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Pharmacology > Pharmacodynamics > Flashcards

Pharmacodynamics Flashcards

1
Q

Therapeutic window/index

A

relationship between beneficial and adverse effects

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2
Q

Wide therapeutic window

A

generally considered safer

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3
Q

Narrow therapeutic window

A

closer monitoring and higher rate of dangerous toxicities

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4
Q

Minimal effective concentration

A

all drugs have a minimum blood level below which they are ineffective

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5
Q

Maximal safe concentration

A

max level above which serious side effects and toxicities may occur

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6
Q

Toxicity

A

interchangeably with adverse drug reaction or side effects. Refers to more serious or unexpected ADRS that tend to occur above the maximal safe concentration or when drug is not monitored properly

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7
Q

Steady State

A

drug input equals drug output
stabilize/plateau
4-5 half lives to occur

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8
Q

Onset of action

A

when the drug begins to take effect, depends on drug’s mechanism of action and long that takes to become physiologically visible

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9
Q

Duration of action

A

length of time a drug can be expected to exhibit its pharmacological effects

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10
Q

Receptor theory

A

drug produces an effect by combining with some specific molecular constituent (receptor). The function of the receptor or cell is modified to produce a measurable effect

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11
Q

Agonist

A

drug that mimics some natural compound by binding with the receptor and stimulating some cellular response

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12
Q

Antagonist

A

a drug that binds with a receptor, blocks the receptor from stimulation, and prevents it from being triggered normally

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13
Q

Affinity

A

strength of attraction between a drug and its receptor; describes the tightness of the bond

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14
Q

Selectivity

A

refers to the degree to which a drug acts upon one site relative to all possible sites

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15
Q

Alteration of Enzyme Activity

A

altering the activity of the various body enzymes and thus increasing or decreasing production of neurotransmitters, hormones, etc.

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16
Q

Adverse drug reaction

A

broad term that can encompass a variety of types of reactions

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17
Q

Adverse effect/side effect

A

undesired pharmacological effect of a drug

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18
Q

Exaggerated drug response

A

for example, a blood pressure medication that unexpectedly bottoms out the patients blood pressure or a sedative that makes the patient unresponsive or sedated for an extended period of time

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19
Q

Allergic reaction

A

immune system mediated, patient is usually allergic to all drugs of that same chemical class

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20
Q

Pseudoallergic drug reactions

A

reactions resemble allergic reactions but they are not mediated by the immune system; there is no antibody production

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21
Q

Toxicity

A

often used interchangeably with ADR or side effect. Toxicity refers to serious or unexpected ADRs that occur above the therapeutic window or when not monitored properly

22
Q

Intolerance

A

term used to describe any type of ADR that the patient feels intolerable thus limiting the drug’s usefulness or acceptance to the patient

23
Q

High risk drugs

A

include those with a narrow therapeutic window, high incidence of side effect, high incidence of allergic reactions

24
Q

High risk patients

A

include patients who would be least likely to tolerate ADRs or loss of efficacy. (neonates/infants, elderly, frail, & malnourished; patients with difficult to control diabetes, arrhythmias, heart disease, & epilepsy

25
Q

Immediate Allergic Reactions

A

IgE mediated activation of mast cells and basophils; generally begins within 2 hours of exposure. High potential to progress to anaphylaxis

26
Q

Delayed allergic reaction

A

begins 6 hrs to days after exposure

27
Q

Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis (TEN)

A

blistering rash with prodromal fever & influenza-like symptoms and sloughing of skin

28
Q

Pseudo-allergic Drug reactions

A

ADRS with symptoms that mimic drug allergy

29
Q

Intolerance

A

broad term for any ADR that limits usefulness or acceptance of the drug by the patient

30
Q

Tolerance

A

higher doses of a drug are needed over time to elicit the same response

31
Q

Physical Dependence

A

the drug is needed to function normally, stopping the drug will cause withdrawal symptoms

32
Q

Withdrawal symptoms

A

usually the opposite effects of the drug

33
Q

Psychological dependence or substance use disorder

A

deviant behavior causing an overwhelming involvement in the use of and acquisition of a drug for euphoria

34
Q

Categories of Drug Interactions

A
  1. Altered GI Absorption
  2. Protein Displacement
  3. Altered Metabolism
  4. Synergistic Effects & Antagonistic Effects
35
Q

1) Altered GI Absorption

A

Altered Intestinal Flora-impact the absorption and metabolism of orally ingested drugs

36
Q

1) Altered GI Absorption (altered pH)

A

more or less ionized, some drugs absorb better in an acidic

37
Q

1) Altered GI Absorption (drug induced mucosal damage)

A

drugs that tear up the gut lining can reduce absorption of medications and nutrients leading to nourishment (chemotherapy)

38
Q

1) Altered GI Absorption (chelation)

A

Chelation interactions is a form of strong chemical bonding of two substances that reduces their solubility and thus prevents oral absorption

39
Q

1) Altered GI Absorption

A

effects of food-1 hr before food or 2 hrs after

40
Q

1) Altered GI Absorption (transport protein interactions)

A

Transport Protein Interactions - multiple drugs competing PGPs may reduce PGP binding of one or both drugs (maybe be inhibitors or inducers of PGPs thus increasing or decreasing absorption)

41
Q

2) Protein Displacement

A

drugs bound to plasma proteins are pharmacologically inactive & exist in equilibrium between bound and unbound. there are a limited number of binding sites available on serum albumin

42
Q

3) Altered Metabolism is

A

concurrent administration of two drugs metabolized by the same liver enzyme system can increase or decrease in blood levels of one or both drugs; most of these interactions involve the cytochrome p450 system

43
Q

3) Altered Metabolism (enzyme induction)

A

caused when one drug induces or speeds up the shared metabolic pathway

44
Q

3) Altered Metabolism (enzyme inhibition)

A

most common type of drug interaction of all the different types of drug interactions. Enzyme inhibition occurs when two or more drugs create a “traffic jam”

45
Q

Cytochrome p450 System

A

Inducers: drugs that increase metabolism
Inhibitors: drugs that reduce metabolism
Substrates: drugs that are affected by other drugs that either induce or inhibit

46
Q

Pharmacogenetics: Ultra metabolizer

A

has higher than normal levels of certain isozymes = faster than expected drug metabolism

47
Q

Pharmacogenetics: Extensive metabolizer

A

has normally functioning and normal levels of that isozyme and thus, metabolize drugs at expected rates

48
Q

Pharmacogenetics: Poor metabolizer

A

abnormally low levels of certain isozymes

49
Q

4) Synergistic/Antagonistic Drug Interactions

A

occurs when the effects of two drugs together are greater/worse than would have been predicted from each of their effects alone

50
Q

Strategies to Prevent Drug Interactions

A

perform complete medication history
be familiar with most common drug interactions
avoid unnecessary drugs
separate chelating or pH interacting rugs
select non interacting medication

51
Q

Inter patient Variability in Drug Response

A 
Pharmokinetic differences
allergy history
age
weight and body size
disease states
genetics
polypharmacy
complaince
52
Q

Medication non adherence

A

degree to which a patient follows a treatment regimen
“America’s other drug problem”
just as high in pediatric population

Pharmacology (11 decks)

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