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FoM > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

Drug

A

An active substance with a direct effect in the diagnosis, cure, mitigation, treatment or prevention of disease

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2
Q

Placebo

A

An inactive substance administered as though it’s a drug but which has no therapeutic effect

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3
Q

Homeopathy

A

Giving patients medicines that contain little to no medicine

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4
Q

Efficacy

A

How big is the max response

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5
Q

Potency

A

How big a dose for the desired outcome

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6
Q

Variability

A

The proportion of patients with desired outcomes

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7
Q

Selectivity

A

How selective a drug is to its molecular target

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8
Q

Safety

A

Proportion of patients with unwanted effects

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9
Q

Bioavailability

A

How much of an administered drug will reach circulation

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10
Q

Cost

A

How much does a course of it cost?

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11
Q

Explain Lock and Key

A

Most drugs are chemically inert but bind transiently to command and control modules

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12
Q

What is an agonist?

A

A drug that binds to a receptor to illicit a response

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13
Q

What is a partial agonist?

A

An agonist that cannot produce a maximal response even when occupying all receptors

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14
Q

How does a partial agonist act in the presence of a full agonist?

A

As a partial antagonist

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15
Q

What is an antagonist

A

A drug that binds to a receptor but produces no response and blocks agonists from binding

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16
Q

What does allosteric mean?

A

Relating to or changing the shape of a protein at a point other than the active site

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17
Q

What is physiological antagonism?

A

Two drugs at different receptors causing opposing physiological actions

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18
Q

What does label one show?

A

Superior Vena Cava

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19
Q

What does label two show?

A

Pulmonary Artery

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20
Q

What does label three show?

A

Pulmonary Vein

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21
Q

What does label four show?

A

Inferior Vena Cava

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22
Q

What does label five show?

A

Hepatic Vein

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23
Q

What does label six show?

A

Hepatic Artery

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24
Q

What does label seven show?

A

Hepatic Portal Vein

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25
Q

What does label eight show?

A

Renal Vein

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26
Q

What does label nine show?

A

Renal Artery

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27
Q

What does enteral mean?

A

Entering through the gut

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28
Q

What does suppository mean?

A

Entering through the rectum

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29
Q

What is a parenteral formulation?

A

An injectable drug

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30
Q

What does Lyophilized mean?

A

Freeze-dried

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31
Q

What is drug distribution?

A

The reversible transfer of a drug between the blood and extravascular tissue

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32
Q

Define Pharmacodynamics

A

What the drug does to the body

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33
Q

Define Pharmacokinetics

A

What the body does to the drug

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34
Q

Give the 6 main Parenteral routes

A

Subcutaneous, Intramuscular, Intravenous, Intraarterial, Intraosseous, Epidural

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35
Q

What does intraosseous mean? And what is the benefit of it?

A

Into bone marrow, non collapsible entry point to venous system

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36
Q

What is a topical formulation?

A

applied to the skin

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37
Q

Why do drugs need to dissolve to work?

A

To penetrate epithelial, endothelial and plasma membranes

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38
Q

What is ficks law?

A

Diffusion = ((Conc 1 - Conc 2) * area * Permeability) / Thickness

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39
Q

In a weak acid what will a PH increase cause?

A

Ionisation of target molecule

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40
Q

In a weak base what will decrease of PH cause?

A

Ionisation of target molecule

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41
Q

How do you calculate Bioavailability of oral drug from a Drug conc over time graph.

A

AUC (Oral) / AUC (IV) AUC = Area under curve

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42
Q

What is Bioavailability (F)?

A

Bioavailability (F) is the proportion of a drug that will reach circulation. It is between 1 and 0 and independent of dose.

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43
Q

How do you calculate Bioavailable dose?

A

Administered Dose * Bioavailability = Bioavailable Dose

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44
Q

What does Total body water include?

A

Blood volume + Interstitial volume + Intracellular volume

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45
Q

What does Extracellular volume include?

A

Blood volume + Interstitial Volume

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46
Q

What does Extravascular volume include?

A

Interstitial volume + Intracellular Volume

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47
Q

What is interstitial volume?

