Pharm Unit 1 Basics Flashcards
FPI=
Full Prescribing Information.
MOA=
Mechanism of Action.
These change biologic functioning via chemical action on the cell.
Drugs.
The study of how chemicals interact with living systems..
Pharmacology.
Chemicals our own body makes. Ex. cortisone.
Endogenous substances.
Drugs/substances administered to a person. Ex. prednisone.
Exogenous substances.
Undesired effects of chemicals on living systems.
Toxicology.
Harmful drugs or inorganic toxins.
Poisons.
Poisons of biologic origin (organics).
Toxins.
The total atomic weight of all the atoms in a molecule.
Molecular Weight (MW).
Organic compounds are based on these 5 elements:
- Carbon. 2. Hydrogen. 3. Oxygen. 4. Nitrogen. 5. Sulfur.
Neutral pH:
7.
Acidic pH:
1-7.
Basic pH:
7-14.
6 ways biochemistry affects drug activity:
- The physical state of the drug. 2. Size and shape (MW) of the drug (average MW 100-1,000). 3. Racemic drugs (right/dextro vs. left/levo orientation). 4. Bonding. 5. Diffusion. 6. Ionization and lipid permeability.
Hydrophilic substances are more __ soluable. (charged)
Water.
Lipophilic substances are more __ soluable. (neutral)
Lipid.
This means that the substance/drub is both water and lipid soluable.
Amphiphilic.
These astrocyte cells selectively absorb substances from the blood.
Neuroglia.
The 3 areas of the Brain that are not covered by the BBB.
- Pituitary gland. 2. Hypothalamus. 3. Pineal gland.
The expected benefit of the drug.
Therapeutic target/target outcomes.
DOC=
Drug of Choice.
When a drug is effective when used alone.
Monotherapy.
What the FDA has legally determined the clinical condition for the drug should be used for.
Label approved.
When clinicians prescribe drugs that are not label approved or a specific condition because the science of the drug and the available clinical evidence has demonstrated that the drug will work.
Off label use.
Possible reasons not to use a drug in a particular patient. Can be absolute or relative.
Contraindications.
The two types of Licit drugs in the US:
- Prescriptions (legend). 2. OTC/BTC.
This book lists all the approved drugs in the US.
The Orange Book.
CS=
Controlled Substances.
A way to draw attention to look alike drug names.
Tall Man Letters.
Drugs considered to have abuse potential and are under control of the DEA.
CS/Schedule drugs.
This schedule for CS is for illegal drugs with high potential for abuse. Ex. Heroin.
Schedule I/CI.
This schedule for CS is for lecit drugs with high potential for abuse and physical dependence. Ex. Oxycodone.
Schedule II/CII.
CSA=
The Controlled Substances Act.
This schedule for CS is for lecit drugs that still have potential for abuse, just not as much as other schedules Ex. Codeines.
Schedule III/CIII.
This schedule for CS is for lecit drugs that have less potential for abuse. Ex. Xanax.
Schedule IV/CIV.
This schedule for CS is for lecit drugs that have low potential for abuse. Ex. Tylenol with Codeine.
Schedule V/CV.
This is s 4-digit number assigned to each CS.
A DEA code number.
Actions of drugs on the body.
Pharmacodynamics.
Actions of the body on drugs.
Pharmacokinetics.
The __ of a drug reflects its strength of bonding to its specific receptor.
Affinity.
Sites on endogenous chemicals that can bind other chemicals.
Inert binding site.
When a drug has effects on the body beyond what is expected from the MOA.
Pleiotropic effects.
Drugs that are engineered in a lab.
Designer drugs.
EBM=
Evidence-based medicine.
6 Steps in the EBM process:
- Asses the patient. 2. Ask the question. 3. Acquire the evidence. 4. Appraise the evidence. 5. Apply: talk with the patients. 6. Self-Evaluation.
A trial in which the investigator and the patient are unaware of who is receiving the active drug or placebo. “Double blind”
Randomized Controlled Trial (RCT).
A substance given to a patient with no known drug effect.
Placebo.
A trial in which the investigator and patient are aware of the therapy. Example: a head to head trial of two drug to see which is better.
Open-label drug trial.
USP=
United States Pharmacopeia.
When generic brand drugs and Brand Name (Proprietary) drugs are interchangeable:
Bioequivalence.
LD=
Lethal Dose.
The lethal dose that kills 50% of the population using the drug. Usually obtained through animal studies.
LD50.
Phase 1 of new drug development is done on:
healthy human volunteers.
Phase 2 of new drug development is done on:
patients diagnosed with the disease.
Phase 3 of new drug development is done on:
a larger number of patients. This is when the NDA is filed.
Phase 4 of new drug development is when:
the drug has been released to the market, this is post-marketing.
In new drug development, this is when the drug company owns the patent on the drug for a limit of 14 years.
Post-NDA approval.
Drugs with limited usage for really rare diseases.
Orphan drugs.
CDER=
Center for Drug Evaluation and Research.
