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BAMS Bds2 > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is a drug?

A

Chemical substance (other than food) that when administered to a living organism produces a biological effect on the structure or function of the body.

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2
Q

Medicinal drugs

A

Substances intended for the use of diagnosis, prevention and treatment of disease.

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3
Q

Non-medicinal (recreational) drugs

A

This includes illegal substances such
as cannabis, heroin and cocaine, as well as legal substances such as caffeine, nicotine and alcohol.

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4
Q

Wha are the effects of drugs?

A

Therapeutic Effects
Side Effects
Adverse Effects

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5
Q

What is Therapeutic Effects?

A
  • Intended/ Desired outcome of drug administration
  • Seen as beneficial
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6
Q

What is Side Effects?

A
  • Unintended effects
  • Known/ predictable
  • Usually harmful/ negative but occasionally beneficial
  • Does not hinder the primary effect of the drug
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7
Q

What is Adverse Effects?

A
  • Undesirable effects
  • Undocumented/ unpredictable
  • More severe/ harmful
  • Can hinder treatment/ cause complications
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8
Q

For what do drugs used in dentistry?

A
  • Local anaesthetic - Prevent pain
  • Antimicrobials - Treat & prevent infection
  • Anxiolytics - Reduce anxiety
  • Analgesics - Reduce postoperative pain
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9
Q

Pharmacodynamics

A

-The effects of the drug on the body and mechanism of action
-What the drug does to the body

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10
Q

Pharmacokinetics

A

-Term to describe the 4 stages of absorption, distribution, metabolism, excretion of drugs
-What the body does to the drug

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11
Q

What can drugs do?

A
  • Stimulate normal body communications
  • Interrupt normal body communications
  • Act on non-host organisms to aid defence e.g. Bacterial cell walls
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12
Q

Types of host communication

A

-Hormone messages
General information to ALL tissues
-Neural messages
Targeted information for SPECIFIC tissues

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13
Q

How dugs can replace the missing active hormone - T3 & T4?

A

-Dose adjusted to correct level gradually
-Replacement medicine acts directly in the tissues
-No direct effect on the thyroid gland

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14
Q

What are the 2 components of Autonomic NS which is part of PNS?

A

-Sympathetic (Adrenaline)
-Parasympathetic (Acetylcholine

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15
Q

How Sympathetic & Parasympathetic system have control in heart rate?

A

Sympathetic - adrenergic stimulation (Adrenaline)
Speeds up the heart via Beta-adrenergic receptors

Parasympathetic – cholinergic stimulation (Acetylcholine)
Slows the heart via cholinergic receptors

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16
Q

What is Autonomic Drugs?

A

Drugs that enhance or inhibit the function of the sympathetic NS and parasympathetic NS

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17
Q

Examples of autonomic drugs

A

Adrenaline (beta agonist)
Atenolol (beta blocker)
Pilocarpine (cholinergic agonist)
Atropine (cholinergic blocker)

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18
Q

Mention types of drugs administration

A

Topical - drug applied to the tissue where it acts
Systemic - drug applied to the whole organism
Parenteral - drug administered by injection
Transdermal - drug applied to the skin for adsorption
Subcutaneous - drug injected into the tissues of the skin
Intramuscular - drug injected into muscle
Intravenous - drug injected into a vein
Transmucosal - drug applied to the mucosa for adsorption

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19
Q

How do drugs work? (modes of action)

A
  • Activation or blocking of Receptors
  • Activating or blocking Enzyme function
  • Opening or blocking Ion Channels
  • Facilitation or blocking Transport systems
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20
Q

Receptors can be coupled to:

A
  • Ion channels
  • G-proteins
  • Enzymes
  • Gene transcription
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21
Q

Drug Efficacy

A

How effective the drug is at producing a response from the receptor

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22
Q

Drug Efficacy is determined by?

A

Affinity
Occupancy

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23
Q

Drug Affinity

A

How avidly (strong) the drug binds to the receptor.

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24
Q

Drug Occupancy

A

How much time the drug spends on the receptor.

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25
Q

The difference between Agonist and Partial Agonist

A

Binds to receptor and initiates the same action that would be produced by the substance (neurotransmitter or hormone) which would normally bind to receptor.While Partial Agonist Binds to receptor but only partially activates the receptor.

26
Q

The difference between Agonist and Antagonist

A

-Agonists bind to receptors and cause an effect
-Antagonists bind to receptors and don’t cause an effect

27
Q

Who has less efficacy Agonist or Partial Agonist?

A

Partial Agonist has less efficacy in comparison to agonist i.e. produces less than maximal effect.

28
Q

How Antagonist works?

A

Antagonist-binds to but does not activate the receptor therefore blocks/ reduces response.

29
Q

Types of Antagonist

A

Competitive Antagonist
Non-competitive Antagonist

30
Q

Competitive Antagonist

A

Binds to same site on receptor as agonist so blocks agonist’s action

31
Q

Non-competitive Antagonist

A

Binds to a different site on receptor from agonist (allosteric site) and prevents activation of receptor

32
Q

What is reversible and irreversible antagonist ?

