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Dental Hygiene > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

What is a log dose effect curve?

A

This is when the therapeutic range of a certain drug is plotted and shows the percent of the maximum response and effective dose.

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2
Q

What is a therapeutic range of a drug?

A

This is where the dose in increasing sharply or where the drug is working

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3
Q

What is a maximum response of a drug?

A

This is where the curve plateaus on the log dose effect curve

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4
Q

What is the term that describes a function of the amount of a drug to produce an effect?

A

potency

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5
Q

When is the potency of a drug greater?

A

when the dose is smaller

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6
Q

What is the term that describes the maximum intensity of effect or response that can be produced by a drug regardless of dose?

A

efficacy

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7
Q

When administering more drug than prescribed, will it increase the efficacy of the drug or will it increase the probability of an adverse drug reaction?

A

It will increase the probability of an adverse drug reaction, not increase the efficacy of a drug!!

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8
Q

Are efficacy and potency related?

A

No not related

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9
Q

What is the term that is related to duration of effect of a drug?

A

Half-life

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10
Q

What equals half the amount of time for a drug to “fall” to half of the original blood level?

A

Half-life of a drug

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11
Q

What is the term that describes the time it takes for the drug to have an effect?

A

onset

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12
Q

What is the term that describes the length of the drug’s effect?

A

duration

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13
Q

According to the route of administration, what can be affected?

A

the onset and duration of a drug

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14
Q

What are some routes of administration?

A

enteral or parenteral

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15
Q

What are some examples of enteral administration?

A

oral, and rectal

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16
Q

What are some examples of parenteral administration?

A

intravascular, intramuscular, subcutaneous, intradermal, inhalation, and topical

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17
Q

What is the difference of enteral and parenteral administration?

A

enteral administration is placed directly into the GI tract, while parenteral administration by passes the GI tract

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18
Q

What route of administration is considered the safest, least expensive, and most convenient?

A

oral route

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19
Q

Is it true that the less we ask of our patient by ways of drug administration the more effective the drug will be?

A

Yes; less means more

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20
Q

What are 3 negative aspects of oral administration route?

A

1) because of the large absorbing area present in small intestine it can cause slower onset of the drug’s effect and can result in stomach irritation with nausea and vomiting, 2) also the drug blood levels are less predictable, 3) and last drugs derived from proteins sources may be inactivated by GI acidity or enzymes

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21
Q

What is an example of a drug that is derived from proteins and are inactivated by GI acidity or enzymes?

A

Insulin

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22
Q

With orally delivered drugs where must the drug pass through first?

A

hepatic portal circulation

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23
Q

What are the terms that describes the first pass of an orally delivered drug?

A

first-pass effect or Phase 1 reactions

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24
Q

What reduces the first pass effect?

A

the amount of drug available to produce systemic effect

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25
Q

True or False, drugs with high-first past effect have a smaller oral to parenteral dose ratio?

A

False; larger

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26
Q

What is an example of a drug that has a high first-pass effect?

A

morphine

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27
Q

What does it mean when a drug has a high first pass effect?

A

they require a larger dose

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28
Q

What is another name for P-450 enzymes?

A

mixed function oxidases

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29
Q

What microsomal or cytochrome enzymes in the liver carry out the Phase 1 reaction aka: first-pass effect?

A

P-450 enzymes of mixed function oxidases

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30
Q

How can the concentration of these P-450 enzymes be affected?

A

they can be affected by drugs and environmental substances like smoking and alcohol consumption

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31
Q

What is a common example of P-450 induction?

A

alcohol tolerance

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32
Q

What does P-450 induction do to the drugs effect?

A

inducement increases enzymes activity and metabolizes the drug more rapidly necessitating a larger drug dose for effect,

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33
Q

What are 2 negative aspects of the rectal route?

A

drugs are poorly and irregularly absurd rectally, not frequently used for systemic effect and poor patient acceptance

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34
Q

What is the best route of administration for the most rapid drug response (immediate)?

A

Intravascular route

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35
Q

What are 3 advantages of using the intravascular route of administration?

A

absorption phase bypassed, more predictable response, and route of choice for emergency situations

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36
Q

What are 4 disadvantages of intravascular route?

A

phlebitis (local irritation), drug irretrievability, allergy, and side effects of high plasma drug concentrations

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37
Q

What are the most common injection sites of intramuscular route of administration?

A

Deltoid and gluteal regions

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38
Q

True or False , massage will increase the absorption of the intramuscular route of administration?

A

TRUE

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39
Q

How does absorption occur in intramuscular route of administration?

A

due to high blood flow in skeletal muscles

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40
Q

What is an advantage of intramuscular route of administration?