This number is assigned by the FDA and is a unique identifier for all human drugs.
NDC number.
PI=
Prescribing Information.
Under this act, certain vaccines must have permanent records kept.
The National Childhood Vaccine Injury Act of 1986.
This program financially compensates a child for a significant adverse event of disability due to a vaccination.
The Vaccine Injury Compensation Program.
VAERS=
Vaccine Adverse Events Reporting System.
CFSAN=
Center for Food Safety and Applied Nutrition.
BBW=
Black Box Warnings.
When a patient takes the medication as prescribed.
Compliance.
When a patient takes the medication as prescribed and follows though on other elements of the management plan such as diet and exercise.
Adherence.
When drug tolerance develops rapidly.
Tachyphylaxis.
This occurs when a drug can have adverse effects such as withdrawal if the patient stops taking it.
Physical dependence.
Feelings of satisfaction and desire to repeat drug experience, also called addiction.
Psychological Dependence.
When drugs are marketed in a combined form to reduce “pill burden”.
Fixed-drug/dose combinations.
The degree to which a drug is able to induce maximal effects of a defined outcome.
Efficacy.
The dose of medication at which 50% of the population exhibits the desired effect.
ED50.
ADR=
Adverse Drug Reactions. Also can be ADE or AE for “event”. This is not a medical error, it is a non-preventable reaction to the drug.
Drugs added to a primary drug to allows the first drug to be used at a lower dose with lower toxicity.
Adjunctive Drugs.
The dose at which 50% of the population using a drug will show the toxic effect.
TD50.
How far away the therapeutic dose of a drug is from the toxic or lethal dose.
Therapeutic Index (TI).
The dose range that give us benefit without toxicity. Efficacy vs. Safety.
Therapeutic Window.
Any mistake made in diagnosis or treatment.
Medical error.
IOM=
Institute of Medicine.
Mistakes made in prescribing, transcribing, dispensing of administering medication.
Medication error.
A mistake that has not caused harm.
Near miss.
Harm caused by a mistake.
Preventable adverse event.
Three types of ADR:
- Dose-related (toxic). 2. Predictable (side effects). 3. Immunologic or idiosyncratic (unrelated to pharmacologic action).
This type of photosensitivity occurs within minutes and looks like a bad sunburn.
Phototoxic.
This type of photosensitivity looks like contact dermititis and starts 24 hrs after sun exposure. Spreads through the body.
Photoallergic.
Rash of red welts.
Urticaria.
Severe itching.
Pruritis.
A serious and potentially life-threatening reaction to medications, foods or other allergens. Occurs quickly and can cause dyspnea, urticaria and other symptoms. May need epinephrine.
Anaphylaxis.
Anaphylaxis, IgE mediated, upper airway edema.
Type I hypersensitivity.
An example of this type of hypersensitivity is hemolysis.
Type II hypersensitivity.
Called serum sickness, due to immune complexes, symptoms are fever, purpuric rash and arthralgias.
Type III hypersensitivity.
Contact dermititis.
Type IV hypersensitivity.
This kind of reaction can occur after taking ampicillin and sulfa drugs. Sometimes called a fixed drug reaction.
Morbilliform rash.
This can progress to Stevens-Johnson syndrome. A type of ligand-induced apoptosis after use of sulfa drugs, allopurinol and anticonvulsants.
Erythema multiforme.
4 bullets of pharmacokinetics.
- Absorption. 2. Distribution to tissues. 3. Biotransformation. 4. Excretion.
When the drug is changed in the body to some degree (usually first in the liver), can affect how much of the drug is dispersed to tissues.
First pass effect.
If the parent is a ___-___, biotransformation actually converts it into the active drug.
Pro-drug.
When the rate of elimination depends on the concentration of the drug in the plasma.
First order kinetics.
When the rate of elimination of a drug is constant.
Zero order kinetics.
A drug with no effect will enhance the effect of another drug.
Potentiation.
One drug inhibits the effect of another drug.
Antagonism.
Effect achieved by using combined drugs is greater that would be predicted than by simple additive effects (additive=two drugs to enhance 2+2=4).
Synergism. In synergism 2+2>4.
The amount of unchanged drug that reaches the systemic circulation.
Bioavailability.
When drugs are converted to be excreted through urine.
Renal Excretion.
When drugs are converted to be excreted through feces.
Hepatic Excretion.
Drugs that inhibit the biotransformation enzymes which results in increased levels of drugs in the body.
Enzyme inhibition.
Drugs induce the biotransformation enzymes resulting in decreased levels of drugs in the body.
Enzyme induction.
If two drugs use the same biotransformation pathway, they have to take turns and thus increase body levels of both drugs.
Shared pathway interactions.
Transporters n the GI tract that pump oral drugs back into the intestine.
P-glycoprotein transporters.
LQTS=
Long QT Interval Syndrome.
The fatal arrhythmia during cardiac distress.
Torsadas de pointes.
The study of understanding the human genome to both explain and predict drug reactions.
Pharmacogenomics.
