Pharmacology

Question 1

• Drug Eval:
• FDA controls what? (4)
• State controls what? Except?
• Drug types? (4)
• What is a drug?
• Phases: Preclinical? Phase 1? Phase 2? Phase 3? Phase 4?
• Patent lasts? Generic must prove?
• Pharmaceutical equivalency?
• Pharm. alternatives?
• Bioequivalence?
• Therapeutic equivalence?

Answer 1

• What may be prescribed or sold OTC; Rx vs. OTC; Safety/efficacy; equivalency for generics
• Who can prescribe except DEA banned
• Rx, OTC, Controlled substances, supplements
• Therapeutic agent used to diagnose, treat, cure or prevent disease
• Pre.) Animal testing 1.) Is it safe? 2.) Does it work? 3.) Does it work double blind 4.) Surveil.
• 20 years; bioequivalence
• (Drug form) Same ingredient, formulation, route, concentration
• Same therepeutic moeity
• (Drug Absorption) Pharm. equivalence with comparable bioavailablity
• (Target) - Same efficacy

Question 2

• DHSEA: Intended to? Cannot mention? Must have? Must provide? (4) Not? Proof of purity?
• Prescription: Must include? (6)
• Controlled substance: 1? 2? 3? 4? 5? Unique about 5? In other states? In CO?
• Conversions: 1 grain? 1 ounce? 1 kg? 1 teaspoon? 1 tablespoon? 1 fluid ounce? 1 gallon?
• Abbreviations Frequency: ac? bid? hs? pc? prn? qam? *qd? *qid? *qod? stat? tid?
• Abbreviations Routes: *ad? *as? au? IA? IM? IV? IVPB? *OD? *OS? *OU? PO? Pr? SC-SQ? Vag?
• Abbreviations Misc: a? c? gtt? h? p? as? s? sig?

Answer 2

• Supplements must provide reasonable evidence; name of product, quantity, directions, manufacturer; active principle; yes
• Rx name,strength, quantity, signature, refills, sign
• High abuse, no medical use; accepted but high abuse potential (no refills & in ink); Accepted but moderate abuse; accept, low abuse; accept even lower abuse; states decide how to treat; OTC; Colorado treats 5 like 3/4
• 65mg;30 grams;2.2 pounds;5 ml;15 ml;30 ml;3.8L
• Before meals; 2/day; @ bedtime; after meals; when needed; every am; every day; 4/d; every other day; immediately; 3/d
• right ear; left ear; both ears; Intra arterial; intramuscular; intravenous; IV piggy back; right eye; left eye; both eyes; by mouth; per rectum; sub cutaneous; vaginally
• before; with; drop; hour; after; sufficient quantity; with out; label

Question 3

• Factors that influence drugs ability to cross membranes? (4)
• Ways drugs cross membranes? (3)
• Routes of absorption: 1.) Oral (enteral): First pass? Bioavail? Rate? Easier to what? 2.) Rectal (enteral): Bio? Rate? 50% bypass? Used when? 3.) Sublingual: Bio? Rate? go to? Useful for? 4.) IV: Bio? rate? best for what type of drugs? Danger? (2) 5.) IM: Bio? Rate for aqeuous? Good for? 6.) SubCu: Bio? Rate? 7.) Inhalation: Bio? Rate? 2 types? 8.) Transdermal: Must be able to penetrate? And? 9.) Topical: For what?
• Bio (F): Equation? Tells you what? Effected by? (2)
• Volume of Distribution: Converts drug dose to? Helps select? Tells the size of compartment based on? High Vd? Low? Varies due to? Extrapolation gives Co in plasma?

Answer 3

• Size, lipid solubility, ionization, conc. gradient
• Passive, carrier mediated (facilitated/active); endocytosis
• 1.) yes; 0-100; slow; control 2.) variable; slow; unconsciouss 3.) High; medium; SVC; lipid soluble and potent 4.) 100%; immediate; narrow ther.; septic/irreversible 5.) 100%; medium; slower sustained absorption 6.) About 100%; medium to slow 7.) 100%; fast; Gas or Aerosol for topical 8.) Must be potent and cross skin 9.) Local conditions
• F= AUC (oral) / AUC IV; absorption to systemic circulation; first pass and absorption
• Plasma concentration;loading dose; explain amount of drug in body; mostly ouside plasma; mostly in ECF or plasma; protein binding; yes

Question 4

• Drugs as weak acids/bases: Ionized forms? Ex? (2) Non-ionized forms? (2)
• HH equation? pH = pKa when?
  1. ) pH pKa?
• Acidic drugs trapped in?
• Effect on mothers milk? urine?
• Tight junctions in body?
• Plasma Protein: Acidic drugs bind? Basic drugs bind? What is diffusable? High binding protein… free drug? Half life? Vd? Cross BBB?
• Other drug possible effect?