A

it provides a sustained effect

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41
Q

What is the route of administration used to administer protein products?

A

subcutaneous route of administration

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42
Q

What are some examples of a subcutaneous route of administration?

A

insulin and local anesthetics

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43
Q

What is a disadvantage of subcutaneous route of administration?

A

sterile abscess or hematomas are produced

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44
Q

What is an example of a Intradermal route of administration?

A

tuberculin skin test

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45
Q

What is the most shallow route of administration and the most deepest route of administration?

A

intradermal is most shallow and intravascular is the deepest

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46
Q

What is an advantage of inhalation route?

A

provides rapid delivery of drug across large surface area of respiratory mucosa

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47
Q

What is an example of inhalation route?

A

inhalers for asthma, nitrous oxide/oxygen sedation

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48
Q

What is some contraindications for the topical route?

A

if surface is ulcerated, burned, or abraded

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49
Q

When is topical route most effective?

A

with less keratinized tissue

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50
Q

can topical route have systemic uptake?

A

yes, but in limited doses

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51
Q

What is the study of how a drug is absorbed, distributed, metabolized, and excreted by the body?

A

Pharmacokinetics

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52
Q

What is a way to remember pharmacokinetics?

A

ADME

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53
Q

What are the only drugs to pass the blood brain barrier?

A

lipid-soluable drugs

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54
Q

How are the lipid soluble drugs readily moved across most biological membranes?

A

by diffusion

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55
Q

What is the term that describes the transfer of drugs from site of administration to blood stream?

A

absorption

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56
Q

What are some factors that cause absorption of a drug?

A

drug solubility, circulation at deposition site, drug pH, temperature at site, and mechanical factors like massaging an injection site.

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57
Q

What is the term that describes the process by which a drug reversibly leaves the blood stream and enters the system?

A

distribution

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58
Q

After a drug is absorbed where does the drug get distributed?

A

organ with the highest blood flow

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59
Q

With the oral route where will the drug be distributed?

A

the liver

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60
Q

With the sublingual route where will the drug be distributed?

A

the heart

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61
Q

What are some factors that depends on where the drug in distributed?

A

blood flow, capillary permeability (blood-brain barrier), and binding of drugs to proteins especially plasma albumin

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62
Q

What is a major site for drug metabolism?

A

In the liver

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63
Q

True or False, liver disease or present/past substance abuse may impair drug metabolism?

A

TRUE

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64
Q

What is the term that describes to terminate the drug effects?

A

elimination

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65
Q

How are drugs most often eliminated?

A

by biotransformation and/or excretion into the urine or bile

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66
Q

What is the most important route of drug excretion?

A

Renal (Kidney)

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67
Q

What are some other routes of drug excretion?

A

liver, lungs, bile, GI, sweat, saliva, and gingival crevicular fluid

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68
Q

How are fat soluble drugs excreted?

A

not excreted in the urine, need to be metabolized into water soluble form by liver

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69
Q

What is the major route of fluoride elimination from the body?

A

through the urine

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70
Q

What are 2 factors that alter drug effects?

A

age and weight

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71
Q

What will board use when talking about weight?

A

surface area rule- when determine child dose of drug use in kg.

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72
Q

What will the board use when talking about age?

A

cowling rule and young rule - in determining child’s dose of drug

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73
Q

What is a term that describes an amount of desired effect is excessive and dose-related?

A

toxic reaction

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74
Q

What is a side effect?

A

a dose-related reaction that is not part of the desired therapeutic outcome

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75
Q

What is an example of a side effect?

A

When given an antihistamine it will take care of the symptom, but will get sleepy which is the non-therapeutic action of a drug.

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76
Q

What is a term that describes an abnormal drug response that is usually genetically related?

A

Idiosyncratic reaction

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77
Q

What is a term that describes a hypersensitivity response to a drug to which the patient has been previously exposed?

A

drug allergy

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78
Q

Is a drug allergy dose related?

A

No

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79
Q

What is a term that describes a causal relationship between maternal drug use and congenital abnormalities?

A

Teratogenic Effect

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80
Q

What is phocomelia?

A

shortened limbs

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81
Q

What is an example of a teratogenic effect?

A

Thalidomide induction of phocomelia

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82
Q

What is an example of a local effect?

A

tissue necrosis at site of injection

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83
Q

What is a term that describes an effect of one drug is altered by another?

A

drug interaction

84
Q

What may result because of a drug interaction?

A

toxicity, and lack of efficacy

85
Q

What is an immune hypersensitivity reaction?

A

allergic reaction

86
Q

What is a life-threatening allergic reaction?

