin)
ANDA
Abbreviated New Drug Application - can be filed before the expiration of the original patent
NDA
New Drug Application - submitted after the sucessful conclusion of clinical trials
Margin of Safety
LD50 ÷ ED50
If LD50 is 10 mg and ED50 is 2 mg then the margin of safety is only 5. This means the lethal dose is only 5x the effective dose.
Name an example of an enzyme, protein, neurotransmitter, hormone, neuromodulator, and controlled substance :
enzyme - lactase
protein - insulin
neurotransmitter - GABA
hormone - Testosterone
neuromodulator - substance p
controlled substance - opioids
What is the Right to Try?
Drugs used after phase 1 of clinical trials but before FDA approval
What is Exapanded Access?
Prior to FDA approval for patients who aren’t in the drugs clinical trial
(desperately ill patients, when side effects aren’t an issue, and no comparable alternative is available)