A

Fluid between cells

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48
Q

What is Intracellular volume?

A

Fluid within cells

49
Q

What is typical blood volume?

A

5L

50
Q

Define Bulk Flow

A

When a large amount of drug is injected into the bloodstream at once. It is distributed passively by passing through major organs.

51
Q

What organs have good perfusion?

A

Liver, Lungs, Kidney, Brain, Heart

52
Q

What organs have poor perfusion?

A

Fat, Bone, Muscle

53
Q

What is Plasma protein binding?

A

When drugs bind to plasma protein so cannot cross membranes rendering them pharmacologically inactive.

54
Q

What happens to plasma protein drug complexes when free plasma levels fall?

A

Bound drug is released from the complex

55
Q

How do you calculate Volume of Distribution?

A

Vd = Drug dose / Plasma Conc

56
Q

When can you not calculate Vd?

A

When drugs distributes unevenly

57
Q

What is the blood brain barrier?

A

A collection of tight junction and astrocytes which prevent large / water soluble molecules entering the brain.

58
Q

What is first pass metabolism?

A

When some oral drugs are metabolised before reaching circulation. This determines bioavailability.

59
Q

Which organ does most metabolism?

A

The liver

60
Q

Where is the CYP450 family of isozymes found?

A

Hepatocyte SER

61
Q

What are the 2 stages of a conjunction reaction?

A

Inactivation and Solubilisation

62
Q

What are the dangers of conjunction reactions?

A

May generate an active or toxic metabolite rather than an inactive one

63
Q

What is a pro drug?

A

An inactive substance that is metabolised by the body after administration into an active drug

64
Q

What drugs are excreted through the lungs?

A

Alcohol and inhaled anaesthetic

65
Q

What molecules are excreted through biliary excretion?

A

Large metabolites (>500Da) and glucuronide conjugates

66
Q

What are the 4 main stages of kidney excretion?

A

Throw away everything small, Take back anything still wanted, expel waste substances, excrete what is left

67
Q

What is the afferent arteriole?

A

The arteriole that feeds blood into the glomerulus of the kidneys

68
Q

What is the efferent arteriole

A

The arteriole that takes blood away from the glomerulus of the kidneys

69
Q

What is Glomerular filtration?

A

The glomeruli passively filter 20 % of plasma on each pass, large molecules are not filtered into tubules, small molecules enter nephrons to be filtered

70
Q

How do Lipophilic drugs pass through the kidneys?

A

Lipophilic drugs are able to diffuse back into

peritubular capillaries so are reabsorbed

71
Q

How do some drug interactions effect absorption?

A

Some drugs can neutralise stomach PH which can alter gut motility.

72
Q

How do some drug interactions effect distribution?

A

Drugs may compete for binding to plasma protein which will increase free concentrations.

73
Q

How do some drug interactions effect Metabolism through induction?

A

Some drugs can increase gene expression of enzymes that metabolise it, drugs that are metabolised by the same enzyme will be metabolised quicker

74
Q

How do some drug interactions effect metabolism through inhibition?

A

When a metabolic pathway cannot metabolise 2 drugs at the same rate as when they are alone.

75
Q

How do some drug interactions effect excretion?

A

Drug excretion can be affected by PH in

kidney tubules

76
Q

What is zero order elimination?

A

When a drug is eliminated at a constant rate

77
Q

What is first order elimination?

A

When a proportion of a drug is eliminated per unit of time

78
Q

What is Clearance?

A

The volume of blood from which the drug is cleared per unit of time.

79
Q

What is continuous drug dosing?

A

a constant IV infusion which results in a steady state

80
Q

what is a steady state?

A

When Plasma Conc (CPs) is constant

81
Q

What is maintenance dosing?

A

When drugs are given at intervals to maintain an average Plasma Conc

82
Q

What are loading doses?

A

A large first dose may be given to fill up the bodys Vd. This is followed by standard maintenance dosing or infusion.

83
Q

How do you measure steady state?

A

Measured in half lives. The empty Vd will halve every half life.

84
Q

What is the equation for Continuous IV infusion Rate of admin?