A

anaphylaxis

87
Q

What do we treat for a mild allergic reaction?

A

antihistamine with or without steroids

88
Q

What do we treat for a anaphylactic reaction?

A

epinephrine subcutaneously with or without steroids

89
Q

What are the three types of medication that can generate gingival enlargement?

A

Phenytoin, Cyclosporine, and Calcium Channel Blockers

90
Q

What are some examples of a calcium channel blocker?

A

nifedipine, verapamil, and amlodipine

91
Q

What type of medication if a cyclosporine?

A

is an organ rejecting preventive medication

92
Q

When taking phenytoin where does the gingival enlargement usually take place clinically?

A

on the anterior facial region

93
Q

What 3 drugs do NOT cause gingival enlargement?

A

Digoxin, Beta Blockers, and Tegretol

94
Q

What nervous system has automatic, involuntary responses?

A

the autonomic nervous system (ANS)

95
Q

What is the ANS responsible for the regulation of?

A

blood pressure, heart rate, GI mobility, salivation, and bronchial/smooth muscle tone

96
Q

What are the 2 devisions of the ANS?

A

the parasympathetic nervous system (PANS) and sympathetic nervous system (SANS)

97
Q

What does the ANS require?

A

neurotransmitters

98
Q

What in another name for the PANS?

A

the Rest and Digest System

99
Q

What neurotransmitter does the PANS use?

A

acetylcholine

100
Q

What is the SANS known for?

A

Fight or flight system

101
Q

What neurotransmitter does the SANS use?

A

norepinephrine

102
Q

What agents are used to mimic the effect of the PANS?

A

cholinergic or muscarinic agents

103
Q

What are some function of the PANS?

A

Dilates blood vessels leading to GI tract, Constricts the bronchiolar diameter, and most importantly stimulates salivary gland secretion etc…

104
Q

What does the cholinergic and muscarinic drugs treat?

A

xerostomia, urinary retention, and glaucoma

105
Q

What are some examples of a cholinergic agent?

A

pilocarpine and nicotine

106
Q

What does pilocarpine treat?

A

xerostomia; stimulates saliva flow

107
Q

What are some contraindications for cholinergic and muscarinic drugs?

A

asthma, peptic ulcer, cardiac disease, and GI/Urinary obstruction

108
Q

Why is peptic ulcer, cardiac disease, and GI/ Urinary obstruction a contraindication to cholinergic or muscarinic drugs?

A

peptic: increase GI secretion Cardiac disease: decreased heart rate, and GI/urinary obstruction: increase GI mobility

109
Q

What blocks acetylcholine receptors by inhibiting acetylcholine effects?

A

anticholinergic agents

110
Q

What are some example of anticholinergic drugs?

A

atropine, immodium, and scopolamine

111
Q

What is Atropine used for in the dental setting?

A

a prototype of anticholinergic drug; used pre-operatively to decrease salivary flow in the dental setting

112
Q

What is a helpful hint to remember effects of anticholinergic agents?

A

ABCD= Anticholinergic, Blurred vision and bladder retention, Constipation, and Dry mouth

113
Q

Where else is acetycholine a neurotransmitter besides in the PANS?

A

at the sympathetic preganglionic synapses, some sympathetic post-ganglionic synapses, and at some sites in the CNS

114
Q

What are some functions of the SANS?

A

vasoconstriction, Dilates bronchioles of the lung, increase heart rate, and dilates pupils

115
Q

What agent mimics the SANS?

A

adrenergic agents; sounds like adrenalin for fight of flight

116
Q

What are some examples of adrenergic agents?

A

epinephrine, albuterol, pseudoephedrine, ritalin, and adderall, dopamine, and clonidine

117
Q

What are the adrenergic agents used for?

A

colds (decongestant), asthma, anaphylactic shock, glaucoma, cardiac arrest, and vasoconstrictors

118
Q

What are some adverse effects of adrenergic agents?

A

CNS disturbances like anxiety, fear, tension, headache, and tremor, also cardiac arrythmias, and cerebral hemorrhage

119
Q

What are some contraindications to adrenergic agents?

A

angina, uncontrolled hypertension, and uncontrolled hyperthyroidism

120
Q

How long should we wait to use epinephrine on a patient if they are taking cocaine or methamphetamines?

A

The patient needs to be off of it for at least 24 hrs before use

121
Q

What is the only local anesthetic with vasoconstrictive properties?

A

Cocaine

122
Q

What are some oral sign of a methamphetamine abuser?

A

rampant caries and burned mucosal surfaces

123
Q

True or False; the burned mucosal surfaces from methamphetamine abuse is from the actual drug?