Answer 4

• Don’t cross membranes, RCOO-, RNH3+
  Can cross membranes, RCOOH, RNH2
• pH-pKa = log (B/A); half protonated and non
• lots of protons; HA and BH+ predominate
• Few protons; A- and B predominate
• Basic solutions
• Basic drugs seep in; urine can be messed with to change excretion
• GI, BBB, Placenta, Renal tubules
• Albumin, a-1-glycoprotein; free drug; low, high, low, low
• Displace drug from protein

Question 5

• Drug metabolism:
• Primary sites? (6) Most common pathway? Membrane bound to smooth ER? Lipid soluble typically?
• Phase 1: Goal? Reactions (3) Enzymes? (3) Major polymorphisms? (2) Age changes? Inhibitory/inducible? Saturability?
• Phase 2: Goal? Reactions (4) Enzyme? Major polymorphisms? Age changes? Inhibitory/inducible? Saturability?
• Induction? Speed? Leads to? (3) Ex? (2)
• Inhibition? Phase affected? Caused by? (2) Speed? Ex? (2)

Answer 5

• Liver, lung, kidney, intestines, placneta, skin; oxidation
• CYP450; changed to polar compounds
• Increase H2O solubility; Oxidation, reduction, hydrolysis; CYP2D6; CYP2C9 (Warfarin); Decrease function with age; yes/yes; minimal
• Conjugation; gluconidation, N-acetylation, glutationine conj., sulfate conj., transferase; less; yes; less; substantial
• Increased clearance/metab.; Slow; increased toxicity, increased clearance; Rifampin ,ethanol, St. Johns Wart
• Decreased clearance; phase 1 more often; occurs quick; decrease synthesis or increased competition; erythromyocin, graefruit juice

Question 6

• Kidney Excretion: Excretion? Filtration glomerular rate? 1/2 life? Type of Drug? Secretion? Half life?Reabsorption options? (3)
• Route of enterohepatic recirulation? (4) Effect on 1/2 life and elimination?
• Clearance helps determine? Eq?
• How many half lives in elimination? To steady state?
• First order: Most Drugs? Rate of elimination?
• Zero order: Rate of elimination? Amount removed per time? What drugs act this way? Half lives?

Answer 6

• Loss of chemically unchanged drug; 120ml/min; 1-4 hours; only free drug; Active secretion from blood to urine; 1-2 hours; passive (based on conc.), weak acids and bases, active
• Drug metabolized and secreted into bile; stored in gall bladder; delivered to intestine; reabsorbed; increased half life and elimination
• maitenance dose; MD/Freq. = CL x Cp (SS)
• 4-5; 4-5
• Yes; depends on concentration of drug
• Independent of amount in body; Constant; Ethanol and aspirin; don’t exist

Question 7

• Adverse Reactions:
• Ed50 =?
• Population ED50? TD50? LD50?
• Therapeutic Index: Eq? Increased TI = ?
• Standard safety margin: Eq?
• FDA with preganance? A? B? C? D? X?
• Ways to prevent absorption: 1.) Emesis: Drug name? Toxic in kids? Contraindications? 2.) Gastric Lavage: Speed? 3.) Chemical absorption: Name? Effect? 4.) Osmotic cathartics: Prevents?
• Ways to increase elimination? (4)

Answer 7

• 50% max dose
• 50% population respond; 50% toxic; 50% lethal
• LD50/ED50 *100; Safer drug
• LD1/ED99 * 100
• A = No risk B = No evidence of risk C = Risk cannot be ruled out D = Evidence of harm x = contraindicated
• Ipecac; apomorphine; comatose 2.) Very quick 3.) Carcoal to bind it 4.) Charcoal briquets
• Hemodialysis, induce p450; diueresis; chelation

Question 8

• Drug response with mass action: Curve shape? At low doses? Then?
• Potency? Depends on?
• Power/Efficacy? Important for?
• Receptor antagonists: Pharmacological?
• Competitive? Emax? EC50? Potency?
• Non-competitive irreversible: Binds how? Effect on Emax?
• Non competitive allosteric: Emax effect? Potency?
• Non receptor physiological?
• Non receptor chemical antagonist?

Answer 8

• Hyperbolic; linear then levels off
• Ec50 or ED50; conc. required to produce 50% effect
• Emax; drugs utility
• Bind same receptor
• Reversible at active site; same; Increased; Decreased
• Covalently to active site; decreases
• Binds at different site; decreases, may decrease
• Blocks a receptor or activates a receptor with opposite effect
• Inactivates the agonist