A

Rate of Admin = Rate of Elim = Clearance * CPss

85
Q

What is the equation for Maintenance dosing??

A

(Dose * Bioavailability) / Dose interval = Cl * CPss

86
Q

What is the equation for Loading Doses?

A

Loading dose * Bioavailability = Vd * CPss

87
Q

What are the 3 branches of the ANS

A

Sympathetic NS, Parasympathetic NS and Enteric

88
Q

Where are ganglions located in the Sympathetic NS

A

Towards the Spinal cord

89
Q

Where are ganglions located in the parasympathetic NS

A

Towards the organ

90
Q

How can the Sympathetic NS stimulate multiple organs at once

A

It can stimulate many post ganglionic neurons at once from the thoracic CNS region

91
Q

What response does the Sympathetic NS create?

A

Fight or Flight

92
Q

What response does the Parasympathetic NS create?

A

Rest and Digest

93
Q

What neurotransmitters are used at Ganglions?

A

Acetylcholine

94
Q

What receptors are used at the Ganglions?

A

Nicotinic recpetors (N1)

95
Q

How many subunits make up a Nicotinic receptor?

A

5

96
Q

How many ACh must bind to a Nicotinic receptor to open it?

A

2 ACh

97
Q

Where are N2 receptors found

A

N2 (NM) are found at skeletal muscle junctions in the Som NS

98
Q

What neurotransmitter is used at Parasympathetic NS post ganglionic nerves?

A

Acetylcholine

99
Q

What receptors are used at Parasympathetic NS post ganglionic nerves on the target tissue?

A

Muscarinic AChR

100
Q

What type of receptor is a Muscarinic AChR?

A

G-Protein coupled recpetor

101
Q

What happens when ACh binds to a muscarinic AChR?

A

Ga protein will swap GDP for GTP. The Ga protein will dissociate and activate a downstream effector muscle.

102
Q

What neurotransmitter do MOST Sympathetic NS post ganglionic nerves use?

A

Noradrenaline

103
Q

What Receptor do MOST Sympathetic NS post ganglionic nerves use?

A

Adrenal receptors

104
Q

What neurotransmitters and receptors do Sympathetic NS post ganglionic sweat gland nerves use?

A

Acetylcholine and Muscarinic receptors

105
Q

What neurotransmitters and receptors do Sympathetic NS Adrenal medulla nerves use?

A

Acetylcholine and Nicotinic receptors

106
Q

How do Adrenal medulla pathways differ to other Sympathetic NS pathways?

A

No ganglions on pathway

107
Q

How do neurotransmitters re-enter the pre-synaptic vesicle.

A

Specific transporters for that neurotransmitter at reuptake sites

108
Q

What is MAO and where is it found?

A

MAO (mono-amine oxidase) is a chemical that breaks down noradrenaline and is found in SNS pre synaptic neurons

109
Q

How can a drug act as an agonist at a Muscarinic receptor?

A

Mimicking ACh and binding to M receptors

110
Q

How can a drug act as an antagonist at a Muscarinic receptor?

A

Blocking ACh from binding to M receptors, this is often reversible but not always

111
Q

How can you increase selectivity of Noradrenaline to Beta Adrenal receptors?

A

Adding groups to the N atom on Noradrenaline

112
Q

What are the 2 types of Adrenoreceptors?

A

Alpha (a) and Beta (B)

113
Q

Which Adrenoreceptor is Noradrenaline more effective towards?

A

a receptors

114
Q

Which Adrenoreceptor is adrenaline more effective towards?

A

Effective against both but more selective to B receptors

115
Q

Where are a1 adrenoreceptors found?

A

Blood vessels and Vascular smooth muscle

116
Q

What does stimulation of a1 adrenoreceptors cause?

A

vasoconstriction which results in increase venous and arterial blood pressure

117
Q

What do a2 receptors do and where are they found?

A

They are autoreceptors and prevent too much neurotransmitter being released. They are found on the pre-synaptic neuron

118
Q

What do B1 adrenoreceptors do?

A

Increase HR and contraction force

119
Q

What do B2 adrenoreceptors do?

A

Relax airways

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