A

Reversible:
Binds non-covalently and can be displaced. Antagonist effect reduced by increasing the concentration of the agonist. E.g: atenolol (β1 blocker)

Irreversible:Binds so tightly to receptor that it cannot be displaced. Therefore, reduces available
receptors for the agonist. Antagonistic effect is insurmountable at any concentration of agonist. E.g:
phenoxybenzamine (α1 blocker)

33
Q

What is Enzyme?

A

Enzymes are proteins that speed up chemical reactions in the body
Remain unchanged at the end of their normal reaction May build or break down existing substances

34
Q

What are the routes of enteral drugs administration?

A

Oral
Rectal
Nasogastric
Nasointestinal
PEG (Percutaneous endoscopic gastrostomy)

35
Q

What are the routes of parenteral drugs administration?

A

Transdermal
Transmucosal
Intravenous (iv)
Intramuscular (im)
Subcutaneous (sc)
Inhalation

36
Q

What is the most commonly used route of drug administration?

A

Oral Route of Drug Administration

37
Q

What are the advantages of oral route of drug administration?

A

-Convenient portable, painless)
-Non invasive
-Cost effective
-Patient can self administer

38
Q

What are the disadvantages of oral route of drug administration?

A

-Slow onset
-May be inefficient- high dose/ low solubility
-Variable absorption- Food interactions in the GI tract, GI disease, Gastric acid may destroy drug
-first-pass’ metabolism

39
Q

What is first-pass metabolism?

A

Blood from the GI tract (except sublingual and rectal veins) flows to the liver via the hepatic portal vein, where drugs undergo metabolism. Only after this first-pass metabolism does the drug reach systemic circulation.

40
Q

What are the advantages of intravenous & intramuscular route of drug administration?

A

-Very rapid onset
-Predictable plasma levels
-No first pass metabolism

41
Q

What are the disadvantages of intravenous & intramuscular route of drug administration?

A

-Allergic reactions more severe
-Short duration of action
-Requires trained staff to administer
-Drug cost higher
-Painful

42
Q

What are the advantages of transdermal & subcutaneous routes of drug administration?

A

-No first pass metabolism
-Allergic reactions often very localised
-Prolonged action – can be days with transdermal patches
-Can be self administered

43
Q

What are the disadvantages of transdermal & subcutaneous routes of drug administration?

A

-Very slow onset
-Drug cost higher
-Effect will vary from person to person and site to site

44
Q

What is Bioavailability?

A

Proportion of an ingested drug that is available for clinical effect.

45
Q

What is drug distribution?

A

The movement of a drug to and from the blood and various tissues

46
Q

What factors control the speed of diffusion?

A

-Blood flow to the area
-Membrane characteristics
-pH
-Active secretion of the drug into the tissue

47
Q

What is Single Compartment model?

A

Drug behaves as if it is evenly distributed throughout the body

48
Q

What is Two Compartment model?

A

Drug behaves as if it is in equilibrium with different tissues in the body

49
Q

Where do most extensive excretion occurs?

A

-Renal excretion of water soluble metabolites – urine
-Liver metabolism and excretion – bile
-Lungs – inhaled gases and volatile fractions of other drugs

Small proportions (related to plasma concentration) also excreted through: Sweat ,Saliva and Tears

50
Q

Mention diseases that interfere with normal function of main excretory organs

A

Renal & Liver disease

51
Q

What is Plasma half-life (t0.5)?

A

Time taken to eliminate half of the drug

52
Q

What happens in first order kinetics?

A

-Drug elimination increases as drug concentration increases
-Excretion is by PASSIVE DIFFUSION only

53
Q

What happens in zero order kinetics?

A

-Drug elimination is at a FIXED rate – ACTIVE process
-Irrespective of drug concentration
-Can lead to the drug accumulation if saturation exceeded

54
Q

What are the BNF categorises side effects in terms of probability?

A

-Common or very common
-Uncommon
-Rare or very rare
-Frequency not known

55
Q

Hazards of Drug Administration

A

Allergy – mild
Allergy – severe – anaphylaxis
Drug interactions
Acute toxic reactions
Death

56
Q

What are the common symptoms of allergy?

A

-Rash/ Hives
-Itching of skin/ eyes
-Runny nose/ Sneezing
-Coughing/ wheezing
-Nausea/ vomiting

57
Q

What is the difference between allergy and anaphylaxis?

A

Anaphylaxis is a severe, life-threatening allergic reaction that occurs rapidly after exposure to an allergen. It requires urgent treatment with adrenaline (epinephrine).while allergy is overreaction of the immune system.

58
Q

What is drug interaction?

A

A drug interaction occurs when two or more drugs, or drugs with food /drinks /supplements, react. This can alter a drug’s effect or cause side effects, by affecting absorption, action, or metabolism.
Examples:
- Protein binding: Warfarin & aspirin/ NSAIDs
- Drug metabolism: Warfarin, simvastatin, erythromycin, fluconazole, carbamazepine.

59
Q

What is drug toxicity?

A

When a person has too much of a drug in their system leading to adverse effects

60
Q

What factors can determine toxicity?

A

-Chemical structure
-Absorption
-Body’s ability to metabolise and eliminate drug (liver, kidney function, hydration)

61
Q

What is DPF?

A

Dental Practitioners’ Formulary: Guidance on drug management of dental and oral conditions

BAMS Bds2 (3 decks)

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