A

False; it is from the method of administration

124
Q

Is there currently any medications to treat meth addiction and what is the best way to go about treating meth addiction?

A

No medications are available, the only avenue is to use cognitive behavioral intervention that helps modify harmful actions and teach coping skills

125
Q

Are there any cardiovascular effects of using the adrenergic drug albuterol?

A

very few cardiovascular effects

126
Q

What is the adrenergic drug dopamine used to treat?

A

to treat shock and low blood pressure, and often used to treat Parkinson’s Disease

127
Q

What is the adrenergic drug Clonidine used to treat?

A

this minimizes symptoms that accompany withdrawal from opiates and benzodiazepines

128
Q

Where are Beta 1 and Beta 2 receptors mainly found?

A

Beta 1 in the heart and Beta 2 mainly in the lungs, muscles and arterioles

129
Q

How can we remember where Beta 1 and Beta 2 are found?

A

We have on 1 heart and 2 lungs

130
Q

What happens when there is action on the Beta 1 receptors?

A

it will increase the heart rate and blood pressure, and the heart itself will require more oxygen

131
Q

What type of drug do we use to block the action on a beta 1 receptors?

A

B-adrenergic blocking agents

132
Q

What do the B-adrenergic blocking agents do to the beta 1 receptors?

A

they will lower the heart rate and blood pressure and are useful when the heart itself is deprived of oxygen

133
Q

true of false B-adrenergic blocking agents are often prescribed after a heart attack?

A

true, allows for more oxygen flow to the heart

134
Q

do the non-selective beta blockers affect both the beta1 and beta 2 receptors?

A

yes

135
Q

Why are non-selective beta blockers contraindicated for patients with asthma or any restrictive airway disease?

A

they can block the effects of Beta 2 agonists, such as albuterol leading to airway and vascular restriction

136
Q

What are B-adrenergic blocking agents effective in treating?

A

Cardiac arrhythmias, angina pectoris, hyperthyroidism, myocardial infarction, glaucoma, migraine prevention, anxiety

137
Q

What are 3 drugs used to prevent hypertension?

A

Propranolol, Atenolol, and Metoprolol

138
Q

What does the medication Timolol treat and prevent?

A

reduces aqueous humor in the eye and is used topically to treat glaucoma

139
Q

What are some other names of Timolol?

A

Timoptol and Timoptic

140
Q

What are 2 cardioselective beta blockers?

A

Atenolol and Metoprolol

141
Q

What is another name for Metroprolol?

A

Lopressor

142
Q

What is Atenolol used to treat?

A

eliminates bronchoconstriction effect and used to treat hypertensive asthmatic patients

143
Q

What medication is a prototype of a non-selective B- adrenergic blockers?

A

Propranolol

144
Q

What are some adverse reactions of Propranolol?

A

Bronchoconstriction and arrhythmias

145
Q

What is Metroprolol used for?

A

hypertension, prevention of myocardial infarction and angina

146
Q

How should we treat patients taking non-selective B blockers when considering epinephrine and why?

A

limit epinephrine to 2 carpules because of potential increase in blood pressure

147
Q

What are some examples of nonopioid analgesics?

A

aspirin, ibuprofen, acetaminophen

148
Q

What does analgesia mean?

A

reduces pain

149
Q

What does antipyretic mean?

A

reduces fever

150
Q

What 2 nonopioid analgesics are considered an NSAID?

A

Aspirin and Ibuprofen

151
Q

What are the uses of NSAIDS?

A

analgesia, antipyretic, and anitinflammatory

152
Q

What is the mechanism of action of aspirin and Ibuprofen?

A

inhibition of prostaglandin synthesis

153
Q

Where part of the brain does aspirin use in order to reduce a fever?

A

hypothalamus

154
Q

What are the side effects of the use of aspirin?

A

Interferes with clotting, GI irritation, and become hypersensitive, and Reye’s syndrome in children and adolescents

155
Q

What medications are contraindicated with the use of NSAIDS due to the drug interaction?

A

coumadin and warfarin

156
Q

What is used to replace aspirin use in children and adolescents?

A

acetaminophen

157
Q

What are some toxic reaction with taking aspirin?

A

GI upset/vomiting, confusion and dizziness, dim vision, and Tinnitus (ringing of the ears) etc…

158
Q

What is it termed with toxicity of aspirin?

A

salicylism

159
Q

What are some drugs that Ibuprofen can decrease there pharmacological effects?

A

ACE inhibitors, Aspirin, Beta Blockers, Corticosteroids, Cyclosporine, Lithium, and Loop Diuretics

160
Q

Is acetaminophen a NSAID and why?

A

No it is not because it does not have any effect on inflammation

161
Q

What is another name for acetaminophen?

