Pharmacological Terms (Exam 1) Flashcards
Antagonism
Opposition between 2 or more medications
Bolus
Single, often large dose of a drug.
The initial dose
Cumulative Action
Increased effect caused by multiple doses of same drug. Caused bu buildup in the blood
Hypersensitivity
Reaction to a drug that is more profound than expected. Exaggerated immune response
Idiosyncrasy
Reaction to a drug that is significantly different than expected
Indication
Medical condition for which drug has proven therapeutic value
Parenteral
Route of administration other than digestive tract
Pharmacodynamics
Biochemical or physiological changes in body caused by drug mechanisms
What drug does to our body
Pharmacokinetics
How drugs enter the body, reach site of action, and are eliminated
What our body does to drug
Potentiation
Enhancement of a drug’s effect by another drug
Refractory
Failure of a patient to respond as expected to medication
Synergism
Combined action of 2 or more drugs that is greater than the sum of drugs acting independently
Therapeutic Action
Intended action of drug given in appropriate medical setting
Therapeutic Threshold
Minimum amount of drug required to cause desired response
Therapeutic Index
Difference between therapeutic threshold and toxic effects.
Safe and effective range
Tolerance
Decreased sensitivity or response. to a drug that occurs after repeated doses
Untoward Effect
Side effect that is harmful to patient
Mechanism of Action
Specific biochemical process by which drug produces effect
Side Effect
Secondary effect; used to describe adverse effects, or beneficial, always unintended
Adverse Effect
Unfavorable and unintended effect
Toxicology
Deals with undesirable effects of chemicals on living systems
Pharmacogenomics
How genetic makeup of individual affects response to drugs
What does the body do to the drug?
A Absorption
D Distribution
M Metabolism
E Excretion
Process of Understanding Pharmacology
- Understand normal physiology
- Understand pathophysiology
- Understand drug’s therapeutic mechanism of action
- Understand side effects
- Understand pharmacokinetics
- Understand potential interactions and patient-specific factors
Atorvastatin (Lipitor) Uses
Treats dyslipidemia and lower cholesterol
Atorvastatin (Lipitor) Normal Physiology
Cholesterol required for hormone/vitamin synthesis, maintain fluidity of cell membranes
Atorvastatin (Lipitor) Pathophysiology
Diet or genetic conditions lead to overproduction or reduced clearance
Excess LDL deposited in blood and forms plaques –> reduce blood flow –> heart attack or stroke
Atorvastatin (Lipitor) Mechanism
Inhibits HMG-CoA reductase to reduce cholesterol levels
Atorvastatin (Lipitor) Side Effects
Inhibition of HMG-CoA reductase in muscle can lead to muscle pain
Atorvastatin (Lipitor) Pharmacokinetics
Taken orally, dissolves in stomach. absorbed in small intestine, travels to liver
Metabolized by CYP3A4, excreted through bile
Atorvastatin (Lipitor) Patient Specific Factors
Drug Interaction-Another medication that inhibits CYP3A4
Pregnancy- Contraindicated, need cholesterol for fetal development
Medicinal Chemistry
Chemical basis of drug action
Chemical structure is key
Pharmacophore
Molecular features of drug required for target interaction
Physiochemical Properties
Solubility, stability, particle size, dissolution rate, lipophilicity/hydrophilicity
Structure-activity relationships (SARs)
How functional groups within a medication influence drug action
General Toxicology
Determining doses to be avoided
Species selection
Dose selection
Duration and route of administration
Endpoints
Dose Selection 1 in Drug Trial
Maximum Tolerated Dose
No Adverse Effect level
Spaced out to allow assessment
3 dose groups and 1 control
NOAEL
NO Adverse Effect Level
Dose Selection 2 in Drug Trial
NOT determined by multiples of human dose
t1/2 is shorter in animals so must be adjusted to human levels
Endpoints
Mortality
Clinical Signs
Hematology
Body weight, temp, activity level
Translational Research Approach
T0, T1, T2, T3, T4
T0
Basic Science Research
Defining mechanisms, targets, lead molecules
T1
Translation to Humans
New methods of diagnosis, treatment, and prevention
T2
Translation to Patients
Controlled studies leading to effective care
T3
Translation to Practice
Delivery of care to right patient
T4
Translation to Community
True benefit to society
Phase 1 Clinical Trials
Drug is tested for interaction with human system
Phase 2 Clinical Trials
Pilot studies to begin to define effectiveness and safety of drug in patients with disease
Phase 3 Clinical Trials
Clinical Trials begin…
Gather additional evidence of effectiveness, understand safety and adverse effects
Phase 4 Clinical Trials
After drug received FDA approval, studies done to monitor long-term effects
4 Ps of P4 Medicine
Predictive
Preventative
Personalized
Participatory
Components of Drug Name
Chemical Name
Generic Name
Brand/Trade Name
What’s in a medication?
Active ingredient - precise amount of drug
Inactive ingredients - added during manufacturing process
Drug Development Process
Preclinical Studies
Investigational New Drug
Clinical Testing
New Drug Application
Marketing/Post-marketing surveillance
Preclinical Studies
in vitro studies and animal testing
Investigational New Drug (IND)
Application to FDA for permission to test drug in humans
Phase I Clinical Testing
Determine safe dosage range and pharmacokinetics
Phase II Clinical Testing
Determine efficacy in small group
Phase III Clinical Testing
Determine efficacy in large group
New Drug Application (NDA)
Application to FDA for approval
Marketing Phase IV
On-going monitoring for adverse effects after drug approval
Bioequivalence Medication
Drugs that contain same amount of active ingredient but may have different inactive