A

Tylenol

162
Q

What are the actions of acetaminophen?

A

analgesics and antipyretic

163
Q

Does acetaminophen have any effect on clotting?

A

no it does not

164
Q

What is the drug of choice for patients on coumadin or with peptic ulcers?

A

acetaminophen

165
Q

What are some side effects of acetaminophen?

A

side effects are rare

166
Q

What type of drug in coumadin?

A

this is an anticoagulant

167
Q

What are some signs of acetaminophen overdose?

A

hepatotoxicity, liver necrosis, and death

168
Q

If a patient has had a periodontal debridement, what is the best post operative medication to recommend for pain?

A

acetaminophen; not ibuprofen

169
Q

What type of medication is an opioid analgesic?

A

a narcotic which are used to manage pain when non-opioid fail to work

170
Q

What is a mechanism of action of opioid analgesic?

A

Blocks pain receptors in the brain without loss of consciousness

171
Q

What are some examples of an opioid analgesic?

A

morphine, codeine, demerol, and dilaudid

172
Q

What is the most common opioid used in dentistry?

A

Codeine

173
Q

what medication is codeine usually used in conjunction with and what is it called?

A

acetaminophen and together it is called Tylenol 3

174
Q

What type of medication is Codeine?

A

an antitussive which means cough suppressant

175
Q

What is a sign of overdose for any opioid?

A

pinpoint pupils

176
Q

What can an overdose of a narcotic lead to?

A

respiratory depression and death

177
Q

What is a side effect of codeine use?

A

emesis (vomiting) and constipation

178
Q

What is the number 1 opioid antagonist?

A

Narcan

179
Q

What is used to treat an opioid overdose and should be located in the dental office emergency kit?

A

Narcan

180
Q

What type of medication is used for the treatment of narcotic withdrawal and dependence?

A

Methadone

181
Q

How often should methadone be taken and how long does it help the withdrawal of a narcotic?

A

once a day; 24 and 36 hrs

182
Q

Why type of addiction is Methadone effective to treat?

A

heroin, morphine, and other opioid drugs; not methamphetamine addiction

183
Q

What type of pupil will heroin users exhibit?

A

pinpoint pupils

184
Q

What type of pupil will cocaine users exhibit?

A

dilated pupils

185
Q

should IV users be premeditated with antibiotics prior to treatment and why?

A

yes because of high vascular bacteremia load

186
Q

What is the best pain medication prescribed to a heroin addict?

A

NSAIDS

187
Q

What does bactericidal mean?

A

the ability to kill bacteria; irreversible action

188
Q

What does bacteriostatic mean?

A

The ability to inhibit or slow the multiplication or growth of bacteria

189
Q

What does Minimum Inhibitory Concentration (MIC) mean?

A

lowest concentration needed to inhibit visible growth of an organism

190
Q

What is the natural or acquired ability of an organism to be immune to or to resist the effects of an antiinfective agent?

A

Resistance

191
Q

What the term that describes range of activity of a drug?

A

spectrum

192
Q

When does synergism occur when dealing with antibiotics?

A

occurs when the combination of 2 antibiotics produces more effect that would be expected if their individual effects were added

193
Q

When does antagonism occur when dealing with antibiotics?

A

occurs when a combination of 2 agents produces less effect than either agent alone

194
Q

What is the most commonly prescribed antibacterial prescribed in the dental profession?

A

penicillin VK

195
Q

What are some penicillin derivatives?

A

amoxicillin, augmentin, and ampicillin

196
Q

Why is Penicillin VK preferred over Penicillin G?

A

Penicillin VK has a less erratic absorption

197
Q

What does TID and QID stand for when prescribing medications?

A

TID is 3X a day and QID is 4X a day

198
Q

Why is amoxicillin preferred?

A

due to TID rather than QID

199
Q

How do penicillins work?

A

by destroying bacterial cell wall integrity which leads to lysis

200
Q

What bacterial phase is the penicillins most effective against?

A

logarithmic phase (rapidly growing organisms)

201
Q

What is the greatest danger of using penicillins in the dental office?

A

most likely antibiotic to produce an anaphylactic reaction

202
Q

Can penicillin be given to a pregnant women?

A

yes

203
Q

What is the most common manifestation of allergic reactions?

A

flat rash

204
Q

Is amoxicillin effective against penicillinase?

A

No

205
Q

What is another name for penicillinase?

A

beta lactamase

206
Q

What is clavulanic acid in combination with amoxicillin known as?

A

Augmentin

207
Q

What does augmentin prevent penicillinase from doing?

A

breaking down

Dental Hygiene (19 decks)

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